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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Injured By Slipping Off,difficulty In Breathing While Laying Down For Sleep.Please Advise.

female, 51 yrs, 5 5 , morbidly obese (about 290) - sweeping snow off cement step and 3 landing. Slipped on ice and feet flew out in front of me, landed on my butt, and upper back slammed against corner of the step, then the back of my head landed on the top of the step. It took me a while to get up, but probably due to the shock of falling and partly fear that I might be paralyzed and also because of my weight; however, there was no one around to help (neighborhood is mostly relatives within a mile radius and all were at work, elderly neighbors not close enough and nearly deaf), but after about 30 seconds I began to groan calling for help, but knew it was pointless so I just started wiggling my fingers and toes slowly and raised my arms, head, and began making fists to make sure I wasn t paralyzed. When I realized I had feeling in my arms, legs, fingers, toes, head, and neck I slowly began to try to get up and because I was still on ice I just kept slipping so finally just rolled over into the snow for traction and proceeded to grunt/groan and eventually stood up, hunched over, and went back in the house. I put on dry clothing and did a few stretches, bends, and twists, just to make sure nothing felt broken, but was still a little frozen from laying on the ice, crawling in the snow so I could have just been numbed at that time and just a little achy throughout the day, but in stride I went to work. Today is Saturday and this happened Tuesday morning. When I got home from work about 10 hours later I had dinner, got in the shower, made a couple phone calls, and watched TV for about an hour and then headed off to bed. I brushed my teeth, got in my jammies, set the alarm, turned off the light, pulled back the covers and OUCH! When I laid down it was like someone shoved a Long Steel Blade in my right side so I immediately tried to get up , but couldn t. Rolled over to my back to get some relief and that was WORSE! Just below my shoulder blades, directly in the center of my back (just below my bra line) it just felt like something wasn t right and I couldn t really breathe, but couldn t tell what exactly because my right side suddenly felt like it fell backwards so I pushed out all the air as hard as I could, so that possibly anything out of alignment would stay stable enough until I could roll to a sitting position. Once I was in a sitting position I felt fine. I have tried laying down every night since Tuesday but with the same results. I now sleep in a recliner, not in the upright position, but not flat either and can sleep through the night comfortably I take Bayer - back & body , to help reduce pain/swelling and I wake up feeling okay; no problem standing up, walking, bending, sitting, twisting, (going to the bathroom), it is only when I lay down; on my front, either side, or my back. I KNOW I should have immediately gone to the ER for x-rays and if I told you why I didn t you would just say that is foolish , but I know I will probably need surgery or have to be put in traction or something and will be out of commission for several weeks so Other than being foolish for not going to ER/doctor, does it sound to you (without seeing x-rays) as though I may have broken something in my back and possibly a rib? I am planning on going to the minute-clinic for x-rays on Monday (M-F schedule for imaging). Please, even though I am foolish for waiting and just asked a stupid question, I will appreciate an intelligent response; just please don t tell me I need to go to the ER right now because bone fragments can puncture a lung or another organ and that would be the end of my foolish fears for good. Thank you in advance for your time AND Patience! Linda
Fri, 27 Dec 2013
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Orthopaedic Surgeon, Joint Replacement 's  Response
Hi, thanks for writing to HCM.

Based on the description of your symptoms, I suspect a simple muscle strain or pull that is producing excruciating pain during specific positions only. So, I personally feel that there is nothing much panic about your condition.

Routine xrays of the injured area are necessary to rule out any bony injuries.

The general treatment guidelines for your problem are as follows -

- Take Rest and do not do any activities that cause pain till the acute pain subsides
- Apply ice or a cold pack to the painful area for 15 to 20 minutes, 4 times a day for several days. Wrap the ice or cold pack in a towel. Do not apply the ice directly to your skin.
- Take ibuprofen (Advil, Motrin) or acetaminophen (Tylenol) to help relieve pain
- Use heat only when you are returning to physical activity. Then use it before stretching. Gentle heating can help loosen the muscle
- When the acute pain is gone, start gentle stretching exercises. Stay within pain limits. Hold each stretch for about 10 seconds and repeat 6 times.
- Physical therapy may speed up the recovery process. Therapeutic modalities such as Ultrasound, Massaging and specific exercises will be helpful.

If your symptoms are not improving with the above measures, consult your family physician for further evaluation and management.

Hope this information is helpful. Good day
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Injured By Slipping Off,difficulty In Breathing While Laying Down For Sleep.Please Advise.

Hi, thanks for writing to HCM. Based on the description of your symptoms, I suspect a simple muscle strain or pull that is producing excruciating pain during specific positions only. So, I personally feel that there is nothing much panic about your condition. Routine xrays of the injured area are necessary to rule out any bony injuries. The general treatment guidelines for your problem are as follows - - Take Rest and do not do any activities that cause pain till the acute pain subsides - Apply ice or a cold pack to the painful area for 15 to 20 minutes, 4 times a day for several days. Wrap the ice or cold pack in a towel. Do not apply the ice directly to your skin. - Take ibuprofen (Advil, Motrin) or acetaminophen (Tylenol) to help relieve pain - Use heat only when you are returning to physical activity. Then use it before stretching. Gentle heating can help loosen the muscle - When the acute pain is gone, start gentle stretching exercises. Stay within pain limits. Hold each stretch for about 10 seconds and repeat 6 times. - Physical therapy may speed up the recovery process. Therapeutic modalities such as Ultrasound, Massaging and specific exercises will be helpful. If your symptoms are not improving with the above measures, consult your family physician for further evaluation and management. Hope this information is helpful. Good day