Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
The health care practitioner will first assess the history of the
injury. Where, when, and why did the injury occur? Did the person trip
and fall, or did they pass out before the fall? Are there other injuries that
take precedence over the fracture? For example, a person who falls and hurts
their wrist because they had a stroke or heart attack will have their fracture
care delayed to allow care for the life threatening illness. The injured area
will be examined and a search will happen for potential associated injuries.
These include damage to skin, arteries and nerves.
Pain control is a priority and many times, pain medication will be prescribed
before the diagnosis is made. If the health care practitioner believes that an operation is
likely, pain medication will be given through an intravenous (IV) line or by an
injection into the muscle. This allows the stomach to remain empty for potential
anesthesia.
A decision will be made whether X-rays are required, and which type of X-ray
should be taken to make the diagnosis and better assess the injury. There are
guidelines in place to help health care practitioners decide if an X-ray is necessary. Some
include the Ottawa ankle and knee X-ray rules.
The body is three dimensional, and plain film X-rays are only two
dimensional. Therefore, two or three
X-rays of the injured areas may be taken in different positions and planes to
give a true picture of the injury. Sometimes the fracture will not be seen in
one position, but is easily seen in another.
There are areas of the body where one bone fracture is associated with
another fracture at a more distant part. For example, the bones of the forearm
make a circle and it is difficult to break just one bone in that circle. Think
of trying to break a pretzel in just one place, it is difficult to do. Therefore broken bones at the
wrist may be associated with an elbow injury. Similarly, an ankle injury can be
accompanied by a knee fracture. The health care practitioner may X-ray areas of the body that
don't initially appear to be injured.
Occasionally, the broken bone isn't easily seen, but there may be other signs
that a fracture exists. In elbow injuries, fluid seen in the joint on X-ray
(sail sign) is
an indicator of a subtle fracture. And in wrist injuries, fractures of the
scaphoid or navicular bone may not show up on X-ray for one to two weeks, and
diagnosis is made solely on physical examination with swelling and tenderness
over the snuffbox at the base of the thumb.
In children, bones may have numerous growth plates that can cause confusion
when reading an X-ray. Sometimes, the health care professional will to X-ray the opposite
arm, leg or joint for comparison to determine what normal is for the child before deciding whether a
fracture exists.
In the U.S., more than 2,000 people are diagnosed with bone cancer every year. There are many types of bone cancer. The most common forms of bone cancer are osteosarcoma, Ewing's sarcoma, chondrosarcoma, malignant fibrous histiocytoma, fibrosarcoma, and chordoma. Pain is the most common symptom. Treatment usually involves surgery, chemotherapy, and radiation therapy.
Foot pain may be caused by injuries (sprains, strains, bruises, and fractures), diseases (diabetes, Hansen disease, and gout), viruses, fungi, and bacteria (plantar warts and athlete's foot), or even ingrown toenails. Pain and tenderness may be accompanied by joint looseness, swelling, weakness, discoloration, and loss of function. Minor foot pain can usually be treated with rest, ice, compression, and elevation and OTC medications such as acetaminophen and ibuprofen. Severe pain should be treated by a medical professional.
A pulmonary embolism occurs when a piece of a blood clot from deep vein thrombosis (DVT) breaks off and travels to an artery in the lung where it blocks the artery and damages the lung. The most common symptoms of a pulmonary embolism are shortness of breath, chest pain, and a rapid heart rate.
Elbow pain is most often the result of tendinitis, which can affect the inner or outer elbow. Treatment includes ice, rest, and medication for inflammation. Inflammation, redness, warmth, swelling, tenderness, and decreased range of motion are other symptoms associated with elbow pain. Treatment for elbow pain depends upon the nature of the patient's underlying disease or condition.
Ankle pain is commonly due to a sprain or tendinitis. The severity of ankle sprains ranges from mild (which can resolve within 24 hours) to severe (which can require surgical repair). Tendinitis of the ankle can be caused by trauma or inflammation.
A torn meniscus (knee cartilage) may be caused by suddenly stopping, sharply twisting, or deep squatting or kneeling when lifting heavy weight. Symptoms of a meniscal tear include pain with running or walking long distances, popping when climbing stairs, a giving way sensation, locking, or swelling. Treatment depends upon the severity, location, and underlying disease of the knee joint.
Sacroiliac joint (SI) dysfunction is a general term to reflect pain in the SI joints. Causes of SI joint pain include osteoarthritis, abnormal walking pattern, and disorders that can cause SI joint inflammation including gout, rheumatoid arthritis, psoriasis, and ankylosing spondylitis. Treatment includes oral medications, cortisone injections, and surgery.
Anorexia is an eating disorder characterized by markedly reduced appetite or total aversion to food. Anorexia is a serious psychological disorder and is a condition that goes well beyond out-of-control dieting. With anorexia, the drive to become thinner is actually secondary to concerns about control and/or fears relating to one's body. There are psychological and behavioral symptoms as well as physical symptoms of anorexia including: depression, social withdrawal, fatigue, food obsession, heart and gastrointestinal complications, kidney function, flaky skin, brittle nails, and tooth loss (this list is not exhaustive).
A hematoma is a collection of blood that is outside a blood vessel. There are different areas where hematomas occur including the inside the skull, scalp, ear, septum, bones, finger and toenails, and intra-abdominal. Treatment for hematomas depend on the type and location of the hematoma.
Chest pain is a common complaint by a patient in the ER. Causes of chest pain include broken or bruised ribs, pleurisy, pneumothorax, shingles, pneumonia, pulmonary embolism, angina, heart attack, costochondritis, pericarditis, aorta or aortic dissection, and reflux esophagitis. Diagnosis and treatment of chest pain depends upon the cause and clinical presentation of the patient's chest pain.
Multiple myeloma is a form of cancer that develops in plasma cells, the white blood cells that make antibodies. Symptoms include bone pain, weakness, extreme thirst, nausea, frequent urination, and broken bones. Treatment of multiple myeloma depends upon the staging and symptoms of the disease.
Internal bleeding occurs when an artery or vein is damaged and blood to escapes the circulatory system and collects inside the body. Internal bleeding can be caused by a variety of situations such as blunt trauma, deceleration trauma, medications, fractures, and spontaneous bleeding. Treatment of internal bleeding depends on the cause of the bleeding.
Learn about osteoporosis, a condition characterized by the loss of bone density, which leads to an increased risk of bone fracture. Unless one experiences a fracture, a person may have osteoporosis for decades without knowing it. Treatment for osteoporosis may involve medications that stop bone loss and increase bone strength and bone formation, as well as quitting smoking, regular exercise, cutting back on alcohol intake, and eating a calcium- and vitamin D-rich balanced diet.
Ankylosing spondylitis is a type of arthritis that causes chronic inflammation of the spine. The tendency to develop ankylosing spondylitis is genetically inherited.
A broken toe is one of the most common fractures among individuals. There are many causes of a broken toe, whether it is the big toe, middle toes, or little toe (pinky). Common symptoms of a broken toe include pain, swelling, stiffness, and bruising. A broken toe can be treated with buddy taping the toe. There are instances where a physician should be consulted for a broken toe.
Shin splints result from inflammation from injury to the tendon and adjacent tissues in the front of the outer leg. Shin splints commonly occur in runners or aggressive walkers, causing pain and discomfort. An increase in workout intensity, weak ankles and pronation may be to blame for shin splints. Stretching, strengthening, and icing the affected area are effective treatments for shin splints. Rest and anti-inflammatory medications are also advised.
Pleurisy, an inflammation of the lining around the lungs, is associated with sharp chest pain upon breathing in. Cough, chest tenderness, and shortness of breath are other symptoms associated with pleurisy. Pleurisy pain can be managed with pain medication and by external splinting of the chest wall.
Paget's disease is a chronic bone disorder due to irregular breakdown and formation of bone tissue. Symptoms of Paget's disease include bone pain, headaches and hearing loss, pressure on nerves, increased head size, hip pain, and damage to cartilage of joints.
Coccydynia is an inflammation of the bony area (tailbone or coccyx) located between the buttocks. Coccydynia is associated with pain and tenderness at the tip of the tailbone between the buttocks. Pain is often worsened by sitting. There are many causes of tailbone pain that can mimic coccydynia including: fracture, pilonidal cysts, infection, and sciatica. Treatment methods include medication and rest.
Myofascial pain syndrome is muscle pain in the body's soft tissues due to injury or strain. Symptoms include muscle pain with tender points and fatigue. Treatment usually involves physical therapy, massage therapy, or trigger point injection.
Osteomyelitis is an infection of the bone. Potential causes include injections around the bone, fractures that puncture the skin, recent surgeries, and bacterial infections that travel from other areas of the body, spreading through the blood to the bone. Symptoms include pain, fever, chills, stiffness, and nausea. Treatment involves antibiotics and pain medications. Surgery is sometimes necessary.
A frozen shoulder (adhesive capsulitis) is when the shoulder joint experiences a significant loss in its range of motion due to inflammation, scarring, or injury. Treatment involves anti-inflammatory medication, cortisone injections, and physical therapy.
An injury to a ligament is called a sprain, and an injury to muscle or tendon is called a strain. Sprains and strains may be caused by repetitive movements or a single stressful incident. Symptoms include pain and swelling. Though treatment depends upon the extent and location of the injury, rest, ice, compression, and elevation are key elements of treatment.
There are several bones in the foot, and these bones can be broken (fractured) in a variety of ways. Falling from heights, dropping heavy objects on the foot, or stress fractures from running or walking. Treatment of a broken foot depends on what bone in the foot is broken.
Osteopenia is a bone condition characterized by bone loss that is not as severe as in osteoporosis. Bone fracture is the typical symptom of osteopenia, though the condition may be present without symptoms. Treatment involves lifestyle modifications (quitting smoking, not drinking in excess) and ensuring an adequate intake of vitamin D and calcium.
In the United States, head injuries are one of the most common causes of death and disability. Head injuries due to bleeding are generally classified by the location of the blood within the scull, these include: epidural hematoma, subdural hematoma, subarachnoid bleed, intracranial bleed, sheer injury, edema, and skull fracture. Some common symptoms of a head injury include: vomiting, bleeding from the ear, speech difficulties, paralysis, difficulty swallowing, and body numbness. Treatment of a head injury depends on the type and severity of the injury.
Hypercalcemia is a condition in which calcium levels in the blood are elevated. Hypercalcemia is associated with other conditions such as hyperparathyroidism, lung cancer, breast cancer, kidney failure, and elevated levels of vitamin D. Symptoms of hypercalcemia include constipation, nausea, abdominal pain, kidney stones, to name a few. Treatment depends on the cause of hypercalcemia.
Shaken baby syndrome is a form of child abuse in which violent shaking of an infant causes the brain to move inside the skull, causing bruising of the brain and tearing of blood vessels. The shaking results in bleeding around the brain, bleeding in the eyes, spinal cord and neck injuries, bruises, and rib fractures. Infants who survive may suffer brain damage and blindness.
Facial nerve disorders affect the muscles of the face. There are many causes of facial nerve disorders including: trauma, nervous system disease, infection, metabolic disorders, tumors, toxins, or Bell's palsy. Symptoms of facial nerve problems include: facial muscle paralysis, weakness, or twitching of the face; dryness of the eye or mouth, or taste alteration.
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