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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Severe Pain When Diagnosed With Fractured Ribs

My mother just fractured her hip. She is in enormous pain. Prior to the fall she was extremely lucid reading 5 to 6 books a week, articulate and sharp as a tack. She now is very weak and has hallucinating episodes seeing things that are not there, confusion and severe disorientation in the late evening and early am hours.
Tue, 3 Jan 2017
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Infectious Diseases Specialist,  's  Response
Hello and welcome to ‘Ask A Doctor’ service.

I have reviewed your query and here is my advice.

Well you haven't mentioned whether she has been given pain killers or not. If not it is better to give diclofenac sodium or ibuprofen (NSAID) together with antacids. When people at old age get any illness or severe pain they tend to become delirious. That is one of the reasons for her disoriented nature.

Other reason is she lacks entertainments she did prior to the accident. Also she has become immobile. So may be she is undergoing a depressive episode. Since just history is not enough to say that you should meet your family physician for that. Other possibility is infection. Infections or sepsis cause elderly patients delirious. So excluding an ongoing infection is also a must. It can be an infection at wound site, pressure sores (if there is any) or urinary tract (if the patient is on catheter specially).

For diagnosing that we need wound site inspection full blood count, CRP, UFR. Last but not least is electrolyte imbalances. Serum calcium, Na, K, together with kidney functions is a must. So it is better to meet your family physician soon.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. K.r.w.m.manori Karunathilaka
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Suggest Treatment For Severe Pain When Diagnosed With Fractured Ribs

Hello and welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. Well you haven t mentioned whether she has been given pain killers or not. If not it is better to give diclofenac sodium or ibuprofen (NSAID) together with antacids. When people at old age get any illness or severe pain they tend to become delirious. That is one of the reasons for her disoriented nature. Other reason is she lacks entertainments she did prior to the accident. Also she has become immobile. So may be she is undergoing a depressive episode. Since just history is not enough to say that you should meet your family physician for that. Other possibility is infection. Infections or sepsis cause elderly patients delirious. So excluding an ongoing infection is also a must. It can be an infection at wound site, pressure sores (if there is any) or urinary tract (if the patient is on catheter specially). For diagnosing that we need wound site inspection full blood count, CRP, UFR. Last but not least is electrolyte imbalances. Serum calcium, Na, K, together with kidney functions is a must. So it is better to meet your family physician soon. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. K.r.w.m.manori Karunathilaka