Take a deep breath and…

Friday, March 9, 2007

So you go to the doc after getting banged into the boards, hurting your chest, and want to know if you have a broken rib and the answer you get is: “Don’t know, don’t care.” Great bedside manner! Anyway, a chest xray is done and the doc lets you know that there is no bruising or collapse of the lung. Great, but what about broken ribs? H just doesn’t care about broken or bruised, gives you pain meds and sends you on your way.

We take plenty for granted with our bodies. Breathing is one of those automatic things that just happen until the system breaks down and then it becomes a big deal. Chest wall injuries can seem so minor, yet a bruised or broken rib can put you out of commission for weeks at a time.

Normally, we breathe like a bellows. The ribs swing out, the diaphragm moves down and we suck air into our lungs. All goes well, 12-14 times a minute, unless the mechanism gets damaged. Injury to the chest wall causes significant pain with each breath and the body, in its attempt to protect itself, starts to decrease the movement in that part of the chest wall. Not bad for pain control, but plenty bad for complications.

Ever wonder why ribs aren’t taped anymore? The big complication of rib fractures is pneumonia. The lung is a dark, warm place and when it doesn’t expand and allow air into all its crevices, areas can get clogged with dead cells and secretions, the perfect setup for an infection. It’s why people, after operations and anesthesia, are encouraged (or forced) to breathe deeply.

While I can prescribe rest in a sling for an arm injury or crutches for a sprained ankle, I can’t tell you to stop breathing. That means a person with broken or bruised ribs will have to move the damaged area plenty of times each minute; not a great way to rest and heal.

And while breathing may be tough, moving is even harder. The ribs are an important stabilizer of the trunk and any rotational movement will cause significant pain. Finding a comfortable place to sleep is hard and that first move to get out of bed can be a killer. So what to do?

Step one: suck it up and take deep breaths and move.
Step two: use ice, ibuprofen as an anti-inflammatory and pain meds to accomplish step one.
Step three: watch out for fever, cough, shortness of breath, all the signs of pneumonia.
Step four: patience and more patience and more step two to repeat step one

Take a deep breath and realize that it may not be a glamorous injury, but broken ribs hurt and there is no quick fix; 4 to 6 weeks of hurt. The first couple will be miserable, then one day, you’ll wake up and that stabbing pain, that you’ve come to dread, which begins your day, won’t be there and you might actually be on the road to recovery.

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