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Suggest Treatment For Tibia Fracture
Question: My grandmother fell at christmas and fractured her tibia. She had been independent living, using walker for balance, living in apt and although older, amazing for her age.
They have her in leg brace which she can't apply pressure and shipped her off to skilled nursing. They were concerned with clots which I understand, however, after being on coumedin and now I understand lovenox as well, she has developed extreme pain in lower back that has now turned deep purple/red, and is now spreading to side and front and she has increased pain in abdomen. Dr. won't back off blood thinners as says he wants her INR to 2, and last time they checked in was 1.2. They are supposed to do ultrasound and lab tomorrow however i am concerned the thinners are actually killing her and not worth it compared to risk of blood clot. She has been nauseous/unable to drink liquid, limited urine and yet everyone just attributes to her age. Would you keep you grandmother on thinners??
They have her in leg brace which she can't apply pressure and shipped her off to skilled nursing. They were concerned with clots which I understand, however, after being on coumedin and now I understand lovenox as well, she has developed extreme pain in lower back that has now turned deep purple/red, and is now spreading to side and front and she has increased pain in abdomen. Dr. won't back off blood thinners as says he wants her INR to 2, and last time they checked in was 1.2. They are supposed to do ultrasound and lab tomorrow however i am concerned the thinners are actually killing her and not worth it compared to risk of blood clot. She has been nauseous/unable to drink liquid, limited urine and yet everyone just attributes to her age. Would you keep you grandmother on thinners??
Brief Answer:
Blood thinners should continue
Detailed Answer:
Hello and welcome
I appreciate your concern
Yes, I would continue the blood thinners if I were the treating physician. Bed bound patients or those with limitations in mobility have a greater chance of forming a thrombus which can lead to embolism subsequently.
The lesions or discoloration on the back can be possible bed sores and need to be evaluated. It's a preventable phenomenon which is difficult to treat once formed.
Dioxin toxicity should be ruled out. ECG, electrolytes especially potassium, renal function tests and thyroid profile can be done.
wishing you best of health
let me know if you have any query
Dr M.S Khalil
Blood thinners should continue
Detailed Answer:
Hello and welcome
I appreciate your concern
Yes, I would continue the blood thinners if I were the treating physician. Bed bound patients or those with limitations in mobility have a greater chance of forming a thrombus which can lead to embolism subsequently.
The lesions or discoloration on the back can be possible bed sores and need to be evaluated. It's a preventable phenomenon which is difficult to treat once formed.
Dioxin toxicity should be ruled out. ECG, electrolytes especially potassium, renal function tests and thyroid profile can be done.
wishing you best of health
let me know if you have any query
Dr M.S Khalil
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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