DS13 with broken leg - need tips!

[brightbluecast]

We've come 5 hours north to stay with my parents for a few days. On Sunday DS13 broke his tibia. I am in need of lots of friendly tips as we navigate this (with additional complications as we're away from home). I have lots of questions. Going to fracture clinic for care plan tomorrow but I know sometimes it's not possible to get all the necessary practical tips when under pressure. Here goes (and please be gentle - it's a bit stressful):

1. he has full cast from thigh to toes. It is so heavy and leg is so straight that it's hard to walk with crutches as he struggles to keep leg off the ground and can't swing it in front or behind him. He's managed it in front a couple of times as we go from sofa to loo, but not consistent. So Dad walks behind him and I walk in front, backwards, bent double, with towel around leg just below knee pulling it up like a hoist. Worried that I'm going to do myself an injury too. I've seen leg slings which look easier but, as they go under the foot and he is non weight bearing, I'm not sure this is allowed (will ask hospital tomorrow).
2. we have booked a wheel chair to be delivered tomorrow, rented for all the time we need it. Lightweight, folding with leg extension. To use around the house so that we can limit the use of crutches, but crutches still necessary for in and out of car, into the bathroom etc, so do need to master it.
3. my parents have a big house so plenty of variety of where to sit etc. Downstairs loo, thank goodness, although it's a bit of a tight fit to get in there. Currently can't contemplate stairs so he's sleeping on large sofa with me on camp bed next to him. I know he's advised to go up and down stairs on his bum, which is the only option. But not sure how he can get from the position of sitting on top step to standing without us lifting him with all his weight from behind. Likewise to get back to sitting position to go down again. I guess it's a job for 2 strong people - 1 in front, 1 behind. Which leads me to ....
4. at some point my husband will probably have to go home for a bit and leave me here at my parents'. They're elderly so I can't ask them to do anything heavy. Therefore I guess DS just has to continue to live downstairs and sleep on the sofa. So I 'just' need to work out the solution to sofa-wheelchair-crutches-loo on my own as I won't attempt the stairs. I would also need to be prepared to get him in and out of Dad's car or taxi if I needed to take him for further appointments.
5. if we went back to our own house, we only have an upstairs loo so we'd have to get him up there and then leave him there like rapunzel forever. So I'm weighing up pros and cons of life downstairs at parents or life upstairs at home.
6. very daunted by the prospect of 5 hour journey home which will have to be taken at some point while cast is still on (I'm imagining it'll be on for 6 weeks). What is the safest option between: front seat with leg stretched out in front (haven't yet checked if that actually works space-wise); sitting along the back seat with both legs up and seat belt only on his lower half, with his legs up on my lap (there will be 4 of us in the car); sitting with legs in an L shape with good leg and body positioned normally, and bad leg out to the side (on my lap). Any seat belt adaptors for this kind of thing?
7. other person in the equation is DS15. He could be left here with me and DS13 and assist in some of the caring but he has ASD and is emotionally a bit difficult. I'm worried he'll be bored and depressed if he stayed here. However, if he goes home with his Dad, it's not great either as there's a bit of a grudge between them at the moment and relationship is not a happy one.
8. DH will come back for me at some point later in the summer holidays (not sure how long to camp out here at my parents) and will probably have to bring DS15 back with him as we can't leave him at home alone, and we don't have anyone he can go to. But that's least of the problems.
9. would also love other tips about how to wash him, and wash his hair. Also what pitfalls I should look out for. I'm trying to check for chafing around the top of the cast. My Mum is great at sewing so I'm thinking of asking her to make a cast cover or something to keep it a bit cleaner at the top. He's sitting down to go for a wee so I'm just hoping he doesn't wee down it. Sorry for long post - but didn't want to drip feed. These are currently my top questions and worries. It'll be an evolving list, I'm sure. My heart goes out to people dealing with these challenges on a long-term basis, it really is an eye-opener.

Oh gosh OP, that sounds like a nightmare! No experience but keeping your post bumped.

I expect its one of those things where you'll get into a routine/find a way and it won't seem nearly so difficult in a few days.

How did he do it?

I can't advise on all your points but when DS was in a full leg cast he very quickly mastered the art of movement without assistance. Up and down stairs, in the shower etc. You can buy shower protection. Also he sat in the middle seat of the car and put his leg through into the centre console where we luckily had an arm rest type box thing. We were on holiday as well and we just did all our plans with DS using a combo of wheelchair and crutches. I would t worry too much tbh, at 13 he will be able to work it all out.

Just noticed he is sitting to wee, isn't that much more awkward for him than it has to be?

For toilet use, consider getting a plastic urinal bottle (lots of pharmacies would sell them) or hiring a commode chair from the Red Cross to avoid difficult spaces and hopping.
When he is at fracture clinic tomorrow, ask if he can see a physio to run through transfers and mobility (and stairs if essential) as they will show him how to get to from the floor if required. They could at least demonstrate to you both if he is not up to it at the time.
When the wheelchair comes, it will probably have removable arm rests. The easiest way to go between sofa and wheelchair will probably be to put the wheelchair at 90° to the sofa, with the arm rest nearest to the sofa removed. Put the brakes on! He can then shuffle between the two, using his good foot in the floor. Again, a physio could show him how to do this.

Oh dear. Poor DS. What car do you have ? Any chance it's one with a third row of pop up seats in the back? We travelled home from Cornwall with thirteen year old DD on very back row with two of central row seats down so she could stretch her leg out. One DD in back with her and other on remaining middle seat. DHLd the luggage home. Could you hire a suitable car for home journey, even?
Otherwise, in the front seat with it as far back as possible. Or sat with leg between drive and passenger seat.
Check out service stations before you set off. They're so varied in their access for non mobile users. The Westmoreland farm shop one even provided a wheelchair for us so she didn't have to hop to the loo.

Also ask at hospital what's available locally re wheelchair hire. Most areas have something

I think he will find this easier as time goes on. The break will begin to heal and also he will get more used to the cast. Anyway, my tip is to get a wide necked bottle for him to wee in. Then you only need to make one journey to the toilet per day if he needs to poo. Then that journey should be alright for your 15yo to help with as it won’t be often.

I’d keep the 15yo with you.

Get a proper cover for the shower. When dd broke her leg ATVs similar age I didn't know they were a thing and we used tape and bin bags.
Your ds needs to practice with the crutches and it will get easier. We did the stairs on her bum. Then I would help her to balance and she would hop up the last step.
Luckily she didn't have the full leg cast on for long and they cut it down to below the knee.

Also, when the initial pain and swelling has worn off he'll be hopping around the house and in and out of the car like no one's business. Just make sure he listens carefully to physio advice about not weight bearing.

If car home is difficult could you and 15yo take the train/fly?

Agree you need physio input. Arm it's still new and painful and would imagine quite a nasty accident to break that bit of his leg.

Do you have a dining room at home or similar? Could you hire a commode and make him a downstairs bed room? Or what about a shed he can use as a toilet so he only has to go upstairs for bed?

I agree those shower covers are amazing.

Yes the shower covers are v good. Just measure the cast carefully. We also ordered a plastic chair for the shower from Amazon but any plastic chair with non slip feet will do as long as it fits the cubicle. Big Welly socks to go over the toes to keep them warm. Towelling shorts for everything including hospital visits. DD had a line dresses but that's no good for you.

Ours slept in a downstairs room next to a bathroom for about the first three weeks or so. After that she bum shuffled and hopped upstairs.

If he is supposed to be non-weightbearing on the broken leg then I would give up on even considering stairs. It is almost impossible to get up from the floor when you can only use one leg. Keep him downstairs. When this happened to me I used a wheelchair constantly (mind you don't damage the floors though). Barely bothered with crutches as they were too difficult. Perfectly ok to wash with flannel for 6 weeks. Helpful to wear clothes with pockets as hands may be tied up with crutches/wheelchair. I got a friend to wash hair with me leaning back over a sink - sitting on normal dining room chair and cushions to gain a bit of height. Good luck!

I did similar on a long awaited family holiday to Disneyland Florida, and spent two weeks on crutches with a full length splint on.

For the car, I had the back seat. With the bad leg nearest the back of the seat, stretched out all along - I managed day to day travel plus a three and a half hour drive like this.

The plane home wasn’t fun - I still judge everyone who refused to give up their seat for me on the shuttle bus at Manchester airport. By then I was swollen, tired and sore, and they were all bastards!

You get used to crutches very quickly, after a few days I was back in Disney having fun, and even went to the beach - don’t wait till you are sore before taking pain killers is the best advice.

Get him taking them regularly for the first few days, till the pain wears off.

He can wash with a flannel for now, showers are luxury which can be skipped.

For 1) can you get him a shoe with a very thick sole (crocs maybe?). That would raise his height off the ground to give him a few extra mm to swing his leg through.
3) could he go from the top step to a small step and then onto a chair. Or a mini (2-step) step ladder. Then you wouldn't be lifting him from the floor to standing and shouldn't be more awkward than getting up the stairs.
6) consider the train.
9) hair wash should be easy. Lean back over sink. Loads of towels to stop water dripping down. A good deodorant!

When ds broke his leg (same age) it was a nasty break needing several surgery trips and his leg needed regrowing several inches, we knew it was going to take months to heal.
To start with we brought his bed downstairs for the first three months or so. When he could manage stairs to get to the shower (fortunately not one over a bath) He had to sit in the shower with his leg out the door. You can get bags to go over casts but he had a fixator with massive pins so they didn't fit inside.
Wheelchair was a life saver. We were also lucky as his school were happy after about 5months or so to let him back (unusual to let a child with fixator and wheelchair into school apparently).

The physio exercises were probably the hardest thing because he found them so painful.

Because he was bed bound for a while we had to find activities like Lego that he could do with his leg elevated. This he struggled with as he had lived on his skateboard before that.

Oh and it may not be such an issue now with social distancing but be aware that wheelchairs don't always fit easily into shops.
And random strangers will talk to you about your child over their head as if your child can't hear them or talk to them themselves.

We’re just out of a full leg cast here following a spiral tibia fracture. Get a limbo bag for the shower, it’s totally waterproof and was recommended in hospital. We used a bottle for peeing at the beginning, not ideal but far easier than struggling to the loo. We couldn’t use crutches either but did use a wheelchair. Bum shuffling was the only way to get about whilst in full leg. It’s now swapped to below the knee which is far easier. Re showering we found bum shuffling in and sitting on the floor, it was a hassle though and showers were a few times a week instead of daily. Good luck.

Thanks so much you lovely people! To comment:

• crutches: I also thought being young and fit and not overweight, he'd be fine (as I've seen kids whizzing along on crutches) but I'm seriously mystified. His cast is just so heavy and so long and straight he doesn't have muscles available in the right place to move it. As he's non-weight-bearing, I'm assuming that this means it shouldn't have any contact at all with floor in case he accidentally rests on it. I'll get the clinic to clarify this tomorrow. A couple of times he's almost managed it (he's got up a few times today to move to a different chair) so maybe it depends on pain level or mindset at that particular time.

• pain relief: dosing him up regularly on paracetamol. Pain seems more or less under control. He's quickly learned to have us lower his leg very slowly when he's about to get up as presumably blood rushing to his injury makes it tingly and painful. But that usually passes. He woke up a couple of times in the night because he'd obviously flexed or tried to move and the pain woke him up. I'm assuming this is all 'normal' but will check tomorrow. He also managed to get a couple of mosquito bites down there while sitting on the ground in the woods waiting for the paramedics (he fell off a rope swing).
• loo. I agree he should just use a bottle (we have a proper one) but he's absolutely adamant not. And thinks psychologically he can't. Very stubborn and currently trying to hang onto his dignity although I've tried to gently explain that he just has to suspend his dignity for a bit and it's fine. Therefore I'm sure a commode chair (which is a great idea) would be a huge no-no. I guess I have to keep gently suggesting it as it'd be so much easier.
• stairs. I see there are some that manage it and others that don't. A variety of stools/steps to do the standing up in stages is interesting, as is the bum-shuffling. I think DH and I need to try it out with each other and see what we think (as the people who will be helping/lifting)
• car. We do indeed have a 7 seater (Zafira) although the back-back seats have never been used and I'm not sure I like them tbh. Also would probably be hard to climb into at the best of times. But again, DH and I should practise. DS is same height as me (5'6") so I can be a good test-dummy.
• cast. I'm really really hoping at some point they'll swap it to a below-knee cast. That would be SO much easier and something to look forward to. I guess we'll find out tomorrow. Slightly worried about transferring care from this hospital to the local one at home. When we know how much time for each stage, then I guess we can plan at what point we'll go home. I'll order a cover for the shower - whether we're brave enough to use it is another matter, but we'll have it. We've been managing so far with wipes and flannels. What we do about his dangly bits I don't know but I might leave that to DH to have a word. I've bought dry shampoo for his hair. My Mum has the idea of lying him on the camp bed in the garden with head dangling over end and wash his hair like that. In due course, that might work. His hair is very long and thick, just to complicate matters. Might actually get it cut by visiting hairdresser while we're here.
• other son. He really concerns me. We've had quite a lot of anger issues with him. He's a lovely lad but complicated. We'd just got to the point where, after the months of home school isolation, he'd started to go out occasionally with friends and I've been actively encouraging that. It's a big thing for him to have some human contact and a bit of independence and so it'd be a bit of a setback to have him stuck here with me in, basically, quite a boring place with not all of his usual stuff around him. He loves his Grandparents but doesn't interact an awful lot and will just sit in his room (much as he does at home). I went for a walk with him today so we could have a chat and I updated him with current thinking - he's not keen on going back with his Dad (because of his current grudge) but he does see the predicament and is being very reasonable about it.

-entertainment. DS has spent the last few months glued to his laptop. He still has last term's work to finish (!) and is very into coding so he's actually quite good at occupying himself. He's in touch with quite a lot of friends on social media, and he's got You Tube stuff etc he likes to watch. I'm planning to play cards and Scrabble with him. He plays trombone (which he has with him) but he's not going to manage it sitting in current position so I've ordered a guitar to be delivered tomorrow (he plays but doesn't have one here) so he can sit and strum. I know it's still going to be really boring but he does have stuff he's happy to do. Would be worse if he was used to going for a run every day. Sometimes it's useful not to be sporty ...

Oh and school: I'll see what point we're likely to be at but I don't think he'll be able to go back at the start of term. Perhaps for a couple of hours a day if they can accommodate his wheelchair. We live close so husband could drive him. He'd never manage the loo at school. A girl in his class is almost permanently in a wheelchair - it's not a very disabled-friendly building but they do manage and they obviously already have plans in place.

Just reading through replies again:
Shoes: we have hiking boots here so will try those tomorrow to see if the thicker sole makes a difference.
Travel: train / plane not really practical because of lengthy transfers either side. And DH doesn't want to take him by car without me there so that there are 2 adults to deal with loo stops or any unforeseen things. DS15 could be helpful but might not, so can't rely on him!

Could he try a Zimmer frame instead of crutches? Like

mmm - interesting about that zimmerframe. The extent of DS's cast is about the same as that little girl's. I just wonder, in general, what damage is done if you accidentally bash the bottom of your foot on the ground. Apart from the pain. I'm trying to envisage a device that hoists that pesky leg up out of the way. Necessity/mother-of-invention and all that!

Crutches take practice, even for the young and healthy. He needs a physio to show him how to do it properly, especially for stairs, but there are quite a lot of good videos on YouTube that help.
I suffered multiple injuries in a car crash a few years ago and was non weightbearing for months. And then again for weeks after every operation later down the line. You do get used to it. I had chest injuries initially too so it was excruciating but I got the hang of it. I started with a walking frame which is easier and then graduated to crutches once I had got better balance. Might be worth you asking if that is an option.It takes you a while to get used to one leg suddenly being so heavy. At first I thought I would never be able to do it, so don't worry to much at this stage - it will come.
I found a chair in the shower was the best way to manage .We just got a cheap plastic garden chair ourselves as I would have stunk to high heaven waiting for occupational therapy to come out. But they did eventually get me stuff like seats to raise the height of the toilet etc which are well worth having.
I would recommend you phoning your GP surgery now so that they can be making the necessary arrangements for when you get home, rather than waiting til you are back.
I hope things look up soon. Its certainly no fun.

The non weight bearing is hard going. We would have to share the load and one lift under the arms and one take the legs for the loo, also found a chair or stool to rest the leg on when on the loo. We ended up speaking to a private physio I found as the hospital kept giving us conflicting information. Since we’ve done that we’ve had some knee exercises to do and it’s improved flexibility so much.
Maybe write questions down for the hospital, as only one parent is allowed in ours at the moment it’s easy to forget things in the midst of masks and being sent for x rays and re plasters.

How's he getting on now @brightbluecast ? Hopefully a bit better!