Monday, March 03, 2008

Cast Claustrophobia

Yes, there is such a thing. I had to call the doctor's office this a.m. The last 24 hours were particularly bad. The burning in my foot--along the outside and on the instep of my heel--could not be controlled by meds nor ice.

I went to bed with a ice pack. I awoke with my foot feeling like the guest star at a weeny roast. Took a pain med. No help. Imagined my feet in a cold spring. No help. Yoga breathing. Strike three. My pain transmitters were in no mood to be fooled by my brain.

After two hours of wakefulness, my mind began to wander into the terrible woods of thinking about what tools were in the garage to assist in removing this cast.  I realized that I was now in dangerous territory of imagining the wondrous feeling of freedom that a skill saw would bring to my foot. I realized that being wakeful while being tired and physically uncomfortable was fostering anxiety and thoughts that would likely separate my foot from this plane of existence if I were to undertake any of the castectomies that I was imagining.

Thankfully, I had a sane idea about trying to take a bath.  Bathing is difficult, and I thought that it would take my mind off my foot discomfort. It did. I went back to bed, and around 5:30 a.m. finally went back to sleep for about 2 hours. Upon waking I was greeted warmly by that weeny-roasted foot sensation.  A call to the doctor elicited a very quick appointment (surprisingly so!) after they asked me if I was feeling anxiety.

The doctor was very understanding about my situation. Frankly, I'm embarrassed and surprised by it. Where I've been able to cope and control past physical discomforts, this one nailed me. It always hurts when you bump against your own boundaries. But its a good thing to know where they are, too.

The doctor stated that cast claustrophobia and it is a very "real" condition. I still feel like it is the pain/hotness rather than the cast that has caused my anxiety. I don't even wear shoes most of the time as my feet naturally respond to the pressure of athletic shoes, dress shoes, etc, by relaying that burning sensation. I can take my shoes off.  I cannot take my cast off hence the frustration and discomfort.  Frankly, I didn't feel claustrophobic so much as discomfort--but I was likely trapped in an eternal feedback loop (I guess Hell is likely that way too!) that ticked up the anxiety meter after each loop.  Of course, night time naturally amplifies all that is unpleasant when one is injured or sick. 

Regardless of my rationalizations, it really doesn't matter. The cast is gone--I can "get" to my foot if I need to, though the boot is permanent, not temporary fixture on my leg. I can take it off to bathe which is nice. I'll likely wrap my foot in that event. I don't want to jeopardize my healing in any way.

Nevertheless, I feel like an ultra-weeny. I've had some pretty bad injuries (broken face, sprained knee from a horse falling on it, broken arm), and I can plow through most illnesses with no problem. My major injuries were all on the south side of 25. I'm considerably north of that, so it's not a fair comparison! When I think of folks confined to larger scale casts for larger scaled injuries, I shudder. You can bet this accident has upped my empathy.

If you are reading this post because you are suffering from this malady, call your doctor, and don't feel ashamed.  Ultimately, you have to have peace of mind to foster the healing that your body desperately needs.  If your cast is causing you physical or emotional pain, trust your doctor to find a resolution that preserves the integrity of your healing process.


Anonymous said...

Wish my doctor believed me,how is the new cast?I only have 2 weeks left but at night it gets bad still,such is life.My name is David by the way and feel free to email me,

Rami*Reconciled said...

Gracious me, I'm glad I'm not alone. I just hacked my cast up this morning with a kitchen knife because of my cast claustraphobia. Id have moments throughout the past ten days, the amount of time the cast has been on, that I'd just go hysterical, crying, screaming and I couldn't control it. I'm like you in that I could keep the boot on, no problem with discipline, just knowing that I 'could' take it off if I needed to, you know? I have an appt today to remove my hacked up cast and hopefully my dr will be as understanding as yours and give me the space boot. Hope you heal well!

Tim Ferguson said...

cast claustrophobia is one of the hardest things i have had to deel with my family doc put me on Klonopin 1 mg every 6 hrs. It nocks the edge off of it but I know it is still there I feel like a big baby I'm 47 not afraid of enything but MRI'S and something confineing a part of my body and it %&*()(* sucks and can say 1 thing thank god they set the break perfect without pins but that is the only thing I can say good about it. I think I am going to stop bitching and whineing about it no. any help ? email me thanks

Anonymous said...

Before I broke my wrist I would have laughed If someone had suggested such a thing as cast claustrophobia.
Unfortunately, It is no laughing matter.
I had a bad dream one night that I had my arm stuck In a pipe and woke up pulling at my cast !!
I had to endure It for almost 7 weeks and I hated It. The only way I could get over It was to try and accept It and not to think too much about it.
Keep it elevated on a pillow at night, keep It dry and don’t do too much physical exertion, or it gets very sweaty and uncomfortable.
It helped me to know I had a joiner friend who could cut the thing off If I finally flipped !!
Taking an allergy tablet definitely reduces any itching, and If It does get hot and sticky buy a balloon hand pump and pump cool air through the cast as often as you need it.
Remember, that things on there for a reason. So try and put up with it.

Good Luck !!

Christina said...

I am in the same boat. I am 48 and have always had "light" claustrophobia. Elevators and rooms without doors usually don't both me but I've never been stuck in one either!

I broke my leg and at the ER after X-Rays they said they thought I wouldn't have to have surgery. They wrapped me up in a heavy duty splint and sent me home...saying to wait until Monday (2 days later) to see the surgeon/specialist.

That first night I had a huge claustrobic attack (nights are always worse too). I felt like I was trapped in a 2' x 2' box but I wasn't. I tried standing outside in fresh air and I had to have my husband next to me. It was so bad that I thought I can't live this way with this brain.... an undiscribable torcher. I finally took half the splint off and it subsided. I felt crazy.

I think that I was transferring the pain into the thought that I was trapped and the pain made it go into some kind of hightened claustrophobia.

After surgery I was drugged up for about a week but I wasn't taking the drugs for the pain but for the anxiety of having the cast on and being "trapped" in bed.

I lasted a week before i had another claustrophobic attack. This time I asked my husband for the wire clipper and I took the cast 2/3 of the way off and felt releaf. Use the bull nose wire clippers if you have to.. not scissors... much safer and quicker.
Now i am in a boot;had to change doctors because the first one was not sympathic; and i am having either med. withdraws or just still in a state of hyper anxiety.

It has been the worst thing I have had to ever indure. The actual breaking of the bone and the surgery were cake compared to the claustrophobia and the high almost constant anxiety of the cast and the bed rest.

Reading other peoples stories and solutions really helped me. So I hope some of my story helps someone else. Christina

Anonymous said...

It's 4am and I haven't slept yet tonight. I feel like I'm having a panic attack. I woke my bus and and had to take a Percocet. Still not feeling like I can sleep. The anxiety is what made me look up this phenomenon. Glad to know it exists and I'm not crazy! Seriously, the wrist feels fine- its the cast. I thought the same- get the wire cutters!! My Dr too is very condescending. If I do this, I will have to switch Drs too.

Anonymous said...

Very common to have cast claustrophobia according to my orthopedic surgeon, They just don't tell you about it because they don't want you to work yourself into it. I have a cast on now and am on Xanax for the anxiety but still get panic attacks, Going tomorrow to get original cast off hopefully getting one on that I can remove,
like they put on last surgery.

kyrasmom said...

I just got my cast on for a broken wrist and I'm honestly freaking out! I've always been a bit claustrophobic but this is ridiculous. Unfortunately it's a bad break and I'm stuck with this. I only hope my dr will prescribe something for the anxiety. i have no idea how I will sleep tonight, or for the next 2 months for that matter.

Anonymous said...

This is my second broken bone. First was my ankle. I had no problems that time. This time I broke my wrist. my anxiety started the second night with my cast. It comes and goes but mostly at night. Good luck everyone. It seems so irrational and embarrassing but its nice to know I'm not the only person experiencing this.

marvin werman said...

last week I just had surgery on my Achilles tendon I have been in a splint for about a week and going nuts I want to tear it right off its hot in my anxiety is through the roofI'm so call him to the doctor tomorrow hopefully he can put me on something for my anxiety and I'm so close of ripping This thing off I just took a percocet pill hopefully I can get some sleep tonight us off

It helps a lot knowing I'm not the only one going through this

marvin werman said...

I know exactly how u feel, I am in a splint and last night I wanted to rip it off so bad why are nights so much worse then during the day. And my anxanty. Is though the roof. I had surgery on my Achilles tendon It helps knowing I'm not the only one hope u feel better.

Kurt Wood said...

Its funny in a way to read all these stories. I felt like I was alone, but most of you are describing my symptoms to a T. I got a cast put on 2 days ago for an injury the doctor can't even diagnose. Told him I always had half-cast splints because of this type of thing, but Im not an MD. No broken bones or muscle tears, just soft tissue swelling & numbness in my fingers for the last 5 months.

The night I came home, a dew problems, nothing major. Last night I got the sweats & my heart started pounding. Tonight was the worst panic attack so far. Shortness of breath, heart palpitations, dizziness, & sweating. Trying to cope, but its getting really hard to.

Want to call him, but his office is 3 hours away. Been taking some of the wife's Ativan to help at night (do a lot of people get them @ night?), but my attacks are getting worse.

Afraid workers comp will freak if I go have it cut off after they just paid for it, but I can't sleep & the anxiety attacks are starting to really scare me. Never had anxiety attacks before.

Kurt Wood said...
This comment has been removed by a blog administrator.
Anonymous said...

Thankfully this actually helped me out! Im going crazy at home thinking nobody knows what I am going through but luckily this page has given me some patience and much needed rest of the heart. I have been in a n ankle cast for a week and have 2 left due to my fracture of my medial malleolus but luckily this has helped me out. I read the comments to help me realize im not alone and need to keep pushing through. Thanks guys!

Anonymous said...

I'm so thankful I found this website. I thought I was going crazy with having this wrist cast on. It's been a nightmare. Two days left to go. I am celebrating.

Anonymous said...

It's nice to know there is such a thing. I had my wrist cast put on 1 week ago. Yesterday I ended up in the ER with the worst anxiety attack I have ever had. I have had anxiety for a few years but was able to control it. Not this. I am now out of my cast and in a brace which can be removed it I panic.

Anonymous said...

I broke my leg last year and was in a cast. I had many panic attacks. Read up on the anxiety and understood it better. I had a clot in my leg and they opened the cast and wrapped it after that. I broke my wrist 2 weeks ago. The put me in a thumb spica cast extending to my elbow. They immediately bivalved the cast and taped it shut. I still have panic attacks but i can remove it anytime i need to. I am lucky i realize. Good luck hope this helps someone.

Anonymous said...

last Thursday I had Achilles tendon surgery put in a splint after surgery Tuesday I went to podiatrist to get a cast for 6 weeks non weight bearing Tuesday night I woke up anxiety attack wanted my husband to take it off went to the hospital and they wouldn't take it off so I could not breathe I set under a fan so I could breath until I got hold of the doctor and his office I had to have it off I never heard of cast claustrophobia but I do know now and it is real I couldn't see my toes and I couldn't feel my feet or legs I had lost control so Tuesday he placed me in a boot I promised no walking on it no weight bearing I won't take it off but I can open it and see and feel my leg 6 weeks I can handle this wow I will never go through that again Please tell your Dr if you are claustrophobic first if I had told him he would have put me in a boot to begin with wow

Anonymous said...

I dealt with cast claustrophobia when I dislocated my wrist requiring surgery and was put in a cast from my hand to elbow for three months. The claustrophobic feelings and anxiety, and associated swelling in the cast, that I had was worse than the pain associated with the post surgery recovery. I was taking 10mg of Oxycodone for pain management, which would slightly reduce my anxiety if I took it regularly, which for me, was every four hours. After three weeks I sometimes needed to take it every three hours. If I was late taking a dose the anxiety would spike causing me to want to cut the cast off or take off my a jacket or shirt that was also covering the cast area or get out of enclosed areas, such as a car. The worst of it was at night when I was lying in bed and of course my mind would inevitably focus on my cast and wrist and all the feelings going on there. Being outside helped in reducing my claustrophobic feelings.

When I went in for my second cast I mentioned the claustrophobia and discomfort of the cast to the nurse practitioner caring for me but she was very unsympathetic. I mentioned it again to the tech putting on my cast and he had the idea in cutting the cast from end to relive some pressure and give me some control. The doctor and nurse and they agreed that would be acceptable. The tech put the cast on normally and then cut it from end to end on the top and bottom, as if it was being removed, but left the underlying sleeve and cotton wrapping in place. He then put two Velcro straps around my cast to hold in together. This allowed me to control the tightness of the cast by loosening the straps or take them off. I could also spread the cast open slightly with a fork, spoon, etc. loosening the cast.

I still experienced significant claustrophobia and pain at four weeks. I called the clinic to talk about what level of pain I should be expeieirncing at this point in my healing and that the Oxycodone effectiveness seemed to have gone down. The nurse that I spoke to recommend I talk to the orthopedic pharmacist about my pain. I called him and he suggested that I start taking Gabapentin (aka Neurontin). I started taking the Gabapentin, along with the Oxycodone, and it had a significant impact on reducing my cast claustrophobia and pain. The first day I was able to sleep with only waking up once at night. Previously I was waking up five to six times a night, often with periods of up to one hour before I could fall back to sleep. By the third night of taking Gabapentin I was able to sleep through the night. I had no desire to cut off my cast was gone and about 90% of my anxiety and cast claustrophobia was gone. I was able to stop using Oxycodone after five days of starting the Gabapentin.

I would highly recommend that people ask their doctor about using Gabapentin to reduce their cast claustrophobia. Although it is an anti seizure medicine it is known for anti-anxiety reduction and reduces nerve pain associated with healing nerves. It has made my healing and life much more manageable while being in a cast for such a long time.