1 THE FIRST 72 HOURS: 10 SIMPLE THINGS THAT CAN HELP YOU HEAL What you do and don t do in the first 72 hours after a car accident can radically affect the course of your recovery. Your body is at the peak of vulnerability to further insult. Simple things like rest, good nutrition, and the right kind of treatment can help you heal. And everyday things like lifting, twisting, or even sitting can make things much worse. If you take it easy now, you will be rewarded in much faster healing and a greater likelihood of complete recovery. And health, as they say, is priceless. Can your physician give you a magic pill that will let you continue - for a little while - with your overstressed life? Maybe. Do you really want one? Yes, you can mask your pain with pills, but that is a ticket to disaster. Your body is telling you something: Slow down! Follow these simple rules and you will be rewarded with a much faster and uneventful recovery. 1
2 Top 10 Silliest Things I Have Seen People Do after a Car Accident No. 10: Go to a yoga class and stand on their heads No. 9: Play Basketball (or football, or soccer.) No. 8: Go grocery shopping and lift heavy packages No. 7: Take 4 dogs for a walk No. 6: Shovel Dirt in the Garden No. 5: Paint the Ceiling No. 4: Carry their 2 year old around for an hour No. 3: Work out hard in the weight room No. 2: Sit on their butts for 8 hours at work And the Number One silliest thing Act like nothing just happened! 2
3 RULE NUMBER ONE: GO HOME! The single most important thing you can do to speed your recovery after a car accident is free: GO HOME AND REST! lot later. You wouldn t go to work after surgery a car accident can be just as traumatic. I have to be blunt: there is no free lunch. You are injured. Pay a little now, or you will pay a In my experience, going to work right after a car accident can add six months or more to your recovery time, require many additional doctors visits, cost you thousands of dollars for additional medical care, and put you at risk for chronic health problems. You may not feel particularly bad after a car accident don t be fooled! The adrenaline that floods your body can dull your pain receptors for a while. It doesn t mean you are not injured. THE EXOTIC DANCER WHO STAYED HOME.. The most dutiful patient I ever had was an exotic dancer named Delilah. Delilah called me from the scene of her fender-bender and came in for treatment that afternoon. Delilah was an excellent businesswoman and knew she had a limited shelf life (her words). She could not afford a less than perfect recovery. She took out her pen. What do I do to get back to work? She asked. No work for two weeks or until the strain is gone. No working out until you are pain free. No high heels. Walk every day. Delilah borrowed money for her mom, used the time to rest and recover, and was back at work shortly thereafter with no long term consequences. 3
4 RULE NUMBER 2: ICE + WATER + VITAMIN C = LESS PAIN AND INFLAMMATION DRINK AT LEAST 6 cups of fluid every day for at least a week after your accident. Extra fluids can help reduce inflammation by carrying away the waste products caused by the injury. Water is best, but be sure to take minerals and vitamin C. Vitamin C reduces inflammation and is essential for tissue repair; electrolytes are important for neutralizing the harmful free radicals that are generated by inflammation. You can add little packets of fizzy powder containing electrolytes or vitamin C to your water. These are available at most health food stores. But not soda pop or alcohol. No, I am not trying to ruin your life. But soft drinks are sweetened with high fructose corn syrup, which can tax the liver, interfere with the manufacture of collagen and elastin necessary for repair of damaged ligaments and muscles, and inhibit the action of white blood cells. Soda may taste great, but it can interfere with your healing. So drink some natural (unsweetened) fruit juice if you really need a sugar fix, or try the natural sodas that are sweetened with (gasp!) cane sugar. And while you re at it, skip the alcohol for a week. Your liver has a lot of work to do after an accident, and alcohol makes your poor liver work that much harder. ICE is excellent for control of pain and inflammation, especially in the first 72 hours after the accident. Put crushed ice in a Ziploc bag and wrap it in a small towel. Place the towel on your upper back and neck. Better yet, wrap the towel around your neck with an ace bandage to create gentle compression. Freeze a few wet washcloths; they re great for odd shaped spots like knees and ankles. 4
5 RULE NUMBER 3 SING! A SUDDEN SHOCK will cause us to gasp and tighten our diaphragm depriving us of healing oxygen. And the sudden snap of the shoulder harness against your chest can jam your rib heads firmly into your spine. Your ribs, instead of moving gently as you breathe, will act like a vise around your lungs. You might find you have trouble getting a deep breath. No wonder you re so tired after an accident you can t get enough air into your lungs. SINGING is one of the best ways to move your compressed rib heads and relax your diaphragm. Sing in the shower if you re shy. If you are just too shy to sing, do this little exercise instead. Lie down and lay your arms across your belly, gently holding on to the sides of your ribcage. Breathe into the back of your throat slowly, pushing your hands out and away. Blow out even more slowly, pause, and inhale again. Do this for a minute or two, three times a day. 5
6 RULE NO. 4: SEE YOUR OSTEOPATHIC PHYSICIAN IMMEDIATELY! Yes, I said an osteopathic physician. Why? What can an osteopathic physician do that s so special? Osteopathic physicians are trained to use their hands to diagnose and treat the human body. We receive hundreds of hours of additional training in medical school in anatomy, physiology, and hands-on, manual medicine. We can check you out medically, but we can also use powerful and sophisticated manual techniques to take the shock out of your poor nervous system and stop the crippling cascade of inflammation, injury and pain. In my experience, this is absolutely critical for healing from a trauma like a car accident. If you don t know a good osteopathic physician who specializes in manipulative medicine, the American Academy of Osteopathy can provide you the name of one in your area (see appendix). Of course, if you have a practitioner who is familiar with treating car accidents, is knowledgeable about anatomy and appropriately gentle, make an appointment as soon as possible. AMY CAME TO ME after three months of sleepless nights, intense anxiety, and unrelenting shoulder pain following a minor car accident. Acupuncture, physical therapy, massage, sleeping pills and vicodan had done little to improve her condition. When I put my hands on her, I felt like I had touched an electric socket. Her sympathetic nervous system had never turned off its fight or flight reaction to the accident and it had commandeered all the energy that should have gone into healing! After her first osteopathic treatment, she slept for 12 hours. Within two treatments, her energy improved and her shoulder started to respond to the physical therapy. I wish I had found you earlier, she said. 6
7 RULE NUMBER 5 TAKE HOMEOPATHIC ARNICA! If you want to speed your recovery, take homeopathic Arnica. Professional athletes use it. Dancers use it. Some surgeons use it for their patients. Homeopathic remedies are some of the most effective, natural healing medicines on the planet. And Arnica Montana is renowned for its ability to help the body heal from acute trauma. Homeopathic remedies come in different strengths or potencies, from 30 C (weak) to 1M (strong), to 50M (very strong) and higher. Your For more specific prescribing information after an accident. see chapter 25, Nature s Healing Remedies. health food store should carry at least the 30C potency. If your health food store doesn t carry Arnica, consult the list of homeopathic pharmacies in the appendix at the end of this book. A STORY ABOUT ARNICA Brigid was driving home with her five year old son William when a car swerved in front of her. Brigid slammed on the brakes. William s seat belt failed and he flew out of his seat. He struck his head on the windshield so hard that the windshield cracked. Brigid immediately pulled over. William was crying but conscious. A large welt had started to form. She kept a small vial of homeopathic Arnica in her glove compartment. She gave William a dose and rushed him to the emergency room. 30 minutes later, William was examined by the Emergency Room physician. He was alert and chatty. He exhibited no symptoms of a head injury. Scans showed no apparent injuries; in fact, William no longer had a bump on his head where he had struck the windshield. The doctors decided the windshield must have been defective. Brigid carefully observed William for 48 hours, as instructed, but he had no apparent further consequences of the blow. I really believe Arnica saved us that day, Brigid told me. And I agreed. 7
8 RULE NUMBER 6 Tell The Team To Play Without You Never exercise right after a car accident! I tell my patients that for the first week after an accident, all bets are off for sports. It often takes that long for your brain to unscramble enough to figure out where you hurt. A week is an awfully long time when you love your exercise. For many of us, sports and exercise are our passion and staying off sports is a true deprivation. Follow the Jock s Survival Guide in Chapter 10 to get you through this time. Don t be fooled because you feel great! Adrenaline pours into your system after the accident. It dulls your pain receptors, dumps sugar into your bloodstream and shunts extra blood to your muscles and brain. Adrenaline does not prevent injury! It is a short-term survival mechanism to help the body deal with acute dangers. Don t cut corners with your recovery: use the discipline from your sport to train yourself to recover. THE LAWYER WHO PLAYED TOO SOON. My wonderful lawyer patient arranged her entire work schedule around the 11 a.m pickup game at the Y. When she played basketball, her mind turned off and she felt like she was flying. She couldn t live without the high it gave her. So I knew my advice to stay off the court for six weeks would not be well received. She had already had interruptions for injuries, pregnancies, and another accident. She didn t listen. Five days after her car accident, she went to the gym. Her reflexes were poor. She was dizzy. A few minutes into the game, she couldn t get out of the way of a much larger male player, who knocked her to the ground. Her weakened neck muscles could not protect her cervical spine, and she blew a disc. Instead of six weeks, she was out for a year. That was so stupid, she says today. I should have listened to you. 8
9 BUT WHAT ABOUT MY WORKOUT? Please, DO NOT LIFT WEIGHTS or do weight bearing exercise for at least a week, and after that, until you are pain free. Let pain be your guide. Your body is telling you, STOP! If you overtax an injured muscle you can create scar tissue, not stronger muscles. you can herniate a disc, impinging the spinal cord or the spinal nerves. These are potentially serious injuries that can require surgery to repair. When our muscles are injured, we often transfer the job of lifting to our joints, ligaments and tendons. Injuries to these structures can take much longer to heal than the muscles you strained in the car accident. So skip the gym until you are pain-free. If you don t, you may never be pain free. 9
10 And No Yoga either.. WHAT! You say. No yoga? Don t get me wrong. I love yoga, do it every day. And I recommend it strongly to my patients after they have passed the acute stage of their injury when their muscles and ligaments are no longer in acute spasm and can benefit from gentle stretching. More than one of my patients has blown a disc by doing the plow to stretch her neck after a car accident. Stretching too early is actually counterproductive. After a rear end collision, the neck muscles often go into spasm to splint or protect the neck until the ligaments heal enough to take back the job of supporting the neck. While this development is very painful, and often sends people scurrying to their massage therapists for a neck massage, it is also essential to the healing process. DO NOT try to stretch out the muscles of the neck or upper back during the acute phase. They are sore for a good and productive reason. So skip your yoga class until the acute phase has quieted down, and your health care practitioner has cleared you for gentle stretching. And NO backbends, plows or headstands until you are completely well. 10
11 RULE NUMBER 7: BUT DO A LITTLE EXERCISE EVERY DAY Walking, however, is something you should do as soon as you are able. I tell my patients to begin walking on a flat path, in supportive shoes, as soon as they are able to do so pain free. Even two minutes, if that is all you can do. A recent study has suggested that gentle movement begun fairly soon after an accident can help the neck recover. While this is very good news for victims of auto accidents, it is not an ok to exercise on your own. Patients with neurological deficits or pre-existing conditions were excluded from the study, and participants were followed carefully by physical therapists, who provided many with individual exercise programs. So get clearance and guidance - from your physician or health care practitioner before you start on any mobilization regimen. But make sure you walk every day. 11
12 RULE NUMBER 8: WEAR SENSIBLE SHOES At the risk of being a fashion dud, I tell my gal patients to take off their high heels,,,, everybody to take off their cowboy boots, and their platform shoes. Ladies, I know you love your heels. They force a curve into your low back so your butt sticks out and you are a hot item. But the price of beauty is back strain, neck strain, and knee and ankle injuries. And that s when you re healthy! After a car accident, your upper back and neck are already at risk; don t make the problem worse by insisting on being fashionable. Delilah the Exotic Dancer tells me that the girls at the clubs take their high heels off as soon as they are off stage, because they can t afford back and ankle injuries. These girls know something: pay attention. A cheap solution to back pain. Gentlemen, take your wallet out of your back pocket. It pushes your sacrum and hip forward on one side and cause back pain and sciatica. Sometimes putting your wallet in your front pocket is the only thing you need to cure an aching back! 12
13 RULE NUMBER 9 DON T LIFT ANYTHING OVER 5 POUNDS Five pounds is a bag of flour. Argh! Don t lift your toddler, your grocery bags, a 2 x 4, your briefcase, your toolbox. If you have injured your neck and back, you tend to lift things using the wrong muscles. Or you will aggravate an already inflamed spot. This is very hard. How can you live your life if you can t lift anything? Check out the practical tips on keeping strains to a minimum in The Home Survival Guide (Chapter 8) and Work Survival Guide (Chapter 7). But the bottom line is. 13
14 RULE NUMBER 10 ASK FOR HELP! Your health may be at risk here, so don t be shy about asking for help with tasks that involve lifting, bending, or reaching. And schedule frequent rest breaks during the day, both at work and at home. That means you are going to need help. Your family and co-workers will be happy to pitch in, and you will be rewarded with new friends and much faster healing. You would help out a member of your family or a co-worker if they needed help you will be pleasantly surprised to find that most people are happy to help. 14
15 AND FINALLY. RULE NUMBER 11 WHEN IN DOUBT SAY, HEY! I WAS JUST IN A CAR ACCIDENT! And then go home and rest.!2009 Maud Nerman SEEK IMMEDIATE EMERGENCY MEDICAL HELP IF YOU HAVE ANY OF THESE SYMPTOMS after A CAR ACCIDENT: 1. Weakness in your extremities 2. Inability to control bladder or bowel functions 3. Extreme drowsiness or headache 4. Blood or fluid in your ears or nose 5. Bruising behind your ear 6. Problems with vision, hearing, or swallowing 7. Severe pain anywhere, particularly in the neck 8. Abdominal pain of any kind 9. Chest pain, particularly if you struck the steering wheel 15
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