Question: Hi there,
I am not the patient, the patient is my husband, who is a 62 year old male (you never know these days!), who slipped and fell on the ice 2 days ago while on a unsalted driveway.

He is quite healthy, with a history of hypertension, (well controlled),on Ramapril 1 tab each am, Glucosamine and Chrondroitan- sp? unsure of dose each day, Vit B12, and unfortunately, suffers from morbid obesity.(6 ft 2 " or so, wt= 248-268.(fluctuates& won't let me see scale!) Other prn OTC meds include ASA 81mg q tab each day, (prophylactically), and and occasional Ibuprofen or Aleve for muscle aches and pains. He recently, had a bout of rt. leg sciatica, and parathesis, for which they ordered an MRI, or CT Scan, which showed the usual arthritic changes that occur at his age. I believe, he was also dx with spinal stenosis.

My question to you, is that this occurred 2 days ago, (I was out of town), and he said "it knocked the wind out of him." He presents with left sided bruising, (very little) in the left kidney area, my feelings are, if in doubt, check it out! (He's a bit more stubborn). I palpated the affected area, and noted bruising and swelling, therefore, had him use ice, and gave him a 800mg dose of Ibuprofen before bed. (I know the XXXXXXX is 2400mg per day)He has no mobility issues, is able to bend forward, didn't try backwards, or side to side, I am just concerned, that he may have a risk of speenic rupture,( know that's upper left quad... but he fell quite forcefully) to or rib fx, that i don't want to miss. He is the love of my life, and if anything were to happen to him....... let's just say, my life would end as well.
1. Should I insist he go to PCP, for at the very least an x-ray?
2. Should I just continue with current regime of rest (yeah, right...doesn't happen), ice....then change to heat?
3. Should I bring him to Urgent care immediately? Better safe, than sorry?
(One sign, I did not like, is that the bruising was diffuse (scattered, irregular pattern, resembling pettachiae.
I am no expert, just a caring wife, who wishes to keep her hubby safe, but his stubborn personality is awaiting your response.


Thanks,
XXXX

Hi Dr. Ditah!

I thought all was OK, but wanted to be sure... I am a newbie FNP ( taking boards this week), and have traveled to 3 reviews, in 3 states in 3 weeks! (This week.....I am too tired to think!)

I have the Best Husband in the World! He put through 9.5 years of school, I graduated in May 2015! I have been caring for 92 yr old Dad/ Dementia! I hate having to know all the answers all the time... but I think the Great NP's, are the ones who don't always know the right answer, and aren't afraid to say so!
Thanks for covering me, if you pray, pray for me this week! Thanks!!!

Most Kindly,
XXXX

Many Thanks