I,CAREGIVER: Living with a cast

IT’S customary to tell thespians and actors “break a leg” before they go onstage, especially on the opening night. But whatever the origins of this superstition, the literal outcome of this wish is far from good.

Breaking any limb is never good. It is painful and inconvenient.

Last week I wrote about fractures — that bone fractures, cracked bones, and broken bones all mean the same thing. The word “break” is what we, the laymen, call it. Doctors and health care professionals call it fracture, and there are many types.

Depending on the type of fracture, the broken bone may need to be fixed internally with pins and other devices to hold a fracture in the correct position while the bone is healing. To ensure this, doctors will also use external fixation methods like plaster or fibreglass casts, cast braces, splints or other devices to keep the limb in place.

Fractures should not be taken lightly because if a fracture site is mishandled early after the injury, more soft tissue could be damaged which could significantly prolong healing time. What we, non-medical people, do not realise is that arteries and nerves run parallel to bones in the arms, legs and other parts of the body. If a severe fracture is mishandled, the arteries and nerves may be severed or lead to potentially fatal bleeding or paralysis.

When I broke my pinky many years ago, the doctors told me that all fractures or suspected fractures, no matter how minor, should be taken seriously. They also told me that even small fractures, such as a fracture of my little finger, can lead to a frustrating disability if not treated correctly.

My hand was in a cast for nearly three months. When the cast was taken off after the first six weeks, they discovered that my pinky had not set properly. They had to re-cast my finger for another six weeks.

Looking back, I wish I had been told more about caring for a limb in a cast and the little tricks that could ease the irritation. Nobody warned me about the incredible itch that can’t be reached, or the possible skin problems that could arise if the skin became damp inside.

At that time, I was quite proud that I had learnt to use a long ruler to reach into the cast to gently scratch the itch. I didn’t know then that one should never do that. You may irritate or tear the skin and get it infected, which can lead to other problems.

Only years later did I learn a few tricks — after having to care for my late mother who broke her foot, and later my son, Omar, who had his entire right leg in a cast.

To begin with, when parts inside the cast get itchy, just sprinkle baby powder (not too much) and use a hair dryer set on cold to gently blow deep inside the cast. This also helps keep the skin dry and hence, there won’t be odour from it.

When you need to take a shower, use a clean plastic bag or those bin liners to protect your cast. Cellophane tape works wonders at keeping it all together.

For those who have a full cast on the arm or leg, take a panty hose, cut it to your needs and wear it over the cast so that your clothes glide on easily over the cast.

Fractures take several months to heal properly, some types longer than others depending on the extent of the injury and how well you follow your doctor’s advice.

Pain usually stops long before the fracture is solid enough to handle the stresses of normal activity, which is why you need to be extra careful even though you don’t feel the pain anymore. In fact, you need to limit your activities even after the cast is removed until the bone has healed well and is solid enough to take on the daily stresses.

The thing about wearing a cast is that by the time the bone is strong enough for activities, your muscles may have weakened from lack of use. Your limb may feel stiff. This is why you need to be mindful and discuss with your doctor your rehabilitation plan, and the types of exercises that are beneficial for you so that your muscles and bone can again perform their functions normally.