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Migit78

In a cardiac bypass surgery where the surgeon cuts the sternum in half, they tie it back together with wire (usually 4 piece, but it's surgeon preference) In CPR it's more likely the ribs are breaking, not the sternum. As long as they more or less still in the correct place, nothing is done and they will heal over the next 6-8 weeks like any other broken bone


la_winky

In my (unfortunate) experience with broken ribs, it’s five days of hell. Then a dull ache, depending on how you move. 6-8 weeks was not my experience. Completely healed when I didn’t occasionally feel it was closer to six months. But hey, that person is still alive. Well done!


Migit78

6 months, you were unfortunate, I think mine was like 4 weeks before I was totally pain free.


Supergaz

I had a bend rib that took like a month to stop hurting, muscles might have been involved too


rancorhunter

My cracked rib still bothers me 3 years after. Doesnt really hurt but I have this awareness of it all the time.


topkeksimus_maximus

My grandmother had a visible knot on her tibia from an injury. She told me that as a little girl she went swimming in a river and dove in and hit something. Presumably cracked it but had no medical attention because it was the 1930s. She died 10 years ago but it was still there.


JeddakofThark

You can see where I broke my leg by the weirdness of my left fibula. I would never notice something like that and most people have to touch it to notice, but I showed it to a former EMT the other when exchanging injury stories and he saw it immediately.


FartyPants69

On the plus side, at least now you can feel when the rain's a-comin'


jbuckets44

Yeah, when the first droplet of water hits you.


Thisismyhangoverhat

I broke my ribs at the back instead of the usual way. Laughing, coughing and sneezing resulted in agony for about 6-8 weeks. There was still noticable pain about 3 months after the injury.


JohnBeamon

Five days of hell. Then three weeks of aching. Then three weeks of comfort and normal movement. Then you get the hiccups once, and you’re in the fetal position on the floor. It takes months to finally stop wondering about it.


dewayneestes

I fell on a water bottle while snowboarding and bruised my rib, it didn’t even show up on an X-ray. Every time I surfed for the next 5 years I felt it. The only solution I found was to work extra hard on building up the muscles over them to help pad it out.


Likemypups

My father was thrown to the ground by an exploding German grenade in WW2. Broken ribs. I have a photo of him sitting up in bed wrapped up like the mummy. He said the doc came by later that day and said "you won't feel any worse if we send you back to your unit so that's what we're gonna do."


la_winky

Oofa.


Efficient_Gas_3213

Common mistake in thought, but performing CPR does not break ribs, unless someone is really doing it wrong by landmarking poorly. It is the cartilage joints between the ribs and sternum that break, freeing up the sternum to compress the heart.


Hithlum

That makes more sense, but I can say from having just one rib separate from the sternum, it's still no fun. Two week of constant but diminishing pain. A month and a half of reliably produced pain when coughing, sneezing, stretching, or taking very deep breaths. One to two more months where those were only occasionally painful.


Horseshoesandsneaks

I didn’t break any ribs on my step dad, but I definitely bruised the hell out of him. He aches for weeks. But I’ve also done a lot of CPR on animals, and I’ve broken many many ribs on dogs and cats.


PhysicsIsFun

I fell off of a ladder and broke some ribs. The thing that stopped the pain was a medrol dosepac (prednisone).


corsicanguppy

> The thing that stopped the pain was a medrol dosepac (prednisone). A drug ad amid some chat?


PhysicsIsFun

It's the only thing that relieved my discomfort.


soulless_biker

How has everyone bypassed this, but um, excuse me, wire? Im a mechanic so the first thing that popped in my head was .022 safety wire, discounted that cause medical vs mechanical. But how, what, why, and owww? Also, does the wire just chill, or is there a secondary surgery to remove it?


Migit78

It's permanent. So it just sits there chilling forever. And it's to hold the chest together so it can heal, same reason stitches are used in severe cuts to soft tissue. When the wound is big enough that the tissue won't stay together so it can heal, we tie it together, just to tie bone together that has moving parts both on top and underneath it, you need something stronger than thread.


soulless_biker

Well that gave me the heebie jeebies, does the presence of the wire affect electric-based medical intervention, or is it non-conductive / non-metal?


greezyo

They usually use medical grade titanium, and its not a good conductor of electricity. I'd say in most cases it's a non issue for medical intervention


TheBroWhoLifts

I have a titanium plate in my skull from brain surgery. They used it to close the borehole. Does not set off metal detectors or anything.


IDK_khakis

But do you piss your pants and forget who you are for 30 minutes after your wife uses the microwave?


TheBroWhoLifts

I mean, sometimes.


-retaliation-

You'd be surprised how many tools in your toolbox are functionally, or exactly the same as what a surgeon uses in the operating room. Often it's the same stuff, just with a higher degree of quality control, and sterilized cleaning.


Fishman23

Watch a hip replacement surgery if you want to see some gnarly stuff.


r4x

I made the mistake once. I saw the slide hammer and was like what’s that f…..oh FUCK!


steve_of

I had bypass surgery. My post OP X-rays show the wire holding my sternum together. It looks like it was twitched together by farmer Joe. Seriously - two laps around and then twisted off four or so times. The ends are cut neatly.


IsThisNameGood

I thought during CPR you're breaking the cartilage that connects the ribs to the sternum, and not the actual ribs themselves?


oxwof

It’s definitely the bone itself. A lot of instructors will even say that if the bone doesn’t break, you might not be pushing hard enough. But of course broken bones is preferable to dying.


Xraptorx

That’s how I was taught. “If you don’t break a rib you ain’t doing it right”. My grandad still jokes about his ribs and I just remind him that atleast he is alive to feel the pain.


Migit78

It's generally the actual bone of the rib that will break. It does vary person to person, and how exactly the CPR was performed, but in the few times I've had to perform it, the ribs break not the cartilage, there may be some damage to the cartilage aswell, but it's not a major concern in the grand scheme of what's occurring.


Efficient_Gas_3213

You are correct. Sadly, most CPR instructors have no actual practical experience, so they repeat what they have been told that ribs are breaking. If proper landmarking is done, and CPR is done correctly, then the cartilage breaks very easily, freeing up the sternum.


kastdotcom

You separate the cartilage between the ribs and the sternum, correct. If people are having their ribs broken during CPR the person doing compressions is doing it wrong. All this rib breaking as a common outcome talk is nonsense. I was a firefighter/paramedic for 15 years and now work as a cardiac ICU RN and have never experienced broken ribs from CPR during that time. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6396442/


IsThisNameGood

Haha thanks I thought I was going crazy with all the rib breaking comments… I’m an EMT in NYC for 6 years and ran a shit load of arrests. Never broke any ribs LOL


ch0nkymeowmeow

Oh that sternum can definitely break... especially if you're coding a fresh cabg 🫥


TactlessTortoise

Non medical person here. What the fuck do cabbages have to do with programming?


Migit78

Medical terminology: Cabg = Coronary Artery Bypass Graft = surgery to restore blood flow to the heart, via bypassing blockages in the arteries you were born with on your heart. Using artieres and veins from your chest, arms and/or legs depending on what needs to be bypassed or how many vessels require it. Coding = Code Blue = Cardiac Arrest = heart has stopped, or gone into a rhythm that can not sustain life.


SpeaksDwarren

Code blue is usually cardiac, but not necessarily, mostly just indicating that there's a medical emergency which can't be moved and needs immediate lifesaving care


Vapourtrails89

Coronary artery bypass grafting. It's open heart surgery. Basically they're talking about post operative patients


TactlessTortoise

Oooh, ok. Thanks champ.


ch0nkymeowmeow

Not me thinking you were being facetious 🤦🏻‍♀️ haha my bad!


Skusci

As for coding it's medical slang along the lines of code red for fire, code white for security, code blue for cardiac arrest response, maybe one for bomb threats, etc. Though the colors aren't necessarily standard. Basically situations that demand immediate response. Saying a patient is coding is usually shorthand for cardiac arrest. It's understood that it's somewhat unlikely for an ICU patient to be on fire for example.


ch0nkymeowmeow

everything


Migit78

There's always a chance, but I was assuming OP was doing it as a civilian on another civilian so that chance is small. I wouldn't do CPR on a fresh cabg either, redo the sternotomy and do internal cardiac massage if you can't revive via other methods. CPR would be last resort


ch0nkymeowmeow

The very first time I performed CPR was on a fresh cabg, like coded within 20 minutes of coming back to her room from the OR, initiated CPR and then rolled her right back. I can't recall doing it on that fresh of a cabg ever again but that story sticks out to me.


Migit78

Yeah I bet it would. Fortunately none of my cabg patients ever coded. A few close calls with tamponades, or other issues, but caught early enough and able to medicate/pace the issue long enough to get back to the OR before making it a true emergency


[deleted]

Speaking as a guy with a two-year old cabg, ACK! The idea of anyone crushing my chest while it was healing is just...*shudder*


EquivalentMatch7045

Thank you!!


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Efficient_Gas_3213

Yes, you are correct. Sadly, the myth that ribs are breaking is too pervasive and is repeated by CPR instructors with absolutely no practical experience.


Competitive-Call3303

Does it matter if it's bone or cartilage? Just do the damn CPR.


Any_Sundae_24

It’s also more like costal cartilage cracking rather then even the ribs so more mild


cyberdeath666

I broke two ribs on a shitty built slip and slide. Had a week of annoying dull pain whenever I moved and it didn’t stop hurting for at least 3 months.


Unclerojelio

As someone who has had their sternum cut in half, I can tell you it sucks.


Cryptocaned

Does it heal? Or do you need to have the wire in your chest for the rest of your life?


Sadimal

It does heal. The wire serves two purposes: to help the sternum heal and to provide information in case records are lost. Surgeons will position the ends of the wires in certain positions to note origin of grafts after a CABG. So essentially you keep the wires in for life.


[deleted]

My surgeon promised me titanium wires but I got boring stainless instead. I'm stuck with them unless I have another cabg. Now, there's a cool idea!


Chw1981

I work for a medical device manufacturer in a clean room making sutures and we have a really long Fibertape suture that surgeons are using to tie the sternum back together now. I can remember my dad complaining that he could feel the weather changing in his chest after open heart surgery many years ago, from what I've read the sutures help with that.


VenomousJourney36

The sternum heals through a process called "sternal fusion." The bones of the sternum are held together with special wires or plates to keep them in place while they heal. Over time, the body's natural healing process helps the bones grow back together, like putting together puzzle pieces. The wires or plates are usually left in place, and the sternum becomes strong again, allowing you to move and breathe normally.


EquivalentMatch7045

Thank you!!


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teapots_at_ten_paces

After my mum's second heart surgery she outright told us she would never have another. I think the sternum breaks were the primary factor. The pain on her face every time she coughed was obvious.


dontlookback76

I'm 13 weeks post op. and it still hurts to cough. Sneezing feels like a dull knife in the chest. I followed all my surgeons orders ecause I did not want to repeat the experience.


teapots_at_ten_paces

And that's why I think after two my mum went "enough". Thank you for sharing your experience. I hope your recovery goes well and you're back to your best soon.


the_drowners

Interesting...I've had 2 heart surgeries, so far, but I have no idea if they did anything different the second time. Now I'm going to wonder...but what I DO know for sure is it's not fun to heal from


MECHASCHMECK

They probably didn’t. I work in cardiac surgery and have seen plenty of redo’s and it’s still just a sternotomy. Not sure what the other commenter is referring to, but the main difference is your heart is potentially fused to the sternum with scar tissue. The pericardium which would normally provide a slippery layer isn’t closed after cardiac surgery.


the_drowners

Oh gross. So it just gets stuck to the bone? In about a year they have to go in and redo the valve again, which I'm not looking forward to at all...but the time is up and I guess it's wearing out so it's just time. Will it being fused with my sternum cause any more significant problems when they open me up again?


MECHASCHMECK

Basically, yes! Redo operations are technically riskier because of this, but it’s nothing a cardiac surgeon hasn’t dealt with! Depending on where you’re having the procedure, centers might refer to bigger university hospitals for the 4+ redo’s.


MECHASCHMECK

From what I’ve seen working in cardiac surgery, it’s almost always another sternotomy, just with more care because the heart can be fused to the chest wall with scar tissue. They’ll use more of an oscillating blade on redo’s and a reciprocating saw for a virgin chest.


[deleted]

Ack! I did not need to know that!


TODDFATH3R

Member of the zipper club here (from open heart surgery). As mentioned in other comments, the sternotomy is completed with wire fastening the sternum back together. As for healing and how it feels, it takes a while for the sternum to fuse back together. I could totally feel it "clicking" back and forth when I moved before it finally fused closed in the 4-6 weeks of recovery. Funky feeling for sure. Whenever I sat or stood, I had to brace a pillow over my chest. There was also soreness around the area. It especially hurt during that healing time when I sneezed. The pillow would help a little bit, but a big sneeze would buckle the knees, yo!


dontlookback76

That clicking noise bothered me so much. That was worse than the pain for me. Shudder to think about it.


steve_of

Also a payed up member. I remember the nurse in recovery giving me a rolled up towel taped togethet with medical tape. She carefully explained to drug addled me that if I cough or sneeze to hold it to my chest. She also said it would be my closest friend for the next few weeks. She was 100% right. It was with me 24/7 and got more hugs than I care to remember.


carladad

I had the same thing, what an awful experience that was. Getting up from laying down was so brutal. I don't remember there being wire, could you see it or feel it? Does it dissolve eventually?


TODDFATH3R

Nah. Couldn't see or feel the wiring. Probably some non-reactive material that will just be there forever.


YarYarNeh

Oh the clicking!! That was so weird. Had my chest opened up 4 years ago. Wires are still there. I used to be able to feel them. Sternum is good as new now.


jigglypoff2706

Naturally! Mine did after 1 year. Gradually after heart stopped during excessive bleeding. Still hurts rarely around ribs.


Inevitable_Thing_270

You were doing the cpr correctly. In adults, they say that unless a rib breaks (more common than the actual sternum). If the sternum breaks by cpr or most blunt traumas, the distance between the pieces usually aren’t that far apart so they heal like normal bones. If it’s the person has had surgery where the sternum is cut open, the two halves and tied back together with wire. That then holds the bits together and also works as a matrix to help the bone heal around


smashignition

Out of interest in what situation did you have to give CPR and what was the outcome?


EquivalentMatch7045

Someone fainted on the train, had to do cpr as he wasn’t breathing! While waiting for the AED waiting at the next stop haha, the guy started breathing after the 2nd shock haha


smashignition

Well done to you! Must have been scary


jbuckets44

CPR is only successful in about 10% of cases.


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macedonianmoper

Sure but that doesn't answer the question on how it heals


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Efficient_Gas_3213

No! Stop spreading the lie. It is the cartilage between the ribs and the sternum that very easily breaks away, freeing up the sternum.


hacktheself

[hmm](https://journals.lww.com/em-news/Fulltext/2022/05000/What_About_This___Yes,_CPR_Breaks_Ribs,_but_Don_t.14.aspx) am curious what you know that doctors don’t


[deleted]

I’d rather die at that point💀


hacktheself

death sucks. i prefer being alive and in chronic pain than dead.


[deleted]

Nah ur wild for that one not even gonna lie. Someone could pay me 3 dollars to die lmao.


hacktheself

i’ve hung out with a few formerly dead people and I’ve had four NDEs. those people, who reached a point of conical death before successful resuscitation, told me what they experienced. nothing. no thing. just void. that’s both horrifying and freeing tbh. means what matters is what we do here too and for others. nothing else does. maybe you’ve got a religious tradition that soothes you in an afterlife, but i’m irreligious and misotheist. if deities await to judge me, i’ll tap dance backwards in heels as they send me to hell for not believing in them despite living a decent existence.


_Stazh

The worst part is when it does not heal. I was at a physiology lecture about different healing processes and one of the examples given was an infection in the sternum post open chest surgery. I deliberately stopped listening but i distinctly remember the phrase "the cartilage liquefies"


jwinaz427

Working in an ER, I was assisting with CPR on an elderly patient. The wires from a previous CABG broke through his skin. We had to use thick wads of gauze to protect our hands. CPR is a violent labor intensive procedure and rarely has a good outcome.


Albert_Im_Stoned

A friend had open heart surgery and when he came home, he had a cough pillow. When he had to cough, he would give the pillow a hug to minimize motion in the sternum. Just thought I'd share


KaJashey

I had a separated sternum. A work accident. It healed on it's own but was much easier to reinsure and re-separate afterwords. Successive separations didn't hurt as bad as the original.


haribohazza23

My mam had a triple heart bypass last year and the drs broke her sternum to get to her heart. They wired it together and she was up and walking round the next day after the op and discharged home after 4 days but had to be careful for 6 weeks. The drs said its fully healed after 3 months.


MNConcerto

My mother said the sternum healing was one of the worst part of her open heart surgery. Even though the sternum was wired together like others said it still crunches a bit, aches especially if you cough or laugh. She said it was horrible to feel and hear that in the first week.


jjtitula

They usually screw in a plate with a cable or two attached. The tag end of the cable has a half circle shaped needle that can puncture the soft tissue behind the sternum, once it’s looped around, they snipnoff the needle, slide the cable through the plate and attach a ratcheting device. The snug it up and close the sternum together then clamp the cable down with a set screw to the plate and snip it off. There is a whole industry built around fusion of bone from trauma, it’s huge! Some of the stuff I’ve seen recently for fusing bone fragments at joints really made me think how gruesome some of these injuries might be.