Mister Tee Posted February 3, 2009 Share Posted February 3, 2009 For either, breaking, or spraining, my ankle in some god forsaken Southeast Asian country, where I will be spending the next couple of weeks. Medical access is not real readily available. I basically stepped in a hole in the street because I wasn't paying attention, and down I went, ripping up my ankle. It immediately swelled to about twice its size, and I had to sit it out for a few minutes before I could hobble back to the office. Office staff kindly was able to procure an ace type bandage. So, um, what do you think I should do? I'm not going to p***y out and go back to the States right now, and I'm told that the local medical facilities that exist are best avoided, for various and political reasons. Symptoms are, massive swelling on the outside of the ankle (left ankle twisted inward during a fall to the left) but I'm still able to walk. I'd ice this b***th if there was ice, but I'll probably have to settle for cool water, or perhaps the bar where I intend to get my pain medication will give me some. I say keep it elevated and cool, and keep it wrapped for a while. Okay here's my real question for you doctor types. Let's say the Tee broke his ankle, or tore something. I'm sure something is torn. If I don't deal with in within a couple weeks, am I risking some permanent damage? I mean, it's not like bones are popping out or anything, and I'm pretty sure it isn't dislocated. It's just massively swollen. Link to comment
Francois_Dumas Posted February 3, 2009 Share Posted February 3, 2009 Seeing how serious this is - or at least could be - , I'd change the title of your post so you have a bigger chance of more people (and hopefully some with more knowledge than me) look at it and advise you ! Link to comment
Selden Posted February 3, 2009 Share Posted February 3, 2009 Yikes. Is going to Thailand or India an option? Both have established good reputations for quality surgical care for foreign patients, at a fraction of US prices. Link to comment
Calvin (no socks) Posted February 3, 2009 Share Posted February 3, 2009 I fell over and hurt my shoulder. By the time my appointment rolled around a week later.......I didn't need to see the Doctor... Never been back... Unless it turns green...Immediate extraction! Link to comment
Silver Surfer/AKAButters Posted February 3, 2009 Share Posted February 3, 2009 I'm not a Dr., but if it is fractured you are clearly looking at a more serious outcome if it is not tended to quickly and appropriately. There is no p&&y out when it comes to your long term physical condition. Link to comment
David Posted February 3, 2009 Share Posted February 3, 2009 I'm not a doctor, but I've broken both ankles, sprained both ankles, and had stress fractures (all running and racquetball). My guess is that the severe and rapid swelling is from tearing of soft tissues (probably ligaments). It's possible that you broke something, but if you can hobble without severe tooth-grinding pain, it's probably not the case. 1) See if it's a fracture, by x-ray or movement, if at all possible. I don't know where you are, but I'd balance that against how much work it would be to get to an x-ray machine. Even in the weirdest parts of the world, if they have electricity, they have x-ray, and it's not like someone can hurt you permanently with that procedure. If it's not possible, don't worry about it. 2) Keep it elevated to drain the blood and reduce swelling. 3) Stay off it. 4) As you are able to move around, support it with tape or a splint, or an oversized boot. As long as it's not broken, you do want to introduce more and more movement. Link to comment
hANNAbONE Posted February 3, 2009 Share Posted February 3, 2009 iCE tHE crap outta it.! Link to comment
Whip Posted February 3, 2009 Share Posted February 3, 2009 I've had every ankle injury you can have. It will get worse for about three days, then it will start getting better, very slowly. Wrap it with the ACE.......ice/cool it as often has you can. If it isn't getting better in a week, then get help. I ain't no Doc.... Whip Link to comment
Agent_Orange Posted February 3, 2009 Share Posted February 3, 2009 As David said, ice, elevation, and try to stay off of it. But ice, ice, and ice is the key. Link to comment
BanjoBoy Posted February 3, 2009 Share Posted February 3, 2009 I'm not a Dr. (but I play one on TV ) All the above advise is good especially if you can get to India or Thailand for some "real" medical care. I sprained, broke, dislocated my ankle back in '01. I waited a month before I ever saw a Dr. (I thought it was just a class 1 sprain, but it kept getting worse) and it took a year before my first surgery. I just had another surgery back in November to fix it some more. The Dr.s told me if I got immediate care I would have been much better off. On a happier note, I have had other sprains, that were fixed just by ice'in elevating them. Good luck Mister_Tee, Link to comment
swfraley Posted February 3, 2009 Share Posted February 3, 2009 If you have no confidence in the local medical care, your choices are to ice, wrap, and elevate it and hope for the best or go somewhere else. Bad care is worse than no care. As to long-term damage, a week won't make a difference but a month might. As to the quality of my advice: On the one hand, I'm a doctor. On the other, I'm an OB/GYN and an anesthesiologist Link to comment
SweetP Posted February 3, 2009 Share Posted February 3, 2009 Get in touch with the embassy. That's why they're there. They'll be able to put you in touch with an english speaking doctor and act as intermediary for getting treatment. Don't risk permanent damage. Link to comment
VinnyR11 Posted February 3, 2009 Share Posted February 3, 2009 For either, breaking, or spraining, my ankle in some god forsaken Southeast Asian country, where I will be spending the next couple of weeks. Medical access is not real readily available. I basically stepped in a hole in the street because I wasn't paying attention, and down I went, ripping up my ankle. It immediately swelled to about twice its size, and I had to sit it out for a few minutes before I could hobble back to the office. Office staff kindly was able to procure an ace type bandage. So, um, what do you think I should do? I'm not going to p***y out and go back to the States right now, and I'm told that the local medical facilities that exist are best avoided, for various and political reasons. Symptoms are, massive swelling on the outside of the ankle (left ankle twisted inward during a fall to the left) but I'm still able to walk. I'd ice this b***th if there was ice, but I'll probably have to settle for cool water, or perhaps the bar where I intend to get my pain medication will give me some. I say keep it elevated and cool, and keep it wrapped for a while. Okay here's my real question for you doctor types. Let's say the Tee broke his ankle, or tore something. I'm sure something is torn. If I don't deal with in within a couple weeks, am I risking some permanent damage? I mean, it's not like bones are popping out or anything, and I'm pretty sure it isn't dislocated. It's just massively swollen. "some god forsaken Southeast Asian country" doesn't help much. I got terrific, amazingly inexpensive hospital care in Manila, and great medical care in Thailand. There are many countries in SEA that offer excellent care that you may be very near to. Also, I'm with Francois. If you want doc's to answer, I'd change the title of your post. Link to comment
tallman Posted February 3, 2009 Share Posted February 3, 2009 Right. The acronym is RICE Rest Ice Compression Elevation I've also broken/sprained numerous times, actually have a broken part of my ankle that I've ignored (most of the time) for the past 22 years. It floats Ok. As David said, the huge swelling is first issue and most likely soft tissue damage. RICE to treat. If no I available, very important to follow other three, I'd look for crutches and completely avoid weight bearing. Keep it elevated all the time, that will help. You are at risk for complications if it is broken, but it would depend on specifics. I've played football and baseball/softball with broken ankle and sprained (severely) ankles. Back in the day you were a wimp to do otherwise. As a result, I have connective tissue that never returned to original shape and I have a continuous snapping when I walk. Annoying, but not life threatening. An x-ray is needed to eliminate the possible break. How about airport scanners? It would show abvious break, not so much on hairline. Good luck. Link to comment
R80RTKen Posted February 3, 2009 Share Posted February 3, 2009 Where exactly are you? I assume Laos or Cambodia or North Korea? You never know who has a friend or colleague nearby these days who could help out.. I passed a kidney stone in Czechoslovakia once... it was interesting how I came to get help.. Link to comment
AZKomet Posted February 3, 2009 Share Posted February 3, 2009 Did not say where you were. Have been to many places over there and can't imagine no medicine? Albeit somewhat questionable there is help. Do you feel any bones on the surface area or "grinding" when you walk? Do you have any NSAIDS like motrin etc.? Elevation is a good thing...and stay off of it if you can. And if there is a break....it needs to be seen ASAP. So.....I never go out of the US w/o getting insurance to include medical and repatriation to the US in the event of a catastrophe. 1 million $$$ limit for that... Try to find a DR. or health care person for an X-ray. If it is broke you don't need that headache....broken bones can lead to fat emboli or other "bad" thing if not treated. Good luck! Link to comment
Mister Tee Posted February 3, 2009 Author Share Posted February 3, 2009 Well, it's not broken by movement, certainly, I'm pretty sure of that. The swelling has gone down somewhat but it's still pretty bad. It hurts to walk, but not intolerably. I've twisted my ankle before pretty badly and managed. I did manage to get some ice at the hotel and I iced it last night, but I'm not going to be able to ice it during the day. I'll take the advice given under advisement and do the best I can. Which, at the moment, means trying to get some sleep because it's in the middle of the night here. Link to comment
GrayNFast Posted February 3, 2009 Share Posted February 3, 2009 Lots of good advice from the other responders. I always have patients do the following for sprains. Although yours may be much worse due to soft tissue damage, this will probably give some relief. 1. First three days, ice for fifteen minutes at a time, followed by one hour without ice to allow tissues to warm up. As long as you allow the hour between treatments, ice as many times daily as you can. 2. After three days Ice - fifteen minutes Damp heat - fifteen minutes (warm a damp towel in a microwave) Ice - fifteen minutes This is called a contrast tx; ice stops the inflammatory reaction, heat warms the area and increases blood flow to remove byproducts of healing; The second ice is to counteract the addition of heat which causes the inflammatory rx to start again. Another trick I use to screen for fractures involves a tuning fork. If you can find one, get it ringing pretty good and apply the stem to various prominences on the foot and ankle. The idea is the vibration gets transmitted to the bone and irritates the periosteum (covering membrane) which contains the nerves to the bone. If there is a fracture if will cause INTENSE pain. In particular, place the tuning fork on the prominences alongside the ankle. The outside screens for a fibula fx and inside for a tibia fx. Good luck, sorry to hear about your misfortune. Dean Link to comment
SageRider Posted February 3, 2009 Share Posted February 3, 2009 Another trick I use to screen for fractures involves a tuning fork. If you can find one, get it ringing pretty good and apply the stem to various prominences on the foot and ankle. The idea is the vibration gets transmitted to the bone and irritates the periosteum (covering membrane) which contains the nerves to the bone. If there is a fracture if will cause INTENSE pain. Now that is a very interesting piece of information! Thank you for sharing!!! Link to comment
AdventurePoser Posted February 3, 2009 Share Posted February 3, 2009 Tee, Signs and Symptoms and method of injury are nearly identical to an injury I suffered last year. Ice, Ice, Ice, wrap, and stay off it. My injury did not show on an x ray due to massive soft tissue swelling. It took about 4 months to heal completely. Best of luck to you, Steve Link to comment
Mister Tee Posted February 3, 2009 Author Share Posted February 3, 2009 Well, I think it's going to be okay, thanks to the BMWST medical advisory board. I've been icing, wrapping and elevating it, and I can actually walk on it comfortably as of early a.m. (right now.) The swelling is still bad but it went down significantly. I won't have ice once I leave the hotel, but on the other hand I don't have to do a whole lot of walking either. Link to comment
AZKomet Posted February 4, 2009 Share Posted February 4, 2009 Another trick I use to screen for fractures involves a tuning fork. If you can find one, get it ringing pretty good and apply the stem to various prominences on the foot and ankle. The idea is the vibration gets transmitted to the bone and irritates the periosteum (covering membrane) which contains the nerves to the bone. If there is a fracture if will cause INTENSE pain. Now that is a very interesting piece of information! Thank you for sharing!!! Hmmmmmm....tuning fork? I will need to investigate that. 1 may be in my med kit! Link to comment
rebake Posted February 4, 2009 Share Posted February 4, 2009 If you happen to be in Bangladesh,I can get you in touch with a friend who lives in Dahka.Ed Link to comment
ERdok Posted February 4, 2009 Share Posted February 4, 2009 Well, I think it's going to be okay, thanks to the BMWST medical advisory board. I've been icing, wrapping and elevating it, and I can actually walk on it comfortably as of early a.m. (right now.) The swelling is still bad but it went down significantly. I won't have ice once I leave the hotel, but on the other hand I don't have to do a whole lot of walking either. Glad to hear things are improving. Would recommend you keep it ace wrapped and/or wear good ankle supporting boots regularly the next week or two to provide needed support of the healing soft tissues. Also, when the swelling goes down and the pain is gone you need to do range of motion (ROM) exercises daily to work out stiffness and re-strengthen the tissues. (ROM exercises = Drawing imaginary circles with your big toe clockwise then counterclockwise - several repetitions of each daily). Happy healing... Link to comment
Hog_Man Posted February 4, 2009 Share Posted February 4, 2009 I would think the LEAST you need is more diagnosis, and an x-ray would be first order. Ya need to see inside to determine some sort of breakage. Go from there. Dr.s ORDERS!!!! Link to comment
Firefight911 Posted February 4, 2009 Share Posted February 4, 2009 Get it checked out and get an MRI once possible!!! AMHIK!!!!! LINKY Link to comment
ERdok Posted February 4, 2009 Share Posted February 4, 2009 Also, here is a link that shows some of the criteria we use to determine if an xray is even necessary. http://www.bcguidelines.ca/gpac/pdf/anklex.pdf Link to comment
Boone60 Posted February 4, 2009 Share Posted February 4, 2009 I would think the LEAST you need is more diagnosis, and an x-ray would be first order. Ya need to see inside to determine some sort of breakage. Go from there. Dr.s ORDERS!!!! +1 on an x-ray. Link to comment
tallman Posted February 4, 2009 Share Posted February 4, 2009 Well, I think it's going to be okay, thanks to the BMWST medical advisory board. I've been icing, wrapping and elevating it, and I can actually walk on it comfortably as of early a.m. (right now.) The swelling is still bad but it went down significantly. I won't have ice once I leave the hotel, but on the other hand I don't have to do a whole lot of walking either. Glad to hear things are improving. Would recommend you keep it ace wrapped and/or wear good ankle supporting boots regularly the next week or two to provide needed support of the healing soft tissues. Also, when the swelling goes down and the pain is gone you need to do range of motion (ROM) exercises daily to work out stiffness and re-strengthen the tissues. (ROM exercises = Drawing imaginary circles with your big toe clockwise then counterclockwise - several repetitions of each daily). Happy healing... ROM addition, writ(h)e the alphabet using your foot. Creating all the different letters puts the ankle through many different motions and is less boring than just circles. If you can find an ankle brace, 1 2 wear it to prevent re-injury. Best wishes. Link to comment
ERdok Posted February 4, 2009 Share Posted February 4, 2009 "ROM addition, writ(h)e the alphabet using your foot. Creating all the different letters puts the ankle through many different motions and is less boring than just circles." Tim, I would have recommended that also but that Asian alphabet can be a little tough. Link to comment
tallman Posted February 5, 2009 Share Posted February 5, 2009 You're right. Wax on. Wax off. Link to comment
Mister Tee Posted February 5, 2009 Author Share Posted February 5, 2009 The predominant language spoken here is Vietnamese, so I can do the suggested range of motion exercises. Except for those funny little accent characters. After relaying pictures to real doctors, it's been concluded that a) it probably ain't broke and b) doc can't do anything about it anyway, except to make the above recommendations. It looks pretty bad, and I'm told it will probably get worse before it starts to get better. That side of the ankle was weak to begin with, and it had been injured before. Just not that bad. Link to comment
velomoto Posted February 5, 2009 Share Posted February 5, 2009 Would recommend you keep it ace wrapped and/or wear good ankle supporting boots regularly the next week or two to provide needed support of the healing soft tissues. Also, when the swelling goes down and the pain is gone you need to do range of motion (ROM) exercises daily to work out stiffness and re-strengthen the tissues. (ROM exercises = Drawing imaginary circles with your big toe clockwise then counterclockwise - several repetitions of each daily). Happy healing... A couple add'l thots from a person with too much first hand experience with broken or badly sprained ankles (it's a basketball thing)... First - to get the swelling to go down one needs to increase blood flow to the ankle. This means movement (exercise). The ROM exercise described above is VERY EASY to accomplish with a bicycle or exercise bike. Just make sure the seat is at the proper height (when heel is on pedal, the leg is fully extended, now pedal with the ball of foot over the pedal axle). A natural physiological reaction of an ankle sprain is that several of your leg muscle groups will shut down. I learned this thru a good physical therapist who demonstrated this by showing how my two legs had vastly different strength to certain forces. Long story short - to accelerate full recovery find a PT who can recommend exercises to get the muscles in your injured leg to fire properly. This may not help your current situation, but should be considered for your full recovery. Good luck! Link to comment
Mister Tee Posted February 7, 2009 Author Share Posted February 7, 2009 The ankle recovery is coming along fine. But oh man, the Tee has other problems. The women are really, extremely beautiful here. Especially one. I may just not want to leave. Link to comment
BanjoBoy Posted February 7, 2009 Share Posted February 7, 2009 Uhhhhhh, why don't you just bring her home with you? You'll need a live in nurse to help you recover from the ankle thing. Link to comment
David Posted February 7, 2009 Share Posted February 7, 2009 the Tee When you get back to the US, perhaps during your recovery period, I'm going to have to insist that you watch a particular episode of Seinfeld and then adjust your terminology accordingly. Thank you for your attention to this matter. Link to comment
Mister Tee Posted February 8, 2009 Author Share Posted February 8, 2009 Uhhhhhh, why don't you just bring her home with you? You'll need a live in nurse to help you recover from the ankle thing. Ummm.... hmmmm..... 1. Wouldn't go over real well at home. I'm pretty sure my girl would have some words on that. 2. Not supposed to bug the State department about those kind of things. Actually, I'm not supposed to bug them about anything at all, if I can help it. Link to comment
Mister Tee Posted February 8, 2009 Author Share Posted February 8, 2009 the Tee When you get back to the US, perhaps during your recovery period, I'm going to have to insist that you watch a particular episode of Seinfeld and then adjust your terminology accordingly. Thank you for your attention to this matter. If I stay a few months, Seinfeld may start broadcasting as new-issue over here. Link to comment
Silver Surfer/AKAButters Posted February 8, 2009 Share Posted February 8, 2009 So, you weren't so f*****'d after all. Great! Link to comment
Mister Tee Posted March 10, 2009 Author Share Posted March 10, 2009 Tee is back home. Here is the verdict: Partial torn ligament, probably less than 30%. Doc evaluated, and decided that an x-ray wasn't warranted. Doc also said that there wasn't anything that could (or should) have been done, beyond icing and wrapping the ankle as previously suggested, and referred the Tee to physical therapy to preserve range of motion and increase strength. No surgery or anything like that will be needed. Other than some localized swelling and hardness on the outside of the ankle, there is no pain and I can run, walk, bike, etc... with no problem. Link to comment
Tank Posted March 10, 2009 Share Posted March 10, 2009 good news and thanks for the update Link to comment
DaveTheAffable Posted March 11, 2009 Share Posted March 11, 2009 What about the girl?? +1 Link to comment
Ken H. Posted March 11, 2009 Share Posted March 11, 2009 Uhhhhhh, why don't you just bring her home with you? You'll need a live in nurse to help you recover from the ankle thing. Ummm.... hmmmm..... 1. Wouldn't go over real well at home. I'm pretty sure my girl would have some words on that. Yes, and putting this on a public forum on the Internet seems like a particularly good idea. Link to comment
StuGotz Posted March 11, 2009 Share Posted March 11, 2009 What about the girl?? +1 Never happened without any pic's.... MB> Link to comment
Mister Tee Posted March 11, 2009 Author Share Posted March 11, 2009 Uhhhhhh, why don't you just bring her home with you? You'll need a live in nurse to help you recover from the ankle thing. Ummm.... hmmmm..... 1. Wouldn't go over real well at home. I'm pretty sure my girl would have some words on that. Yes, and putting this on a public forum on the Internet seems like a particularly good idea. Precisely why I'm the Tee., and why you won't see any pictures of the adventure. We talk. Link to comment
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