Dd injured - not happy with A&E.....

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Posting here for traffic

Dd took a crashing fall from a height at sports training last night and has hurt her foot and unable to bear weight on it.

Went to A&E last night and they took X-rays and said her ankle was fine. They wouldn't listen to her when she repeatedly told them the pain was under her arch and across the top of her foot not in her ankle. Sent her home still unable to weight bear with no crutch's and a self care leaflet for ankle injuries.

Would ibu to take her to our local minor injuries unit today for a second opinion? She's on paracetamol and ibuprofen alternating every 2 hours and it's only just taking the edge of the pain. Foot is swollen along the outside and across the bridge and is very painful to the touch. She also has a high pain threshold so when she is crying in pain I sit up and take notice!

Dh reckons they will review her X-rays as a matter of course this morning and will ring if they've missed anything - is this right?

Codeine does nothing for me!!

I have to have oramorph or IV morphine to feel any kind of relief from pain at the moment.

Even then it’s a hit and miss. It sometimes works. It sometimes doesn’t. And sometimes it just makes me doped in the head enough to realise I still have pain, I just don’t care

Ah so with codeine, I’ve just got to get through the vomit stage to see the benefit?

Go back! My DH broke his foot - 2 hospitals and 2 X-rays couldn't see it. Due to pain, swelling and bruising they saw him in the fracture clinic. The consultant looked at it and said there's a fracture but it'll take and mri to find it and there's no point as the treatment is the same and put him in a knee length boot cast for 4 weeks.

Hope she’s ok. I’d definitely have it looked at at minor injuries stating the pain isn’t where x rayed. I’d also stress that dd is stoic and this level of pain and reaction isn’t normal for her.

It sounds very much like a torn ligament at the top of her foot. I did it and couldn't weight bear on middle of foot to toes. Even balancing on heel was agony for a few days.

I was advised ligament teats can be a painful as breaks, to raise foot, ice foot ans rest it. I bought a Velcro strap bandage to keep the foot from splaying at all.

I'm over a month past I just and my toes were numb, then felt like needles in them for a week. Now just sore and the top of my foot still hurts when flexed.

Haven't made it to the end of the thread, so not sure if this has already been sorted out, but it's each every 8 hours, but staggered so they're getting something every 4 hours.

So, for example, brufen at noon, paracetamol at 16:00, brufen at 20:00, and paracetamol at midnight. At least that's how you do it for a child possibly prone to fever convulsions.

Hope your daughter is ok and gets seen soon. This thread certainly highlights how many people are dismissed and the poor quality of care. My dd had the same. A&E said no break as she could weight bare. I knew something was wrong and went private. A break and fracture.

A break and fracture
A break is the same thing as a fracture.
I hope she was ok in the end x

No idea why the Dr said break and fracture?! I recall it was 2 places so I probably misheard. Yes she’s all good now and it healed

Ok so she has refused to back to minor injuries!

She's slept most of the day and hasn't had any pain relief since the tablets at 6.30am when I told her to go back to sleep. She doesn't want any more tablets at the moment

I've taken the bandage off and the swelling has gone down a bit, no bruising to see and she can now weight bear a little when standing but still hurts to walk with the foot flat.

Pain is now at the front of the ankle where it meets the top of the foot but she's not squealing when it's touched. She was happy for me to follow each toe up to her ankle with a couple of sore spots but nothing that was making her really squeak. Bit of pain in her arch when standing but nothing significant

It looks like I've been very unfair to the A&E team and she hasn't actually done any major damage. I'm sorry for all of you who had missed fractures and long term problems and I apologise for panicking.

I will keep an eye on her over the next few days and see if she continues to improve.

To the poster who asked what it would mean to her sporting career, basically a serious foot injury would end any future she had in the sport (FIG senior gymnastics) time will tell but it is what it is.

Thankyou all for your advice and I promise I will be more careful with painkiller usage in the future!

The correct dose for anyone should be taken 6-8 hourly maximum 3 times a day unless otherwise prescribed. Weight medication calculations have a maximum dose per age due to the fact that if overweight the dose could be much higher than the liver/kidneys can process as this does not increase by weight but rather age.

I had a feeling she was a gymnast. The fall from height and the high pain threshold. My dd was also a highly competitive gymnast and when she damaged her foot discussed below still trained everyday with a boot on 🙄. High pain thresholds can be so frustrating though, people don't think she is as injured as she is a lot of the time. She wanted to compete on a broken toe (different injury)

I broke my foot when I was a child. A&E said it was fine based on an x-ray and I limped about on it for weeks in quite a bit of pain before the x-ray finally made it back to my GPs office and he reviewed it, called up and told me to go back to A&E immediately to get it looked at because he'd spotted hairline fractures that had been missed. Of course by this point the fractures were a hole lot worse and I was in plaster for ages and then needed physio. It's maybe a bit much to take her back in today, but let her rest and if you've not seen a big improvement within a few days take her back in for a second opinion.

It looks like I've been very unfair to the A&E team and she hasn't actually done any major damage. I'm sorry for all of you who had missed fractures and long term problems and I apologise for panicking

Nice 👍

I used to take codeine for bad headaches way back in the dark ages when they were sold over the counter like aspirin, and I had no bad effects. Since that was banned I've only had the occasional paracetamol and codeine mixed tablet which I assume is pretty mild. Recently I was prescribed co-codamol but found that just one tablet made my stomach hurt, and I felt sick and really faint. Not sure whether than means I've developed some sort of intolerance to it - is that common? It's fair to say I was quite ill at the time anyway, hence the fact that it was prescribed for me.

I’m glad she’s doing better and you are feeling calmer. It’s very scary for both adult and child, especially a sports enthusiast. Trusts the professionals, they generally know what they are doing. (Of course they make mistakes sometimes and everyone is desperate to tell you about when the doctor was wrong. But every profession does, and its relatively rare)

Ahh I really hope she recovers well all of my love and if it does get sore or worse it's really worth going back xx

Several times A&E have misdiagnosed a broken bone with my kids…. I’d take her back and if it’s not broken get her to a good private sports injury physio. The NHS won’t do anything for muscle, ligament etc damage but it definitely needs treating especially if your child is active in sports.

If this is true, why does my packet of ibruprofen say every 4 hours up to 3 times a day?

You can take paracetamol then 2 hrs later take brufen then 2 hrs later paracetamol therefore keeping pain relief topped up, this of course is with the caution of no more than 8 of either in 24 hrs.
You can buy co codamol 8/500 over the counter, with the caution of not taking it for more than 3 days without medical.advice.

They can be taken together, with 4 to 6 hours between doses, a maximum of 4 doses a day.

Ditto, I had broken foot (metatarsals) for 12 weeks before someone thought to X-ray as weight baring.

another 8 weeks in a boot cos it then took ages to heal as I had to walk about those first 12 weeks without any support or crutch or anything becuase apparently I was making a fuss over a bit of bruising when I went back to GP for a referral . The joy of being a 50 year old women ! Went private in the end and they found it straight away .

Tiny breaks as are common in the foot don't show up on X-ray right away, it's the healing that shows some weeks after. I've had 3 stress fractures, they show on MRI but only on X-ray some weeks later.

Paeds dr here!

If they didn’t see her weight-bare in there (even a painful/antalgic one) they shouldn’t have sent home. Or if they did they should have treated as a fracture with a cast and a fracture clinic followup.

X rays in kids are not always conclusive (but yes probably they will be re looked at).

pain isn’t always an indicator as tbh soft tissue injuries are not a lesser injury. Just a different injury. And can hurt like crazy and account for the silent tears etc.

Please just take her back if completely unable
to bare weight.

If doing some weight-bearing follow the soft tissue advice and monitor. (Rest but some small movement, elevate, and ice but not directly onto skin).

ps just being a doctor doesn’t mean you can ever remember if it is bear or bare! I have always got this wrong so please don’t judge me. 😂

Paramol behind the counter is stronger. But only every four hours.