Day 1
I was in England. The suddenness of the fall was a shock. One minute I was walking into a washroom, the next I was on the floor, not knowing what had happened. I didn’t lose consciousness. In a fall the body’s automatic response is to protect your head. It’s quite amazing. I have no memory of the fall, but I know I will have landed on an outstretched hand, my left (dominant) hand. My wrist hurt, a lot.
Still feeling a bit shaken, I sat down and wondered how much damage I’d done: the pain showed no sign of diminishing, and now I had swelling. My physio brain kicked in: no skin broken, no bones at an odd angle (thank goodness!) and I was able to gently move my hand, wrist, elbow and shoulder joints. It could be worse, I thought, but it still hurt. It must be one of the small carpal bones, I thought. My scaphoid, probably, judging by the location of the pain and swelling. Scaphoids can be tough to heal, I remembered, because the blood supply isn’t great. No point in dwelling on the negatives, I told myself. Just be grateful you didn’t hit your head, or fracture something so badly that the bones displaced.
I was heading home to Toronto in a few days, and wearing a cast can be problematic if you’re flying, so I opted not to seek medical care yet. I took anti-inflammatories, applied ice and wore a wrist brace that night. It helped a bit, but discomfort and anxiety prodded me awake every time I dozed off. My physio brain was definitely not engaged, and those negative thoughts I’d resolutely pushed away earlier came flooding back: what if my scaphoid is broken and doesn’t heal properly? Will I need surgery? What if I have to stop work?
I mean, really!
Day 4
Still in my brace I got back to Toronto, on the Sunday of a long weekend. Despite my panic, I was pleased to note that my hand was still attached to my arm, and the pain had subsided. I decided not to clog up Emergency. I could wait a couple of days to talk to someone at my doctor’s office.
Day 6
I obtained an X Ray requisition from my doctor.
Day 8
The X ray showed a possible crack in one of the carpal bones, but not where the pain and swelling was. I was confused, and getting alarmed. I was so sure it was my scaphoid.
Day 14
I continued to experience pain and swelling at the base of my thumb and decided to go back to my family MD. She recommended a further X-Ray, made an Orthopaedic referral and also told me about an Emergency Minor Injury Clinic at a different hospital. I continued to wear the wrist brace. It was cumbersome and I had to adapt some of my clients’ treatments to accommodate it, but it protected my wrist and kept the bones in place. I just wished I knew for sure what was damaged, and how badly.
Day 15
The second X-Ray gave no more information.
Opening jars, lifting things, washing dishes were all off limits. I was worried something was being missed.
Day 18
My doctor’s surgery called me to ask if I had a date for my Ortho referral, which I didn’t. They said they would do what they could.
Day 21
Still no news about my Ortho referral. I went to that Emergency Minor Injury Clinic. I was immediately aware of how truly minor my injury was, compared to many of the folks I saw there. And how patient and professional the staff were.
7 hours and a CT scan later I finally had a diagnosis – not my scaphoid at all, but a non-displaced fracture of the distal radius. It’s not always easy to see a break on X-Ray if it hasn’t been displaced. Because I had been very cautious and was wearing a brace for activities and work, it was healing well, but to be safe they decided I should still have a cast. My wrist immediately felt safe.
I relaxed, got better at using my right hand, and waited for my follow-up appointment with the Orthopaedic surgeon from this other hospital.
Day 29
Appointment with the Orthopaedic Surgeon and out of the cast. Phew! He told me that the pain at the base of my thumb was likely arthritis, which had flared up with the fall. He clarified that I should continue with the brace for a total of 6 weeks (now at 4 weeks post injury) to allow the radial fracture to heal, then start to wean myself off it. He advised me to start range of motion exercises.
What have I learned?
A bit more about me: how my mind goes into overdrive when I can’t get a concrete answer to my body’s problems. How unhelpful that is. How misleading self-diagnosis can be. How important it is to have faith in the careful process of medical diagnosis and treatment. How right I was to listen to my body and protect it. How much energy it sometimes takes to remain calm and be persistent when dealing with the medical system. How grateful I am to the professionals who helped me in this process. How grateful I am that their expertise was available to me, free of charge.
R. Sian Owen
Registered Physiotherapist.