Dr. Jacqueline Gerhart: Falls Are Major Medical Concern
Madison, Wisconsin - UW Health Family Medicine physician Jacqueline Gerhart writes a column that appears Tuesdays on madison.com and in the Wisconsin State Journal. Columns are re-published here with permission.
Dear Dr. Gerhart: My mother fell last week, and she now has painful bruises. She's on aspirin so the bruises are dark. When should I expect the bruises to heal?
Dear Reader: I'm sorry to hear that your mother fell. Falls are a major medical concern - as they can cause fractures, bleeding and pain.
Regarding your question, there are actually three things to consider:
- Why did she fall?
- Why is she on aspirin, and does she need to be?
- When can you expect the bruises to heal?
First: Why did she fall? Fall risk is directly related to the safety of one's surroundings, and one's own strength and balance. Be sure that any rugs in the house are secure on the floor and do not slip. Also, decrease clutter, and consider installing bars on the wall for the toilet and shower and for any stairs. Also, make sure any assistive devices, such as walkers or canes, are appropriately sized. Most physician offices, physical therapists and even medical supply stores will be able to fit these correctly. And if your loved one is slowing down or getting weaker, have her see a physical therapist or attend a senior physical fitness class - such as water aerobics. Physical therapy and exercise will improve her balance and strength. I often encourage my patients to join our local senior center, or to join a class called "Stepping On" - available in many communities - which provides fall risk education and prevention.
Next, aspirin. Aspirin has long been used in our culture - for everything from aches and pains to preventing a heart attack or stroke. The United States Preventive Task Force currently recommends a daily aspirin tablet for specific age groups - namely, men aged 45 to 80 to help prevent heart attack, and women aged 55 to 80 to prevent stroke.
However, the recommendations also note that the benefits of aspirin may not outweigh the risks. In fact, more recent evidence shows that doctors must give daily aspirin to more than 300 people before we will prevent a single stroke or a single heart attack. But the number of people who will be harmed by aspirin - by getting a serious intestinal bleed or other complication requiring hospitalization - is much lower, about one in 100. Taking a daily aspirin is not benign (as demonstrated by your mother's painful bruises!). So talk to your mom's doctor to see if a daily aspirin is indeed right for her.
Finally, bruises. Medications that decrease clotting - ones like aspirin and coumadin - also increase the risk of bruising and bleeding. The larger and darker the bruise, the more blood that has leaked out of the small blood vessels, and the more time it will take to resolve. Bruises on frail skin also may take longer to heal - and may bruise more easily. Your skin type, your age, your medications, and how much tissue damage there is will help determine when the bruise will no longer be discolored and when it will stop hurting. The average healing time is from two days to two weeks.
This column provides general health information and is not specific advice intended for any particular individual(s). It is not a professional medical opinion or a diagnosis. Always consult your personal health care provider about your concerns. No ongoing relationship of any sort (including but not limited to any form of professional relationship) is implied or offered by Dr. Gerhart to people submitting questions.
Date Published: 11/06/2012