broken bones and MPN

[Val_P]

I’ve never broken any bone in my body but last week I broke my ankle. I’ve been told it’s a stable fracture and have been given a boot and crutches. I do normally have bone pain anyway but my lower leg is extremely painful and hot to touch. I’m taking zapain full daily dose but it’s only barely touching the pain. I’m not allowed to take NSAID’s and wondering if there is anything else I can take. Also is there further implications from trauma with ET?

[hunter5582]

The combination of codeine with paracetamol is one of the stronger pain relieving medications. If it is not relieving the pain then you would need to consult with the treating doctor for other options.

This kind of injury can cause reactive thrombocytosis, so you may see a temporary elevation in PLTs. This is unlikely to be significant unless your PLTs are very high, in which case there may be increased risk of hemorrhage. Best to consult with your MPN care team if you have any concerns.

[clematis26]

I broke my wrist at the weekend - taking codeine. I am in shock and agony - told it's normal - trying to adjust .... will inform my MPN team today - thinking of you .... take care, Sue

[Joetcalr]

I have excruciating back spasms which get set off every few months. I’ve discovered the only thing that shifts it is naproxen which I think is a NSAID. I’m unable to take any of the morphine/codeine type painkillers. What is the reason that we shouldn’t take NSAIDs? Thanks

[PhysAssist]

Hi Val_P,

Have you had a Dexa [bone density] scan to see what your bone mineralization status is?

I would [without prejudice] have to hazard a guess from reading your bio, that you might possibly be post-menopausal, and that alone ould be reason enough for you to suffer a fracture.

We in the states have pretty much eschewed the use of codeine, [except for the dentists], because it's really not a great pain reliever, but it is a great cause of opioid-induced constipation.

Make sure that in addition to drinking lots of fluids, you also stay regular through use of a [preferably- stimulant] laxative. [Not just a fiber-based one].

It's especially important to elevate the injured area above your heart,- it doesn't have to be way above, just a bit. Also although resting and keeping your ankle protected is important, so is getting up and moving around every 2 hours during waking hours- unless you're asleep and napping.

Failure to maintain short periods of moving around regularly between resting periods can seriously increase your risk s for clots and even pneumonia- especially w/ opioids on board.

Sorry you got broken, best wishes to quick healing.

PA

PS: You might ask your MD/provider about your Vitamin D level- because it's essential for bone strength and healing.