Surgery from Dr. Buchko

With lots of Percocet and Ibuprofen I tried to make it through the night but I couldn't lay still and kept Linda awake all the time. Around 4.30 I left my bed to spend some time in the living room and hopefully give Linda some sleep. She would need it more than me.

Since Linda had to work on Monday, and since she has to take care of most of our income now, Chad my landlord and friend drove me to Banff Hospital. I had an appointment with orthopedic surgeon Dr. Greg Buchko from Banff Sports Medicine at 11 AM.

I can be very lucky with the facilities in my area. Having both a hospital in my own town and a world renowned Sports Medicine Clinic in Banff, only 20 minutes away. 35% of their Emergency Department injuries is sports related, 90% off them are skier/snowboarder accidents. Somebody told me they treat 700 ankle fractures a year in Banff. That's 2 a day. Sounds a lot to me, maybe it's lower leg fractures but you get the point. These guys know what they are doing!
And they all love outdoor sports themselves too. That's why they live and work in Banff.

Dr Buchko told me my ankle was destroyed pretty severe. It shouldn't have been much worse or they even wouldn't be able to fix it completely themselves. I was going to need some hardware in my foot. They had to fix both my Tibia and my Fibula with a stainless steel plate and use some bone cement to fix some of the loose chips.
Dr Buchko told me it might take half a year on average before I walk "normal" again and a year until I regain full motion within my ankle joint. The thing I should worry most about is getting Post Traumatic Arthritus in my ankle joint 25-30 years from now.

They lay me on a bed and attached me to IV and started giving me antibiotics, or did they start that after Surgery. I can't remember. Around 1 PM they drove me into the OR room and lay me on the operating table. They discussed the anesthetic with me and we agreed on a spinal anesthesia with a light nap. After a little fiddling with the needle they managed to give me the injection in my spinal fluids. About 6 people were getting everything ready in the OR room and I was having a chat about some common friends with the hospital staff.

Next thing I remember is waking up 2 hours later under a warm blanket. They drove me to an acute room were Linda soon appeared. Yes!
They had to keep monitoring my vitals and keep me on IV for the rest of the day and night. Limping to toilet with an IV bag on a pole is no fun. Especially when part of your lower body is still numb from the anesthetics.
Linda stayed for a few hours, after that she went home. She was even more tired than me. I had had my little nap during surgery.



I didn't feel much in my foot at all until midnight. And then it started hurting bad. The nurse gave me a morphine injection but that did didn't help much so they soon afterwards had to give me another injection. That must have been the time that the freezing in my foot stopped working.

I managed to get through the night on Morphine, Percocet and Ibuprofen while the nurse came every few hours to take my vitals and give me intravenous Antibiotics. I tried to read a bit but I felt like a drunk, had to close one eye to focus on the letters and couldn't concentrate for long. Listening to my ipod worked better.

In the morning they took new x-rays and I asked to see both these and the original ones. On the old ones you see a lot of damage although I couldn't tell how severe it was. But clearly a lot more damage then just a fracture. On the post surgery x-rays my foot looked pretty scary with 2 big plates , 11 screws and lots of staples. I'll be setting of metal detectors on airports the rest of my life with that much stainless steel in my foot.

Around 11 AM Linda came to pick me up and I was discharged from Hospital. I'll have to be back for a followup appointment with Dr. Buchko next week Thursday. Then my foot will go in a removal cast so I can take it off when I shower or go to bed. I'm still on the Percocet but I'm taking 1 instead of 2 pills a time know. Hopefully I can stop taking it soon and finally grab some wine and beers. Supposedly pretty good pain medication too.

I'm not allowed to bear any weight on my left foot for 6 weeks. After that, I don't know. I'll probably plan my first physiotherapy appointment after my follow up with Dr. Buchko next week. I just hope I can start swimming fairly soon and go to the gym for at least some exercise with my arms. Luckily there are some very good physiotherapists in Canmore with that many Professional and Amateur sportsmen, including Olympic Champions and the Canadian Ski Team , in Town.

Breaking my ankle on "This House of Sky".

Last Sunday I broke my ankle while ice climbing in the North Ghost near Canmore.

Ian and I left Canmore at 6.00 AM to drive to the Ghost Area. We opted to climb "This House Of Sky". A 500 meter WI 3-4+ climb consisting of mostly short (5-10meter) grade 3 pitches mixed with easy little steps and topped off with 2 longer grade 4 and 3 pitches in an alpine bowl. (I did this climb last year with Linda, see our older post: http://lindaenbram.blogspot.com/2009/11/blog-post.html )

The approach was a 2.5 hour drive, mostly on back country roads followed by only a 10 minute hike to the beginning of the ice. At 9.30 AM we started climbing.




Since it was a minus 20 C last Sunday this would be a nice climb where we would both be able to solo most of the shorter pitches as I did last year. In this way we wouldn't get freezing cold while belaying. The climb turned out to be a lot more slushy then we expected. According to Ian water was pouring out of my pick holes when he climbed after me on the last few pitches before the accident. That said, I felt pretty comfortable climbing the ice all day up to that moment.


This last pitch I was climbing that day was a little bit steeper, and slushier then everything before. I was climbing really careful until suddenly my crampons and my "solid" tool placement ripped through the slush and then I started sliding down the ice with still both tools in my hand. Somehow I managed to drag them through the ice to try to brake and not fall backwards but on impact with the conical bottom of the ice my crampon caught and I tripped backwards. It was 10.30 AM

Laying on the ground I tried to move my leg but my foot just hang really awkward to the side.
It was quite obvious that my ankle was broken or severely sprained. Standing on it was far from possible. I couldn't even move my foot while it was dangling from my leg but at least I still could wiggle my toes.

Descending our climb would have meant at least 5 rappels and numerous little down climbs. Not a serious option in my state. Both knowing the seriousness off this situation with -20 C temperatures Ian splinted my leg, lay me down as comfortable as possible with the little gear we had, checked me for further injuries and went down the route back to the car to drive to a spot with cell phone reception. We were guessing 1.5 hours each way so I wasn't expecting Ian back before 2 PM. It was 11 AM now.

Since "This House of Sky" is one of the more popular climbs in the area and it was a Sunday I was desperately hoping there would be an other party on the climb to come to my aid. Maybe Ian even would encounter other climbers with a Sat Phone, Spot or Radio so he could arrange a faster rescue.

Laying down I was cooling off really quick. I kept wiggling my toes in my boots but it got harder and harder to wiggle my toes in my broken foot until I lost all feelings in it. My foot swelling up in my boots with still gaiters and crampons on it didn't make things better.
I was laying on my side with my broken foot on top of the good one but every few minutes it started sliding off and I had to put it back with my hands. I couldn't lay on my back because then my foot would just hang to the side which caused enormous pain.
To compensate my ankle not being able to do anything I continuously contracted my upper leg muscles which caused a very painful cramp in my upper leg.
Partly I wanted to fall asleep to make the time go faster but the cold and pain prevented me from doing so. And I had to prevent falling asleep at all cost. It would cool my body down even more. I slowly started to worry more about frostbite than my broken ankle.

After being on my own for an hour I had finished all my warm tea and was starting to loose faith in an other party climbing up to me. I can't explain how happy I was when I suddenly heard the sound of ice tools swinging in the ice around 12.15 PM.

Soon after hearing them Rebecca followed by Tobias climbed over the lip of the ice below me. They positioned me a lot warmer and comfortable on there packs and rope and wrapped their jackets and an emergency blanket around me. Tobias collected wood on the sides of the canyon and Rebecca managed to get a fire going. They also tied my legs together which relieved the tension in my upper leg and made it possible for me to lay on my back with my feet and knees elevated.



I asked them to open my boots and take my crampons off what turned out to be quite difficult since everything was covered in a huge amount of now rock solid ice. Luckily the cold had made my foot so numb that by now I felt hardly any pain in it while they were struggling with my crampons.

To stay warm themselves Rebecca and Tobias had to keep moving since I was covered in their jackets. Searching for wood kept Tobias warm and at least they had a nice fire going. Seeing the clouds getting lower all the time and knowing it was getting later started to get us worried about the rescue. At 3 PM there still wasn't any sign of Ian coming back but then suddenly we heard a helicopter approaching. It hang still above us for a few seconds and then left again.

The rotor wash killed our fire and we quickly took my comfy "bed" apart to make sure Rebecca and Tobias would have all their own gear since they still had to descend themselves. We were cooling down really quickly after that and we started to be afraid that this place would not be able to reach with the longline but after almost 30 minutes we heard the heli again and saw it approaching with 2 persons and a haul bag hanging from the long line. They got dropped next to us and the helicopter was gone again.



The Alberta Parks rescuers Mike And Ken, climbers themselves, with Mountaineering Boots, Crampons and Harnesses, wanted to get me out of there as fast as possible. Both for me and for the deteriorating weather I guess. They put me on a Vacuum Mattress, which is a bag that folds around your body when you vacuum it with a pump. Everyone had to be extremely careful with there crampons since a hole this bag would ruin the rescue. After that they put me in a bag and attached themselves to a ring hanging from the bag.

The helicopter came back, they attached the long line and immediately we were in the air. Since the helicopter had to make a 180 degree turn we started spinning really fast. I really had to focus on the heli and the clouds not to get dizzy. They flew me to a flat spot, close to were we had parked our car that morning. There they took me out of the bag since I didn't have any spinal injury and we all went inside the helicopter. Mike and Ken had gotten really cold from hanging under the helicopter in these arctic temperatures. At least I had been in the warm bag.


Off we went to Canmore Hospital, for the second time of my life inside a helicopter, but with quite different feelings then the first time. Although just as cloudy and with lots of snow everywhere around. Since the clouds were so low they had to fly a longer route to the hospital, I even got to see our place from the air.



At the hospital we had to wait for an ambulance first. The Hospital staff wasn't allowed to go outside and they didn't have a stretcher that would roll through the snow to the helipad. All the hospital could do for me was give me a blanket.

When EMS arrived they rolled me on one of their burly stretchers inside the hospital. There they finally took my boot off. My ankle was deformed and obviously broken.My left foot further looked and felt really cold but they didn't bother much about that in hospital. I had to keep asking them for more blankets to stay warm. And I finally could pee. I asked for a urinal and filled it completely. "You really had to pee" the nurse said. I just hadn't wanted to wet my pants, especially with the cold temps.



Soon Linda appeared in the hospital . That was great company. Ian later came as well. He had to wait in the car with cell phone coverage until the rescue was done. After they flew me out he was finally allowed to drive to Canmore.

They took x-rays off my foot and it turned out I had fractures in both my Tibula and Fibia and some loose bone chips. This was something they were unable to fix themselves and they made an appointment for surgery with dr. Buchko at Mineral Springs Hospital in Banff for the next day.

After giving me a really strong sedative and painkillers they straightened my leg. The sedative they gave me made me forget the straightening immediately afterward. They had asked me whether they should cut my pants or take them off. I can't remember. They suddenly just were off and my leg was straight and in some kind of cast.

My foot finally started warming up around this time without any frostbite which I can be very grateful for. Especially since I later heard my rescuers definitely thought I would have frostbite.
While warming up my foot started hurting like crazy. They gave me Percocet, a narcotic painkiller, against the pain and gave me the option ( and some more Percocet) to spend the night at home. If the pain would get to bad I had to come back to spend the night in hospital with a stronger narcotic. Monday I had to be in Banff Mineral Springs Hospital at 11 AM for surgery on my ankle. Finally home I tried to sleep.