Tom, Field, and Willey with an Avalon Bonus, 4/5/2008

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BIGEarl

Well-known member
Joined
Jul 18, 2005
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Location
Nashua, NH
April 5, 2008: Mts. Tom, Field, Willey, and Avalon

Trails: Avalon Trail, A-Z Trail, Mt. Tom Spur, Willey Range Trail, Mt. Avalon Spur

I was just walking along minding my own business. Suddenly I’m experiencing more pain that I have in a long time. But, I’m getting ahead of myself…

Trail Trotter (Sue) and I had a plan to complete a loop hike of the Willey Range from Crawford Notch and visit the summit of Mt. Avalon on the way out. We arrived at the pullout on route 302 in Crawford Notch and quickly prepared to get started. The conditions were low clouds, fog, no wind, and a warm temp in the mid 30’s to start. The National Weather Service forecast indicated the conditions were expected to improve through the day. We had the place to ourselves.

We started the day bare booting the hike. The trail was very firm with an inch of wet snow on the surface. On the level section to start traction wasn’t an issue. Within a short time of heading out a solo hiker went past headed for Mount Tom. We met him a couple more times later in the morning. The warm condition was really softening the snow creating traction problems. Soon Sue pulled out her snowshoes. A short time after I was experiencing traction problems and went with crampons. With the traction issue resolved we slowly made our way past the Avalon & A-Z trails junction and onto the height of land on the Willey Range and the Mt. Tom Spur. Along the way we could see places where the solo hiker frequently drifted off the packed trail and managed some impressive postholes. The wind had come up a little so before heading to the summit of Mt. Tom we added a layer. Roughly half way to the summit we came upon the solo hiker headed down with plans to hike Mt. Field and call it a day. On the summit of Mt. Tom the view was limited to the inside of a cloud. We took a couple pictures, explored the area a bit, and headed back to the Willey Range Trail to head south for Field and Willey.

Back at the Willey Range Trail I changed from Crampons to Snowshoes. I could see the other hiker was postholing more and more, clearly it was time for snowshoes. A short distance south on the Willey Range Trail we found the place where the other fellow made the change to snowshoes as well. The Willey Range Trail is in pretty good shape leading to Mt. Field. The snow is very deep and many times we were hiking in treetops. The fog was still drifting through the area with no sign of improving. When we reached the Avalon Trail & Willey Range Trail junction we could see where the solo hiker headed out – must be he is not a peakbagger. In a hundred yards we were on the summit of Mount Field getting a couple more pictures but still no views. No Gray Jays either!

Now the day got a little more interesting. There was no evidence of traffic between Mt. Field and Mt. Willey. The trail was completely drifted in. Most of the blazes are under the level of the snow. The blazes we were able to locate were generally in tough shape. We broke through a snow drift and set off for Mount Willey. The next couple hours was filled with breaking trail, searching for blazes, pushing through treetops, and more. I started the trailbreaking, Sue took over in the middle section, and I was leading again at the end. At more than one point we were unable to find blazes and wandered trying to locate the trail. Consequently, there are a few places where our tracks drift for some distance away from the trail. Anybody following our tracks should always stay right on the way to Mt. Willey. As we were approaching the summit area we lost the trail and drifted to the east. I had been in this area a couple years ago and knew we needed to work our way to the west. Believing we could simply bushwhack our way back on trail we set off. We made several attempts at bushwhacking to the west. Each attempt included being caught in a spruce trap, sometimes several. On one occasion I went in to my shoulders. As I was taking my camera out to have Sue take a picture the snow gave way and she was up to her shoulders. There we were, talking to each other with perhaps ten feet between us and all either of us could see was the other’s head. We’re having fun now!

We backed off from the bushwhacks and backtracked to a position where we found more open conditions. Here we made our move west and soon landed on the trail. There were no blazes at first but it was clearly a trail. Off we went and eventually found a blaze at snow level. We managed to stay with the trail all the way to the summit. The clearing conditions that were forecast were still in the future. A couple pictures and we were on our way back to Mount Field but now we have a trail to follow.

The return hike and re-climb of Mount Field of 1.4 miles and 350 feet went quickly. Soon we were on the summit with food out and still no Gray Jays. After quick refreshment we were heading for Mt. Avalon via the Mt. Avalon Trail. Other hikers had come through and there were now multiple sets of tracks headed down the Avalon Trail. Unfortunately, at least a couple did not have snowshoes.

We made our way without any problem to the Mt. Avalon Spur. The side trip to the summit is only a hundred yards and 100 feet in elevation. Off we went to hit the final summit for the day. Sue had been thinking about her Swiss Bob all day and planned to do some sliding on the way out from Mt. Avalon. She got rid of the snowshoes, secured everything on her pack, and headed down from the summit. Riding a Swiss Bob off the summit of Mt. Avalon looked like a great way to get hurt, not for me – I was walking.

There I was just walking along, minding my own business, hiking down the very steep trail from the summit of Mt. Avalon. Suddenly I’m experiencing more pain that I have in a long time. A spruce tree that was mostly buried in the snow caught my left snowshoe and I went down face-first. Evidently, I reacted to the developing situation by putting my arms out to break my fall. I believe my right arm must have caught in the crusty snow but the rest of me wanted to continue. First I heard a very loud snap or pop (no crackle) and then there was the pain. I didn’t know what happened but knew it wasn’t good. While I was laying face-down I could see my right arm in a position that was unusual. I believe this was about the time that I exercised my vocabulary (sorry Sue). After a short time I decided the arm was either broken or the shoulder was dislocated. I didn’t know which the case was but the pain was impressive. Sue wasted no time in coming to my aid and we were able to get me turned around facing feet-first down the hill. Slowly, Sue helped guide me and I slid down to the base of the spur path. At that point I was sure the problem was a dislocated shoulder. Sue had a nylon strap that she used to make a sling to support my arm during the walk out. One of my poles was broken with the fall but since I had only one arm to work with I only needed one pole – I was good. Only 1.8 miles to go and we’re out.

At one point I realized the sling was preventing blood flow to my right hand and we stopped to relieve the situation. The sling was readjusted and we set off again. After a while I was again experiencing blood flow problems. I decided letting my arm hang to my side might be better, hooking my thumb in my pants pocket could possibly stabilize it from excess movement. I also realized changing the arm position was probably going to be really uncomfortable. Sue undid the sling and I lowered my right arm with my left. Slowly I was able to extend it straight down, but I couldn’t hook my thumb into my pocket. I asked Sue to help push my hand to my pocket. As she pushed and I attempted to help as much as I could I felt the shoulder go back together. It didn’t feel very good but it was a relief. I was able to flex my fingers and bend my elbow – a little. This was a great improvement and we were once again on our way. A couple brief stops along the way and we were soon at Crawford Depot.

Off with the snowshoes and we walked to the waiting truck. I was concerned removing my pack would be another unpleasant part of the day but it slid off with no real pain. We packed our things away, I downed some pain medication, gave Sue the keys to the truck, and we headed south.

Everything up to the fall combined to make a great day in the mountains. Thanks Sue for taking care of me. I’m looking forward to our next adventure – can’t wait.

I've posted some pictures from the day.

Straight to the slideshow.

BIGEar's pictures.


:D
 
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You're tough, Earl. I'm sorry I missed you "exercising your vocabulary." I hope the shoulder mends quickly and you're soon back on the summits.

John
 
Thanks guys.

All things considered the recovery shouldn't take very long. I wasn't in great shape to begin with. A partial recovery should get me back to where I was. That's probably the best I should hope for. ;)

The annoying part of the day was the broken Leki pole. I really liked that pole. :rolleyes: I'll check to see if their Lifetime Shaft Breakage Warranty applies.

I am very thankful for my hiking partner. Trail Trotter really saved me. :)
 
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BIGEarl said:
Thanks guys.

I really liked that pole. :rolleyes: I'll check to see if their Lifetime Shaft Breakage Warranty applies.

It should:

All LEKI-branded trekking poles are covered by a LIFETIME WARRANTY
against shaft breakage.* › Warranty does not cover wear and tear from
normal use or damage from abuse.
*One-year limited warranty on Carbon poles.

Sorry to hear about the fall and injury but we suspect it won't slow you down much at all!
 
Nice self rescue, Earl and Sue.

Did you get a confirmation on a shoulder dislocation from the docs?

Good luck with speed recovery.

Leki poles are replaceable; bodies less so. ;)
 
Dr. Dasypodidae said:
Nice self rescue, Earl and Sue.

Did you get a confirmation on a shoulder dislocation from the docs?

Good luck with speed recovery.

Leki poles are replaceable; bodies less so. ;)

Yes, and only a dislocation. The good news I have just learned is the x-rays show there was no other damage done. In other words nothing was broken, except for the Leki pole.

I really liked that pole. :(
 
Earl,

Thanks for the trail report & pictures. I am glad to hear that the damage was limited. Knowing you, you would have been back on the trail the next day even if it had been broken. Challenges in the mountain come in many forms and you and Sue met all that came your way. The hikes we all remember are the ones in which we were challenged.

Looking forward to hitting the trail with you soon.
 
Yikes! :eek:

Very glad to hear it was not broken, and it is on the mend.

Maybe it was the spruce trees way to get even for you both escaping their well made traps! :rolleyes:

Hope to see you out there soon!

:)
 
Amicus, Rols, and Chinooktrail, Thanks.

Pain medications could get me back on the trail but they wouldn't prevent additional damage. I'll give things a chance to recover, a little. :rolleyes:

If you're interested in what a broken Leki upper shaft looks like I've added some shots to the slideshow. In a couple shots you can see the locking mechanism inside the upper shaft section. The folks at Leki tell me it is extremely unusual for an upper shaft to fail.
 
BIGEarl said:
If you're interested in what a broken Leki upper shaft looks like I've added some shots to the slideshow. In a couple shots you can see the locking mechanism inside the upper shaft section. The folks at Leki tell me it is extremely unusual for an upper shaft to fail.
You can also look at the mechanism by unscrewing it a bit more than usual and then pulling the sections apart. (It is a plastic expansion nut.)

If you open it up for a look, it might be worth a small dab of silicone lubricant on the threads and cleaning the inside of the outer shaft and the outside of the inner shaft...


Hope you heal quickly and well.

Doug
 
Wow, Glad you're okay Earl!

It's sad about your pole, but better it than you. Hopefully Leki will replace it for you...

Nice TR!
 
Hey Earl,

Glad you made out OK. I didn’t notice this thread until recently. Just for future consideration though you might want to talk to your doc about learning how to reduce a dislocation in the field. Dislocations are usually pretty easy to spot with a little training. There are several reasons to do this and I believe that once you have suffered a dislocation you are more likely to suffer another one. Generally speaking it always better to reduce a dislocation as soon as possible after it happens. Outcomes are almost always better when this is done sooner rather then delaying the reduction. Also someone that has a dislocation reduced can usually help with their own self rescue much easier and safer. Talk to your doc about this. There are several ways to do this in an accepted manner and in all instances if when it is being done the pain increases then the attempted reduction is not continued. As with any medical procedure there can be risks, so like I said, talk to your doc about this and see what he says.

Take care,
Keith
 
SAR-EMT40 said:
Hey Earl,

Glad you made out OK. I didn’t notice this thread until recently. Just for future consideration though you might want to talk to your doc about learning how to reduce a dislocation in the field. Dislocations are usually pretty easy to spot with a little training. There are several reasons to do this and I believe that once you have suffered a dislocation you are more likely to suffer another one. Generally speaking it always better to reduce a dislocation as soon as possible after it happens. Outcomes are almost always better when this is done sooner rather then delaying the reduction. Also someone that has a dislocation reduced can usually help with their own self rescue much easier and safer. Talk to your doc about this. There are several ways to do this in an accepted manner and in all instances if when it is being done the pain increases then the attempted reduction is not continued. As with any medical procedure there can be risks, so like I said, talk to your doc about this and see what he says.

Take care,
Keith

Keith,

Thank you. I am aware of your background and respect your observations and suggestions. I have sent an email to my Doctor and asked about this procedure. While waiting for a reply I decided to do a little research. With the help of Google I located several reports on the topic specifically related to shoulder dislocations and attempted to develop a basic understanding.

I’m not a medical person and don’t pretend to be one. I have no medical training. The following is nothing more than speculation on which perhaps you could offer a comment.

I believe Nurse TT and I may have accomplished just as you have suggested. If you re-read the report you will see where I was experiencing discomfort on three occasions after the accident that I attributed to poor blood flow caused by the sling. Twice we stopped and relieved the temporary sling and on the third instance we took steps to eliminate it completely allowing my arm to simply hang straight down. I discussed this with my Doctor and he indicated a belief the discomfort was actually a pinched nerve. He also suggested it was good that we gave up on continuing with the sling since there may have been additional nerve damage had we done so. When the arm was lowered and TT & I worked to bring my thumb to my pants pocket it was possibly very much like the suggested techniques I read about in the Dislocation Reduction reports. I believe with her and I working together we managed to achieve a dislocation reduction without knowing it. The shoulder went back together. It was not entirely pain free but I got through it.

Is this essentially a dislocation reduction as you suggested?

Thank you again Keith. I really appreciate your suggestion, and your approach. The folks on various boards that are practicing medicine without a license could learn a lot from you.
 
BIGEarl said:
Keith,

Thank you. I am aware of your background and respect your observations and suggestions. I have sent an email to my Doctor and asked about this procedure. While waiting for a reply I decided to do a little research. With the help of Google I located several reports on the topic specifically related to shoulder dislocations and attempted to develop a basic understanding.

I’m not a medical person and don’t pretend to be one. I have no medical training. The following is nothing more than speculation on which perhaps you could offer a comment.

I believe Nurse TT and I may have accomplished just as you have suggested. If you re-read the report you will see where I was experiencing discomfort on three occasions after the accident that I attributed to poor blood flow caused by the sling. Twice we stopped and relieved the temporary sling and on the third instance we took steps to eliminate it completely allowing my arm to simply hang straight down. I discussed this with my Doctor and he indicated a belief the discomfort was actually a pinched nerve. He also suggested it was good that we gave up on continuing with the sling since there may have been additional nerve damage had we done so. When the arm was lowered and TT & I worked to bring my thumb to my pants pocket it was possibly very much like the suggested techniques I read about in the Dislocation Reduction reports. I believe with her and I working together we managed to achieve a dislocation reduction without knowing it. The shoulder went back together. It was not entirely pain free but I got through it.

Is this essentially a dislocation reduction as you suggested?

Thank you again Keith. I really appreciate your suggestion, and your approach. The folks on various boards that are practicing medicine without a license could learn a lot from you.

First, let me say I would never second guess Nurse TT or your decisions. I wasn’t there so I can only add the little I know of what I have been taught in what might be a similar situation. I do assume that you call her Nurse TT because she is a real nurse, a RN or LPN?

Before a splint, sling or swath is placed it is essential that CMS (circulation, motion, sensation) is checked distal (away from the core, towards the toes or fingers) to the injury. Not doing this, there is no way to tell if a loss of CMS is the result of the injury or what we have done to try to make things better. With your particular injury I would check your fingers on the injured arm to see if they have good color and good capillary refill, if your fingers have sensation and if they have movement. This will help me determine if you have a loss of CMS from your injury before I do anything. CMS should then be checked immediately after the application of any type of splint and every 10 minutes after that to insure things are not getting worse and hopefully are improving. From what you wrote checking was done en-route so that is very good and no one ignored that things got worse a couple of times and corrections were taken. That’s excellent care! IMHO

The reason it is good to try to reduce a dislocation as soon as possible, if it is reasonable to do so is many. First, it will help restore normal function and any nerves or vessels that are trapped will probably be released. With this sooner is almost always better. Long term crushing of these items is very bad and can cause lose of use of the limb up to and including needed amputation. This happened to a young boy in the woods a few months, maybe a year or so ago and whose reference I can’t find right now. He wound up needing an amputaion of the lower leg. But, it should be noted that any reduction also runs the risk that you could entrap vessels or nerves during that procedure but you are putting things back into their anatomically correct locations so the odds are probably pretty good that won’t happen. It is a possibility but I think considered by most as remote and unusual. Second, the longer you wait, after around 20 to 60 minutes spasms often start. Remember, these are strong, involuntary muscle contractions yanking on the dislocated joint. I am pretty sure you can feel this just by its description. This will cause tremendous pain and that person is almost certainly going to have to be litter evacuated after the joint is stabilized. Again, adding much time to the evacuation and having the limb in a non-anatomically correct position for an even longer amount of time.

There is no way I can explain how to do a reduction. There are several ways to do it but it also depends on the joint involved and the way the dislocation occurs. Arm hanging at the side or laying prone with weight attached is a fairly common way to reduce a dislocation of the shoulder. Usually there is significant relief when this happens. The key here again is that if whatever you do causes a significant increase in pain to stop doing it. Reductions do happen spontaneously fairly often though. I have seen this on more than one occasion. People with breaks and dislocation often self-splint. Meaning that when you find them, if they are conscious, they will be holding the injury or laying in a position of comfort. This can sometimes allow a dislocation to slip back into place.

My only medical advice consists, as always, is use this information as you see fit after checking it with your doctor. It’s always possible that I may have a typo or didn’t proof read something well enough or I may just be full of crap. :p

Regards,
Keith
 
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Sorry Keith,

Nurse TT isn't a nurse at all. But she was there to provide assistance to me and did a great job. It is simply a friendly reference to her and the care she provided.

There was no intent to show any disrespect to the licensed medical folks out there that might be annoyed by the comment.

After the accident I was immediately aware of CMS in my hand and wrist. I was also aware of the ability to move my forearm but didn't really want to because of the discomfort involved. As you observed, I continued to be aware of the conditions as we made our way out. The decision to lower my arm brought with it an expectation for significant discomfort. We went through the process as described and there was a great relief when the shoulder went back together.

I knew there was enough distance left for the hike out to present opportunities for further injury. This concern had me paying very close attention to any changes as they developed.

Thanks again Keth. I appreciate your thoughtful comments.

Earl
 
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In general, a Wilderness First Aid course is an excellent investment. SOLO comes highly recommended (and often will run courses for the AMC), but BU's course may be more convenient for some. (Unfortunately not offered this summer, and the fall schedule is not up yet.)

One of the topics covered is dislocation reduction--both when, and how. (One of the differences between a frontcountry first aid course and WFA.)

BIGEarl, it sounds to me like the two of you did as well as one could expect without training. Basically kept your head and carefully tried things to see what felt better. This is an excellent self-rescue account and I hope Mohamed's reading :)
 
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