Right, fasten up #MedTwitter... a #FOAMed thread about rib fractures, analgesia, and breasts. Relevant to anyone who may end up managing pain in patients with rib # (and anyone who has the boobs to carry off the Renaissance Fayre look who manages to get #HurtyRibs!)... n/1
Now, if you haven't been following my #HurtyRibs saga may I humbly suggest you take a look - 5 weeks of my whingeing about multiple left-sided rib fractures following an unscheduled dismount from my appaloosa mare, Chip... n/2
And - as someone who most definitely can carry off the Renaissance Fayre look - I had semi-twigged that bra choice is crucial to tolerating #HirtyRib pain... n/3
I adopted the sleeping w/ foam wedge & nest of pillows tactic from the get-go, following suggestions from the lovely people who live in the Twitter app in my phone... top tips you don't tend to see mentioned on typical NHS chest injury advice leaflets... n/4
But if you're over about 18, sleeping semi upright, & take an F/FF cup size, there's a boobs vs. gravity problem. So I also quickly worked out that jamming a memory foam pillow into my left axilla - supporting my left breast in the process - hurt much less. n/5
My postero-lateral rib #s were confirmed when I had a CTPA for SOB 19 days post-injury, but w/ pain, crunching/crepitus & "sensation of something moving" at the sternal end of the same ribs, I'm pretty damn sure one or two of ribs 3-5 are bust antero-medially too. n/6
... and this is where breast tissue moving around and pulling at the sternal end really hurt. I've never seen or heard of breast movement being mentioned as exacerbating pain from rib #, so I thought I'd check with breast surgeon guru @Liz_ORiordan that I wasn't imagining it! n/7
So @Liz_ORiordan kindly confirmed that no, I was not imagining it... "A 36F weighs 900g... they're connected to pectoral fascia by strands of connective tissue, and below the pec, the base of the breast is attached to the periosteum over the 5-6 ribs and near the sternum..." n/8
Hence, from this day forward, if you write leaflets, examine/treat, or prescribe analgesia for patients with rib fractures - please include advice that women who take larger cup sizes of bra and have rib injuries need to get some slip-on, non-underwired night bras! n/9
And as a bonus - Liz recommends using them even after rib fracture have healed, to delay your boobs heading south for the winter, and to help reduce breast pain caused by having 2kg of breast tissue dangling off your chest wall... n/10
At which point I should hand over to @Liz_ORiordan to give us a mini tutorial on breast pain from big boobs! n/11/ends (for now - #HurtyRibs not yet better 🥲)
Added tweet: what's the smallest size of breast where this might be an issue? @Liz_ORiordan and I just conferred on this... we reckon any breast that flops when you roll over... the Pencil Test, maybe? n/12/may or may not stay the end of the thread
@ceribattle @Liz_ORiordan @ResearchWales Megan - my friend in the pic - would’ve loved that role. Sadly she died by suicide in 2017 😢 I missed her terribly yesterday: she should’ve been on the phone cackling about flashing her boobs on Twitter. She was very very proud of them (!!), as a mutual friend recalled:
@ceribattle @Liz_ORiordan @ResearchWales I guess I just have to treasure the memory of that day at the Renaissance Fayre in Florida, nearly 20 years ago, which was so much fun. I’ve never laughed so much in my life, before or since. Though I wish Frizz Ease had been available then! 😂
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