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    Old 03-20-2008, 01:02 PM   #1
    drumsandkeys
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    Wait and see attitude for "possible" spleen injury

    Hello,



    I was hoping I could get some feedback before making a decision on what to do. Me - a fairly healthy 53 year old male, don't smoke, drink very infrequently.



    Its embarassing to bring out the background of my problem, but it might help. I live in a mobile home park. I have a neighbor that is a hard core alcoholic - he's been in and out of rehab and can't stay off the binging for too long. When he is binging, he plays his music too loud at any hour. To make a long story short here, I've gone over to his place a number of times to ask him to turn it down. The last time he was particularly drunk and it got physical between us. He outweighs me by about 80 lbs. I was on top of him in the beginning and could have hurt him if I wanted, but chose just to defend myself. ( I know - shouldn't have gotten into this situation in the first place) He went into a blind rage and while he was on top of me, got under my arm and kept pushing it out until it dislocated my shoulder. He was also strangling and biting me, and I was lucky to get out of his trailer alive. Can't bring charges since I pushed him in the beginning, which put him into the rage.



    I went to ER that night, and they put my shoulder back in place under IV and anesthesia. I was in excruciating pain. This was 9 days ago, and I know its going to take a while to regain my shoulder and arm strength. Can't do anything with it now.



    On to the subject - a few days after the incident, I noticed intense rib pain at night while trying to sleep, maybe possible bruised or cracked ribs. Since its been nine days, I thought maybe the pain would ease up some, but its bad at night, really only if I make any contact with the ribs. I'm learning to sleep on my back.



    I lost a lot of sleep last night over the uncomfortableness and pain, and went back to the doctor today. The rib pain is on my left side to the left of my diaphram and around to the back a bit. Since I was tender to the touch in this area and its near the spleen, my doctor suggested that it may have been injured and I should get a CT scan or at least an ultrasound done. I am very poor, and my insurance is lousy. I was hoping I could adopt a wait and see attitude day by day.



    I've looked at the symptoms and side effects of an injured spleen, such as increased heart rate and respiration, possible pain in the left shoulder, nausea, paleness of the skin, vomiting, etc. I have none of this. The only thing that is making me weak, it seems to me, is the lack of sleep from not being able to sleep on either side. Other than the pain, which I hope will diminish if I give myself the proper rest, there is nothing else. My doctor also told me to look for blood in the urine, which I have not seen at all.



    As you can see here, I am trying to convince myself to get through this without the tests I can't afford, and since I don't have the aforementioned symptoms, I'm hoping I can take that wait and see approach. The only thing that is bothersome is that the pain in my shoulder and ribs returns with about the same intensity every night, and there doesn't seem to be a diminishment (is that a word?) yet.



    Sorry to be so long winded and hope to hear your opinions, maybe you have had a similar situation. I'm a kayaker and a fisherman, so hope to be able to get back to that, but will take all the time needed.



    Thank you,



    Drumsandkeys

     
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    Old 03-20-2008, 01:21 PM   #2
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    Re: Wait and see attitude for "possible" spleen injury

    If you were bleeding internally 9 days ago, I think you'd be dead by now.

     
    Old 03-20-2008, 05:17 PM   #3
    drumsandkeys
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    Re: Wait and see attitude for "possible" spleen injury

    Yes, that makes sense. I guess what your saying is that a wait and see attitude may not hurt as long as nothing major develops and I continue to heal?

     
    Old 03-20-2008, 06:02 PM   #4
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    Re: Wait and see attitude for "possible" spleen injury

    Yeah. If anything scary, like a large increase in pain, or vomiting or urinating blood, or feeling sick happens, go to ER. If you don't seem to be recovering, go get the tests done.

     
    Old 03-21-2008, 07:01 AM   #5
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    Re: Wait and see attitude for "possible" spleen injury

    in your particular situation,i would really just wait and see how things with the ribs go. the chances of you actually having a major spleen injury are of course there but pretty minimal considering how well protected it is(in adults). i am thinking it just could be the rib and of course having a dislocated shoulder would most definitely play a big part in any pain you are feeling too. thats a painful type injury in and of itself that still will emit pain even after the it has been put back into place. this is becasue of the trauma to the surrounding soft tissue.its kind of like a sprain where the bone gets knocked out of place,stretches out all the tendons,ligaments and the muscle,then is placed back into posistion,you know what i mean?thats alot of trauma to that area alone. this can cause alot of pain along with a certain level of swelling too.

    if nothing else,going with a simple ultrasound would be the cheapest way to go and it would give you info on how the spleen and the other abdominal organs are doing in there as well. if you notice any under the skin bleeding(this is usually reddish brown in color)or a bruise of any kind or you just feel 'sick' not just weak,but plain 'sick" i would defintiely go back to see your doc. this should be followed up on anyway just to see how well things are healing. if you don't follow up on this out of financial concern,it "could' turn into something much more spendy down the road if something could have been caught earlier on and just cared for and done with. you just really need to know that everything has healed properly before just forgetting about it,you know what i mean?

    unfortunetly you did suffer trauma to a couple of areas that will cause some levels of pain for awhile. did the hospital give you anything for the pain? ice would possibly help when it gets too out of hand,but at this stage you could also do the alternating cold/heat thing? this would be to the actual shoulder blade area or top of shoulder and the ribs or just wherever they hurt the most.

    sorry you had to go thru this,but if something still doesn't 'feel right' to you in the next few days or just never really "feels' better,please at least get that US done,along with some very simple bloodwork.it will give you alot of info on the spleen and well as other possible organs that,considering the mechanism of injury,just 'could' possibly have been injured too.

    hope you feel better soon. next time please just give the police a call and let them handle him. if he is too drunk,they will take him to detox. if he decides to fight with a police officer,well you wont have to deal with him at least for awhile anyways. just 'baby' yourself for the rest of the week and very slowly try and get back to things. when in doubt,just seek out your primary doc and get that referral for the US. take care and please keep us posted on how you are doing. **
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    Old 03-21-2008, 04:34 PM   #6
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    Re: Wait and see attitude for "possible" spleen injury

    Great advice, thanks for the response. Still lots of pain at night, not too bad during the day - the shoulder felt a little bit more stable today, a little stronger. My main concern of course is beneath the ribs, but I will take an easy weekend and if the rib pain doesn't lessen in the next few days, I will take your advice in getting the ultrasound done. That is exactly what my physician recommended that would be cheaper than the CT scan.

    Believe me, its not worth getting into a confrontation with somebody that is in an animal rage and is trying to kill you. One more mistep on his part in violating the rules, and this guy is gone. Next time, the police can deal with him, as you recommended. Thanks again.

     
    Old 03-22-2008, 08:01 AM   #7
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    Re: Wait and see attitude for "possible" spleen injury

    no problem. just keep us posted on how you are doing,K? take care, **

     
    Old 04-03-2008, 06:26 AM   #8
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    Re: Wait and see attitude for "possible" spleen injury

    Just a followup. Its been just over 3 weeks since this happened. I had an ultrasound done which showed no internal organ damage fortunately. I am still having a lot of pain in the shoulder at times, stability is a little better but have to watch range of motion or there can be extreme pain. I'm trying to do some exercises each day (again range of motion) to get the shoulder used to a little more movement and strengthen it. Part of my right hand (same side as shoulder) is always asleep which is a little disconcerting. At night the ribs are very uncomfortable and feel out of place to a degree, and the shoulder pain is worse. Averaging about 3 hours of sleep a night even with painkillers, so I'm frustrated even realizing its going to take time. The rib pain at night does not seem to be getting any better which has me concerned since I thought it would get a little better each day, but it may just be a matter of months not weeks to heal. I guess I just need some reassurance that time will take care of all this. I'm doing everything I'm supposed to, but its painfully slow in the healing process.

     
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