The following is the first in several posts I plan to write about my new adventure involving the injury to and subsequent reconstruction of the Anterior Cruciate Ligament of my left knee. Before starting to write, I was conflicted about even doing this. I could just suffer in silence and get on with the business at hand. But with an extra 15 to 20 hours a week on my hands and a real need to quell some demons in my head, I decided that writing about the experience would be good medicine. I also believe that documenting this medical adventure may provide insight to other members of our tribe that might face the same road someday. This injury leads to a series of important decisions that many skiers are completely ill-prepared to make. I hope these pages provide a resource for making well-informed decisions about treatment and ultimately, return to the sport we love.
Sam on top before the weather got interestingPOP
I’ve made a lot of ski turns in my life. Some of them pretty, some not. Some easy, some difficult. Powder snow or frozen chalk board. Usually taken for granted, every turn is a mini adventure into possibility. Blissful, fear-inducing or down right dangerous. Steep skiing provides all of these sensations. Most of these moments pass with a smile or a sense of relief, or both, to be repeated every time we venture out. But for many of us, one single turn can be different from the rest. And that turn can alter the course of one’s life in ways you dread. For some, that alteration comes in the form of broken bones. For others like me, torn tissue. Both kinds lead to unwanted challenges and the temporary abandonment of skiing and traveling in the mountains for the foreseeable future.
Ben enjoying lighter moments when all was right in our Alpine world
SamOn April 3rd while skiing steep couloirs with two friends in the Western Chugach of South Central Alaska, one of my biggest fears came to pass. An off-balanced turn in a 45° couloir filled with some funky snow led to an awkward hip check and the oft-mentioned “pop” in my left knee. I tore my Anterior Cruciate Ligament (ACL). I was sure of it. It hurt for a moment but the absolute avalanche of thoughts that tumbled through my mind in the next 60 seconds erased any fleeting sense of pain.
First, the realization of suffering the most cliché of all skiing injuries and all it entails. Honestly, it’s surprising to many that I’ve made it this long skiing as much as I do without sustaining an ACL tear. I don’t think there is a day I’ve gone out where it didn’t cross my mind. At the top of every run, the ceremonial locking or unlocking of my tech toe pieces brings the event to mind if only for a moment. Having worked in orthopedic surgery for the past 24 years, I’ve treated many patients through all phases of the injury.
Second, was the absolute destruction of my vacation plans with Karol, a ski adventure to Italy and Switzerland to start in about two weeks. The ripples and waves of the injury were spreading outward quickly.
And in the next moment, as I declared my fate with much obscenity to my partners watching just a few steps away, I became acutely aware of the impact the injury would have on their lives for the next few hours. This became my primary focus as I pondered the logistics of traversing the five and half miles of moderate terrain to the car with an uncertain weight bearing tolerance. As I looked up at Sam and Ben, I tried to read their facial expressions. The falling snow and fogging glasses made my effort fruitless.
AssessmentSam sprung to action, rushing over to me, freeing my injured leg from my binding and helping me get a sense of things. He had an alumafoam (SAM) splint and pulled it out. I quickly pulled up my pant leg and tried to assess the situation, trying to find tenderness and elicit pain and make some sort of diagnosis beyond what I already knew. I tolerated standing on it so I clicked back into my ski. With the falling snow, a sense of urgency nearly overwhelmed me. I wanted to get on with it. I absolutely loathed the idea of burdening my friends with the task of getting me out. Standing on my left leg was reasonable but twisting motions sent sharp pains from the back of my knee. I was going to depend largely on my right leg for the task.
Sam taking my loadSam took my pack and I quickly side-slipped down the apron to my partners. We lashed the splint to my leg with my climbing skins and some Voilé straps. Ben and Sam talked amongst themselves and I started moving. The terrain is gradual for the 5 miles down the valley and can be done without re-skinning. I used Ben’s longer poles to make flat sections more efficient. I had a couple of painful moments when I forced a right turn or two and I even crashed once in some breakable crust. But for the most part, the execution of the extraction was much easier than the anticipation of it. Along the way I got a cell signal and my phone came to life. I texted Karol what had happened then I called her to tell her. That was probably the most difficult part of the whole thing. I felt like I’d completely let her down with the upcoming vacation.
Ready to rumbleI made good time and was mostly out of the zone in about 90 minutes. I borrowed Sam’s skins for a section of steep road in hopes that they’d keep going slow enough to avoid disaster. Both Sam and Ben went for the car and left me to my own devices and the non-stop rush of thoughts pouring through my brain. Then the car arrived and it was over. Just like that.
Scan
As soon as I had cell service again I called my boss and told him the news. I also called the office to see about getting an MRI that evening. They obliged. Karol met me at the office and wondered out loud of I could be wrong about my presumptive diagnosis. I wish. The scan was done in less than 30 minutes and confirmed the ACL tear and brewing swelling. No fracture. My old medial meniscus stuff was there from two years ago. I hobbled to the car and drove home.
The swelling was significant over night and my range of motion was pretty shitty in the morning. I convinced one of the PAs at work to drain it for me since I had to work for a few hours in the operating room. He pulled off 60cc of blood. It felt better immediately but the blood reaccumulated later in the day after standing in the operating room and I was back where I started. Crutches made things easier.
I now had some important decisions to make regarding what to do next. I was certain I wanted to have my knee fixed but when, who and what needed to be answered. The next post will dive into this mess of opinion and hopefully make some sense out of what I ultimately decided to do. Stay tuned.