If you are injured on the slopes....

Sports and Hobbies
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Just a little story I wanted to share.

Last week I was skiing in Ischgl with my sister and a few other friends. Naturally we were on the last run of the day, on the highest point of the mountain when my sister clipped a ski. Of course it was the Black 13.

She went face down the slope for about 40 meters (making Anja Pearson look like an amateur), lost a ski (luckily) and then came to a stop. We managed to get her to slide to the flat area and called a skidoo.

She then saw the Doctor, who was thinking, ka-ching, and he told her that she needed an operation that day. He diagnosed her with one damaged ligament. We decided to go back to St Anton and ask a cousin who has had previous knee injuries what to do. He organised an appointment with a specialist for her in Innsbruck the next day.

She had actually damaged 2 ligaments, but was told that she would not need an operation, just a lot of physio which was a huge relief.

A few things that bothered me though were:

1) The nurses. My sister does not speak much German, and they would not let me go in and help. They told me that they spoke no English, but then when I went to get my friend from outside she called out that she spoke perfect English.

2) The Doctor was more than happy to tell her she needed the operation, which is crap. I cannot imagine how many people have an operation because they are in a foreign country and they are scared into thinking that there is no other choice.

So, might I suggest if you have an injury whilst on the slopes, you try and get a second opinion (unless of course something is clearly broken).

I am also hoping Eire will be along to give some further insight into this.

Also, my sister finally got a helmet 2 weeks ago. She had not wanted to wear it that morning, as it was such a nice day, but I told here that she should as we were going to be going at a cracking pace. If she had not had a helmet things would be a lot worse.

I know that it is late in the season, but please keep this in mind, especially in the current conditions.

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What if the first doctor says you don't need an operation, and the second one does? Who's advice do you take then?

Anyway. Glad she's OK. And that she was wearing a helmet.

3
Hey Tash, Hope your sister is recovering well.

In my opinion if non-emergency surgery is being recommended then a second opinion is always a good idea. In Switzerland many of us are insured privately (through work) for accidents so surgeons may "offer" to do more for you if you are an accident case then if you walked in saying my knee just got sore doing my normal day to day activities. In the Austrian surgeons case maybe he was just hoping to charge another surgery to someone's travel insurance.

The costs aside though with an ACL injury which is what I believe the doctor diagnosed can be treated conservatively depending on the extent of the injury, the fitness and coordination of the patient and the demands that the patient are going to make of the knee in the future. As far as I know it is difficult to diagnose the exact extent of the injury immediately due to swelling and bleeding in the joint. Its better to give it a day or two to see how things work out before deciding if surgery is an option or not. You are always entitled to get a second opinion if you are in anyway unsure. If a surgeon is recommending surgery always ask what the options are. A surgeons job is to operate, in many cases this may be his preferred treatment but another doctor may have a different preferred course of treatment.

This is all good if its something like an ACL that you can decide over a few days if you want the operation or not. If you injure yourself and need an emergency operation you may not have that time. A bad compound fracture should probably be set and fixed as soon as possible.

Your post made me think of another point though. How many people who ski know what to do at the scene of an accident? I witnessed two bad crashes within two weeks of each other a few years back. In both cases the person had head injuries and were unconscious when I got to the scene. In both cases the friends were trying to get the person up and moving BEFORE the ski patrol could come and get help!!! The first one the guy came too really quickly, and was coherent and just a little embarrassed. He wanted to get up and go, but I persuaded him to get checked out by the ski patrol since he had been unconscious. The second guy was unconscious (but breathing) for a few minutes. He had a seizure before he came too, and when he finally did come too he was totally incoherent. His mates were trying to get him to just get up and get going!!! I sent my girlfriend for the ski patrol and waited till they got there. In both these cases there was the potential for very serious injury that could potentially be exacerbated by incorrect first aid. They people that were skiing that day had absolutely no idea what to do in such instances!!!

You still have to make your own decision. The surgeons are giving only advice. If the injury is non life threatening or the injury isn't prolonged or made worse by putting off the surgery then you are perfectly within your rights to wait till you get home and have a doctor in your home country advise if you need the surgery or not.

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The first one was at the bottom of the mountain, and he must see 20-30 people a day.

The second one was a Professor in Innsbruck who treats members of the Austrian Olympic Ski team.

For us the choice was easy.

This post was not suggesting you ignore the doctor, I am simply encouraging people to explore other alternatives rather than being bullied into getting sliced and diced immediately.

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Take home message of the day.

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My cousin's recovery is also coming along well: he is back in light training. Sis is at physio now.

As for the surgeon, that is what annoyed me. It is not the travel insurance money that is the problem, more the encouraging someone to have an operation which may lengthen their recovery time for your own financial gain.

I have done several first aid courses, and used to be a volunteer medic in Oz, but I realised that I did not even have a number programmed into my phone. Lesson learnt .

We were, however, with 2 locals, and one of them is a paramedic and piste control.

He was great, and they were there quickly. The tough part was getting her to a safe area without moving her knee at all, as it is a run that people like to gun down, and as you come over the crest you can not see much below.

Perhaps we should look and see if there are any safety courses around for people who want to, later this year just before the season?

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I'm with Eire on the emergency vs. non-emergency approach. If you are not sure about how to tell the difference, you can easily and should challenge the doc to explain why treatment should be immediate (and this doesn't just apply to skiing). If you remain unsure go get a second opinion.

Another easy way to tell if it is an emergency situation is that usually they won't ask you for an opinion - i.e. they'll start treatment immediately. If they start asking for your consent you know you have a bit of time. Think about it - how often do paramedics and doctors at the scene of a serious emergency start asking if it is OK to do such and such?

As for...

I would suggest that not many people know what to do at an accident scene. Period.

That said, just got back from skiing with lads on a long stag w/end. Survived with no injuries - unlike mine (9 yrs ago) which included 2 blood-wagon runs and a heli evac from two incidents. Needless to say, I am (now ) familiar with what to do

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That might be an example of the beauty of the UK National Health system where there is no profit it in it for the surgeons/doctors so you actually get what you really need. However, the UK National Health system is being abused often by foreigners.

Your example reminds me of the dentist.

My sister and I have no fillings and we had been going to the same dentist for years. My sister moved and it was therefore logical to go to a nearer dentist. She went for a check-up and rang me up distressed that she would need three fillings. I advised her to go back to our old dentist and not to tell him that she had been to another dentist. He told her her teeth were fine and no fillings were required.

Very worrying in my opinion!

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There are so many incompetent "medical specialists" out there that it would be foolish to listen to the first Doc who opens his big gob. Recently I had the pleasure of meeting "specialists" who knew less about a medical condition than me. Really made me cringe. Always get as many opinions as you need unless it is life threatening situation.

Wishing your sister a speedy recovery.

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Thanks for the thread Tash, do hope sis is well on the way to recovery. I'm sure she could still kick my ass on 1 leg!

Agree with Eire on the non-emergency opinions.

To add my two cents,

I took a nasty fall and cracked two ribs earlier this year. Was able to ski another couple of runs but then had to bail due to the pain (still skied down to the bottom of the mountain though )

Being a Sunday and not knowing German, went to the Permanence health center in HB. They were excellent and I was in an out in a couple of hours.

Found out my work insurance covers accidents, even EPIC failure ones like my own. So if you are on the slopes, be sure to have your work insurance info with you - it will save some hassel on the back end trying to reverse the charges. As well, have a clear understanding of what the requirements from your work insurance provider are - 2nd opinions, police/ski patrol report, etc. It can be very easy for them to deny the claim which will mean you need to rely on your private insurance.

As well, invest the 30 CH in REGA mountain rescue. You never know when it will come in handy.

http://rega.ch/en/goenner/start_goenner.aspx

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A stupid question: What's the quickest way to contact the ski patrol if there is an accident? Is there a common phone number? Or should one simply ski down to the next lift and ask for help there?

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Hi, sorry to hear about your sister's accicdent and thankful that she was wearing a helmet. I sustained a similar injury a few years ago and was splinted, given a huge array of pills (anti-inflammatories/coagulants, etc) and flown back to the UK. Weeks of intensive physio followed and, the tip I would like to give your sister, is to take strong painkillers before her physio sessions (unless she is advised against it). The treatment is exceedingly painful. I wish her a speedy recovery.

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I don't think that is a stupid question, I was thinking exactly the same thing as I read this thread, hopefully someone will know!

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I am sure it differs between Switzerland and Austria, and my phone is currently charging.

Paging Eire.

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1) when you get the resort, programme the local emergency/ski rescue number into your phone (it is usually on the piste map you get given when you buy your pass)

2) depending on the location of the accident call or ski to lift hut to get help

i.e. if you can see the hut is close then ski. If not, call.*

I would add that if you are in an isolated location, probably better to stay with the casualty & call by phone.

Also always have a survival blanket in your pocket/pack. They are very small (size of a cigarette packet) and quite literally could be a life saver.

*EDIT: If you are alone (i.e. you + injured person) and no one can (or is willing to) help, I would choose to stay with the casualty and call

EDIT II: I would add, that if it can save your life then it is not a stupid question

16
I would think that taking pain meds before physio is frowned upon

Anyhow, some doctors prefer to treat an ACL injury right away (within hours) with surgery because otherwise you have to wait three weeks until swelling goes down. But unless you are a professional athlete and need to get back quickly, no reason to hurry. I suppose one could argue that you have to recover twice, but better to be sure of the injury. It is very difficult to diagnose a torn ACL without an MRI. I suppose once they go in they with the camera they can determine this as well. But you need to trust the doctor before signing up for the surgery. When I blew my ACL in Flums, I actually walked to the midstation (probably adrenaline) and took the bus/train back to Zurich and only saw the doctor a few days later. Not the case for most people I understand.

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My wife tore her ACL skiing as well, and the doctor had her wait

3 weeks or more as well. Definitely do not rush into surgery.

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What's that?

P.S. On the topic, the main prevention is - you have to physically exercise regularly, 3 times a week. Load your legs. Walk to work, bycicling in summer, crosstrainer in winter. Proper ski bindings + strong legs = no injuries.

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One of these:

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Re: survival blanket

You are unlikely to need it if you have an accident on the slopes as they (rescue) can usually get to you quickly. But if you are seriously stuck somewhere less accessible, and could be out for more than a few hours lying still (i.e. due to injury) or worse a night, then it could mean the difference between surviving and not.