Should I remove plaster myself (update post#24)
, Nov 21 2012 06:32 PM
29 replies to this topic
Posted 21 November 2012 - 06:32 PM
Some of you may remember my post last month about my DD's broken arm. Briefly, I took her to hospital A which x-rayed and diagnosed break. They put a half cast on, told me it would need to be on for a minimum of 2 weeks and referred her to a GP in a weeks time. The GP said she didn't treat breaks and hospital A should have referred me to the fracture clinic at Hospital B so she gave me a referral for there (and another x-ray referal to have done before visiting the fracture clinic). I phoned the fracture clinic and they refused to see DD because they only take referrals from hospitals, not GPs. Back to hospital A who can no longer help because she has been discharged and referred to GP.
So, in a nutshell, neither hospital A, hospital B nor our GP will see DD about her broken arm (which has been in a cast and not painful to her).
Now that it is almost 6 weeks I don't know what to do. General consensus seemed to be to take her to a physio who will remove the cast so I called in to see one yesterday and he told me that yes, he can remove the cast but only if I'm sure the fracture is healed.
My question is, how do I find that out? She had the x-ray done this morning and the reposrt says:
"They're are healing greenstick type fractures of the distal radius and ulna with some periosteal reation. Detail is obscured by overlying plaster.
There is mild focal deformity on the dorsal aspect of the radial fracture but no significant displacement of angular is seen.
The alignment of the ulna fracture appears to be essentially anatomical."
Based on that, do you think it is safe to remove the plaster? I know the standard response is to seek expert medical advice but given that neither of the 2 nearby hospitals, nor our GP or physio will give advice I need to decide myself.
Edited by tle, 23 November 2012 - 03:42 PM.
Posted 21 November 2012 - 06:34 PM
Can the physio read the report?
Posted 21 November 2012 - 06:40 PM
Take the report to the physio and they will confirm it is ready to be removed.
Posted 21 November 2012 - 06:44 PM
When I spoke to the physio he told me he could remove it at a cost of $10 but I nedded to know myself whether or not it was safe to do so beforehand.
Posted 21 November 2012 - 06:51 PM
Can you see another physio - all the physio's I have seen have been happy to review x-ray reports and determine whether a cast should some off.
Posted 21 November 2012 - 08:21 PM
There is a 2nd physio in town. I might stop in with the xray report tomoprrow and see what she said.
Posted 21 November 2012 - 09:16 PM
Can you see another GP? DD saw the fracture clinic once after her break and then our GP ordered the final xray and removed the cast.
Posted 21 November 2012 - 09:55 PM
When I broke my arm, the GP at the hospital (country town) removed my plaster. My arm was re-xrayed to check all was fine. Remember I'm old so this was 20 years ago.
When DD broke hers it was removed by an orthopaedic surgeon, x-ray done to check all had healed. Not a bad break but still referred to an ortho.
I wouldn't remove it without a medical professional telling me it's fine. Is there a health number you can ring who can tell you where to go?
Posted 21 November 2012 - 10:02 PM
How awful you've been given the run around so badly by the professionals who are supposed to help you. I would not take the plaster off myself though as I can not read an xray report.
Good idea to see the other physio. Good luck with it.
Posted 21 November 2012 - 10:13 PM
What an awful situation. Is there another GP? Otherwise turn up at Hospital B's ED - they will be able to get you into fracture clinic.
6 weeks should be fine for it to heal but the site of the fracture should be examined for tenderness - if it's really sore when pressed its not ready for the cast to come off.
Write complaints to both hospitals - utterly appalling.
Posted 21 November 2012 - 10:15 PM
I broke my ankle about 15 years ago now. The hospital put on a half cast which was supposed to be there until swelling went down but it fell off after less than 2 days so I had a full cast put on which was supposed to be taken off after 2 weeks and replaced but that never happened.
The cast started cracking at the bottom and cutting my foot so after 6 weeks I decided to remove it myself.
I wouldn't recommend it, while my foot felt fine while in the cast as soon as it was removed it was obvious it was not healed. I just strapped it and didn't bother getting it checked (but I was 20 and knew everything) and I don't think it ever healed properly.
I would definitely not recommend removing the cast unless you know it has healed.
It does seem strange that neither your doctor or the hospitals will help you. Can you phone and speak to someone in charge and explain the situation?
Posted 21 November 2012 - 10:27 PM
Go to ED, ask for a plaster removal and x-ray. ED can refer to fracture clinic or remove the cast that day.
Posted 22 November 2012 - 06:37 AM
I would try to see an orthopedic surgeon or see if another physio can read the report. Or find another GP to read it as they should have some understanding of an x-ray report.
My DD1 broke those bones a few years ago. But she had surgery to put her bones back in place and a full plaster. When the plaster was removed 6 weeks later the surgeon actually thought about replastering it again. In the end he decided it would be ok but she was very restricted in what she was allowed to do and he told he a number of times that 1 fall will most certainly result in it braking again. So I wouldn't be doing anything until I found someone who could actually read the x-ray.
Posted 22 November 2012 - 07:04 AM
I've broken my arm 3 times, it all started with a break when i was 8 that didn't heal properly, so I would never remove a plaster from one of my kids myself.
Who referred the recent xray? And given the 6 weeks have passed and you need to follow up I'd go back to Hospital A or B. Don't just let them pass you off.
Posted 22 November 2012 - 09:48 AM
I would go to the ED or see another physio before getting the cast removed. It must be so frustrating to not be given specific instructions.
Posted 22 November 2012 - 09:55 AM
OP in your post you said it was a half cast, did they eventually put on a permanent one?
If it is a half cast I can't see how a physio can charge you to remove it as it only involves unwinding a bandage?
Posted 22 November 2012 - 09:59 AM
I would ring 'A' back and ask to speak to somebody higher up. They have her records. How can it be possible to not be able to refer her to 'B'.
It is often amazing what somebody else can do when you have been told it is 'impossible', even though it should be simple and logical.
Posted 22 November 2012 - 10:02 AM
Yes, it's only a half cast. She never got to have a full one put on because we've been going around in circles trying to get someone to see her. That's why I was tempted to remove it myself. I know it will be easy to get off but I need to know if its healed or not first. I was hoping the wording on the x-ray report would make the decision easy but because it says "healing" and not "healed" I'm still no clearer to making a decision.
Posted 22 November 2012 - 10:21 AM
What a crock!
So some bean counters at hospital A and B can refuse to let her be seen and thus have inadequate follow up because of some stupid protocols. Did they stop to think who was going to see her if they said no? Like the fracture would miraculously go away?
She was seen at Hospital A so I would be ringing them and demanding that they organise something. She is lucky that it sounds like it is healing ok and won't have long term problems, but that follow up is appalling.
And please, go through their complaints procedures and do it in writing. Its a total disgrace.
Posted 22 November 2012 - 12:14 PM
What a nightmare. I would go back to the ED of one or other hospital and not leave until it's sorted.
I broke my arm at age 6 and it healed twisted and had to be rebroken and reset.
Posted 22 November 2012 - 12:25 PM
If there is a fracture clinic at Hospital B I would rock up to the ED and tell them you are there as you want someone to take it off (and provide X ray report). They will refer you to the fracture clinic there if there is a problem.
I am not a fan of people rocking up to ED for things such as this but I feel you have been placed in a ridiculous position due to some weird beurocracy and in this case I see it as the simplest way forward. Alternatively pay a physio to read the report and remove if they are happy.
Posted 23 November 2012 - 10:35 AM
I've made an appt for the physio this afternoon so hopefully he will read the xray report and know what to do.
I'm reluctant to make a formal complaint to the hospital because I know that it's the individual Drs and nurses that will cop the blame not the system that is at fault. I used to work in recruitment for both the hospitals involved and I know that the vast majority of medical staff within them do a great job in very difficult circumstances.
I let you know what the physio says. Hoefully it will all be over by this afternoon.
Posted 23 November 2012 - 10:43 AM
Crossing my fingers for you tle
Posted 23 November 2012 - 03:41 PM
Back from the physio and still no closer to getting an answer. Turns out that yes, he can remove a plaster but not without prior approval of a "medical professional". Something to do with medical insurance. To his credit, he did ring 2 orthopeadic surgeons, my GP and a 2nd GP in an attempt to read the xray report to them and get their OK. Sadly, none of them would give the OK without a personal consultation and none could get me an appt within a reasonable time frame.
He's given me the names of some peadiatricians to make an appt with but again, they have waiting lists that are several weeks (if not months) long for new patients.
So basically, I'm right back where I started from.
The physio did tell me however, that looking at the xrays and the report everything is as he would expect it to be and there is nothing to indicate any problems. He also said that six weeks is routinely the amount of time a plaster stays on even for more severe breaks so it would be very unusual for a greenstick fracture to need longer than that.
Based on that, and the fact that I've run out of places to try and get an answer, I've decided that I'm going to remove the cast myself tomorrow. I'd do it today but DD has a dance concert rehearsal tomorrow and it would be just her luck to fall and injure it again. SO, as soon as the rehearsal is over, the cast is coming off.
Posted 23 November 2012 - 03:49 PM
Does your local hospital have a GP clinic?
They should be able to help you there.
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