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Cough leading to rib fracture

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my husband recently coughed so hard he fractured ribs on the left side. he has massive bruising covering his entire chest area from armpit to waist. he also has an anurysm in his heart. he has been in severe pain for over a week, in and out of er and hospital, with treatment being fluids, steroids, breathing treatments and pain meds. my concern is a blood clot. his left side bulges out abnormally and the bruise continues to grow even after all this time. he is experiencing a lot of painfull tingling to stabbing pains, it is very sensitive to touch, he feels like he has a giant gas bubble in there and can't get it out.

i am totally frustrated as i dont know if this is the normal healing process or if something worse is going on. please help.

last thing - my husband is 59, 6'3", 250 lbs
had a quintuple by pass 4 years ago
his anurysm is 5 centimeters
was supposed to get the anurysm taken care of this week, but due to cold and ribs they are putting it off 6 more weeks

Category: Internal Medicine Specialist

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Dr. Deepu Sebin Sebastian is online now

Expert:  Dr. Deepu Sebin Sebastian replied 4 Days.

Thank you for choosing DoctorSpring.

I understand this could be really a hard and frustrating period for you and I will try my best to help you out here.

I assume that he has been adequately evaluated for the broken ribs with Xray and CT chest.
The bruise may continue to grow for few more days. This is not abnormal per se. But the bulging of the chest wall while breathing is indeed a concern. This could be the sing of something called a flail chest.

If your Doctor has not noticed it, please bring it to her/his attention. If this was already seen and evaluated by your Doctor then there is no need to worry.

Other that this the best approach this would be allowing and waiting for a natural healing. Do not worry about the discolouration as it may be because of the old extravasted blood.

You have not mentioned antibiotics in his treatment protocol. Ideally he should be getting antibiotics and cough suppressant medications. Do take the pain medications as prescribed. If the pain persists inform your Doctor and up the medications as adequate pain relief is important for good breathing.

In short :

1. If bulge is increasing in size and not yet noticed by your Doctor, please inform him asap to rule out flail chest.

2. Allow some time for the natural healing process to set in

3. Antibiotics and cough supressents

4. Adequate pain medications.

Hope this helps.
Feel free to ask followups
Thank you

Dr. Deepu Sebin Sebastian
Category: Select Speciality
MD, Internal Medicine - Stanley Medical School
Medical School - MBBS - Govt. Medical College, Kottyaam

Diagnostic Prediction - Stanford School of Medicine
Received Specialty training in Critical Care, Cardiology, Neurology, Gastroenterology, Nephrology from Stanley Medical College and in Endocrinology, Rheumatology.

Hematology and Geriatrics from Madras Medical College.
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