Undiagnosed 29.05.16

It took almost 3 months to get a diagnosis – of what turned out to be a disease – even though my family physician, my physiotherapy team, and I had all known that something was seriously wrong.

I’d broken my right arm (fractured my radius; a Colles’ fracture) in early March 2016, and within a few weeks it was fairly obvious that my arm and hand were getting worse rather than better.

a woman's broken arm, with a bone sticking out near the wrist
©Sandra Woods

About 2 weeks after the fracture, new symptoms started in the fingertips of my injured arm. First off, my fingers were far more swollen than they should have been. Next was a terrible burning sensation – that would come and go – as though the tips of my fingers were being blowtorched.

When this happened at night, I’d get up and turn on the bathroom light to see whether blisters were forming; it really was that bad. Third, I’d occasionally have a different type of pain; as though an electrical current was running from almost my shoulder all the way down my arm. Fourth was a horrid constant pain, in my finger joints.

I kept telling myself that the pain would go away as the fracture healed, but one weekend I woke up with all of those different types of pain at the same time. It was excruciating pain. I called our provincial (Québec) telehealth phone line. “Info-Santé” (I suppose that would translate to Info-Health) connects patients directly with nurses.

The nurse went through her scripted questions with me, no doubt linked to some kind of standard algorithm, over the phone. After a few minutes, she suggested that I go back to the hospital emergency department because the cast might have become too tight due to swelling.

I’d hoped to see the same emergency physician who had set my fracture, but she wasn’t on duty that night. The physician there noted my symptoms and confirmed that my fingers were much more swollen than they should have been – more than 10 days post-fracture. She sent me off to radiology for yet another X-ray, and then had a nurse remove my cast and replace it with a slightly looser one.

The emergency physician had given me the option of cutting the cast open along its length, and then taping it loosely back together until I could return to the orthopaedic department. But I wasn’t sure how long it would take to get another follow-up appointment there, so I opted for a new cast.

Before I left, the emergency physician asked me to call the orthopaedic department the next day, to schedule another appointment. She told me to be sure to tell them that I’d required emergency treatment. The next available appointment at the outpatient orthopaedic clinic wasn’t until the following week, so I thought I’d made the best choice in having a new cast put on!

Although the new cast hadn’t done anything to alleviate the pain, I decided to wait for that appointment in the orthopaedics department. I don’t like to waste either healthcare resources, or the time of healthcare professionals, in our taxpayer-funded health system – and the emergency physician hadn’t found anything wrong.

To say that I was disappointed by the orthopaedic surgeon’s re-evaluation and reaction the following week would be an understatement. He dismissed all of my symptoms, and told me simply that some patients experience more swelling than others.

a woman's broken arm, with a bone sticking out near the wrist
©Sandra Woods

In his opinion, all the various types of pain I’d described could be attributed to the swelling. He told me to try to put my fingers in ice up to the cast, and to take NSAIDs (e.g. Tylenol) to help reduce the swelling.

I’d been using a stationary exercise bike at my gym – my way of dealing with pain and stress is to exercise – so I asked him if I should stop doing that. He said the exercise was a good idea, as long as I kept the casted arm elevated on the exercise bike. I’d already been doing that, because it was just too painful not to!

It was my physiotherapist who told me not to sweat ‘too much’ while exercising, because if the inside of the cast got damp it could start to crumble from the inside out. And it might start to smell. I have to admit, it was the latter that I was more concerned about at that point ‘-)

Once again I left the hospital with no answers, no explanation for why my fingers were so swollen and why my hand and arm were so painful. It turned out that I wasn’t going to get a diagnosis that day, either…

I didn’t get a diagnosis until two days ago, and it wasn’t good news. I’ll write about the rest of this story in my next post!