Broken rib tips?

Fell over, caught my rib cage on the corner of a bit of furniture, and I have a broken rib. I'm skinny enough that you can see that it's broken... :/ Day 3 today. Lots of swearing has happened!

I haven't been to A&E as the treatment is just painkillers, mix of rest and movement. (I broke 3 in my 20s).

The main risk is of chest infection or pneumonia from not breathing deeply and suppressing mucus clearance and cough - so I'm trying to make sure I breathe nice and deeply from time to time. I can just about take my inhalers.

I've got a GP appt in a week, and they'll see me sooner if I need it - just wondered if anyone has any tips for helping to avoid succumbing to the dreaded pneumonia?

I'm not super-tight but my partner says I'm definitely not breathing normally.

I can't do a peak-flow, so can't really track things that way.

Was wondering whether I should neb daily - it would probably loosen things up and make me cough up any crap that is collecting. I've got backup abx if I spike a temp or cough up anything weird. I'm trying to take enough painkillers to be able to breathe, but not so much codeine that I suppress any cough...

Anyone been through the same? Got any thoughts / tips on minimising the impact on my lungs?

Cx

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Ouch. As an aside, it might not be broken, - rib subluxation is common and can be mistaken for a broken rib. The downside is it still hurts a lot!! In that situation, opiates aren't ideal, can you take NSAIDs? (Ibuprofen, diclofenac, aspirin etc). I can't, but plenty of folk with asthma can.

Unless you are particularly wheezy or mucousy at the moment, I wouldn't think nebs would make much difference. What a pain, hopefully the discomfort will reduce soon.. I guess the best thing you can do is keep as active as possible. Feel better soon x

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Thanks NF, yes, did wonder if it was dislocated / subluxed - but it feels very 'fracturey' - though I know really the treatment and prognosis is the same regardless of whether it happens to have cracked or just popped out a bit or even just be badly bruised.

I can take ibuprofen and paracetamol but really need the mild opiate to make it bearable - though only taking minimal amounts of that (8mg twice today) as I don't like the gastric effects. I do have some diclofenac but it has given me problems with ulceration before so I try to keep away from it. I'll give the NSAID gel a whirl tonight I think.

I'm never wheezy - tend just to cough and cough and cough and then bronchospasm, rinse and repeat etc! But yes, I don't feel especially mucousy right now at all - just finished some abx a few days ago so my chest is really clear right now. I think you're right that staying active (but not doing too much!) is the key - keep it all moving. I'll hold off on the nebs until I have definite signs of needing them (which hopefully won't happen).

The good bit about being adrenally insufficient is that at least I sleep like a drunk baby even when in pain at night - can't make the extra cortisol required to say awake!

zzzzz...

Cx

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Meh. Spent the morning in A&E - who were brilliant.

Over the last 3 days my whole abdomen has inflated like a balloon. I can still take a full breath but it's really hard work to get the last 3rd or so of my lungs to expand due to pressure.

Chest X-ray doesn't show a pneumothorax at the moment, but they said if I've got a slow-puncture and small pockets of air then X-rays aren't definitive - and hopefully it just means I'm reabsorbing it at a faster rate than it is escaping. I look like I've had a laparoscopy and have the same shoulder-tip pain and random chest pain that goes with that (I've had 3 so I know the ropes).

A&E were great - triaged in minors and then transferred straight thru to majors. X-rays, bloods, very thorough because of my adrenal crap. Upshot is that basically whatever is going wrong isn't going to kill me, but if it gets any worse I should go straight back. Seeing GP on Monday anyway so I'll get her to check if things aren't back to normal. So far I'm doing a good job of keeping my chest clear - phew!

My main goal now is to not pick up any respiratory infections for at least a month until I'm healing!

I'm also rethinking on the bisphosphonates - bit scared by how innocuous a fall it was compared to the extent of the injury

Cx

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oh dear!! at least you have an excuse for a pot belly, not sure what mine is.... ;D You poor thing, have they confirmed the ribs broken then? Really good to hear that A&E were good, with all the horror stories I've heard, I absolutely dread ending up in that situation because of the AI and the seemingly huge amount of ignorance!

Feel better soon.... x

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Thanks NF,

Clinically it seems like a rib fracture, but because of where it is (bottom, last fixed rib before the floating ones) they couldn't get a clear view at all on x-ray to rule fracture in/out, so the assumption is that it is - apparently only around 50% in that area show on x-ray, and poking about is more accurate :/

Yes - lots of ignorance around the AI - fortunately I have been in charge of my own steroids - much safer!

It's not too bad when I've got a full lot of painkillers on board, but horrible when they wear off. I guess I just need to not let them wear off!

Cx