Doug Paul injured in a back-country ski accident

[DougPaul]

Glad you're back on your skiis.

Thanks, it was fun, albeit short.

Do you think you'll be skiing in Waterville soon. I skiied on Livermore on sunday-lower part not groomed. Think of you when skiing that trail. I think five hours of shovelling is good aerobic preparation for the skiing.

I think it will still be a bit longer. The left hip was a bit tired* from the 2 miles. And there is the issue of the carrying a BC pack... Pemi-Wilderness-East Side Rd might be a better place for me to ski initially. I suppose lower Greely Ponds Tr and lower Livermore Rd might also be flat enough, too.

* For some reason, the muscles that were damaged in the operations seem to build more slowly than the undamaged ones, even 9 months after the operations.

The part of Livermore Rd (Tr) to worry about is the section between the upper hairpin turn and the junction with the the Flume skidder path--just watch out for aggressive blowdowns...

Doug

 

[skibones]

The part of Livermore Rd (Tr) to worry about is the section between the upper hairpin turn and the junction with the the Flume skidder path--just watch out for aggressive blowdowns...

Doug[/QUOTE]

When skiing that part last year I did think of your encounter with a snow covered blowdown and tried to be careful-as much as was possible!

 

[DougPaul]

One year anniversary

The accident was one year ago yesterday (Feb 11).

In the past two months, I have managed to lift-served Tele ski four days (including a black diamond at Sunapee and Cannon in somewhat icy conditions (no black diamonds, but some of the runs felt like black diamonds )), do some moderately vigorous XC and BC skiing, and walk a local (level) bike path with up to 35 lbs on my back.

Still not 100%, but I'm in good enough shape to enjoy some of the snow.


Thanks again to all who have helped me, wished me well, etc...

Special thanks go to Shaun (not on VFTT), DebW, dave.m, JohnL, and gforce for transporting my carcass to various appointments.

And, of course:
* Andy (not on VFTT) who stumbled on me lying in the snow and provided initial support,
* Jeff (NH State Police) and Cathy (WVV ski patrol) who transported me to the trailhead on a sled behind a snowmobile,
* Jerry (NH F&G) who provided backup when the snowmobile rolled,
* and countless medical personnel who treated my injuries and me.

Doug

 

[Paradox]

Go Get'em! Glad you're back.

 

[jjo]

Glad to hear of your progress and good news!!! Great to have you back on the trails.....

 

[Dr. Dasypodidae]

Hey, Doug,

Seems like your freaky accident was only yesterday. Good work on the recovery, and best wishes for getting back to 100%. You are an inspiraton to me.

Dr. D.

 

[--M.]

Fantastic: it's great to see you're back in the lab and figuring stuff out!

 

[DougPaul]

Billski asked about the long-term effects of my injuries. As it was off topic in the original thread, ("Cell Phone Pinging Cell Towers?", http://www.vftt.org/forums/showthread.php?t=40455, post #29) I am answering it here.

Incredible. Do you hike or do other sports differently now? I sure do. My family made it perfectly clear that I put them at risk as well. Another thread.

It is now four and a fraction years from the accident. All bones are fully healed, but there are some lasting effects:
* Left wrist: plate still in place. I'm basically unaware of its presence.
* Left leg: The hip screws have been removed but the nail (rod) is still in my femur.
- Slight loss of hip flexibility, occasional mild ache.
- Reduced flexibility of the knee joint. (I can only get my heel to ~5 inches from my butt--I used to be able to touch my heel to my butt.)
- The leg was 1 cm longer than the other leg, it is now .5 cm shorter than the other leg.
- The leg is twisted about 15 degrees inward
- The muscles are still a bit weak and I have had significant difficulty with overtraining of the quads. I continue to do exercises to strengthen the leg muscles.

Effects on "normal" activities:
* When I first get up in the morning, my left leg feels short and I feel like I am limping, but I soon get used to it. (I wear a lift in my left shoe to reduce the difference.)
* If I stand and adjust my feet so they feel to be at a neutral position, I find that my left foot points ~15 degrees inward compared to the right foot.
* When walking I twist my pelvis slightly (backward on the left) to compensate for the twist. I suspect an astute observer would notice a slight limp.
* I can't walk quite as fast as I used to: I used to be able to do 3.9 mph--I now typically walk 2.9--3.2 mph and only recently reached 3.7 mph by pushing fairly hard. (However, fast walking causes pounding which can cause overtraining--see below.)
* I feel as if I have to be careful going down stairs if the leg muscles are cold--I'm never quite sure how strong they are until I have made a few steps.

Effects on sports:
* Walking: mostly just a bit slower
* Biking: the twist bothers my knee from the constant deep flexing. It becomes painful unless I raise the seat to the highest position at which I can still pedal properly. It is a bit awkward, the bike is less stable, and standing up when going over bumps doesn't work as well as it should, but it is workable.
* Hiking: I've stuck with lighter duty day hikes since the accident. I'm not confident that the leg is strong enough to move safely on steep downhills so I use poles very aggressively on the downhills to help. Hopefully I will be able to build the muscles sufficiently to overcome this problem.
* XC Skiing: I had to adjust initially to the twist, but it is now fully automatic. As long as I am not on steep downhills, I am fine. (I was able to do a 27.5 miler in 28.5 hours this winter...)
* Tele Skiing: I started out well the first winter after the accident, but the pounding of descending on NE groomers caused overtraining of the quads. I have taken the last two winters off from Tele skiing in the hopes that I can beat the overtraining.
* Skiing kick turn: Kick turns have always been difficult for me, now they are impossible due to the twist.
* Skiing in general: I find I am more timid on the steeper downhills in the trees than I used to be. (I wasn't all that bold under those conditions before the accident either... I don't mind steep open slopes or wide trails--nothing to hit.) Perhaps this is a direct effect of the accident, perhaps it is due to my lack of practice on such terrain since the accident, and/or perhaps it is an effect of the weak leg.

I have learned (by trial and error (error=injury) that the overtraining is caused by excessive eccentric contractions of the quads which occur during pounding of downhill skiing, fast walking, or downhill hiking. I took over a year off in the hope that the quads would heal and have been rebuilding and recreating carefully.

So in general I can do most of what I used to be able to do, but have had to stick to the lighter duty versions. I continue to work on rebuilding the leg muscles, but still have to deal with the threat of overtraining.

Doug

 

[slevasse]

- The leg was 1 cm longer than the other leg, it is now .5 cm shorter than the other leg.

(I wear a lift in my left shoe to reduce the difference.)

Doug

I'm curious as to why the lift would be necessary now, since the legs are actually closer in length now? I haven't had an injury like yours, thankfully, but I do have a mismatch in leg length and was always told by my doctors and PTs not to do a lift, since once it is in one shoe, it has to be in all the shoes. Besides the longer leg changing for you it seems like it should be less noticeable now for you, unless the twist in the leg and other issues make it far more noticeable. Just curious.

 

[DougPaul]

I'm curious as to why the lift would be necessary now, since the legs are actually closer in length now? I haven't had an injury like yours, thankfully, but I do have a mismatch in leg length and was always told by my doctors and PTs not to do a lift, since once it is in one shoe, it has to be in all the shoes. Besides the longer leg changing for you it seems like it should be less noticeable now for you, unless the twist in the leg and other issues make it far more noticeable. Just curious.

The system had adapted to the original leg mismatch (slight pelvic tilt and mild scoliosis) and has been slow to adapt to the new configuration. As one gets older, the system becomes less plastic... So it is more the change than the degree of mismatch that I am noticing. I'm still adapting to the change.

Many years ago, I had a right leg problem which was probably exacerbated by the leg length difference and was advised to use a small right side lift (1/8 inch) along with custom orthodics in my street shoes. After several years I no longer needed the lift and stopped using it. (After the orthodics wore out, I switched to superfeet.) I never used or needed the lifts in my hiking or skiing boots. (Outdoor shoes are generally used on uneven ground while street shoes are generally used on very flat surfaces.)

When I tested the lift in my street shoes (now on the left side) with the "new configuration", they seemed to help. My PT agreed that they were a good idea. The left leg occasionally still feels short even with the lift, but it usually goes away after I walk for a bit. I still feel no need to use it in my outdoor shoes.

I find I can use my lift with some sets of shoes and not with others without difficulty, but it is a pretty small lift. (The lift interferes with the fit of my outdoor shoes, so I would need new outdoor shoes if I needed the lift. Fortunately I can do without...)

Perhaps you can do the same. But of course, if the current system ain't broke, don't fix it.

FWIW, my lift reaches all the way from my heel to just behind the ball of my foot. It is flat under my heel and tapers to zero thickness at the front end. I use it with a custom orthodic or superfeet (ie a manufactured orthodic). Since I need arch support, I need the 3/4 length lift--a heel-only lift would reduce the arch support, even with an orthodic.

It is made of a hard plastic foam--it is semi-flexible but does not compress under my weight. (The soft foam heel lifts that you can buy in the drugstore are useless--you want at least a dense felt which will not collapse under your weight.)

Doug

 

[billski]

So in general I can do most of what I used to be able to do, but have had to stick to the lighter duty versions. I continue to work on rebuilding the leg muscles, but still have to deal with the threat of overtraining.

Doug

Wow. You sure are lucky you can still get out. I dread the day that might happen to me, that I'll be stuck in a hospital bed or inside all the time or unable to walk. I admire your tenacity. It takes a lot of courage to make the advances you have.


I always think of Ed Garvey, who advocated for and hiked the AT many, many times. He lived and breathed the AT. When his body began to fail, he could hardly do section hikes anymore and wrote about his frustrations, his satisfactions and his disappointments. As he got older, due to heart problems, he was relegated to walks around the neighborhood. He passed on at age 84.

I'm a lot more reserved about boulders and boulder fields these days. I still walk for miles, but like you, I call it more "walking" than "hiking" although most people would still call it "hiking" since there is a moderate amount of vertical. Unfortunately I won't be doing things like Knife Edge any more. I'm just got a chance to do it when I could. I wish for you every good wish for more happy hiking, skiing, biking and all activites you have a passion for.

 

[DougPaul]

Wow. You sure are lucky you can still get out. I dread the day that might happen to me, that I'll be stuck in a hospital bed or inside all the time or unable to walk.

Fortunately I "waited" until medical technology was sufficiently advanced that my basic injuries were fixable.

It isn't all that bad--I have no trouble performing my "normal" around the house and around town activities. And I have discovered that certain activities are pretty safe (for the leg): eg level walking at a moderate pace, XC skiing and road biking. I just have to be careful of fast walking, hiking downhill, and fast skiing with bumps (eg lift-served Tele).

I admire your tenacity. It takes a lot of courage to make the advances you have.

IMO, tenacity yes, courage no. I want to do the outdoor stuff so I only have one choice: keep trying, learn from each mistake (reinjury), and don't let the frustration and lost time of each reinjury stop me.

I always think of Ed Garvey, who advocated for and hiked the AT many, many times. He lived and breathed the AT. When his body began to fail, he could hardly do section hikes anymore and wrote about his frustrations, his satisfactions and his disappointments. As he got older, due to heart problems, he was relegated to walks around the neighborhood. He passed on at age 84.

My view is that what you do is less important than that you do something. If you can't do big hikes, do little ones etc.

As we get older (beyond a certain point) our capabilities will diminish (with or without accidents). One has to pay more attention to training (staying in shape), resting, and injuries take longer to heal. Just do what you can with what you have.

I'm a lot more reserved about boulders and boulder fields these days. I still walk for miles, but like you, I call it more "walking" than "hiking" although most people would still call it "hiking" since there is a moderate amount of vertical. Unfortunately I won't be doing things like Knife Edge any more. I'm just got a chance to do it when I could. I wish for you every good wish for more happy hiking, skiing, biking and all activites you have a passion for.

As I noted, I'm a bit more leery of downhill skiing when there are obstacles to avoid (ie in the trees or on narrow trails) and extra careful when I am doing something which could cause reinjury (ie steep downhill hiking) but other than that, I'm still comfortable in the woods. (Perhaps these issues will go away when the leg becomes stronger and I get in a bit more practice.)

FWIW, I'd be perfectly happy to hike the Knife Edge again--I might be a bit slower but the ridge should be ok. (I've done it in summer and winter.) My biggest concern would be the descent...

The (relatively) natural outdoors are part of me--to give them up would be to lose an important part of myself.

If the woods are as important to you as they are to me, I suggest that you keep getting out in whatever way you are comfortable. Try not to let fears from a past accident hold you back.

Doug