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Asthma and Rib Injuries

Does anyone have suggestions how to protect my ribs when I'm coughing?

In the past I broke my left 6th and 7th ribs at the same time coughing. I have now injured my ribs on my right side coughing from asthma. The initial x-ray didn't show a fracture on my right side, but when I broke my left 6th and 7th ribs it only showed up on a bone scan. It is very painful to cough, sneeze and move in certain positions. This how I felt when I broke my ribs before. I have Osteopenia and I take extra Vitamin D. I take oral steroids for severe asthma problems as needed and replacement doses of steroids on a daily basis because I have Addison's Disease. I also take inhaled steroids daily.

 

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  • Kathy P

    Ouch! I haven't broken ribs, but I've strained the intercostal muscles.Do you have an endocrinologist following you for the osteopenia? I've been diagnosed as well – age, long term use of steroids so doc sent me for a scan. I do calcium, magnesium and D in doses specified by endo. Oddly dh is on different doses and no mag – but he does the yearly infusion. His numbers were worse than mine.As for protection now, can you ask the doc for suggestions? I don't know if there might be some sort of "binder" for broken ribs that might help.

  • Marie E Natzke

    MMKB, Kathy P

    Try putting a pillow in front of your stomach and and wrap your arms around it if you are able to do so when you are coughing.  It might help. Someone in my family was told to do that after surgery.

  • MMKB

    Kathy P and Marie,

    Thanks for your messages. In the past the doctors use to recommend a binder for broken ribs but they don't any more. They say now that a binder or wrap increases your risk of pneumonia because they restrict you from breathing deeply. I have used a pillow or I cross my arms around my front to support my ribs. My gynecologist has been treating me for the osteopenia ,but I'm going to speak with my endocrinologist at my next appointment. 

  • LK

    @MMKB,  I feel for you with the broken ribs!  Ouch!  I broke five ribs a few years ago - not helpful when you have cough-variant asthma!  Broke mine getting bucked off a horse.    I asked my doctor about binding my ribs and he said that is not done any more because of a higher risk of pneumonia, as you mentioned.  It took a few days for my breaks to show up on x-rays.  I held a pillow against my ribcage when I coughed.  Although it hurt less when I'd cough, it still hurt.  Took 8 weeks for mine to heal.   Slept, well kind of slept  , in a recliner for those weeks as it hurt too much lying flat.

    If you have a pulmonary doctor for your asthma, maybe he or she has some suggestions?

  • K8sMom2002

    Oh, man, that sounds super painful, MMKB … I definitely think your plan of speaking with your endocrinologist is a good move. I like yours and @Marie E Natzke's idea of a pillow.  

    Could you arrange for a team meeting or conference call among ALL your specialists so that they could figure out ways to balance things out and address issues like this?

  • Pljohns

    OUCH!!  Been there done that-got 3 ribs kicked in doing martial arts a few years ago-They wouldn't bind mine either because of the increased risk of pneumonia.  I found a pillow close when I needed to cough helped too and as odd as it was, laying ON the broken ribs was the best way I could find to sleep.  that was a long, painful 8 weeks.

  • MMKB

    Thanks everyone for your replies! Another question for those of you that have broken ribs in the past – Do you still have pain if you touch where you had the breaks? My ribs still hurt if I touch where I had my broken ribs on my left side. I'm just wondering if this is unusual or normal?

  • LK

    @MMKB,  For me, yes, those spots still hurt for quite some time.  Mine were on my right side and I still have a slight twinge or two when I lay down on that side.  It's been just over two years since I broke them.  I also strained the intercostal muscles when I landed on my side and broke my ribs.  It was hard for me to tell what was hurting some times – my broken ribs or the muscles between them or all of the above! 

    This article on broken ribs from the Mayo Clinic web site mentions icing the ribs may help reduce pain, but it would probably be wise to ask your doctor first before trying something new.

    Treatment

    Most broken ribs heal on their own within six weeks. Restricting activities and icing the area regularly can help with healing and pain relief.

    How long ago did you break them?  What does your doctor say you can do to help ease the discomfort?

    Hope it gets a little better each day for you!!

  • MMKB

    LK,

    Thanks for your message and the Mayo Clinic article. It has been six years since I originally broke my ribs on my left side. However, I have reinjured them in the same location several times. My doctor didn't have any good advice other than try to support my chest/ribs when I cough.

    Thanks again!

     

     

     

  • K8sMom2002

    Ouch, that's a long time for ribs to hurt. I do hope that your endocrinologist can help. Do you take anything for the osteoporosis/osteopenia? 

  • MMKB

    K8SMOM2002,

    Thanks for your message. I take an extra 10,000 IU of Vitamin D3 per week. Yes, I also hope my endocrinologist has some answers for me.

     

  • K8sMom2002

    Fingers crossed! That's a lot of D3! When was the last time you had a bone density scan?

    Here's a general recap from the National Institutes of Health about .

  • MMKB

    K8SMOM2002,

    Thanks for your message and the article you included. My last bone density was in 2016.

  • K8sMom2002

    Hopefully your endocrinologist and your asthma specialist (allergist? pulmonologist?) can review that scan and maybe do another, then figure out a game plan. How are your ribs doing today? I sure hope you've found something to help — I know when my brother-in-law had broken ribs and pneumonia, it was NOT a good combination. 

  • MMKB

    Hi K8SMOM2002,

    Thanks for your message. My ribs are still very painful. I saw my allergist yesterday. She said I should try to brace my chest when I cough, continue taking my asthma medications, watch for signs of pneumonia and it is just going to take time to heal. She did not want to order any other scans. 

    I wish it didn't take so long for ribs to heal and that I could eliminate all coughing until they are healed!

  • MMKB

    Here is a update. My ribs are worse! On Thursday, the teacher beside my classroom sprayed a cleaner in the morning. It was horrible!!!! I had an instant asthma attack – coughing, short of breath and chest tight. I took my Albuterol Inhaler 2 puffs, 4 Albuterol nebulizer treatments which didn't help very much. I had to go to the ER and be hospitalized until Friday evening. When they did a chest x-ray in the ER they were only looking at my lungs and didn't include the necessary views to look at my ribs too. I had even told the doctor and x-ray technician about my ribs. I also told 4 other doctors about my ribs. I was given pain medication, told to brace my chest when I cough and it will just take time for them to heal. I'm wondering if they are ever going to heal considering I keep coughing!!! I'm Prednisone and more breathing treatments so I hope this helps to give me some relief. 

    Side Note – Yes, the other teacher knows I have severe asthma and can't tolerate cleaners, fragrances and etc.

  • Kathy P

    How awful! Ugh on them taking the right views to check on your ribs. I have 2 friends who have broken ribs in biking accidents and they do take a long time to heal .With all the coughing, that must really hurt. Gentle

  • K8sMom2002

    @MMKB, thinking about you and wondering how those ribs are doing. I really hate that another teacher sprayed cleaner that sent you to the ER! Maybe the other teacher will understand better how serious things are? I hope so.

  • MMKB

    K8SMOM2002 – Thanks for your message. My ribs are still very painful! It is agony any time I sneeze, cough, get in/out of a chair, bed or vehicle! The pain is better when I'm standing. I'm have been trying to stifle any sneezing or coughing. I'm hoping I don't get influenza because there are two confirmed cases in my classroom.

    The teacher works part time in my building so tomorrow will be the first day I will see her since she sprayed the spray. I have a meeting with my administration on Thursday to remind them of my triggers and ask for their assistance to address some situations that are causing me to be continually exposed to some of my triggers. I'm hoping the meeting goes well!

  • K8sMom2002

    Yikes, @MMKB. Is there any way the janitorial staff could go in and clean the room before you get there so that it will be as germ free as possible AND will have time to air out?

    Hugs on the spray. @Pljohns has had some really good luck advocating for herself when it comes to her workplace. I'm crossing fingers, toes and eyelashes that your bosses will help you keep things as trigger-free as possible.

  • Pljohns

    MMKB-ugh on the spray and that the teacher knows you have asthma and can't tolerate it!  I used to work in that type of environment-they knew and didn't care-thankfully a job change a year ago, and an AMAZING boss as far as my asthma goes, and an overall much better situation.  You should be protected by ADA and as such, can apply for reasonable accommodations to your asthma.  I ended up doing that to get an air purifier and to avoid being exposed to construction fumes.  I ended up buying my own air purifier from Amazon for $120 but it has been well worth it-it is specifically for odors and it totally took care of construction fumes-paint, glue, new carpet, floor wax etc-and since my old employer never paid me for it, I brought it with me when I left and it has done wonders for people that walk in covered in perfume.

  • K8sMom2002

    Lynn, I'd forgotten that you'd done that! What a great idea!

    @MMKB, a terrific place to start looking for air purifiers is the asthma & allergy friendly™ Certification Program. Here's a quote about it:

    The asthma & allergy friendly™ Certification Program, administered by the Asthma and Allergy Foundation of America (AAFA) in partnership with the international research organization, Allergy Standards Limited (ASL), is an independent program created to scientifically test and identify consumer products that are more suitable for people with asthma and allergies. You can find certified products and services such as carpet cleaning, flooring, vacuums and more at 

  • K8sMom2002

    @MMKB, how are your ribs doing? And are you over that awful exposure to cleaners? I'm hoping you've escaped the flu as well!

  • MMKB

    K8SMOM2002 – Thanks for your message. My ribs have not improved! Now that I have started tapering my Prednisone from 40 to 30 mg I have been having daily asthma and allergy problems . I have a call in to my doctor. The other teacher came to apologize and was very apologetic, but she came wearing perfume! I have a sign posted on my classroom door about fragrances and she has been told multiple times about fragrances. So I have come to the conclusion once again she just does not get it!!!! Yes, so far I have escaped the flu !

  • LK

    Oh, @MMKB, Sorry that your ribs are still giving you grief!  Glad you have at least escaped the flu! 

    Even people that try just don't understand how scents affect those of us with asthma.  I was at my parents' house the other day and my mom started wiping off a table with a scented wipe.  My parents know about my triggers and are the most thoughtful folks, but it didn't occur to her that the scented wipe would bother me.  I mentioned it to her and used my inhaler and put on my mask.  She was very apologetic.  I told her it was okay.  It is their house after all.  Different situation when it's your classroom, though.

    That's a great idea to put the sign on your classroom door. 

    When putting on perfume or wiping down a table is a such a normal part of someone's routine, he/she just doesn't even notice scents and don't realize it affects those of us with asthma. 

    Hope your doctor gets back to you soon with helpful ideas about how to help you!!

  • Kathy P

    Ugh sorry the other teacher doesn't get it w/ the perfumes. I think for some people, they wear scents to often, they aren't even aware anymore!

    How are the ribs doing?

  • MMKB

    LK and Kathy P – Thanks for your messages. Due to daily allergy and asthma problems on 20-30mg, I had to increase the Prednisone back up to 40mg as directed by my doctor. She is also considering switching me to Nucala from Xolair. I wonder if Nucala would be more helpful. It was difficult to get my insurance to cover the Xolair. I'm concerned if I stop the Xolair but then need to restart it that my insurance will give me problems again. I have not been well enough to get my allergy shots.

    Yesterday I had an allergic reaction and asthma attack when I was pulling green grapes off the vines/stems, washed them and ate some at the same time. Symptoms – sneezing, histamine release, nose congested and running, cheeks swelled up, coughing, chest tight and short of breath. This is very disappointing because I had taken 20mg of Prednisone in the morning  ! I'm wondering if it was caused from mold.

    I have had the sign on my classroom door for several years. To make it more visible, I think I'm going to make it larger. I met with my administration. They are going to speak with the school staff again to remind them about fragrances and etc.

    My ribs are terrible ! I dread sneezing, coughing, sitting down/getting up, having to bend down and etc. Yawning even hurts! I haven't been able to stifle some of my sneezes that bring me to tears. I have a medical appointment on February 26th and I hope my doctor can come up with a treat plan for my ribs/bones!

     

  • LK

    @MMKB, Oh my, you had a rough day yesterday!  I know that once I start reacting to triggers I am overly sensitive to everything.  Takes it longer than I would wish for my lungs to settle down again to 'normal'.

    Hope you and your ribs  are doing better now!  Wish I had better advice to help you.  Sending more gentle hugs  and prayers your way! 

  • K8sMom2002

    Oh, man, MMKB! That was a rough day! Do you have an epinephrine auto-injector? 

    There is something called oral allergy syndrome. 

    Kids With Food Allergies (the food allergy division of AAFA) has this to say about :

    Some people who have allergies to pollens, such as ragweed and grasses, may also be allergic to some foods. Proteins in the pollens are like the proteins in some fruits and vegetables. So, if your child is allergic to ragweed, he or she may have an allergic reaction to melons and bananas. That’s because the protein in ragweed looks like the proteins in melons and bananas. This condition is oral allergy syndrome.

    And .

    Also, could you circle back and talk to your doctor about this reaction? While grape allergies are rare, the AAAAI's Ask the Expert does have several links to articles about . Your allergist can help you figure out whether it was the grapes, possible mold, or possible cross-contamination with something else that you're allergic to.

  • MMKB

    LK – Thanks for your message and well wishes! Yes, I have the same problem – once I start reacting to a trigger, my reactions continue like a rolling snowball! 

    K8SMOM2002 – Thanks for the information. Yes, I have EpiPens. Yes, I plan to speak to my doctor about the green grapes. I'm really wondering if it's the green grapes or mold because I usually can eat green grapes. However, I have not been able to eat red grapes for over 20 years because of reactions.

  • Shea

    Hi MMKB! I am allergic to grapes, apples, peaches, pears, plums, and nuts. I became allergic at age 13, and they started off mild and now are severe.

    At agev28 I was diagnosed with a chronic allergic disease called churg-strauss dybdrome and allergic asthma is one componant of it. I did xolair for a year then switched to nucala bc the xolair wasnt reducing my eosinophils (allergic blood cells) or helping me lower successfully on prednisone (which I have been stuck on now for 6 years) Within 3 months of starting the nucala my eosinophils lowered and at one point I was down to 18mgs but then I had a flare and could only get back to 20mgs.  After a year, the program I used to help pay for Nucala ran out of funds so I had to stop. Im still doing well on 20mgs maintenence prednisone, but Id like to get lower–I just cant! Ugh. 

    I wish I knew something to help your ribs, but I can only think of a few things… Nebulizing my asthma meds I have noticed helps me keep more moisture in my throat and helps prevent coughing, my other thought is constantly keeping cough drops around to help quell the cough… Maybe ones that have manuka honey. 

  • MMKB

    Shae – Thanks for your message. I'm sorry you had to stop the Nucala due to the lack of funding. 

    My Update – My Internist finally ordered the appropriate chest x-rays. My right 6th rib is broken ! I now have a cold and sinus infection on top of my uncontrolled asthma and allergies ! I don't know if my rib is ever going to heal! Hopefully I won't break anymore in the meantime. I did receive some good news – I don't have influenza ! I'm going to have another bone density test in March to see if my Osteopenia has progressed.

  • Megan Roberts

    Oh OUCH @MMKB! Really gentle hugs as you recover from that injury with some other respiratory infections on top of that. So thankful you have avoided the flu thus far!! That's the last thing you need with everything else going on. Hope you are finding some ways to protect your ribs just a bit when you cough. Like putting on a back brace and turning it around so it covers your ribs just when you need to cough to keep your ribs stabilized a bit. Keep us posted on how the healing is going!

  • K8sMom2002

    Ugh on the broken rib! So not good! But it's super good that you don't have the flu and that you will be getting an updated scan on your bone density.

    My doctors have told me that there are improvements in the way osteoporosis is treated now … hoping that there are some options that work for you. 

  • MMKB

    Megan and K8SMOM2002 – Thanks for you messages. My doctor said I need to restrict my activities for 2 months. When I broke two ribs on my left side in the past, it took over 2 months for my ribs to heal. I'm hoping it doesn't take that long this time!

  • Shea

    MMKB hugs!!! Im glad they found out that the rib was broken thpugh–that certainly backs up the pain you've been experiencing! I hope you find something fun you can do during the restrictive activity time, and that you have support and help getting housework and things done! I hope it heals quickly– did they recommend any supplements or body wraps or sleeping positions or anything to help the healing process? 

    I would think like, cal-mag-vit d supplement (which you might already be on– my doctor recommended me that for osteopenia–but always run it by your doctor) and maybe ask about a stretchy supportive back/waist wrap like 

    I had one similar to this (I couldnt find mine online) but the link above is similar and it just helped my back out a lot and made my whole body feel better. I gotta dig that thing out! It might help with ribs during coughing. 

  • K8sMom2002

    Hugs on the two month restriction — I hope it heals more quickly than that. Is there anything that helps with the pain?

  • MMKB

    Shea and K8SMOM2002 – Thanks for your messages. Regarding the binder/wrap, my doctor said I shouldn't use one because it will increase my chance of pneumonia. I do have some help with house work and other tasks that require lifting ! I'm currently taking Vitamin D3 and Calcium. I have my bone density test on Monday and I'm anxious to get the results.

    I wish I could stop sneezing and coughing! The sneezing about kills me! I have more luck trying to stifle my coughing than sneezing. I think the sneezing and coughing are going to delay my healing. I really dread the start of the tree pollen season!

     

  • LK

    MMKB,  That's wonderful that you have help with lifting and household chores!  I can imagine how your ribs hurt when you sneeze!  I remember how much mine hurt when I'd cough!  I know not all tricks work all the time, but sometimes gently pressing on the center part of my nose just above my upper lip if I feel a sneeze coming will stifle my sneeze. 

    Hope your ribs feel better tomorrow than today!  Sending more gentle hugs your way!!