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We understand that patients can often
find themselves overwhelmed near the end
of their office visit. This can result in
questions not asked and explanations not
fully understood. Among those frequently
asked questions are those regarding:
Cast
and Dressing Care
Casts, splints and dressings should be
left intact, unless specifically advised
differently. They should be kept dry. To
bathe or shower a commercial cast cover or
garbage bag secured with an elastic band
above the cast or dressing should be
utilized. Hold the arm and hand elevated
in the shower and out of the bath. If a
cast or splint immobilizing a fracture
should accidentally get wet, dry it
thoroughly with a blow dryer. If a
traumatic or surgical wound dressing gets
wet, please call us for instructions.
Casts, splints, dressings should not feel
too tight, should not 'dig in' or 'rub'.
We encourage you to notify us if you
experience such discomfort.
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Pain,
Swelling and
Discoloration
These are common and to be expected
after injury or surgery. The difficulty is
determining when pain, swelling and
discoloration is excessive. Of the three
symptoms, pain is perhaps most important.
Bruising and swelling accompanied with
mild to moderate pain is normal in the
context of an injury or surgery,
particularly when the pain is diminishing
over time. On the contrary, moderate to
severe and increasing pain over time
should raise concern. This is particularly
so when the pain is exacerbated by moving
the fingers and accompanied by numbness in
the fingers. Under such circumstances
or just if you are simply not sure, we
urge you to notify us immediately.
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About
Commonly Ordered Tests
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About
Commonly Prescribed
Medications
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About
Cortisone Injections
Corticosteroids (cortisone-like
substances called "steroids") are produced
naturally in your body's adrenal glands.
One of the purposes of body cortisone is
to reduce inflammation and irritation.
Corticosteroids are not the same as the
anabolic steroids that some athletes take
to decrease body fat and increase the size
of their muscles.
The inflammatory process is the way
that nature heals injuries. First the
blood brings white blood cells to the
injury to fight off infection and clear up
dead tissue. Nutrient building blocks
assemble to rebuild weakened tissue. New
blood vessels form to bring increased
amounts of blood with oxygen to the site.
Inflammation is a vital process, but the
inflammation process can sometimes become
chronic or excessive and decrease the
normal ability of the body to heal. An
example of this would be chronic
tendonitis or a flare up of a joint with
arthritis. When other measures such as
medications, resting or special exercises
fail, your doctor may elect to give you a
steroid injection directly into the
affected joint. The most common reason for
injecting corticosteroids into a joint is
to provide a localized anti-inflammatory
effect, thereby decreasing swelling and
reducing the accompanying pain. This is
done without having the undesirable
systemic effects that oral corticosteroids
can have.
Usually with the steroid the doctor
will include a novocaine-type medication.
One reason for this is to decrease the
pain following the injection itself.
Another is to allow the doctor to know
that he has injected the trouble causing
spot because almost immediately the
patient will have an increase in range of
motion, or a decrease in pain with
movement.
Before an injection, the skin around
the site must be thoroughly cleansed. This
is important so that no skin bacteria are
introduced into the joint.
When the novocaine wears off, some
patients will have increased pain in the
joint for 24-48 hours. You may use
aspirin, Tylenol, or ibuprofen products
during this time. An ice pack applied to
the affected area may also be helpful.
Apply it for twenty minutes, remove for
ten minutes, re-apply for twenty minutes,
then remove. Do this 3-4 times daily. Do
not use heat as it increases swelling and
pain. If increased pain continues beyond
48 hours, you should notify your
doctor.
The relief from a corticosteroid
injection is variable. Many patients will
have dramatic relief while others may have
less or no relief. The relief may last
from only days to months. Maximum effect
generally occurs in 5-7 days. If pain
persists for several weeks to a month, but
it is less severe than before, the doctor
may administer a second injection to
provide additional relief.
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