Benefit of hindsight
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- trailgumby
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Benefit of hindsight
Postby trailgumby » Fri Aug 16, 2013 9:58 pm
Went to the medical centre that day to get it cleaned and sutured.
5 days later its gotten much more tender over the afternoon and I've realised the redness and pulling sensation with certain movement isn't from the impact injury, its infected. I've gotten some antibiotics tonight but have set the alarm for early this morning (1:30am) and if it continues to deteriorate I'm taking myself off to emergency.
The hindsight is that the doctor didn't spend as much effort examining and cleaning the wound as I expected and I should have been more vocal.
We'll see how it pans out over the next few hours. .
- Mulger bill
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Re: Benefit of hindsight
Postby Mulger bill » Fri Aug 16, 2013 10:08 pm
I hear a well aged single malt or a bottle of Pussers rum helps greatly in these cases
Good luck mate.
Shaun
EDIT, push 'em HARD onto an embedded foreign body check, took ages and day surgery post injury before all the splinters were out of my thigh.
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Re: Benefit of hindsight
Postby QuangVuong » Fri Aug 16, 2013 10:17 pm
Nah, do get better soon, and hopefully it aint something serious.
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Re: Benefit of hindsight
Postby TraceyG » Fri Aug 16, 2013 10:21 pm
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Re: Benefit of hindsight
Postby foo on patrol » Sat Aug 17, 2013 4:03 am
This works even better when taken with mates around!Mulger bill wrote:Fingers crossed Gumby.
I hear a well aged single malt or a bottle of Pussers rum helps greatly in these cases
Good luck mate.
Shaun
EDIT, push 'em HARD onto an embedded foreign body check, took ages and day surgery post injury before all the splinters were out of my thigh.
I hope this old bridge was not arsenic dipped TG.
Foo
Goal 6000km
- trailgumby
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Re: Benefit of hindsight
Postby trailgumby » Sat Aug 17, 2013 5:08 pm
The intern said they don't usually suture the area due to poor blood flow and prefer adhesive closures. Made a lot of sense. They were going to remove the sutures and thoroughly clean the wound and look for foreign material.
When the sutures were removed there was a moderate amount of pus from the holes but the wound itself stayed closed. Seems to me therefore it was the stitches that were the foreign body infected not interior of the wound.
He massaged some more material out of the suture holes, gave me a strong IV antibiotic, a script for additional antibiotics on top of the ones the doc prescribed last night and some strong painkillers. He gave me orders to keep it elevated and dry - no dressing except at night.
I wasn't aware you could take full adult doses of paracetamol and ibuprofen concurrently and oxycodon on top of that
Anyway things seem to be trending the right way again. Less pain and the inflamed looking area is a lot cooler to touch.
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Re: Benefit of hindsight
Postby Mulger bill » Sat Aug 17, 2013 6:01 pm
The GLW tells me it's a likely vector for infection if the wound site is not thoroughly cleaned before suturing.
Now, ask your GLW to nip out and buy some prunes, you will probably need them after the Oxycodone.
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Re: Benefit of hindsight
Postby trailgumby » Sun Aug 18, 2013 11:13 am
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Re: Benefit of hindsight
Postby petie » Thu Aug 22, 2013 10:04 pm
I'm in the trade and had a similar injury that I elected to treat myself earlier this year. Didn't suture it and it still got infected despite some serious scrubbing! Took about 40 days to heal, but I did work and ride/race throughout...
Probably hang back on the grog and keep it elevated!
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Re: Benefit of hindsight
Postby briztoon » Thu Aug 22, 2013 11:19 pm
Hope everything has worked out and your now on the mend trailgumby.trailgumby wrote:I wasn't aware you could take full adult doses of paracetamol and ibuprofen concurrently and oxycodon on top of that
I found this out today as well, as I ended up back in hospital due to complications with a rib. Doctor said to take nurofen 3 times a day with a meal to go with the Targin, Endone, and Panadol I take each day.
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Re: Benefit of hindsight
Postby winstonw » Thu Aug 22, 2013 11:48 pm
Appropriate ice application is better imho, though most people are too lazy/indifferent to applying ice intelligently.
Drug wise, IME,
for moderate to intense pain, codeine, oxycodone, tramal, and oral pethidine are better.
for moderate inflammation and associated pain, voltaren and nurofen are better than paracetamol.
generally, anti-inflammatories, and synthetic or natural opioid anaglesics can be used simultaneously.
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Re: Benefit of hindsight
Postby matagi » Fri Aug 23, 2013 7:43 am
Paracetamol together with an opiate is a standard combination for treatment of severe pain particularly long term. The paracetamol acts synergistically with the opiate and in many cases allows a lower dose of opiate to be prescribed.winstonw wrote:I don't know why paracetamol is so universally prescribed for moderate to severe pain/inflammation. It is weak in managing both.
Appropriate ice application is better imho, though most people are too lazy/indifferent to applying ice intelligently.
Drug wise, IME,
for moderate to intense pain, codeine, oxycodone, tramal, and oral pethidine are better.
for moderate inflammation and associated pain, voltaren and nurofen are better than paracetamol.
generally, anti-inflammatories, and synthetic or natural opioid anaglesics can be used simultaneously.
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Re: Benefit of hindsight
Postby briztoon » Fri Aug 23, 2013 9:11 am
Pretty much what my doctors said.matagi wrote:Paracetamol together with an opiate is a standard combination for treatment of severe pain particularly long term. The paracetamol acts synergistically with the opiate and in many cases allows a lower dose of opiate to be prescribed.winstonw wrote:I don't know why paracetamol is so universally prescribed for moderate to severe pain/inflammation. It is weak in managing both.
Appropriate ice application is better imho, though most people are too lazy/indifferent to applying ice intelligently.
Drug wise, IME,
for moderate to intense pain, codeine, oxycodone, tramal, and oral pethidine are better.
for moderate inflammation and associated pain, voltaren and nurofen are better than paracetamol.
generally, anti-inflammatories, and synthetic or natural opioid anaglesics can be used simultaneously.
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Re: Benefit of hindsight
Postby winstonw » Fri Aug 23, 2013 9:34 am
yes I get the synergy. I am referring to the common recommendation by GPs and hospital staff to take paracetamol for moderate to severe acute pain, when an opiate like drug +/- more effective anti-inflammatory is justified...and I say this considerate of the side effects.matagi wrote:Paracetamol together with an opiate is a standard combination for treatment of severe pain particularly long term. The paracetamol acts synergistically with the opiate and in many cases allows a lower dose of opiate to be prescribed.
Further, much acute musculoskeletal pain is very often most responsive to anti-inflammatory intervention alone...and yet paracetamol alone, or opiate like analgesics and benzo class drugs are prescribed.
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Re: Benefit of hindsight
Postby winstonw » Fri Aug 23, 2013 9:40 am
good luck if you were prescribed opiate class drugs "long term", rather than getting the underlying cause of pain diagnosed and managed effectively.briztoon wrote:Pretty much what my doctors said.
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Re: Benefit of hindsight
Postby petie » Fri Aug 23, 2013 10:23 am
Thankyou! If I had a dollar for every time some arse told me "panadol does nothing" I wouldn't be working (it's paracetamol! Ffffff!). Also, at recommended doses paracetamol is a much safer drug. All the other drugs mentioned by Winston can pretty easily have catastrophic side effects, it is much better to start with paracetamol and add small doses of the other drugs if required.matagi wrote:Paracetamol together with an opiate is a standard combination for treatment of severe pain particularly long term. The paracetamol acts synergistically with the opiate and in many cases allows a lower dose of opiate to be prescribed.winstonw wrote:I don't know why paracetamol is so universally prescribed for moderate to severe pain/inflammation. It is weak in managing both.
Appropriate ice application is better imho, though most people are too lazy/indifferent to applying ice intelligently.
Drug wise, IME,
for moderate to intense pain, codeine, oxycodone, tramal, and oral pethidine are better.
for moderate inflammation and associated pain, voltaren and nurofen are better than paracetamol.
generally, anti-inflammatories, and synthetic or natural opioid anaglesics can be used simultaneously.
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Re: Benefit of hindsight
Postby briztoon » Fri Aug 23, 2013 11:32 am
Mate I was hit by a semi trailer Monday week ago, have a broken collar bone and 9 broken ribs, all flail fractures. Pretty sure my doctors know what the underlaying cause of my pain is.winstonw wrote:good luck if you were prescribed opiate class drugs "long term", rather than getting the underlying cause of pain diagnosed and managed effectively.briztoon wrote:Pretty much what my doctors said.
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Re: Benefit of hindsight
Postby Venus62 » Fri Aug 23, 2013 8:51 pm
Are you sure you don't need a second opinion?briztoon wrote:Mate I was hit by a semi trailer Monday week ago, have a broken collar bone and 9 broken ribs, all flail fractures. Pretty sure my doctors know what the underlaying cause of my pain is.winstonw wrote:good luck if you were prescribed opiate class drugs "long term", rather than getting the underlying cause of pain diagnosed and managed effectively.briztoon wrote:Pretty much what my doctors said.
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Re: Benefit of hindsight
Postby trailgumby » Tue Aug 27, 2013 11:20 am
By yesterday the inflamed area was back out to the pen lines marked on my shin at the beginning. To say I.was scared is a bit of an understatement. So back to A&E I went last night. More IV Cephalosporin.
This morning it is dramatically improved. IV Cephalosporin preceded by Probenicid daily for the next seven days.
I checked the medication chart and the diagnosis is cellulitis.
Unfortunately it looks like this places the NZ mountain biking trip to Rotorua with my 17yo son in jeopardy
Last time we had something major and fun planned together I dislocated my shoulder in 2009
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Re: Benefit of hindsight
Postby jules21 » Tue Aug 27, 2013 3:44 pm
cellulitis will disappear before the symptoms (skin discoloration). this confused the hell out of my less-than-useless GP who couldn't work out why it was 'still infected' 2 months later. proper treatment is crucial.
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Re: Benefit of hindsight
Postby MichaelB » Tue Aug 27, 2013 3:58 pm
Hope it heals quick so you can go riding with the son !!!
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Re: Benefit of hindsight
Postby twizzle » Tue Aug 27, 2013 4:20 pm
'tis but a scratch - I got beaten in a TT on the weekend by a guy with two broken ribs.Venus62 wrote:Are you sure you don't need a second opinion?briztoon wrote:Mate I was hit by a semi trailer Monday week ago, have a broken collar bone and 9 broken ribs, all flail fractures. Pretty sure my doctors know what the underlaying cause of my pain is.
(On a more serious note...... Faaaaaaaarout! Mentally, it took me six months to get over being on the scene of a motorcyclist being pinned under the wheel of a semi a few years back. I can't image how briztoon must be feeling. )
...real cyclists don't have squeaky chains...
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Re: Benefit of hindsight
Postby jules21 » Tue Aug 27, 2013 4:22 pm
ouch. heal well.briztoon wrote:Mate I was hit by a semi trailer Monday week ago, have a broken collar bone and 9 broken ribs, all flail fractures. Pretty sure my doctors know what the underlaying cause of my pain is.
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Re: Benefit of hindsight
Postby elantra » Tue Aug 27, 2013 5:25 pm
No You'll be fine to go MTB riding in NZ, as long as you don't come a cropper again.trailgumby wrote:After 5 days of IV Cephalosporin last week with Probenicid to slow my kidneys from eliminating it, the intensity of the redness was much reduces and they put me on oral for the weekend.
By yesterday the inflamed area was back out to the pen lines marked on my shin at the beginning. To say I.was scared is a bit of an understatement. So back to A&E I went last night. More IV Cephalosporin.
This morning it is dramatically improved. IV Cephalosporin preceded by Probenicid daily for the next seven days.
I checked the medication chart and the diagnosis is cellulitis.
Unfortunately it looks like this places the NZ mountain biking trip to Rotorua with my 17yo son in jeopardy
...............................................
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Re: Benefit of hindsight
Postby jules21 » Tue Aug 27, 2013 5:27 pm
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