quack

quack

Thursday 29 August 2013

in search of a bone-setter

Immediately following the break of my clavicle, I had a sense that a Chinese bone-setter type person would be useful to get the bones in place.  (I spent early years in south-east Asia, and my parents have stories of such).  However, I thought perhaps the orthopaedic people were the orthodox version of this, and so it was in the best place possible.  I googled a bit and found articles where traditional bone-setters had made things worse, so didn’t follow this up.

By happy chance, I reconnected with pain/injury consultant, John Perrott, last week, and he wondered if he could help.  I had my second treatment yesterday, and he managed to get my clavicle back into place – perhaps in the shoulder joint – I can’t quite visualise it – no doubt he’d express it officially – but he worked, it clicked oddly, I felt strange, and wondered if this was a good thing or not, but he seemed very pleased with the result. 

I can now feel my clavicle doesn’t seem to be trying to escape from the top of my shoulder – I hope it stays in place – I’m not quite sure if this is likely.  Buuut, it is such a relief to feel my shoulder back in the apparently correct, or at least better, place.

My general point and concern here is that there seems no general knowledge of this kind of event.  I’m not quite sure if John is just an unbelievably talented bone-setter bringing together various trainings and intuition, or whether this is generalisable to particular profession eg osteopathic training.

No-one gave me to believe that my situation was anything other than good in my recovery.  So, it was a shock to discover it was not good after all, and the long-term implications of further surgery sound serious to me – eg numbness beneath the shoulder, and possibly into thumb and first finger – particularly? serious for a shiatsu practitioner – but presumably everyone is keen on having sensitive fingers!

So, do post any thoughts or comments here, and any ideas on how this kind of positive outcome can be spread so others may receive better support when injured like this.

Saturday 24 August 2013

old chestnut - private cf public; options

Feel a bit silly writing this blog, but I guess it logs my thoughts for myself – though the reason I make it publicly available is I hope it will help others in various areas of health learn something – other people with broken clavicles, or more general principles on health; and health practitioners who may forget or not know about the service user/ client/ patient experience.

1.  private cf public medicine.

so, a first thing I asked the consultant when he told me my clavicle had not joined up after 10 weeks was whether it would be any advantage to go privately – absolutely none, he said.

However, now a few weeks on I don’t think I agree with him.  Potential advantages of ‘going private’ I realise include:

1.  choosing a specialist for ones problem – in my case, a ‘shoulder guy’ rather than a ‘hand guy’.  In the NHS, my issue comes under general surgery, so I may have lucky if you like to get someone in the right general physical area!

2.  if surgery is indicated, a more choicey process – seemingly more choice of date, a private room, staying overnight afterwards; from my point of view, not feeling useless if I don’t have someone immediately obvious to look after me in the initial post-surgery time.

and, of course, on the down side:

1.  considerable amounts of money...

2.  possibly time spent trying to figure out the process, and who to visit.

 
2.  options:

Last week I found myself moving toward immediate surgery (that is to say a plate – meaning eek my shoulder opened up, and bone graft meaning taking something out of my pelvis – very scary – and presumably painful).  I felt very uncomfortable with this – and although it sounded like the most sensible option, I was really stressed at the thought of having to be ready for surgery any of the next four Wednesdays to include rearranging commitment on and after that day, and managing the painful process of surgery and post-surgery.

now, having visited another practitioner, I find myself more drawn to a slower approach.  He didn’t seem to think that if I had the surgery in a few months time that would make that much difference.  There seems a possibility that actually finding a way to live with a broken clavicle may be the better option for me, and this gives time to explore that.  It also means I can explore some private options so if I have the surgery I can feel I have the person with the best experience for the job, and to allow myself the most comfortable experience (private room, overnight stay post-op) – if I feel I can afford it – which I may feel able to, and to prioritise this.

allfornow – any thoughts yourself, anyone out there?

c

Wednesday 7 August 2013

Seamless... to CT

so, I was regretfully shocked recently when I discovered at my ‘discharge’ appointment that my clavicle had NOT JOINED UP AT ALL, and the consultant recommending surgery (which arguably should have been done right at the start of the injury).  Internet searching (which the consultant criticised me for doing) suggests that pinning is more likely to take if done at the start with the initial wound, rather than creating a new/artificial one, which is what is needed when the pinning is done at a later stage.

I have been for a CT scan as a next stage in this process.  I thought I would just note a bit about it, since I realised I was unclear what it was, and a friend of mine asked.  A CT scan seems to be a lot of X rays done to give a 3D picture of a body situation – eg in my case, where the two ends of the clavicle now are, and whether they are joined in any place at all.  The hospital said it was considered potentially damaging to a foetus, since it was a ‘high dose of radiation’ [alarming].  The machine is like a giant polo mint, and you lie down with the particular area to be scanned in the middle of a bed.  The [polo mint] machine then (with others outside the room) moves to and fro [around the body - clavicle/shoulders in my case]; I was asked a few times to breathe in and hold my breath for a few seconds, presumably to be still.  I wasn’t clear when the rays were doing their thing – throughout? just when I was breathing in?  The whole process took maximum 15 minutes.  I would have found more explanation helpful, though the process was conveniently timed for me in the evening, and the hospital was not busy at all, and having arrived early I was out before my actual appointment time.

Moving on to my point about ‘seamlessness’, what has shocked me is how there has been (from my point of view) no acknowledgement of my transition from a break due to have healed up within 10 weeks, and no hint that it might not, to the situation of it having joined up at all.  I have also missed out on an understanding of why this has happened – very unusual? to be expected for this kind of break? – [when shown the Xray in my fracture clinic appointment 2 weeks after the break, I couldn’t believe it could join up by itself, but was assured both by orthodox and complementary practitioners that it would, and the new bone cells would seek out the other half so to speak.]

At the same time, I have been marking essays for my Open University teaching on health and social care, where for example, a model of transition is mentioned where the sequence of change may include initial anger, ultimately with being reconciled and adapting to the situation.  This also reminds me of the Kubler Ross model of bereavement.  I haven’t felt any knowledge of this kind of process really from any health professional that I have come in contact with, except a physio who observed that my confidence had been shaken.  Too right.