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Elderly female with cracked pelvis and ribs - Printable Version

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Elderly female with cracked pelvis and ribs - xizi - 01-09-2014 08:27 AM

Greetings James

I hope you are doing well and I send my condolences to your business partner on passing of her mother.

Here is the relevant data on an 82 year old female who is suffering from a cracked pelvis and ribs.

Current Difficulties
------------------

Injury: Non-dislocating fracture of ischium bone.
Reason: Unknown. This injury was not the result of a fall.
Date: Early November 2013
Treatment: One month of rest at nursing facility.

Injury: Two cracked right ribs
Reason: Rollator tip over.
Date: Late December 2013
Treatment: Currently residing in nursing facility.

Complaints
----------

Severe pain around the rib cage when turning in the bed or getting up from the bed.
Overall body aches.
Occasional flare up of right knee with intense pain.
Near constant painful feet (top and bottom) and occasional complaint of 'heaviness' in the feet.
Left groin heaviness and dull pain when standing or walking.
Inability to stand or walk.

Health history
-------------

Hypothyroidism
Hypertension
Osteoporosis
Arthritis of right knee

Diagnostics
-----------

CT scan of brain did not show any sign of bleeding.
CT Scan and x-ray of spinal column did not show any fractures.
X-ray and ultrasound of right knee indicated arthritis and possible presence of crystals. It is not known as of yet if the uric acid levels were tested to rule out the presence of gout. The report specifically stated the following:

- Profound calcification of the medial and lateral meniscus of knee.
- Joint space is preserved.
- Large marginal osteophytes.
- Moderate high attenuation suprapatellar bursa joint effusion.
- Mild patellar enthesophytes.
- Extensive chondrocalcinosis consistent with CPPD arthropathy.
- Joint effusion.


CT scan and x-rays revealed ischium and rib cracks.

Medications
-----------

Evista 60 MG - once daily
Amlodipine 5 MG - once daily
Levothyroxine 88 MCG - once daily
Lisinopril 10 MG - once daily
Naproxen 500 MG - As needed for pain
Tramadol 50 MG - As needed for pain
Narcotic and other non narcotic pain medications as needed for acute pain.

Supplementation
----------------

Alive once a day multivitamin - once daily on an empty stomach
http://www.swansonvitamins.com/natures-way-alive-once-daily-multi-vitamin-ultra-potency-60-tabs

Your Bone and Joint Formula - 3 tabs twice daily on an empty stomach

New Chapter Ginger Force - One tab twice daily on an empty stomach
http://www.newchapter.com/force-of-the-whole/ginger-force#supplement-facts

Solgar Gelatin Capsules - 3 tabs twice daily on an empty stomach
http://www.iherb.com/Solgar-Natural-Gelatin-with-Calcium-Carbonate-250-Capsules/14420

BioSil Silica - 6 drops twice daily with lemonade or water on an empty stomach
http://www.vitaminshoppe.com/p/natural-factors-biosil-30-milliliter/jf-1001

Carlson Norwegian Salmon oil - 2 tabs twice daily on an empty stomach
http://www.vitacost.com/carlson-norwegian-salmon-oil

Vitamin D3 - One 5000 IU gelcap once daily

1/2 cup of Isopure whey protein drink
http://www.naturesbest.com/en/beverages?product_characteristic=3

Andrographis - 2 caps as needed (if there is an elevated temperature).

Ivy tabs - One tab twice daily as needed (if there is an evidence of coughing, etc.)

Physical Therapy
----------------

Nearly two hours of PT per day/5 days a week that consists of stationary bike rides, stationary hand rows, short walks and seated upper body exercises. Otherwise the patient is either in bed or seated for nearly 22 hours a day.

Notes
-----

I believe Alive multivitamins is perhaps the only brand that you recommend.

Solgar's Gelatin capsules contain calcium carbonate but it is only 10 mg. I believe this may not be a problem.

There is some concern with Isopure's food coloring ingredients and Splenda in general but I doubt if it is a significant problem.

I understand that BioSil is not the most efficient way of obtaining the much needed silica but given the current restrictions, it is the best that we can do.

Questions
---------

Please feel free to ask for any further information that you may need.

Please comment on any other supplement or treatment that can be added or deleted. For example, do you think it is wise to add Nettle Leaf to this regimen?

Thanks very much in advance.


RE: Elderly female with cracked pelvis and ribs - xizi - 01-09-2014 11:29 PM

Addendum: Cipro was just added for UTI.


RE: Elderly female with cracked pelvis and ribs - James - 02-17-2014 02:19 AM

(01-09-2014 08:27 AM)xizi Wrote:  Greetings James

I hope you are doing well and I send my condolences to your business partner on passing of her mother.

Thank you.


Here is the relevant data on an 82 year old female who is suffering from a cracked pelvis and ribs.

Current Difficulties
------------------

Injury: Non-dislocating fracture of ischium bone.
Reason: Unknown. This injury was not the result of a fall.
Date: Early November 2013
Treatment: One month of rest at nursing facility.

Injury: Two cracked right ribs
Reason: Rollator tip over.
Date: Late December 2013
Treatment: Currently residing in nursing facility.

Complaints
----------

Severe pain around the rib cage when turning in the bed or getting up from the bed.
Overall body aches.
Occasional flare up of right knee with intense pain.
Near constant painful feet (top and bottom) and occasional complaint of 'heaviness' in the feet.
Left groin heaviness and dull pain when standing or walking.
Inability to stand or walk.

Health history
-------------

Hypothyroidism
Hypertension
Osteoporosis
Arthritis of right knee

Diagnostics
-----------

CT scan of brain did not show any sign of bleeding.
CT Scan and x-ray of spinal column did not show any fractures.
X-ray and ultrasound of right knee indicated arthritis and possible presence of crystals. It is not known as of yet if the uric acid levels were tested to rule out the presence of gout. The report specifically stated the following:

- Profound calcification of the medial and lateral meniscus of knee.
- Joint space is preserved.
- Large marginal osteophytes.
- Moderate high attenuation suprapatellar bursa joint effusion.
- Mild patellar enthesophytes.
- Extensive chondrocalcinosis consistent with CPPD arthropathy.
- Joint effusion.


CT scan and x-rays revealed ischium and rib cracks.

Medications
-----------

Evista 60 MG - once daily
Amlodipine 5 MG - once daily
Levothyroxine 88 MCG - once daily
Lisinopril 10 MG - once daily
Naproxen 500 MG - As needed for pain
Tramadol 50 MG - As needed for pain
Narcotic and other non narcotic pain medications as needed for acute pain.

Supplementation
----------------

Alive once a day multivitamin - once daily on an empty stomach
http://www.swansonvitamins.com/natures-way-alive-once-daily-multi-vitamin-ultra-potency-60-tabs

Your Bone and Joint Formula - 3 tabs twice daily on an empty stomach

New Chapter Ginger Force - One tab twice daily on an empty stomach
http://www.newchapter.com/force-of-the-whole/ginger-force#supplement-facts

Solgar Gelatin Capsules - 3 tabs twice daily on an empty stomach
http://www.iherb.com/Solgar-Natural-Gelatin-with-Calcium-Carbonate-250-Capsules/14420

BioSil Silica - 6 drops twice daily with lemonade or water on an empty stomach
http://www.vitaminshoppe.com/p/natural-factors-biosil-30-milliliter/jf-1001

Carlson Norwegian Salmon oil - 2 tabs twice daily on an empty stomach
http://www.vitacost.com/carlson-norwegian-salmon-oil

Vitamin D3 - One 5000 IU gelcap once daily

1/2 cup of Isopure whey protein drink
http://www.naturesbest.com/en/beverages?product_characteristic=3

Andrographis - 2 caps as needed (if there is an elevated temperature).

Ivy tabs - One tab twice daily as needed (if there is an evidence of coughing, etc.)

Physical Therapy
----------------

Nearly two hours of PT per day/5 days a week that consists of stationary bike rides, stationary hand rows, short walks and seated upper body exercises. Otherwise the patient is either in bed or seated for nearly 22 hours a day.

Notes
-----

I believe Alive multivitamins is perhaps the only brand that you recommend.

Solgar's Gelatin capsules contain calcium carbonate but it is only 10 mg. I believe this may not be a problem.

There is some concern with Isopure's food coloring ingredients and Splenda in general but I doubt if it is a significant problem.

I understand that BioSil is not the most efficient way of obtaining the much needed silica but given the current restrictions, it is the best that we can do.

Questions
---------

Please feel free to ask for any further information that you may need.

Please comment on any other supplement or treatment that can be added or deleted. For example, do you think it is wise to add Nettle Leaf to this regimen?

Thanks very much in advance.


Envista is a bisphosphonate drug, which are well known or inducing bone brittleness and therefore increasing the risk of fractures. These drugs are given for osteoporosis, but people need to understand that hard bones does not necessarily mean strong bones. Diamonds are the hardest substances known but are easily fractured.

The bad news is that it can take up to 10 years to get the very dangerous bisphosphonate drugs back out of the system once the drugs are discontinued.

It is also pretty stupid on the part of the medical personnel to be giving her Naproxen with high blood pressure since nonsteroidal anti-inflammatory drugs (NSAIDs) such as Naproxen raise blood pressure. See:

http://www.medcapsules.com/info/NSAIDs.html

http://www.medcapsules.com/info/nsaids_and_heart.htm

Yes, nettle leaf will provide a lot of the minerals needed for healthy bones. Alfalfa herb (not sprouts) and seaweeds such as bladderwrack are also great sources of minerals for bones.



RE: Elderly female with cracked pelvis and ribs - xizi - 02-17-2014 09:14 AM

Thanks for the response, James.

Thankfully Evista is not a bisphosphonate. It is a SERM.

OTOH, she was taking Fosomax several years ago and perhaps that caused her bones to be brittle.

Your point is well taken in regards to Naproxen and high blood pressure. She is now taking this medication infrequently.

As I stated, she is taking your Bone and Joint formula but I will add Nettle Leaf to her regimen in the near future.

Thanks again and take care.