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broken elbows not healing after 8 months due to RA and meds!! Options
Anne-P
#1 Posted : Wednesday, April 03, 2013 5:59:50 PM Quote
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Hi Everyone

Has anyone else had any problems with breaking a bone and it not healing?

I have 2 broken elbows (radial heads) fractured all the way through last August (plus a coronoid fracture one side) - and found out last week that they do not expect them to heal at all. There is absolutely no bone growth showing on the Xrays. I had a CT scan on them too. Nothing..... although they are reasonably lined up......

The Orthodpaedic Consultant says they are not healing due a combination of the RA and steroids and immunosuppressant medication that I take (humira). I am, therefore, too high risk for replacing the elbows as they are worried about healing, infections etc - plus I do have a chronic lung condition.

So what now....... I am only 51 - so potentially a lot of years with broken elbows ahead of me.

I did meet a lady a while ago who had a permanently broken arm - but that was due to osteoporosis.

Anyway - I decided to re-start hydrotherapy today - so I can get some exercise without the risk of falling over. And it looks like there will be no more cooking ever .. husband has been cooking since August (so that's been lovely - as I hated cooking anyway) and I now have a home help! So it's not all bad! Isn't it sad not being able to lift a saucepan LOL But I can manage the washing. Sad

I take Vit D supplements (which are fine) and was told that the alendronic acid actually stops fractures healing - but it does stop other bones from fracturing!! So have decided to take a break with the alendronic!

Any ideas anyone? Anyone else had bones taking longer than a year to heal?

The other good bit, is I can drive my automatic car fine - just mustn't lift things (elbow fractures have to be used & kept moving otherwise the joint seizes up) - so I can go round to see friends and drink their tea!!

Anne x




Naomi1
#2 Posted : Thursday, April 04, 2013 9:50:16 PM Quote
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Oh gosh! This sounds awfully painful and very distressing that there's no hope of it healing quickly. I don't have any experience of fractures since i got RA but I'm sure someone else will step in here. Could the rheumie cut back on the meds for a while?.......though obviously this would bring its own problems. Good luck. I hope there is an answer for you. xx
suzanne_p
#3 Posted : Thursday, April 04, 2013 9:58:57 PM Quote
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hi Anne,

no answers here,

just to say i really feel for you!

wonder just how common this is?

be interested to see if this has happened to anyone else.

Suzanne x
Sheila-R
#4 Posted : Thursday, April 04, 2013 11:07:55 PM Quote
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Oh Anne, that sounds awful, and quite limiting, sorry I can't help as have experience of this. The thing I don't understand is that there are now many of us on immunosupressant drugs, yet some us us heal okay (hopefully) albeit a little slower, so it must be fairly unusual. Do they just intend to leave it?
I was interested in what you said about Alendronic Acid as I also take that and Adcal D3 as well, all a bit scary really. Hope they come up with something soon.
Best wishes
Sheila
Wendy2509
#5 Posted : Friday, April 05, 2013 6:18:30 PM Quote
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Hi Anne,
I am sorry that I can't help you with your question as I have not experienced any fractures/breaks with RA. It sounds horribly painful and quite a bumpy road obviously lies ahead for you.
I really wish you well and hope you get the help and support that you need.
Best wishes,
Wendy X
Eve_V
#6 Posted : Friday, April 05, 2013 10:01:45 PM Quote
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I badly twisted by ankle and broke my fibula last summer. I did wonder about the effect of immunosuppressants (I am on methotrexate) on the healing process. I had the plaster on for six weeks but my broken bone hurt beyond that time. However, after about four months I seemed to be back to normality, though no x-rays have been done beyond the original at the time of the accident, and a further two at accident plus two and four weeks. I guess that your elbows have been x-rayed because of the continuing pain. With my current flare I am experiencing a lot of pain in that foot - all over it - but I have no idea, and don't suppose the medics would either, whether that is because of the trauma my foot suffered (I have some very colourful photos!) or whether it is just the way things are with RA. Hydrotherapy sounds perfect and am just so sorry about what you are experiencing it must really get you down.
.....eve x
jenni_b
#7 Posted : Saturday, April 06, 2013 7:34:03 AM Quote
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Anne! That's awful

I'm sorry to hear that the elbows are in such a mess all this time later.
You know what I think about age limits on joint replacements- for me it's about benefit ratio and yes part of that is age related- I think the younger you are the better you recover

I was wondering Anne, how you are off the humira
Would it be a possible consideration to take the rheumatology team that you'd like a managed time off the meds say 2 months?

I know the steroids might be harder to get off of but I wonder what they'd say to that

Sending you love and gentle hugs

Jenni xx
how to be a velvet bulldoser
Anne-P
#8 Posted : Saturday, April 06, 2013 4:51:59 PM Quote
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Hi Everyone

Thanks for all your lovely encouraging comments. Had been feeling really fed up with it all.

I am still taking the humira and the steroids as we had a good discussion about the effects of coming off for 3 months - and that would mean I'd end up not being able to walk!!! - as my knees are my biggest problem when I'm off the immunosuppressants - so we decided that wasn't a good plan. I couldn't use crutches if I couldn't walk either!! So the plan is to just keep going and see what happens. I have stopped the alendronic acid though!! - seeing as my dexa scan was ok.

I am ok with the plan! Just very frustrated with everything!

But if anyone does know of anyone where broken bones have eventually healed after 8 months of not healing, I'd love to know!

love to you all.

Anne xxx

FIONA752
#9 Posted : Saturday, April 06, 2013 9:38:00 PM Quote
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Dear Anne,

I read your post with great interest.

I fractured a Thoracic vertebra in my Spine 9 months ago.

This was my fourth Spinal fracture.

I had my latest M.R.I scan in Mach this year and the Consultant showed me the image and said that

it was about half healed at present. (That was at month 8 after the fracture.)

I asked him how long til it would be completely healed and he said at 12 or 18 months or longer.

The thing is that since my first three vertebra fractured nearly 4 years ago they have pushed me to take this Alendronic Acid

too!

I researched it on the internet and found reports of fractures not healing and even occurring in places not usually

associated with fracturing in the general population who do not take Alendronic acid.

I have had a bone density scan twice and I do not have true Osteoporosis but Osteopeania, which as you probably

know is bone density at the lower end of normal but not drastically lower. (My Rheumatologist said this is because I am of

quite a slight build really although I am nearly 56 now.) Heavier builds have higher bone density apparently.

My bone density has not got lower since my first bone density scan either.

So I am truely fearful of ever taking Alendronic Acid and up til now have refused to.

I have an appointment on Monday to discuss my latest M.R.I with my G.P and I just know the topic of Alendronic Acid will

come up again. I will refuse them again I expect.

I am not on steroids for R.A luckily, as I know over time they can possibly cause bones to thin.

But good luck to you and maybe you will begin to heal better whilst off the Alendronic Acid.

I really feel for your predicament with your elbows, it must be awful but you seem to be taking it stoically.

Please keep us posted about how you progress.

Warmest wishes,

FionaSmile


annamaria
#10 Posted : Sunday, April 07, 2013 12:05:55 AM Quote
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Hi Anne

So very sorry to hear about your elbows not healing after all this time. So unlucky to break both:-(

I'll just tell you of my experiences and if it helps at all, the meds that have been prescribed for me.

I had early osteoporosis in my 30's, started RA 10 years before. My 1st shoulder replacement went wrong due to 'egg-shell' bones.
I have had 5 fractures, through doing small things like coughing or starting to walk after coming out of plaster and leaning on crutches. Didnt actually know I had done them until weeks later upon x-raying.

I recently fractured my pelvis after a bone graft was taken for my neck fusion. They wanted to operate but I wasn't keen as a good result was not nearly a sure thing (and weeks of immobility after, not like a replacement).

Sorry abut the boring background but the positive bits - I am now on 6 monthly injections of Denosumab for the osteoporosis, which apparently has good results and no side effects. Due another bone scan in August and crossing my fingers metaphorically.

I recently had a vitamin D blood test and was found to have almost none, likewise folic acid. I take ADcal too, but my rheumy is suggesting a vitamin D capsule instead (something like Fulia sp?) which he says is better absorbed as I have coeliac disease and malabsorption can be a problem.

My surgeon hopes that some 'fibrous tissue' will be formed in my pelvis to stabilise it and I do hydro to help.

I empathise with the elbows as I had both shoulder replacements removed and now have none. I do manage with lots of restrictions. They want to replace both elbows as there is double nerve crush, but I have had so much surgery.

Great that you can still drive, well done - I miss that so very much, the independence of it.

I really hope that you have some improvement and less pain soon, these things do take so long.

Take very good care,
Lizx
annamaria
#11 Posted : Saturday, April 13, 2013 3:10:31 PM Quote
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Hi
Just bumping this up for Anne.

The Vitamin D capsule recommended by my rheumy over ADcal is called Fultium D3, sorry I couldn't remember exactly.
As I have severe deficiency I have to start on 4 a day. Hope to get down to 1 or 2 eventually.
To be avoided if there is an allergy to peanuts or soya
I note that you have a lung condition - it says on the leaflet that your GP should be consulted if you have sarcoidosis and plan to take this.
Other than that it is supposed to be very efficient at raising Vitamin D levels. Apparently sunshine (if and when we get some!) isn't nearly enough but it would be so nice:-)

Hope your elbows are not too painful today, take care,
Lizxx
Anne-P
#12 Posted : Saturday, April 13, 2013 6:32:29 PM Quote
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Hi Liz et al

Thanks for your information, much appreciated. That's interesting to hear about your shoulders. I am presuming it is fibrous tissue that is growing in the gaps on my 2 elbows. I am obviously not alone with this problem.. sorry to hear you have it too.

I take Calceos - which is says it is Calcium and Vit D3 supplement. It says each tablet contains 1250 mg calcium carbonate (eque to 500 mg or 12.5 mmol elemental calcium and 10 mcg of colecalciferol (400 iu Vit D3). I take 2 a day. It sounds like it must be something similar to what you have.

I have to admit I did visit the canary Islands for a week at Christmas to get some sunshine!!!! Now got to wait until summer... but I am tempted to book again for the canaries for next Christmas!! It was so nice soaking up the sunshine. Special assistance at the airport makes it so easy to do something like this.

I see my Chest Consultant in 2 weeks so I will double check with him the medication I'm on to make sure it is all ok (I have bronchietasis).

Next Xray on the elbows is in 5 weeks.... so we'll see if there are any changes.

love
Anne xx



zena_mary
#13 Posted : Monday, April 15, 2013 11:17:55 AM Quote
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Sorry Anne, only just catching up,
How you manage to do anything seems amazing to me.
Your elbows must affect using walking aids etc etc.
Hope your new x-rays show some improvement starting to happen.
Its so good you managed to get away for a while. Its important to still get out and about.
Zena xx
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