Kickas.org Forums Ankylosing Spondylitis General Discussion #1 AS Web Support Group 4x4 vrs bike My daughter was hit by car.

Hi all, have a question for you.
My daughter was due to start her methotrexate.
Yesterday she was hit by a 4x4 car when riding to school on her bike. She was very lucky she wasn't hurt more and has a crush fracture in her foot, soft tissue injuries in her knee, hip and wrist. She had to stay in hospital last night as they are still worried about internal injuries. CT scan showed some bruising of her liver but her bp was quite low and would not stabalise hense why they were still concerned there may be more going on internaly. I have spoken to Tay this morning and she said her bp was more stable over night and only dropped once so she sould be on the mend.

My question is, I asked the doc if she should still start her methotrexate and they said yes but I am concerned with her starting it if her liver is still in shock from the bruising.
Mind you all of her arthritis is flaring from the accident which was to be expected I guess.
But what do you all think? Should she start the methotrexate with a bruised liver?
Not sure if I will be able to get in contact with her rhuemy to ask and the docs that treated her don't seem to have a lot of knowledge regarding this.

Thanks
Trish

No dr. here for sure Trish!! I am so sorry about this. I probably would go ahead and start it but please don't take my thoughts as gospel. Do what you are most comfortable with. It takes a while for the MTX to take effect.

Hope you all are better soon.

Hugs.
Possi

OMGosh Im so glad that she wasnt hurt any worse than she was....whew!

Ok just for me yes I would think flaring after the accident because of the stress, I would call the Dr. and ask or ask the nurse to ask him and then as her Mom I would do what I think is best for her.

If it was me I would probably wait a few days and let her body heal and make sure everything is ok and then start fresh say in a week or so.

Hugs!

Thanks for the replies. I was thinking of waiting a few days given she has a bruised liver. Will try and contact her rhuemy tomorrow.
She came out not too bad they have now also plastered her left hand as they suspect a small fracture of the scaphiod (sp) so that is only 2 fractures some soft tissue damage and a bruised liver. 4x4 landcruiser 1 taylah 0. Lets just hope she never tries to even the score.
Thanks again.

That is really horrible for her and you. Waiting a day or two for the MTX until you can check it out with the rheumie probably is more sensible than starting straight off, though I think you are probably more than enough aware to watch out for any signs that it is causing problems if you did decided to start it straight off.

Be aware that when you have that kind of accident, it is quite common to have a kind of "delayed shock" emotional reaction, so keep a really close eye on her for a few days as she could just go to pieces suddenly and need you around.

I hope those bones heal properly and quickly too. Can you line up some physio early, so she gets proper treatment especially for that wrist as soon as the cast comes off?

That sounds scary,I will say a prayer for the both of you. Glad she seems to be on the road to recovery. I agree with Cemc, sometimes when you get home from the hospital it all sinks in, and she may want to talk about it and how she feels. I don't know what to say about the mtx.

My prayers are with her and your family. I hope she heals fast.

Sorry to hear some horrible news.. hope she mends quickly and everything turns out fine.

Tim

so sorry to hear that! hope she's ok!

as for starting the mtx:

i'd listen to the doctors but also listen to my gut, and with their counsel do what felt right to me.

if i were unsure, i tend to play it rather safe, so i'd wait a little bit til i felt sure, what's a few extra days or weeks? is the way i look at it.

for example, when my liver enzymes became a bit elevated, i decided to put off the SSZ until we got a handle on the liver enzymes. i figured i'd waited this long, what was the harm in waiting a little bit longer. plus i figured it would always be there waiting for me, it was't going anywhere; wasn't like i was missing some small window of opportunity or anything.

well, that's how i see it. but i may not know the whole story and may have oversimplified it.

anyway, thank goodness it wasn't any worse than it was! :hugs:

that does not sound like a fair matchup!

huggs to you and her!

Thanks everyone for the well wishes.
I was able to get on to a rhuemy but not the one treating my daughter. He pretty much said what everyone else has, that it won't hurt holding off for a week before starting the meds. Give her body that time to heal then start next week.
Thanks again