Posts Tagged Pain
If you don’t care about the discussion, just skip down to the boo-boo in bold.
In my recent post about most scientific studies being wrong, I began questioning the very basis for evidence-based medicine. How can we know what we know? When we do a large scale human study, we have to trust the results. We can’t run off to a lab and have them do it again.
So I thought a quick check into alternative medicine advances might be in order. As expected, most studies are small and underfunded compared to the massive studies produced by drug companies. And it is those massive drug studies that are in question for their ability to give us truthful answers about what will work. If they cannot be reproduced in a consistent manner, then what chance does alternative medicine have?
There is another avenue for medical knowledge, largely disregarded by current researchers but widely used by the public. It is the school of what works. One of the basics, something we are taught from the school yard, is that ice helps boo-boos. In more medical terms, cryotherapy is largely regarded at efficacious for the treatment of minor acute trauma. But is it true?
Do Boo-Boos Get Better With Ice?
According to the Cochrane Meta-Analysis entitled: Does Cryotherapy Improve Outcomes With Soft Tissue Injury? (free full article here) the researchers concluded: “no authors have assessed the efficacy of ice in the treatment of muscle contusions or strains.”
That’s right, mothers across America. You are applying ice to those boo-boos without a shred of scientific evidence that the ice is effective.
Yes, icing has been shown to be effective after: “ligament repairs and knee and hip replacements. The results of these studies cannot be generalized to muscle strains and contusions.”
But ice works? You’ve seen it work? Mere anecdotal evidence. Unreliable and prone to patient bias. The researchers tenatively regarded ice as possibly helpful for pain, but concluded that: “Many more high-quality studies are required to create evidence-based guidelines on the use of cryotherapy.”
So until they do that, don’t waste your hard-earned health care dollars on ice cube trays and washcloths.
Let’s all wait until definitive studies conclude that ice does indeed help with boo-boos. It may not happen anytime soon, because ice is not patentable (although you know they keep trying). So we may need to create the “Boo-Boo Foundation” to fund ice research. Get ready to march in “Stop the Boo-Boos” marches and send your dollars in. Who knows? In a few decades we might just be able to apply ice to those bumps with the knowledge that it actually works.
Or, if you’ve been following the discussion about studies, we might conclude that good-hearted researchers might want to spend a little less time in the lab and a little more time in the playground. If they banged themselves on the monkey bars, they might just ask for a little ice.
Some things, because they work consistently and well, do not have research. Giving a hug and a kiss are also tried-and-true, unscientific, aids for boo-boo relief.
- I feel like a five year old with a boo boo. Help me take care of my knee. (ask.metafilter.com)
- Ode to an Ice Pack (thefridaynightwine.wordpress.com)
- Being a Klutz (theascentblog.com)
- I Heart First Aid Kits (womanmdsguide.com)
- 13 handy uses for ice cubes (mnn.com)
- Lessons From A Broken Nose (mydisruption.wordpress.com)
- Panthers Smith bruises knee, held out of practice (wcnc.com)
- My Worst Day As A Youth Sports Coach (ashimmy.com)
- Salute to ice packs!!!! (theaveragebookenthusiast.wordpress.com)
- Will Muschamp clarifies Jeff Driskel’s shoulder injury (jacksonville.com)
Warning: The following contains graphic stupidity (by me), concussing and cussing, and descriptions of metal objects entering flesh.
It was sunny recently.
In Maine, this extraordinary event meant that I went dashing into my
garage to liberate my ancient hand mower.
Using this mower to cut my lawn is the equivalent of dragging a large,
sharpened rock around, which is great for my cardiovascular fitness if not my
Unfortunately, I own a hand truck. It’s one of those things that UPS men use to
carry lots of boxes stacked up. (Still don’t know? Have a look at Handtrucks.com) I own it because I once met a very small man who used his hand truck constantly. So it sits in my garage and never gets used, but acts as a kind of shrine to him.
Also unfortunately, I was on space saving mode a year or so back, so I thought it would be a great idea to stick the hand truck up in the rafters with its handle facing downward.
How crafty! I saved a full two feet of floor space and provided myself with fifty pounds of sharpened steel in an awkward balanced position.
So when I went dashing into my garage I pushed a rolling chair full of those foam floaty things that children like to beat each other with in pools out of my way.
The foam pushed the hand truck handle, and I had a sudden flash of…pain. Nothing like a fifty pound hand truck blade to the top of your head for sudden insight.
My first thought was “What the…?” I reached up my hand and touched my
head. It came away covered in blood. Those of us in medicine know that
head wounds bleed like nothing else. Monty Python blood spurts are not uncommon. Forget whatever injury you have, it’s cleaning up the gouts of blood afterward that is the real pain.
So I clapped my hand tightly to the top of my head. I honestly never thought of calling an ambulance. Here in Augusta calling an ambulance probably means that four different emergency vehicles will converge in the next twenty minutes, blocking my street and convincing my neighbors that I have either died or poured gasoline into my furnace oil tank like my next-door-neighbor did last winter (we all know who you are, my friend).
My next thought was for insurance purposes I needed my insurance card. Modern medical researchers should take note. This is not what we want people concerned about in emergencies and basically defines what is wrong with U.S. health care.
So I went inside to get my insurance card. I was glad to feel that the blood was no
longer coursing down my neck, but seemed to be confining itself to soaking my
It occurred to me that since I was not unconscious, and now I wasn’t soaking my clothing with blood, that I might be an urgent care situation. I certainly didn’t want to clutter up the ER department with a minor head wound.
So I drove myself, one handed, other hand clapped hard against my head, to Walmart’s urgent care clinic. Let me say now that Walmart’s clinic is only
urgent care if you happen to have your injury during their hours of operation. Even though I was there a good forty-five minutes before opening, a wonderful person there let me in and looked at my head. She then informed me that they didn’t have any suturing material at the clinic.
It occurred to me as I headed bleeding out the door again that having an urgent care clinic without anything for urgent care didn’t make a great deal of sense.
Bizarrely, the Walmart person told me they see a good number of head wounds, mostly from people hitting their trunk hoods in the parking lot. I was unaware of this particular epidemic. Evidently we need foam cars as well as foam hand trucks.
I drove down to the Augusta ER, which took a very long time. I suspect my adrenals were kicking in, and the stoplights seemed to stretch forever.
The torrential downpour that had just been waiting for me to arrive at the ER let loose as I parked in the visitor’s parking lot. They don’t have an ER parking lot, which would make sense for the idiots like me who drive themselves in.
I was utterly soaked by the rain, which must have done wonders to the blood already drying on my scalp. I went in the normal way to Maine General, because the ER entrance is not clearly marked for anyone walking.
There was no one at the front reception area, so I walked right in and looked for some sign by the elevator on how to get down to the ER. Again, it was fairly confusing.
Fortunately, an aghast hospital employee took pity on me and escorted me
down to the ER.
Once in the ER, I expected fairly prompt service. Usually there is a triage nurse who takes a look at you and sends you to wait or to be seen. Dripping in blood, I figured I had a pretty good chance of getting to the front of the line.
No such luck. The ER receptionist took my insurance card, gave it back to me, and then asked me all those questions you never answer for anyone because of identity theft fears: name, B date, SS#, etc. All this was done in the open waiting area,
while I’m dripping blood on the carpet.
Maybe, just maybe, they could have supplied me with a written form for my sensitive numbers and some gauze to minimize the carpet damage? Hey, I’m not complaining. At least the wait was short. I did drip on the drinking fountain and apologized for it.
Once in, I was seen, not for the head wound, but to take my temperature, pulse, and blood pressure. Again, I doubt if my blood pressure, 134/92, was an accurate measure of my actual blood pressure. It seemed a bit, well, unnecessary.
Finally I got seen by the nurse, who rinsed my head after a bit and wrapped me up in mummy gauze. A while later the doctor, a great fellow I happened to know personally, came over to see me. We talked shop and he told me my options for closing up my head.
I chose the staples without the Novocaine. Honestly, I had things to do and I couldn’t take an hour to wait for the Novocaine to kick in.
I also hate needles so much I’d rather feel the pain. Really. I’ve had my teeth drilled without the Novocaine. It hurts, but I much prefer that dull ache to the sharp and tangy stabbing pain of a long needle probing about for my nerve
Even when I told them about my preference to never see a needle, they made me get a tetanus shot, which truthfully hurt as much as the staples and kept hurting far longer. Three days afterward my head was barely swollen but my arm still hadn’t
returned to full strength.
Having staples in your head is exactly as fun as it sounds. They use a staple gun, just like you would get at Home Depot. It sets up a “what not to do to yourself at home” educational experience. To get the staple into my head, they had to hold my head pretty tight and push pretty hard. I got ten staples, and I think I was pretty done with the experience by about number six.
Again, I lucked out because I have a medical friend who pulled my staples out for me five days later. No visits, no fuss. If you don’t have medical friends, get some. They are great to have around.
What did I learn from this experience?
Don’t provide heavy metal objects with enough potential energy to smack you in the noggin.
Urgent care at Walmart is more a drop in clinic for minor complaints.
The Augusta ER is pretty low key, but they get the job done if you know what you want. (I asked to have my cut slathered in antibiotic after the staples because I knew hospital bugs are not something I want anywhere near my blood). Overall, it was a pretty positive experience as far as stupid trauma injuries go.
And insurance? I have no idea if any or all of it will be covered. My one advantage is that I didn’t get screening x-rays so I won’t have them billing me separately. I fully
expect to get a bill from the hospital, the doctor, probably the receptionist,
and maybe even the staple gun manufacturer (ten bucks a staple, don’t you
Postnote: As with all accidents, my insurance didn’t kick in until the next day. I received a bill for $761 for ten staples. I guess the billing office staff used to work
for the defense department. $76 a staple seems a bit steep. Next time I’ll stop at Home Depot and bring my own in with me. Maybe pick up a staple gun on the
I applied for hospital financial aid, and we got turned down because, although we met the cutoff, they decided I could afford it. But, I got a discount for putting it on my
credit card. Ain’t modern medicine grand?
- Owie Owie Owie (9 viles of Novocain and 3 and a half hours later, I have a hole in my jaw where a tooth used to be. ) (melissabrown1988.wordpress.com)
- Cutting Costs, Medicaid, States and Lawsuits (urgentcaring.wordpress.com)
- iTriage – Healthagen LLC (itunes.apple.com)
- Sharia Law, What About Sharia Medicine? (alternativendhealth.wordpress.com)