In case of injury...act fast, before it really hurts!

Misanthropist, I think you did a damn fine job of clearly analyzing your situation and doing the most important things that needed doing quickly and effectively. When you feel a little better you can reach around and pat yourself on the back for handling it that well. Hey, guess what... Now you will have a "weather ankle" to let you know when the fronts are moving in. :D

But the rest of the story is that you may very well be in and out of the hospital for awhile yet. Your next hurdle is to avoid becoming depressed because your ankle is FUBAR. You will most certainly have to be involved with Workers Comp now, but insist on choosing your doctors carefully and don't just rely on some "doc in a box" walk-in clinic the Workers Comp people may try to send you to. They seem to try to have injured workers patched up by the lowest bidder if they can get away with it.

Be very, very careful about signing any papers related to your injury! This is extremely important! You will want to be sure you don't sign any sort of release before you know the long term ramifications of your injury. At some point in the near future I recommend that you see a good lawyer (yeah, I know, but sometimes you have to have one) who specializes in Workers Comp cases. If and when you decide to accept a lump sum settlement for your injury -- and only do this after the doctors and physical therapists have done all they possibly can for you -- the lawyer will get a percentage (maybe one-third), but what you will receive with the lawyer's help will probably be way more than anything you would have gotten without legal counsel.

Eventually, way down the line, you may have to participate in a hearing before what is called (in my area) an administrative law judge. It is just a sit-down meeting in an office between you, your lawyer, the Worker's Comp people, and a judge to referee and help decide how much your injury is worth. Be very wary of Workers Comp people because they will shaft you in a heartbeat!

Depending upon the extent of your injury and the resulting disability you might encounter, you need to make yourself aware of what Social Security Disability options you have. You need not be "totally and permanently disabled" to receive some temporary financial help from Social Security, as I understand it.

The medical can of worms is just the first part of your ordeal. The legal part -- for lack of something better to call it -- is another big can of worms. It will require patience on your part and you'll have to ask lots of questions of lots of people to hopefully get steered in the right direction. Remember, don't sign anything too quickly and be sure you understand what it is first. And not everybody who seems to be trying to help you is really your friend.

If my long-winded sketch here sounds like "been there, done that" you're right on the money!
 
Misanthropist, I think you did a damn fine job of clearly analyzing your situation and doing the most important things that needed doing quickly and effectively. When you feel a little better you can reach around and pat yourself on the back for handling it that well. Hey, guess what... Now you will have a "weather ankle" to let you know when the fronts are moving in. :D

But the rest of the story is that you may very well be in and out of the hospital for awhile yet. Your next hurdle is to avoid becoming depressed because your ankle is FUBAR. You will most certainly have to be involved with Workers Comp now, but insist on choosing your doctors carefully and don't just rely on some "doc in a box" walk-in clinic the Workers Comp people may try to send you to. They seem to try to have injured workers patched up by the lowest bidder if they can get away with it.

Be very, very careful about signing any papers related to your injury! This is extremely important! You will want to be sure you don't sign any sort of release before you know the long term ramifications of your injury. At some point in the near future I recommend that you see a good lawyer (yeah, I know, but sometimes you have to have one) who specializes in Workers Comp cases. If and when you decide to accept a lump sum settlement for your injury -- and only do this after the doctors and physical therapists have done all they possibly can for you -- the lawyer will get a percentage (maybe one-third), but what you will receive with the lawyer's help will probably be way more than anything you would have gotten without legal counsel.

Eventually, way down the line, you may have to participate in a hearing before what is called (in my area) an administrative law judge. It is just a sit-down meeting in an office between you, your lawyer, the Worker's Comp people, and a judge to referee and help decide how much your injury is worth. Be very wary of Workers Comp people because they will shaft you in a heartbeat!

Depending upon the extent of your injury and the resulting disability you might encounter, you need to make yourself aware of what Social Security Disability options you have. You need not be "totally and permanently disabled" to receive some temporary financial help from Social Security, as I understand it.

The medical can of worms is just the first part of your ordeal. The legal part -- for lack of something better to call it -- is another big can of worms. It will require patience on your part and you'll have to ask lots of questions of lots of people to hopefully get steered in the right direction. Remember, don't sign anything too quickly and be sure you understand what it is first. And not everybody who seems to be trying to help you is really your friend.

If my long-winded sketch here sounds like "been there, done that" you're right on the money!

Man, sure sounds like you must have been put through the wringer by the Workers Comp people there!

I appreciate the tips, hopefully it doesn't come to all that up here! But if there's one thing I can do, it's nothing, so when they bring me things to sign, I can fail to do that like a pro!

On the plus side the system of worker's comp is a little different here - the WCB as we call it is an advocacy group for workers in addition to providing insurance coverage for injuries sustained at work. They called me yesterday to tell me to take it easy, take my surgeon's advice on healing and to let me know they were processing information and would be covering any expenses I incurred.

But man, when it comes to dealing with people on money, you can sure never be too careful and I really appreciate your thoughts!

In fact I appreciate everyone's thoughts on this, just you wait and I'll be hiking again this summer!
 
It could be worse, Misanthropist. I could still send you my kids...

UkrainianRadiation.jpg
 
Thank God, though, you had training in handling pain as a child:
845KidsOwnedNinja-f4a.gif


(Hope this cheers ya up, buddy, get well soon!)
 
Reminds me of a recent DARPA test I just heard about from an ex SF medic buddy of mine. They took 24 pigs and put obstructions in the descending aorta.

They pulled out the obstruction, and 12 of them were given IV therapy. All but two of those died.

They let the other 12 lay there, as once they had the object pulled out, they fell over on their sides and lay still.

All but two lived.

It seems the body knows that if you get a traumatic hit, it lays you down and lowers your blood pressure, so the wound, even a serious wound, can coagulate. Giving the IV causes your blood pressure to rise, and you actually have a greater risk of bleeding out, since your body thinks you're good to go.

Not giving the IV lets you "heal" faster on the initial hit.

Apparently this has led to a much lesser use of IV therapy in combat, which used to be the big deal through the 90's. As it turns out, the body knows better.

It reminds me of the old "4 life saving steps" that was drilled into me in USMC boot camp.

Stop the bleeding.

Start the breathing.

Protect the wound.

Treat for shock.

Of course screamed as loud as possible in unison.

But very true.

Nature knows what we don't.
 
Man why did you have to post that- you just made my ankles hurt all over again. I totally understand what you went through. When I broke my fibulae and right malleoli in August I had a half hour wait until found. I made sure that they were broken (left outer ankle bone was halfway down my foot), set myself up comfortably (see avatar) and bundled up my parachute as a pillow. Luckily for me the endorphans were so good I did not feel much pain until they reset my foot bones manually, but they gave me an amnesiac so I only have my fiancees word as to how loud I screamed. I am finally able to hobble around, so listen to the Docs and let yourself heal. An enjoy lots of Bladeforums!!!
 
That little adrenaline window lets you have a bit of extra strength and to ignore pain. You took some good opportunities, probably reducing the injury (fortunately). Removing the boot probably was a pretty good thing. Once your foot swells in the boot, it can restrict circulation further so that was good to get ahead of the curve, irregardless of saving the boot. Given the inevitable swelling to follow, you would be better off out of the boot.

A few handy points. Cold reduces swelling so some of that cold water would help on the foot if it isn't dirty and the skin isn't broken.

The rate of swelling is reduced if the foot is elevated above the level of the heart, improving venous drainage.

Raising the level of your feet above the heart, will transfer for the average male, about 500 cc of blood from the limbs to the core, which will lower the odds of you going into shock, especially if you have major bleeding. Referred to as autotransfusion. You want to optimize blood flowing to your head to stay conscious. You can get a few more ccs out of havng your arms up too.

I hope none of you need to use this info either for yourself or someone around you.

Smooth moves!

---
Ken
 
Unfortunately all DR MUDD says is good advice. You also might want to get some signed written statements from people who saw the event occur describing it.

While the 4 step program is good, breathing comes first. If your descending aorta rips, even if you are already on the operating room table when it happens, the overwhelming result is - you're done. If you have it temporarily clamped, it depends on what level the clamp is at (e.g above or below the kidneys). Pulling a plug out doesn't really describe the procedure, since you would need an incision and that's a serious problem in it's own right. If it's 'just' clamped, well even more fluid backup is just more load that ain't moving through. Hard to make much of the study.

---
Ken
 
I'm not sure of the exact medical procedure they used, but it has led to medics not applying IV treatment right away like they used to a few years ago, which to me is an interesting change in procedure.

Of course battlefield medicine has gotten much much better.

Another interesting thing is that the use of tourniquets has gone way up. That used to be a big no no. Now it's become very common.

Interesting times.
 
I wonder - do you figure the use of tourniquets has gone up because we think they're better than we used to, or is it because improved body armour combined with the frequency of IED attacks rather than shootings has led to a situation where more guys are receiving injuries in which there is no way to save the limb, but the victim's core is sufficiently protected that they will survive?

I've read that combat fatalities have gone down but limb loss has gone up...I suspect it's the combination of IEDs and good armour that is saving lives at the expense of limbs, maybe that is leading to the increased acceptance of tourniquets.



Yeah, Kris as I lay there on the rails, I thought of you and your broken fibiae and how much worse that would have been! In total, it was 1 hour from time of injury to arrival at the hospital and I am sure you would have had a much longer wait than that!

Of course it was nine hours before I got any pain meds so hopefully you did better than that! I guess you can ask your girlfriend for the answer!
 
That sucks Bro...I wish I could say I feel your pain...but I don't think I can!!! that sounded nasty, glad you handled it well, good man. Gene
 
Unfortunately all DR MUDD says is good advice. ... Ken

Just to try to avoid confusion, I spell my user name "Dr. Mudd" but somebody else is operating as "DRMUDD." I'm not exactly sure how that came to be, but virtually duplicating user names doesn't seem like good practice to me. :confused:
 
I'm not sure of the exact medical procedure they used, but it has led to medics not applying IV treatment right away like they used to a few years ago, which to me is an interesting change in procedure.

I wonder - do you figure the use of tourniquets has gone up because we think they're better than we used to, or is it because improved body armour combined with the frequency of IED attacks rather than shootings has led to a situation where more guys are receiving injuries in which there is no way to save the limb, but the victim's core is sufficiently protected that they will survive?

being a former paramedic, former military medic, and former ER nurse that hasn't worked in EMS for over 10 years, I'm a little long in the tooth, but I do still talk to people in the biz today. I think you are right to an extent, that being that explosions created different wounds than rifles. However, bleeding is treated somewhat differently now. In the olden days, medics and ER personnel would get two large bore IV's started almost immediately and push IV fluids almost as fast as they could. Sometimes, you could literally see that the patients were "bleeding pink" as the Ringers Lactate (or whatever fluid) thinned the blood.

Today, the bleeding is treated first and treated much more aggressively. If you think about it, the platelets and other clotting components cannot work effectively if the blood is thinned precipitously by large amounts of IV fluids. So the protocols, especially for military patients, is direct pressure, then powdered external anticoagulants (chitosan or quickclot), then tourniquet, then aggressive fluids, plasma or other fluids (packed RBC's or whole blood?) once the hemorrhaging has been controlled.
 
Misanthropist,

I'm sure I'm being overly cautious, but be careful what you post here, in case anyone from the company -- who is trying to get you to sign things -- knows you post here. Don't want them to use anything here to screw with you.
 
Hmm...have to keep that in mind next time I get chewed up by something or other: in event of sudden unwanted drainage, plug the holes, then refill the tank, not the other way around!
 
Jesus, Brian, you're freaking me out!


Okay, guys, that's it. Everyone that was waiting on my review of the latest Jumpmaster 5000 ULTRAmpoline is just going to have to wait.

Brian ruined it for everyone.
 
That made my palms sweat.
You made some excellent points there.

Here's to a complete and speedy recovery!
 
Jesus, Brian, you're freaking me out!


Okay, guys, that's it. Everyone that was waiting on my review of the latest Jumpmaster 5000 ULTRAmpoline is just going to have to wait.

Brian ruined it for everyone.

LMFAO! Just being paranoid for you, that's all.
 
Hmm...have to keep that in mind next time I get chewed up by something or other: in event of sudden unwanted drainage, plug the holes, then refill the tank, not the other way around!
It seems obvious, doesn't it? Especially when it is put that way. Yet it wasn't the way we operated. The thought was, back then, to get the pressure up to ensure perfusion to the core organs then return to the bleeding to deal with it.

The sexual innuendos were not missed. I'm just taking the high road.
 
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