Contact Info & FAQ

Do you have any questions or concerns? You have a few options:

7:00 am – 3:00 pm weekdays Call our fracture Nurse Practitioner at (617) 697-4806
Anytime, any day Email your question to: fractureMGH@partners.org
Emergencies 3:00 pm – 7:00 am
(nights, weekends and holidays)
Call our Pager at (617) 280-9956

Download the Geriatric Fracture Care Guide

Geriatric Fracture Care Guide PDF - download for more information

The information found on the following pages can be found in a PDF that you can download.


Frequently Asked Questions

Fracture Team

Orthopedic Trauma Surgeons

The attending physicians are senior orthopedic surgeons who take overall responsibility for your care. They work closely with residents, who are training to be orthopedic surgeons and are available 24 hours a day, 7 days a week to provide care while you are in the hospital.

Mitchel Harris, MD Marilyn Heng, MD, MPH
Mitch Harris, MD Marilyn Heng, MD, MPH
David Lhowe, MD R. Malcolm Smith, MD
David Lhowe, MD R. Malcolm Smith, MD

Geriatric Inpatient Fracture Service

Our geriatric medicine physicians and nurse practitioner have specialized training in the care of patients 65 years and older and work with your surgeons and acute care nurse practitioners to optimize your care and rehabilitation.

Esteban Franco-Garcia, MD
Esteban Franco-Garcia, MD

Acute Care Nurse Practitioners

The acute care nurse practitioners specialize in care of patients with traumatic injuries. These nurses work very closely with all physicians, nurses and other care providers involved in your care.

Kathleen Burns, NP Benjamin Hollingsworth, NP
Kathy Burns, ACNP Bens Hollingsworth, ACNP

Orthopedic Trauma Outpatient Clinic

Clinic patients receive comprehensive care for their orthopedic injuries by a team of expert physicians and nurses. Patients who are recovering from orthopedic surgery will typically visit with their surgeon about 2 weeks after surgery to assess how their injury is healing and remove incision sutures or staples. Additional clinic visits will be scheduled as needed. The staff also helps patients coordinate care with other MGH services such as physical therapy, occupational therapy, and social services.

During your recovery at the hospital, a physician assistant for osteoporotic fracture care and prevention will visit with you to discuss a treatment plan to help reduce your risk of another broken bone from osteoporosis.

Lisa Beyer, PA Cortney Dryer, RN  
Lisa Beyer, PA
MGH Fracture Liaison Service
Cortney Dryer, RN
Nurse Manager
Orthopaedic Trauma Outpatient Clinic

Before Surgery

Before your surgery, you will be asked many questions

Surgeons, anesthesiologists, doctors, nurse practitioners and nurses will all ask:

Before your surgery - quesitons you will be asked, information for geriatric fracture care patients and their families
  • What happened?
  • What is your medical history?
  • Have you had other surgeries?
  • Who is your health care proxy and do you have advanced directives?

Make sure you ask questions about your care and surgery. We are happy to answer all of your questions.

What to Expect

  • You will have nothing to eat for 8-12 hours before your surgery.
  • You will receive pain medication. Let us know if you are in pain!
  • You will have a chest X-ray and blood work performed.
  • You will receive fluids and medications through an IV in your arm or hand.
  • You might have difficulty sleeping because of noise, light and regular interruptions from your care team.
  • You will probably have to use a bed pan or urinal to go to the bathroom. Do not worry, your nurse will help if you need assistance.

After Surgery

After your fracture surgery:

You will get daily visits from:

You can expect to feel:

  • Tired
  • Discomfort/Pain
  • Not as hungry as usual

Your goal will be to get out of bed and move when your doctor gives you the okay. Your physical therapist can give you exercises to do while you are in bed too.

The more you move, the faster you will recover!

You will begin eating and drinking again. The nursing staff will assist you with your care needs, such as providing medication, bathing and getting out of bed.

After your surgery - things to know following geriatric fracture surgery, information for geriatric fracture care patients and their families

You will receive medication to manage your pain. You will wear compression boots wrapped around your lower leg that will massage your legs and help prevent blood clots.

Blood tests and x-rays will be done to manage your recovery. You may need a blood transfusion if you are anemic or lost a lot of blood.

Physical therapists will work with you to increase your strength and balance so that you can return to activities you enjoy.

Use the incentive spirometer to exercise your lungs and help prevent pneumonia.

Possible Complications

Complications include:

  • Pneumonia
  • Urinary tract infection (UTI)
  • Mental Confusion (delirium)
  • Blood clots in your legs or lungs (deep vein thrombosis or pulmonary embolism)
  • Bed sores (pressure ulcers)
  • Further loss of muscle mass, increasing your risk of falls and injury
  • Experiencing more pain than normally expected

How to prevent complications:

  • Your physician will tell you when it is safe for you to get out of bed and move about.
  • Practice deep breathing to expand your lungs and sit upright in bed or chair if allowed.
  • Perform your physical therapy exercises to increase your strength, balance and flexibility.
  • Take only the medications as instructed by your care team and ask your physician if you have any questions or if you think something is missing.
  • Eat complete meals and take supplements if your doctor ordered them.
  • Drink frequently unless your care team has placed restrictions on the amount of fluid you are allowed to drink.
  • Do not hesitate to discuss your concerns with your medical team.

Your medical team will work with you to help ensure a successful surgery and recovery

Pain Management

How to Treat Pain:

  • Rest
  • Ice
  • Elevation
  • Medication

What to Keep in Mind:

Pain makes recovery from surgery more difficult and stressful for your body. It is important to take your pain medication to help your body heal.

You should take pain medication before physical therapy to get the most out of your session.

Most people who take narcotic pain medication for short periods of time as instructed do not become addicted to it.

If your pain medication is not working for you, we have other medications or non-pharmacological ways (like ice) to treat your pain. Tell us about your pain so we can help you!

It is normal for you to feel some pain following a bone injury and surgery and while you are healing and recovering from your accident.

Constipation

Why are you at risk for constipation?

  • you are moving around less than usual
  • You may be drinking less water
  • You probably changed your diet
  • You are probably taking pain medications
  • You just had major surgery

Treatment for Constipation

  • Increase your fluid intake.
  • Increase your fiber intake.
  • Move as much as possible.
  • Bowel medications may be used for a short period of time.

Delirium

After your surgery - delirium and what family and friends can do to help, information for geriatric fracture care patients and their families

What is delirium?

A new, fluctuating change in mental status that is reversible and is frequently caused by several factors related to the patient’s injury and hospitalization.

Family and Friends: What can you do to help?

  • Tell the care team that the patient is acting differently than they normally do.
  • Tell the patient where they are, who they are, why they are here—reorient them frequently.
  • Bring in objects the patient may recognize such as favorite photos, pillow, blanket.
  • Make sure the patient has their hearing aids, glasses, dentures and are using them.
  • Ask the patient’s nurse if you can help the patient eat and drink the food that is brought to them. You can also bring in food from home that the patient enjoys. Remember to check with the patient’s nurse first before offering food brought to the hospital.

Delirium: What you may observe

Poor thinking skills & memory Difficulty with speaking or writing Personality changes Emotional disturbance
Easily distracted Sleeping more Lack of focus Being withdrawn
Being hyperative, restless, agitated Saying things that do not make sense Rapid changes in mood Changes in normal behavior

Family and friends can help us take better care of the patient

Discharge Information

Before you are discharged from Mass General, it is important for you and your family to make sure:

  • Your questions have been answered.
  • If you are going directly home, remember to ask who will be contacting you to help you recover from your surgery, such as a visiting nurse and when to expect their call.
  • If you are going directly to a rehabilitation facility, remember to confirm where you are going and ask how long you should expect to be there.
  • You understand your discharge instructions that are given to you in writing.
  • You know who to contact with questions or concerns after you leave MGH: Email: fractureMGH@partners.org; Call: (617) 697-4806; (weekdays); Pager: (617) 280-9956 (emergencies, nights and holidays)
  • You understand what medications you are taking and why. You also understand why these medications may be different than what you were taking before you were hospitalized.
  • You have received prescriptions for your pain medication.
  • You have contacted your PCP to alert them to your recent hospitalization.
  • You have scheduled a follow-up appointment with your orthopedic surgeon.

Your Recovery

Frequently Asked Questions about your Recovery

Putting weight on your injured leg

Placing weight (known as weight bearing), on your injured limb depends on how well your bone is healing and what type of surgery you had. X-rays are used by your orthopedic surgeon to confirm the status of your bone healing. Each fracture is different with different bones and fracture repairs healing at different rates. Your orthopedic surgeon will give you specific instructions regarding when you can safely put weight on your injured limb and how much weight is safe to place on it. Placing weight on your repaired limb before you are cleared to do so may damage it and put you at a higher risk of complications and increase your time to recover.

It is very important to follow the instructions given to you by your orthopedic surgeon, trauma nurse practitioners and physical therapists. Remember if you have any questions about your recovery please ask us to clarify your activity instructions!

Weight bearing as tolerated (WBAT):

Your recovery from geriatric fracture surgery, faqs for geriatric fracture care patients and their families

When you stand or walk, place as much weight as feels comfortable on your affected leg. Let pain be your guide. If you feel pain, place less weight on the affected leg.

Partial weight bearing (PWB):

When you stand or walk, you may place some amount of weight on your affected leg to help you move while using an assistive device like a cane or walker. Exactly how much weight you can support will be specified by your surgeon and how to support your weight will be shown to you by your physical therapist.

Touch-down weight bearing (TDWB):

When you stand or walk, you may put your foot down to touch the floor only for balance. Do not place actual weight on your affected leg.

Non-weight bearing (NWB):

Place no weight on your affected leg. Do not touch the floor with your affected leg. While you stand or walk, you must hold your affected leg off the floor.

Fall Prevention

Exercise for improved bone strength and balance

Fall prevention - ways to set-up your bathroom to prevent falls, information for geriatric fracture care patients and their families
  • Weight bearing exercise such as walking
  • Balance training such as Tai Chi and upper body strengthening exercises

Get enough calcium and vitamin D

  • 1200 mg of calcium daily
  • 1000 to 2000 international units of vitamin D a day
  • Always check with your doctor or nurse practitioner before starting to take calcium or vitamin D

Check your eyes at least yearly

  • Have an eye exam yearly
  • If you have diabetes or eye disease you may need more frequent exams

Watch your medications

  • Feeling weak and dizzy are possible side effects of many medications and can increase your risk of falling
  • Talk to your doctor about side effects caused by your medications
  • Do not start and stop medications, except under your doctor’s direction

Avoid smoking or excessive drinking

  • Smoking and alcohol consumption can reduce bone strength
  • Drinking too much alcohol can impair your balance

Dress appropriately

  • Wear properly-fitting shoes with non-skid soles
  • Replace slippers that have stretched out of shape and are too loose
  • Use a long handled shoehorn if you have trouble putting on your shoes

Fall Prevention at Home

Fall prevention - ways to set-up your home to prevent falls, information for geriatric fracture care patients and their families, orthopaedic trauma center, massachusetts general hospital, boston
  • Floors
    • Remove all loose wires, cords, and throw rugs. Minimize clutter. Make sure rugs are anchored and smooth. Keep furniture in its usual place.
  • Bathrooms
    • Install grab bars and non-skid tape in the tub or shower
  • Kitchen
    • Install non-skid rubber mats near sink and stove. Clean spills right away
  • Lighting
    • Make sure halls, stairways, and entrances are well lit. Install a night light in your bathroom. Turn lights on if you get up in the middle of the night.
  • Stairs
    • Make sure treads, rails, and rugs are secure.
  • Bedroom
    • Place a lamp, telephone and flashlight near your bed

Osteoporosis & Bone Health

Osteoporosis

Warning Signs and Symptoms

  • A broken bone when you fall from your own height
  • Back pain or hip pain
  • Loss of height

Treatment

  • Certain medications prescribed by your physician can help prevent bone loss, increase bone density and reduce your risk of fractures

Prevention

  • A healthy diet including foods with calcium and vitamin D, like milk, yogurt, eggs, some fishes, and dark leafy greens
  • Weight bearing exercises like walking, dancing, Tai Chi and upper body exercises
  • Avoid smoking, excess alcohol and caffeine because they can weaken your bones

Nutrition for Bone Health

Bone health - nurtition for improved bone health, information for geriatric fracture care patients and their families, orthopaedic trauma center, massachusetts general hospital, boston

The U.S. Dietary Guidelines can help you choose the right foods for your bone health:

  • Go lean with protein
  • Focus on fruits
  • Vary your veggies

Get your calcium-rich foods from dairy products:

  • Fat-free or low-fat milk, yogurt and cheese
  • Lactose-free and lower-lactose products are widely available
Bone health and osteoporosis - nurtition for improved bone health, information for geriatric fracture care patients and their families, orthopaedic trauma center, massachusetts general hospital, boston

You can also get calcium from non-dairy foods:

  • Canned salmon and sardines (with bones)
  • Dried figs
  • Broccoli, kale, mustard greens and turnip greens
  • Nuts (almonds, roasted soy nuts)
  • Foods with added calcium (juices, soy milk, rice milk, cereals and others)

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