RA, Physical Trauma, and Healing

Vanessa Collins Health Guide
  • I still remember the date and time of my injury.  It was April 2nd, at 4:30 in the morning.  I had awakened and was making my way downstairs for some pain medication.


    I didn’t switch on the light.  I didn’t give myself a moment to clear my head.  I was half sleep-walking down the stairs that lead from my bedroom to the main floor of our home.


    I was also thinking about something I wanted to do that day.  I was not being careful. 


    I remember taking the last step. I remember my right foot hanging in the air just before I fell forward into the living room wall. I remember bending my left forearm and hitting the wall with my closed fist and forearm. 

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    I was stunned.  I found myself on my back trying to assess my situation.  I knew it was bad. 


    I didn’t wake anyone.  My husband and my parents were still fast asleep.


    I considered the option of going to the ER, but I didn’t want to deal with doctors asking questions about all my RA medications.  I didn’t want to deal with sitting for hours in an ER waiting room.  So, I made my way to the couch and sat down.


    The almost-immediate swelling of my left arm and wrist told me what I needed to know: I had at least one broken bone.


    When daylight came, I called my orthopedic doctor and he saw me right away.


    After a set of x-rays that were quite painful, I was told my humerus was broken in two places.  The break on the back of my arm was splintered.  A three-inch “sliver” of the bone was attached in one place.  I had also fractured a carpal bone in my wrist.


    My orthopedic doctor told me I would probably need surgery.  She was afraid my joint would shift and dislocate whenever I attempted to use my arm.  She was also aware of my RA and how it might slow down my healing.


    I went home in the most complicated sling setup I have ever seen.  It was painful to put it on, and almost impossible to get off.


    The most vivid memory I have of this time was the amount of pain I was experiencing. Demerol and my Butrans patch dulled it a bit, but it was impossible to sleep for more than a couple of hours.


    I remember trying to sleep in my recliner.  I had a dream I was falling down the stairs again, and I jerked myself awake, with my right foot raised and hanging in mid-air. 


    The bruising on my left arm was extensive.  My arm was a deep purple-black.  There are still some residual bruises on my left arm as I write this today, the 18th of August.


    I had just started Actemra, and it was helping me.  I did not want to stop that medication to have surgery.  I didn’t want to have surgery at all!


    The first three weeks after my accident are a blur of pain, fitful sleep, and more pain.  The fourth week after my injury, I started to believe I was going to get better.


    Six weeks post-accident, I was in physical therapy.  I worked with a physical therapist in our area that has been educated about RA.  He watched my swelling and pain level closely. 


    Some days, I could do exactly what he instructed me to do.  Other days, I had to dial it back because of an RA flare.  Together, we worked diligently to improve my range of motion. 


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    Some days I missed physical therapy because I was just too tired and achy to go.  As soon as I felt better, I started again.


    When I was feeling able, I worked on my exercises at home.  I did everything the physical therapist asked of me.  I let him know when the RA in my wrist was too active to complete some of my exercise plan, and he listened.


    I saw my orthopedic doctor six weeks after my injury. She was surprised at my range of motion.  She had told me I would never be able to raise my arm above my shoulder.  I raised my arm above my shoulder, and above my head that day.  My doctor was smiling.  So was I.


    At that time I was told that surgery was not going to be necessary.  My shoulder joint is a bit misaligned, but it works amazingly well. 


    What have I learned from this experience?  First and foremost, I must be careful when I am walking up or down stairs.  My balance is impaired because of RA in my feet and toes.  I knew that at the time of my fall, but I did not realize how serious my carelessness could be.


    If you are ever injured and need physical therapy, please ask for a therapist who is familiar with autoimmune diseases. It can make all of the difference.  You do not want to make an injury worse than it already is.


    I am happy to say that my range of motion continues to improve.  My shoulder is a bit cranky at times, but it is so much better than they thought it would ever be. 


    For those of you with impaired mobility, please be careful.  Turn on the lights if you are up in the middle of the night.  Pay attention to what you are doing.  Do not let your mind wander.  Taking these easy precautions could save you a lot of pain, and possibly surgery.


Published On: August 19, 2014