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Broken T9 vertebrae

 Poster: A snowHead
Poster: A snowHead
I'd be grateful for any advice on pain relief and rehab for my back. I broke it 4 days ago and it was diagnosed by the brilliant NHS people at West Cornwall Hospital. I was bodyboarding in superb overhead waves, misjudged a manoeuvre off a dumping lip, and was driven into the seabed on the top of my skull. Having had a number of chest injuries before, including a broken sternum, I'm reasonably knowledgeable on how this will pan out over the next 6 weeks, but I would really appreciate any tips on coping with current spasms around my chest, and a schedule of rehab when things settle down. I'm sure one of the regulars here (Pam?) suffered something similar.
I'm 55, reasonably fit, swimming, surfing and building were my main forms of exercise.
Many thanks,
Caleb
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Obviously A snowHead isn't a real person
You are lucky to still be walking
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Well, the person's real but it's just a made up name, see?
Truly, I know. It couldn't have been a better outcome considering the impact and being in heavy surf. It's a stable fracture and I'm very fortunate.
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What advice were you given by the hospital? I would follow that advice then look for or get a recommendation for a local physio to continue rehab after initial trauma settles. GP can prescribe antiinflammatorys and painkillers. Gentle mobilisation, walking etc but don't do anything stupid.
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I was advised to not bend or lean forward, or carry more than a cup of tea in each hand.
I'd just like to have some foresight of rehab, to focus on, because I'm currently at that point in an injury where the outcome seems very distant.
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Currently, Co codomol seems to be a double edged sword, with heavy sleep in a static position, waking up with something like a hangover, very stiff and dozy, with a cracking headache. Paracetamol and nurofen provided less pain relief, but seemed more manageable. I'm sure I'll get the hang of it, early days yet
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@cstreat, 4 days is still very early. The pain will ease slowly over the months. For now just rest and let nature take its course. There is no rehab you can do at the moment. Do you have steel plates in your spine to stabalise it or are you in a corset?

And thank your luck stars you are still walking. While resting on your bed in pain just keep repeating that matra to yourself.
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cstreat wrote:
Truly, I know. It couldn't have been a better outcome considering the impact and being in heavy surf. It's a stable fracture and I'm very fortunate.


Amazing. Good luck with the recovery
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No surgery, no corset. Really appreciate advice and wishes, thanks
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@cstreat, talk to the consultant responsible for your treatment?
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cstreat wrote:
Currently, Co codomol seems to be a double edged sword, with heavy sleep in a static position, waking up with something like a hangover, very stiff and dozy, with a cracking headache. Paracetamol and nurofen provided less pain relief, but seemed more manageable. I'm sure I'll get the hang of it, early days yet


I'm not a doctor, but have had back problems that have put me in hospital. You may well be better informed/qualified than me, but just incase you're not my understanding of the painkillers available to you is....

1) Nurofen is a mix of Paracetamol and Ibruprofen, so don't take it with either of the others separately. It's also very overpriced - it's more sensible to buy the Paracetamol and Ibruprofen separately.

2) Co-Codomol is a mix of 500mg Paracetamol and either 8, 15 or 30mg Codine. 500/8 is available over the counter. 500/15 and 500/30 are only available on prescription. You don't say what strength Co-Codamol you're on. If you're on 500/30 then that's as strong as it gets. Codine is a narcotic and highly addictive so don't take it unless really necessary. It also tends to 'bung you up', so a mild laxative may be necessary (Senna).

3) Paracetamol 500mg. Available over the counter, but be careful and DON'T take it with other meds that contain Paracetamol (like Co-Codamol or Nurofen).

4) Ibruprofen 200/400mg. Available over the counter, but use caution if you have stomach/ulcer or heart problems.

5) Asprin.

You can take up to the maximum daily dose of any/all of Codine, Paracetamol, Ibruprofen and Asprin - they don't interact with each other. Just be careful with brands that contain mixtures of these that you don't accidentally overdose.

If the above can't/don't manage the pain then you'll need to see the doctor for something stronger. Gabapentin and Amitriptyline are sometimes used, but these can have nasty side effects including psychological ones.

And I repeat, I'm not a doctor. Get well soon.
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The consultant was sent the x Ray's by email to check the fractures, as specialist unit is Derriford, Plymouth, 90 odd miles away. Follow up is a couple of weeks away. All I've had is casualty treatment, and full strength codomol. Pain has been worst today, despite being the 1st full day on opiates.
This kind of pain is treated in Australia and Canada with THC by enlightened doctors, crazy it can't be used here instead of opiates.
Thanks for help
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Quote:

1) Nurofen is a mix of Paracetamol and Ibruprofen,


Nurofen is simply branded ibuprofen; it does not contain paracetamol. It is horribly overpriced though.

Quote:

You can take up to the maximum daily dose of any/all of Codine, Paracetamol, Ibruprofen and Asprin


Aspirin and ibuprofen are both non steroidal anti-inflammatory drugs. Taking them together increases the risk of side effects. Avoid unless advised to by a doctor.

Codeine works well for many people, but a small proportion (ask me how I know Confused ) really don't get on with it, and feel nauseous, lethargic and generally rubbish. If you have pain that ibuprofen and paracetamol don't control, and don't tolerate codeine, ask your consultant for another option - there are plenty of though they're not all pleasant.
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mgrolf wrote:
Codeine works well for many people, but a small proportion (ask me how I know Confused ) really don't get on with it, and feel nauseous, lethargic and generally rubbish. If you have pain that ibuprofen and paracetamol don't control, and don't tolerate codeine, ask your consultant for another option - there are plenty of though they're not all pleasant.

My partner had an allergic reaction to codeine when prescribed it after a fracture. I think he ended up with max doses of paracetamol and ibuprofen (but best talk to a doctor or pharmacist about what those are wink )
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I find opiate painkillers quite odd; they definitely have a euphoric feeling, but don't exactly stop the pain ( I've had intravenous morphine before) These cocodomols leave me hung over, and the pain as they wear off seems worse than with the ibuprofen/paracetamol combo. The sedative effect of opiates makes me sleep in one position, which leaves me pretty sore upon waking. I'll see if I can do without.
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What I hadn't expected after being diagnosed in A & E was an anal reflex test. Poor Dr! What a day!
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@cstreat, The anal test is probably a test for damage to the descending tracts from C to S regions. There is a lot of reciprocal connections in the spinal cord. EG when moving the arm you need to coordinate relaxation of one muscle and contraction of another. Similarly, into Sacral for coordination of reflex. I beleive that the Anal reflex is via S4/5 in humans so it makes sense to test that because it is at the end of the cord.
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Well, the person's real but it's just a made up name, see?
Cauda equina syndrome, or Mare's tail, where the nerves feather off the spine lower down
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Fractured L, 4 & 5 about 15 years ago. Corset but no surgery. I was walking almost immediately, but had to keep my spine straight. Was only allowed to stand up or lie down, no sitting. 10 weeks in corset. Was very uncomfortable for about 4 weeks and intermittently so for about another 4. After that, it was mostly Ok but jarring it in any way would send shooting pain up my back - just stepping heavily off a kerb would set it off, even after 3 or 4 months. I was riding bikes gently after about 2-3 months, mountain biking on tame trails after 4 months and snowboarding after 6 months.
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No useful advice from me - except to emphasize the "bunging up" effect of the stronger versions of co-codamol. I badly injured a lot of soft tissues in my back in February (fall at table tennis, stupidly flung myself sideways after an impossible ball) and found that alternative hot water bottles and ice packs helped a fair bit, especially at 4 am when it was too sore to stay in bed any longer. Paracetamol and ibuprofen. It's still not 100% but that's probably because I've been lazy about rehab. Hope it improves soon.
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@Judwin Nurofen is a just a brand of ibuprofen, there is no paracetamol in it. You are correct though that generic paracetamol and ibuprofen are better and cheaper.
You should not take both aspirin and ibuprofen. One or the other. Ibuprofen is the better option. Take both and it will really f@ck up your stomach and cause a bleed. You do not want a gastric bleed on top of a spinal injury.

@cstreat, regular paracetamol (max dose 4g per day) and 400mg ibuprofen three times daily. Avoid the codeine if you can, but it might be good to have some separately on prescription to take occasionally as required.
If your pain isn't controlled and you are worried about anything, contact your GP.
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After an agonising day yesterday, I've given the codeine a miss today, and just had 2 doses of ibuprofen. It's been SO much better. I've also been very careful, as I had been doing hoovering and lifting things before diagnosis. Spasms have greatly reduced as I've learnt to lie and get up correctly. @stevomcd, I find sitting most uncomfortable, so will probably avoid it now.
Thank you for all your kind advice, I feel that I've turned a corner on day 5.
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After all it is free Go on u know u want to!
Just take your time. It's a broken bone is all. Very stable (or you'd be in a device) in light use and will stabilise completely as the fragments meld. I've never seen one rebreak. Don't crash your car. Start rehab as soon as allowed. Take the pain killers if you need them, no prizes for being in too much pain and it definitely makes the recovery longer.

Sounds like you was doing well, good luck!
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@motdoc, many thanks, that's all reassuring.
I felt a little lost, as when I broke my sternum I was at least given an advisory list of what to do with a chest injury. This time I was warned of nerve damage and verbally warned about not bending forward or carrying more than cups of tea, but nothing on breathing exercises ( I can't cough at all) or recovery times.
I really appreciate all this advice. Good old Snowheads, guaranteed to be full of medically qualified people, helpful people, and people who have been expert in self administered traumatic injuries. Thank you.
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Quick update 2 wks in; whilst chasing up my follow up appointment, I have been informed I have T5, T7, T9 and T10 fractures! Slightly concerned that they didn't xray my neck at all. Now being passed onto neuro specialist.
Starting to sleep at night now.
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@cstreat,
Crying or Very sad
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 And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
Get well soon!


https://www.casinophilosophy.com/
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Thanks for all your advice. All 4 fractures are now mended, loads of regular private physio ( nothing from NHS in these difficult times)
Back to digging trenches and rebuilding listed buildings, just feel my 55 years more now, only sore when tired. In fact, it's panned out almost exactly as Steve described, with only sudden movement causing problems.
Thanks again, Snowheads.
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You know it makes sense.
@cstreat, Good to hear. Go steady with that bodyboarding.
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@cstreat, when my hubby fractured his neck way back about 11 years ago, he was told to get private physio, NHS was not an option. Fortunately, he had private insurance through work. Glad to hear you are on the mend. Take care.
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cad99uk wrote:
@cstreat, Good to hear. Go steady with that bodyboarding.


it sounds like waterboarding, only worse !
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