Broken Or Cracked Ribs.

[Scully]

I fell over after having a shower and having not dried my feet thouroughly I landed on the back of a solid wooden chair full force. First day painful but bearable, second day extreme pain when coughing,moving,breathing and no sleep for two nights hence a 5am post.

Went to the doctors yesterday and the same old Thai doctor syndrome, using his stethoscope he says it sounds like a fracture when I move but he can't even prescribe me codeine 15mg with paracetamol, but doesn't mind giving me a bag full of diazepam for my sleep.

My question is would it be worth a trip to the hospital for a little more pain relief ie codiene, they have given it to a relative before or am I waisting my time, there is also a government drop in centre that have doctor's that prescribes medicines.

I live up north in Thailand and fly international from BKK in 10 days and lugging about baggage with all this pain and no sleep is begining to worry me, as I am solo traveller and have tried tramadol,paracetamol,and ibuprofen all with little effect.

Thanks in advanve.

[dogpoo]

I fell over after having a shower and having not dried my feet thouroughly I landed on the back of a solid wooden chair full force. First day painful but bearable, second day extreme pain when coughing,moving,breathing and no sleep for two nights hence a 5am post.

Went to the doctors yesterday and the same old Thai doctor syndrome, using his stethoscope he says it sounds like a fracture when I move but he can't even prescribe me codeine 15mg with paracetamol, but doesn't mind giving me a bag full of diazepam for my sleep.

My question is would it be worth a trip to the hospital for a little more pain relief ie codiene, they have given it to a relative before or am I waisting my time, there is also a government drop in centre that have doctor's that prescribes medicines.

I live up north in Thailand and fly international from BKK in 10 days and lugging about baggage with all this pain and no sleep is begining to worry me, as I am solo traveller and have tried tramadol,paracetamol,and ibuprofen all with little effect.

Thanks in advanve.

When I broke 4 ribs the hospital gave me an X-ray to confirm what the problem was, there is nothing to be done about this other than take pain relief, it took months for my ribs to heal and I have to say its the worst thing I have ever had!!

[Scully]

I fell over after having a shower and having not dried my feet thouroughly I landed on the back of a solid wooden chair full force. First day painful but bearable, second day extreme pain when coughing,moving,breathing and no sleep for two nights hence a 5am post.

Went to the doctors yesterday and the same old Thai doctor syndrome, using his stethoscope he says it sounds like a fracture when I move but he can't even prescribe me codeine 15mg with paracetamol, but doesn't mind giving me a bag full of diazepam for my sleep.

My question is would it be worth a trip to the hospital for a little more pain relief ie codiene, they have given it to a relative before or am I waisting my time, there is also a government drop in centre that have doctor's that prescribes medicines.

I live up north in Thailand and fly international from BKK in 10 days and lugging about baggage with all this pain and no sleep is begining to worry me, as I am solo traveller and have tried tramadol,paracetamol,and ibuprofen all with little effect.

Thanks in advanve.

When I broke 4 ribs the hospital gave me an X-ray to confirm what the problem was, there is nothing to be done about this other than take pain relief, it took months for my ribs to heal and I have to say its the worst thing I have ever had!!

I know how you feel, but in my country they would give me opiote pain relief, apparently Thai people are very sensitive to opiotes and theres also the addiction side so Thai doctors are reluctant to give them out.

I am sure I woke the neighbours up at 3am getting out of bed, screaming like a baby

[jrtmedic]

Scully

Sorry to learn of your mishap.

Chest wall injuries can indeed be very painful and often (sorry to say this) get worse before improving. If you have fractured(broken) a rib it will take up to six weeks to heal.

Achieving pain relief is a challenge because it is not possible to "rest" a rib in the same manner as one would "rest" an injured arm/leg.

Icing can prove to be very beneficial. Apply a bag of frozen peas or crushed ice to the painful area of your chest. Do not allow the ice bag to make direct contact with your skin but apply the ice bag to your chest using a towel to protect your skin. You should do this 3-4 times a day for about 20 minutes at a time.

The analgesics you mention should help in lessening the pain.

You may care to try Tramadol (400mgm/day MAX) COMBINED with Ibuprofen ( 1,600mgm/day MAX) taken in divided doses on a regular basis

Make sure you are aware of any contraindications to these medication(s) and don't take the ibuprofen on an empty stomach.

I am very unsure about the wisdom of taking diazepam but do understand your point about sleeping. May I suggest you try making yourself comfortable in an armchair and sleeping upright. In this way you will avoid aggravating your injury by laying down.

It is important to at least try to take a few slow, deep breaths every hour or so -----best done immediately after or during your "icing" sessions. This will assist in lessening the risk of developing a chest infection.

It is possible to infiltrate the painful area of your chest with a long acting local anaesthetic. This cannot be undertaken outside hospital and does carry the risk of causing a pneumothorax (collapsed lung) and for this reason you may have difficulty in finding a doctor willing to undertake the procedure. If you do find someone to undertake the procedure make sure you understand the potential risk and be prepared to spend a night in hospital.

Finally if the pain suddenly becomes much worse, you develop a fever or become breathless seek further urgent medical help.

Best wishes

Edited June 9, 2013 by jrtmedic

[devolad]

To the OP: I feel your pain - literally.

Broke ribs two months ago (for the third time). In my experience there is little to be gained by going to a hospital - unless, like other posters have indicated, complications arise.

Recovery is an exercise in patience - is unfortunately just a function of time.

As far as pain relief goes, after trying most things, I ended up using a nurofen gel - may have been all in my head, but seemed to help.

For your enjoyment:

1st time - "mates" ran over me with a golf cart. Was part of a stag do - didn't feel much until the next day.

2nd time - a romantic night at a hotel (that I couldn't really afford) trying to impress a lass. A few drinks had been consumed. We were both sans clothing. The lady in question took a call from a friend. The call went on for a while. I thought it would be a great idea to stand on a chair and launch myself onto the bed wwf styles to remind the lovely lady of my presence. Chair pivoted as I launched, hit the side of the bed, game over. romance not forth coming as I lay naked on the hotel room floor.

3rd time - had just arrived at my local to meet friends for weekly debrief. I grabbed a drink and walked outside and straight into the midst of WWIII - a table was thrown by one navy lad at another - I managed to get collected.

With your injury being the result of a slip in the shower, take heart, you still have your dignity - mine has taken a bashing along with ribs.

Hope you get well soon.

[Scully]

To the OP: I feel your pain - literally.

Broke ribs two months ago (for the third time). In my experience there is little to be gained by going to a hospital - unless, like other posters have indicated, complications arise.

Recovery is an exercise in patience - is unfortunately just a function of time.

As far as pain relief goes, after trying most things, I ended up using a nurofen gel - may have been all in my head, but seemed to help.

For your enjoyment:

1st time - "mates" ran over me with a golf cart. Was part of a stag do - didn't feel much until the next day.

2nd time - a romantic night at a hotel (that I couldn't really afford) trying to impress a lass. A few drinks had been consumed. We were both sans clothing. The lady in question took a call from a friend. The call went on for a while. I thought it would be a great idea to stand on a chair and launch myself onto the bed wwf styles to remind the lovely lady of my presence. Chair pivoted as I launched, hit the side of the bed, game over. romance not forth coming as I lay naked on the hotel room floor.

3rd time - had just arrived at my local to meet friends for weekly debrief. I grabbed a drink and walked outside and straight into the midst of WWIII - a table was thrown by one navy lad at another - I managed to get collected.

With your injury being the result of a slip in the shower, take heart, you still have your dignity - mine has taken a bashing along with ribs.

Hope you get well soon.

Thanks for your post but please remember it hurts when I laugh

[grumpyoldman]

Broke ribs in my back as a youth playing American football.

"Play on young lad" was the mindset then, I was wrapped fairly tightly with an Ace bandage, seemed to help a lot actually. I used to wear the thing even when I wasn't playing. Yes, took a couple months before all was back to normal.

[jrtmedic]

grumpyoldman

What you say about the "old days" is true !

But for many years now bandaging/strapping an injured chest has been actively discouraged as the practise does lead to unnecessary complications.

[robblok]

@jrtmedic,

Most people I know sleep real well on diazapam and its great if you need to sleep. I don't understand how someone with your experience would not know about it. The only reason I almost never use it is because I need a clear sharp mind and when I take it the first few hours of the next day are certainly not that. But I am sure a night without sleep would be worse.

Some people might get addicted to the stuff but there is a large portion of people who are not addiction sensitive and they seem to always loose out because a other group is addiction sensitive.

[jrtmedic]

Robblock

I am sure you are correct ! and I am fully aware of the risk/benefit ratio in relation to the use of diazipam and other "benzos"

However many heath care practitioners would regard such use of diazipam as an abuse and many would refuse to prescribe in the circumstances you describe.

In addition many would regard the use of any "sedative" in relation to a chest injury to be most definitely contra indicated.

There are always risk/benefit associated with any medication.

Doctors usually help their patients to gain maximum benefit whilst minimising risk.

[grumpyoldman]

grumpyoldman

What you say about the "old days" is true !

But for many years now bandaging/strapping an injured chest has been actively discouraged as the practise does lead to unnecessary complications.

I for sure am not a doctor, and as it's very frustrating for me to have my "internet doctor" friends giving me medical advice, I surely did not intend that.

Also, I wouldn't pop-off advising people to take drugs without discussion with a real health professional.

That was purely my experience and from the experience I remember the support of the wrap seemed to minimize the pain when (God forbid) I had to sneeze or cough.

Also, maybe even as bad or worse is when you damage the cartilage between your ribs. Had that happen with a surfing accident.

jrtmedic, if you are indeed a health professional, when trying to get that cartilage material to heal, due to lack of blood flow there, what does one do? I'm wondering if the OP might have this problem. Acupuncture?

[jrtmedic]

Costochondral Chest Pain (chest wall pain) is associated with the "cartilage" in the rib cage. Treatment is exactly the same as for a suspected broken rib ---

I am not a particular fan of "alternative therapies " but some find acupuncture helpful for a whole range of conditions.

[Scully]

@jrtmedic,

Most people I know sleep real well on diazapam and its great if you need to sleep. I don't understand how someone with your experience would not know about it. The only reason I almost never use it is because I need a clear sharp mind and when I take it the first few hours of the next day are certainly not that. But I am sure a night without sleep would be worse.

Some people might get addicted to the stuff but there is a large portion of people who are not addiction sensitive and they seem to always loose out because a other group is addiction sensitive.

You are right, I do know the benefits of diazepam but I also know the benefits of opiotes and paracetamol combined. My point was they are prepaired to prescibe large amounts of benzo's and not even 15mg codeine with 500mg paracetamol when you can purchase 18mg of codeine and 500gm paracetamol over the counter in the uk (solpediene max).

Anyway I went to a private hospital yesterday had an ex-ray and as expected a broken rib so he prescribed mydocalm which I agree with but no pain killers.

Problem solved anyway as Dr google and mims have helped with my problem, you can buy codeine 10mg tablets with an expectorant for persistant coughs which will clear my chest too, two codiene and two paracetamol every four hours and I can function.

Oh and they did strap ribs back in the day but it causes shallow breathing which can cause the ribs to heal at shallow breathing point and you should take regular deep breaths.

Thanks everyone, I slept till 4.30 am, 5 1/2 hours best yet and a lot to do today.

Off to the broken collar bone thread now as I broke that years back, now that's pain

[Sheryl]

There are a number of codeine + exectortant products in Thailand but AFAIK they are all controlled drugs, class N3-

"Sale restricted to Narcotic Drug Schedule 3 licence holder. A first grade pharmacist should be on duty. Monthly and yearly purchase and sale report should be submitted to FDA - Ministry of Public Health"

Not requiring a script but in practice few pharmacies hold the necessary license and even fewer want to deal with the reporting requirements. In fact I haven't ever found one (which is not to say there are none, just haven't found them or previously heard if them).

Actually Tylenol/para with codeine is the same class. So if you found a pharmacy which holds an N3 license and doesn't mind making the required FDA reports, it should just as easily be selling tylenol + coceine/para with codeine

[thaipod]

Buy a thoracic brace from a drug store I found that it helped a lot especially when sleeping . My first experience was a couple of years ago after falling and went to BNH and asked the doctor for an xray as I suspected broken ribs and she insisted I didn't and gave me antibiotics and panadol . Next day my wife took me to another hospital and the doctor checked me over and ordered a xray and found 2 broken ribs.

BNH never again..