Tuesday, February 12, 2013

Healing Bone Fractures, Part 1

Things have really slowed down in my life and I haven't been able to post anything for a few weeks. That's because on January 30th I badly broke my lower right leg! Even though I'm an outdoorsy kind of person, I figured if I made it this far in my life without breaking any bones, maybe I never will. Well, it turns out I was wrong!

The Niagara Escarpment along the east side of the Saugeen (Bruce) Peninsula not far from where we were hiking.

We were hiking along a trail near the Niagara Escarpment on the Saugeen (Bruce) Peninsula. This area is characterized by lots of dolomite rock outcroppings. Normally we would have been snowshoeing, but we got a couple of days of unseasonably warm weather and it rained a lot. The amount of snow went from 45 cm (1.5 feet) down to about 5 cm (2 inches), making it much more easy to walk in boots. While we were hiking, I stepped with my left foot into a crevice in the rock that I couldn't see because it was covered in snow. It was quite deep. I never hit bottom and all of my weight came down on my right shin on the rock. I have a clean break in my fibula just below my knee, but my tibia was shattered just above my ankle. I'll spare you the details of how we got out of there, but it was quite a trip! Had there still been enough snow to snowshoe, my foot wouldn't have fit into that crevice.

This is more like the terrain where we were hiking (and the right season!).

Because of the severity of the fracture, I needed surgery. They weren't able to get me into surgery until the following day. The injury occurred around noon on the 30th and I didn't get into surgery until around 4:30 pm on the 31st. I had to have a 25 cm (10 inch) plate screwed into my tibia to hold the pieces together. I have no cast because I need to be able to move and stretch the tendons and ligaments in my ankle and knee so they don't tighten up too much while I'm off my leg.


Here are a couple of x-ray views of my leg with the plate taken the morning after my surgery.
It's a pretty messy affair and I suspect that I will need to have surgery again at some point to remove it.

According to the surgeon, this kind of fracture takes about four months to heal. If I'm lucky, three months at the absolute minimum. During this time my leg can't bear any weight. Once it is strong enough to bear weight, I will require a month or two of physiotherapy to get the strength back in my leg. So, he's predicting that this process is going to take 4-6 months.

What the surgeon doesn't know, because it's outside his paradigm, is that I have tools available to me to accelerate the healing of my leg. I have a basic protocol for treating bone fractures that I have used to help heal other people. This is the first time I'm going to be using it on myself!

I am going to use this as an opportunity to provide an example of how to heal a bone fracture. I will provide details of exactly how I am treating this on an ongoing basis, and updates as to how my healing is progressing. The important thing to keep in mind is, although I am following a basic protocol, it needs to be fine-tuned for each specific situation. If four different people came to me with similar fractures, I would treat each person slightly different depending on their specific needs, constitution, history, etc. What I am describing is how I have adapted this protocol to my own specific needs. Nevertheless, it will provide a good example of how I treat this kind of injury.

The protocol that I use is very complex. It requires five different components all of which are important: herbal treatment, both systemic and local; homeopathic treatment; supplements that help our body heal tissue damage and rebuild bone tissue; physical therapy; and dietary adjustments to support the healing of this type of injury.

I am going to begin by providing details of what I used in the interim when I didn't have everything available to me to complete the protocol. Then I will document what I am using and my progress in a continuing series of posts.

In the early evening on the day of the fracture, when it became apparent that the surgery wasn't going to happen that day, I had myself checked out and we went back to the cottage we were renting where I knew I would be more comfortable and be able to eat some good food and make use of whatever herbs and supplements I had on hand. My partner, Monika, tried to find some of the additional remedies I needed but was only able to obtain homeopathic Arnica in a 30C potency. Homeopathic Arnica is an essential remedy for any kind of sudden traumatic injury. It reduces swelling, bruising and pain, and supports the healing process. While we were still there and through the evening I took it every hour. I didn't sleep very well and took it every couple of hours through the night as well, and continued taking it every hour the next day up until my surgery. I resumed it when I awoke on Friday.

Mountain arnica (Arnica montana) is mostly used topically by herbalists because it is very irritating and mildly toxic when taken systemically.
It should only be used systemically by experienced herbalists. In homeopathic potencies this is not an issue.

Homeopaths rarely use homeopathic remedies in combination with other modalities. Although I am not a homeopath, I have a good understanding of the system and sometimes use homeopathic remedies in combination with herbs, especially for the treatment of acute conditions. In order to treat a situation holistically, I have found that it is best if we address it on as many different levels and in as many different ways as possible. The more severe the injury or illness, the more important it is to do this.

At the cottage I also had available to me a general herbal tonic formulation containing 1:5 fresh herb tinctures that provided some benefit in terms of reducing inflammation and pain, increasing circulation and supporting the healing process. It also contained some liver herbs that would help protect me from the side-effects of all the medications I was going to have to take before and after the surgery. I upped the dose from 3 ml into the acute dosage range at 6 ml. Because I was going to have to fast the following day before my surgery, I only had one dose before my dinner, but I resumed it as soon as I returned from the hospital after my surgery. I also had some supplements including vitamins C (calcium ascorbate), D and E, zinc, polyphenols, and a good quality low potency multivitamin with a very good trace mineral complex. I took one of everything and two vitamin C with my dinner, and resumed these when I returned after my surgery as well. The last thing I had is a herbal sedative which I travel with because sometimes I have difficulty sleeping when I'm in an unfamiliar environment. I took this before bed and a couple more doses through the night. I didn't sleep very well that night, mostly because I had to sleep on my back which I never do, but it did help me sleep a bit and reduce the pain and inflammation.

Up to this point, except for the insane pain when I actually broke my leg, as long as my leg didn't get banged or twisted the pain wasn't that bad. The Arnica was definitely a factor in this.

After the surgery, the doctor wanted me to stay another night to make sure I didn't end up with a kind of serious swelling that can occur with this kind of injury, or an infection, and that my pain was under control. However, I was determined to get out of there as quickly as possible so that I could get onto the remedies that I needed. I stopped dosing myself with the intravenous hydromorphone (a semi-synthetic derivative of morphine) as soon as I woke up so that they would see that I was managing the pain and asked to be disconnected from everything. The surgeon saw I was doing OK and I managed to get out by 1 pm. He gave me a prescription for a drug containing 300 mg of acetaminophen and 30 mg of codeine phosphate. I didn't fill the prescription. We did pick up a product containing 500 mg of acetaminophen without the codeine. I took one tablet on Friday evening shortly before bed when the pain in my leg got pretty intense for a few hours. That was all I used.

It is important to note that we should not use non-steroidal anti-inflammatory drugs (NSAIDs), such as acetylsalicylic acid, ibuprofen and naproxen, to treat the pain and inflammation associated with bone fractures as these drugs interfere with bone formation. Drinking alcohol also interferes somewhat with bone formation. This is mainly a concern for moderate to heavy drinkers, nevertheless, it is best drink very little or not at all. Smoking has a more pronounced negative impact on bone formation than alcohol.

We went back to the cottage and stayed for the next three days. Some friends were coming up for the weekend and we asked them to bring me some additional homeopathic remedies. At this point my interim protocol was as follows:

Homeopathics: Arnica 200C, Hypericum 200C and Symphytum 200C taken individually, four pellets per dose alternated throughout the day every 1-2 hours so that I was taking each remedy 4 times per day. Hypericum is a specific for nerve damage and nerve pain. Although I did not have any numbness or tingling, indicating that there probably wasn't any nerve damage from the original injury, there was a risk of nerve damage resulting from the surgery. Symphytum is a specific for healing bones. I tend to use Hypericum and Symphytum both in homeopathic form and in crude tincture form as you will see later. The two forms taken together are very synergistic, working much better than either the tincture or homeopathic individually.

Common comfrey (Symphytum officinale) is a specific for bone fractures, both in herbal and homeopathic forms.
Crude herb preparations must be used carefully as it contains pyrrolizidine alkaloids, which are liver toxins.
This is not an issue when taken in homeopathic potencies.

Herbs: I continued taking the tincture formulation I had with me at a higher dose until I was able to get home and formulate something specific for my injury. I took 6 ml in a bit of water on an empty stomach 10-15 minutes before each meal. I also continued to take the sedative formulation, 6 ml before bed and additional 3 ml doses through the night, if necessary.

Supplements: Making the best use of the supplements that I had available, I took the following (these are the doses of the nutrients that are particularly important for bone repair as provided by the individual products I had available to me):
  • With breakfast: Vitamin A 3,500 IU, beta-carotene 7,500 mg, vitamin C 1,325 mg (from calcium ascorbate), vitamin D2 200 IU, vitamin D3 1,000 IU, vitamin K1 50 mcg, vitamin K2 10 mcg, calcium 152 mg (ascorbate), copper 0.5 mg (citrate), manganese 0.5 mg (citrate), zinc 5 mg (citrate), selenium 50 mcg (chelate), boron 0.35 mg (chelate), lutein 0.5 mg, bioflavonoids 100 mg (citrus extract), quercetin 100 mg, anthocyanidin 100 mg (mixed berry extract).
  • With lunch: Vitamin C 1,200 mg (from calcium ascorbate), vitamin D3 1,000 IU, calcium 137 mg (ascorbate), quercetin 100 mg, anthocyanidin 100 mg (mixed berry extract).
  • With dinner: Vitamin A 3,500 IU, beta-carotene 7,500 mg, vitamin C 1,325 mg (from calcium ascorbate), vitamin D2 200 IU, vitamin D3 1,000 IU, vitamin E 200 IU (mixed tocopherols), vitamin K1 50 mcg, vitamin K2 10 mcg, calcium 152 mg (ascorbate), copper 0.5 mg (citrate), manganese 0.5 mg (citrate), zinc 20 mg (citrate), selenium 50 mcg (chelate), boron 0.35 mg (chelate), lutein 0.5 mg, bioflavonoids 100 mg (citrus extract), quercetin 100 mg, anthocyanidin 100 mg (mixed berry extract).
Some of these are ingredients from a multivitamin that I took with breakfast and dinner. It is a good quality low potency multi with an excellent trace mineral content. It does not contain iron, calcium or magnesium because iron should only be taken when absolutely necessary and the amount of calcium and magnesium that can be included in a multivitamin is too low to be relevant. I did not list all of the ingredients of the multivitamin, only those that are important for bone repair. However, the full range of nutrients in the multi are important to support healing in general. In addition, I was also taking omega-3 fatty acids in the form of organic flax seed oil, 2-3 teaspoons taken throughout the day mixed in food (but not heated).

Other: From the moment I was able to stand after my injury I spent a lot of time wiggling my toes to help with circulation and to keep my feet as flexible as possible. Most other forms of movement were not possible until a few days after my surgery due to the severe swelling of my leg. Whenever I was sitting (always with my leg up to reduce swelling), a periodically massaged my knee and lower thigh to help prevent them from tightening up as much as possible. I was also doing deep breathing exercises in which I focused on "feeling" the life force energy or qi circulating through my body, particularly in my leg.

This is the end of my first post on the ongoing saga of my leg. In Part 2 I will provide the details of the complete protocol that I put myself on once I returned home.



5 comments:

  1. A really very good blog..I have been looking for post like this for a research project I am working. BONE HEALING

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  2. Very nice blog.I have also experienced the similar pain like u Michel. My left ankle was broken on 30th January 2015.I had to undergo ORIF surgery.I have also a written a blog about my safe, speedy and comfortable recovery.
    dimple45.blogspot.com.I will be more happy if some of the things I have shared in my blog helps anyone for their broken ankle recovery.

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  3. Thanks this has helped me alot. I had ORIF on right humerus and have used a number of your methods. I found this a few weeks after my break but am eager to help others with the info as well.

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  4. Did you ever have the hardware removed? I am about to have mine removed and looking for some guidance. Mine is humerus ORIF but I found your blog useful when I had the original surgery.

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