To wonder if they could do more for my mothers "broken" foot.

[Lucyellensmum99]

My mum (75) has had pain and swelling in her foot, for nearly two weeks now - she is stubborn and i coudlnt get her to make appointment until Monday, when we took her to the local minor injuries. She was X-rayed and after initially the radiographer saying no fracture, the nurse practitioner said ther was a possible hairline fracture in her ankle (or that area, i cant remember if she specified). She said there was no mileage in putting it in a cast, offered my mum crutches (which the stubborn old bint refused - "too much to do" FFS!) advised her to rest it, elevate it when possible, put a packet of frozen peas on it.

My poor mum is really suffering, she is trying to put a brave face on, but i can see she is really struggling. She can only take paracetemol as she can't take anything else as she is on steriods (probably the reason for the break).

So, she has broken her foot, its bound to hurt, its not going to be better quicky, I don't honestly see what else they can do about it really, but im really worried - she is 75 and whilst normally very active, does have a long term medical condition that can lay her pretty flat, and could be life threatening if not managed. She looks ill, i think she is much more pain that she is letting on (she is VERY stubborn - wanted to walk to the minor injuries unit - err, only about three miles away!!) .

So not really saying that i don't feel enough has been done, because i dont see what else they can do, but WIBU to take her back to minor injuries and ask if there really isn't anything else to do?

Whereyouleftit, i agree, it was a nurse practitioner, in a minor injuries unit, i certainly had no reason to think she wasn't qualified to look at an X-ray, why would i want a doctor to look at it?

Sort of feel a bit better that you are all about wanting to take her back - she wont go anyway so i can stop feeling guilty - why do i feel guilty when she wont bloody listen to me anyway!!!!! Eeee she can press my buttons that woman! But i am worried, she is very fit and healthy but if she doesn't keep active, things will creep up on her.

She's offloading Lucy.
She's telling you but doesn't really want you to do anything about it other than sympathise.
Just chivvy her along with the pain relief - she'll be able to be a bit more active if she's on top of the pain, tell her it will get better given time then try diversional therapy ie. change the subject.
Good luck.

Thanks again Winged. Am just going to take her up to tesco, might see if she wants to eat out later xx

Where you left it. I USED TO BE a NP

And your point would be, theodorakis?

Without you knowing what bone she has actually fractured no one can give any specific advice but if she has been advised to partially weight bear on crutches, and isn't doing, it will hurt more.
She needs to take 2x Paracetamol 4x a day and REST.

"The X-ray was checked by a nurse practioner , who are all but doctors within their speciality."

Oh gosh, how terrifying someone thinks this! Nurses do not have the training in diagnosis or treatment that doctors have. I have never met a nurse who thinks as much of themselves and that level of overconfidence could be dangerous.

Xrays in the UK are traditionally reported on by a radiologist (doctor specialising in this field), however, there are now reporting radiographers (who take the xrays) who are trained to report on certain examinations.

As you rightly say Barlet, nurses in general do not have the same training in diagnosis or treatment as doctors, but a nurse practitioner has undergone extra training in a specialist area which, in a minor injuries unit, could well have included reading xrays for fractures. It all comes down to training, not whether they are a doctor, nurse or radiographer.

bebe, thts exactly right - i would rather a nurse practitioner who looks at this stuff day in day out than a GP for instance, looking at the X-rays. Its about experience i think.

Foot still bad, still swollen and painful, but will she put it up? will he rest it? Will she arse!!

I think if the pain is getting worse when she's taking the correct pain killers you should take her back to minor injuries (or gp if that's as good as you can manage - perhaps she'll pay attention if he tells her to go).
I'm surprised you haven't had a follow up call/ appointment if there wasn't a conclusive result - x rays can be extremely difficult to read and will double checked by a senior registrar at some point. I had a broken radius picked up by this years ago and DS1 had a cracked bone picked up a couple of months ago - it took 7 days but they did recall us and fitted a splint. He was re x-rayed because hair line fractures show up better if " they haven't been looked after" (he'd been sent away and told to keep his knee moving ) . We had actually gone to gp with DS's injured knee 1st and been told to go straight to A&E - minor injuries didn't have the expertise if anything was wrong. Since even the 2 A&E doctors we saw missed the fracture I don't think it's at all unreasonable to get your mum looked at again.
I'm truly shocked at people thinking she would be wasting hospital time.
You sound lovely and caring OP, I hope things get easier soon.

The problem is Chinsup that she isn't looking after it, but that is no surprise - she is stubborn personified! It did look really swollen today, probably will go to GP if the problem persists as you say, she might listen to doctor i he refers to A&E. I think it because nothing has been actually DONE my mum thinks it should get better quickly and that she can walk around on it etc. It was very much downplayed tbh, but i doubt anything else CAN be done and she needs to rest it, she wont, i just have to let her decide what to do i guess. It stresses me out as i know that relatively minor injuries can "do for" elderly people and that she will get run down and this will allow her other condition (addisons syndrome following bilateral adrenalectomy) to manifest and it can be life threatening - god she is so frustrating!!!!

The break if its hairline isnt the problem, its the damage she may of done to soft tissue, just the same as when you sprained yours. When I sprained mine I couldn't walk on it properly foe a couple of weeks and my foot was black with bruising for a long time

"The X-ray was checked by a nurse practioner , who are all but doctors within their speciality."

With no disrespect at all to nurses, that just isn't true, and I doubt that many nurse practitioners would think it was either.

But a nurse practitionerwith extra training and who frequently looks at x rays, would be better than some Drs who rarely do this. being a Dr does not make you an expert at everything

No, but they are different roles, albeit with overlap in places. It diminishes both roles to claim that being good at an aspect of one all but qualifies you in the other.

Yes the overlap may mean one is better than another at something. Doctors are not god or experts at everything.

If she INSISTS on walking on it, it is not getting a chance to heal . I think all that is left is to get her an air cast. I am not in the UK so not sure how you go about getting it. Maybe a foot doctor or Physio Therapist are good options for her? An air cast is a lightweight boot that she can put on when she is out of bed and remove when going back to bed, or when she is resting with her foot up on a pillow with a cold pack. You can get cooling things too that help.
Ankle hairline fracture healing tips
Light wrap type aircast

CryoCuff

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Good luck.

In many cases where there is a query over the interpretation of an x ray a radiologist or reporting radiographer win hands down over doctors and nurse practitioners.

It would be unlikely that your DM would be seen in A & E now as her injury is not recent .

I agree that regular pain relief is taken and rest is the best course of action.

Also Tubigrip is not recommended anymore.

NP training is not all it's cracked up to be. You should have seen some of the morons on my course. A radiologist is obviously going to be more qualified to read an x ray and is less likely to make a diagnosis of "possible fracture".
If the patient was young, she would have sought a doctor's opinion.

I also have Addisons's disease, and I'm surprised that your DM has been told that she can't take NSAIDs, as I've never been told any such thing, and have taken them whenever necessary for the last 18 years with no ill effects.

Sorry, not that's that's much help.

If the swelling is increasing, then she needs to see a doctor IMO - useless GP would be better than nothing. Good luck with your negotiations!