Thursday, March 24, 2016

After Rupture of Ligaments (ACL & MCL) in ski

Apart from the pain at the very beginning, the feeling of ligaments rupture is rather weird than painful: a dangling leg which does not listen to my brain, but always announces its existence by making walking difficult. A more unexpected trouble was a psychology depress feeling which lasted for the entire 2nd week. 
Falling, ski rescue and Ambulance

About 20 days ago (March 6), I fell when ski in "Loser Schiarena" resort near Bad Aussee. It is common that I fall 2-3 times every ski day, so Tim always skis behind me in order to help. This time he thought it was another regular falling, hence he first went to pick up the ski poles I dropped, then came to check with me. When he asked: "Are you OK?", I cried out with fear and tear :"No! Pain! I can't move my leg!"
Yes I realized right way that my left leg could not move anymore, besides it was in sharp pain. Strangely my skis did not peal off from my boots, although they usually peal off when I fell with big force. A skier in my father's age stopped and came to help Tim to remove my skis. After that I could finally lie down my legs from the twisted angle which might be the reason for the injury. Luckily the sharp pain went away right after the position adjustment. However I still could not feel my left leg.
More skiers stopped to check if we needed help. A group of young people skied down to get the rescue-team. A lady used my skis and ski poles to make "X" shapes above me on the slope, so that other skiers can avoid hitting me. We really appreciate these kind people, they made me feel much more hopeful.
After 10-15 mins waiting, the rescue-team arrived. Most of skiers who stayed with us left, apart from two skiers. One was further from me so I could not see him, but Tim told me that he stayed with us all way to the foot of the hill. Another gentlemen I remember very very well, because he companied me all the way since he arrived. He talked with us, helped the rescue team to fix my leg, translated for us, and skied down with us. He even offered Tim that he can drive Tim to the hospital when I was moved to the ambulance. I really appreciate him. It is ashamed I did not know his name, even hardly remember his face as he wore a ski helmet. The only information I know was that he had two daughters, and he sent his daughters to the car after the rescue team arrived, but he stayed to help. Another thing we know was that his grandmother is Irish, which might help for his good English. It is unlikely he will see this blog. But incase he sees, I would like to say thank you soooo much for your kindness!
Talking about the rescue team, they are very professional. They used an air inflation tube to fix my left leg, and moved me on the stretcher which is an air inflation pad. The stretcher was lying on the floor and ski-dragged down the hill by two rescue team members. 
It was a very weird experience being skied down the hill in a lying position. I was bound tightly with the inflation stretcher, like a zombie. Many times I felt I was going to be thrown out, but of course I was tightly bound on the stretcher. The two skiers were really wonderful at controlling, it is hard to imagine how well they can ski while they need to carry a person even if the stretcher was lying on the ground. My leg was facing up the hill, so in my view I saw Tim and the kind gentleman skiing behind us, and snowflakes flying on the sky and sometimes dropped on my face. I was thinking, what if it is a dream.
After we arrived at the root of the hill, the Ambulance was already waiting there. A young lady came to check my temperature on my hand and kept saying “too cold, too cold”, although I didn't feel that. Quickly I was transferred into the ambulance and sent to Bad Aussee hospital. The X-ray image shown that a tiny piece of bone peeled off on my left leg, but more information is needed from MRI or CT. 
⬇️X-ray 
The doctor made a calcium cast for me and suggested us to go to a bigger hospital in Vienna as soon as possible. This was the first cast I got, felt quite heavy. 
⬇️heavy Ca-cast, the first disable night

Train ride back to Vienna
This strong Ca-cast was very uncomfortable but did protect my leg well on the 5 hours train ride from Bad Aussee to Vienna. Before this time, I had not worried about a train ride so much. And I was right, the train ride was a pain. 
First of all we have a lot of luggages: two backpacks, two pairs of ski-boots (heavy), two pairs of ski-poles and two pairs of skis (heavy and big). I could not carry anything, so Tim became a tree hanging of all sorts of bags.
Second I was still learning how to walk with one leg plus a pair of crutches, which was super tiring for the muscle of the arms and the right leg. Besides my right foot and both palms felt a lot of pressure. The most challenging part was that the doors of trains are not on the ground level, I had to jump up and down the 3-steps narrow stairs for each train! Nowadays after practicing jumping on stairs is not too difficult, but by then it was almost an impossible mission for me. 
I also knew transferring would be a trouble so I chose a train schedule with 13 mins for transfer from platform 1 to platform 2. Before the injury, it took less than 2 mins: Walk (Take lift) downstairs, walk to another side from underground, and walk (take lift) upstairs. However, I almost could not make it even if we had 13 mins, and I was super exhausted at the end. Disappointedly, the small train stations do not supply wheelchairs. Luckily in Vienna train station the staffs offered us help with a wheelchair.

Emergency room, MRI, and diagnose
From Vienna train station, we took a taxi and went to a hospital (AUVA-Lorenz Böhler), after quickly dropping luggages at home. This was the first time I went to an emergency room. Although the hospital was quite busy, it was high efficient. The doctor even managed to get the MRI operator back from another side of the city. The MRI tomography results show that the bone bruise is not the critical thing for me. The biggest problem is the rupture of anterior cruciate ligament (ACL) and medial collateral ligament (MCL).
The prescription is waiting for the ligaments to recover by themselves, which usually take 6 weeks. The doctor also changed my previous heavy cast to a temporary brace which is not too strong. And we were told to get a real brace from a professional shop for healthcare and nursing products, which we did in the second day. The new brace is much lighter and more flexible for which the bending angle can be tuned.
⬇️A better brace: light and flexible

Luckily I don't have constant pain, if I don't put too much weight on or twist my knee. The most painful thing in the prescription is the Lovenox injection once per day. The doctor said it is necessary for preventing blood clots, as far as I wear the brace. When I was told that I should do the injection once one day by myself, I could not close my mouth. Are you kidding me? Doing injection myself?!! It turns out that this injection is done on the fat, not on blood vessel, so not too difficult. But the medicine causes a sharp pain for 2-3 mins after the injections. I gave this job to Tim so I do not need to do it myself. This became our most "fun" game daily....
⬇️Lovenox injection once per day


Different view and life when disabled
After this injury, I see the world in a very different way. I used to think that the public facility for disable people in Austria is very considerate: lifts in every metro stops, doors at ground-level for the new style trams, etc. But after this accident, I realize that there are many small things which could cause so much trouble for disable people, which I did not think about before. For instance, there might be  2-3 steps stairs in front of many buildings such as train stations, schools, which I did not notice at all before. But now they became big troubles. Besides, the inclined road surface could make balance with crutches difficult. Even if now I have improved a lot on walking with crutches, I still do not like going out, as a short distance between trams/metro transfer could exhaust me easily. I think if the city designers have experience of injury, they will be able to think about these facilities in a more considerate angle.
Although immobile, I was quite efficient and productive in the first week: seeing the doctor in hospital; getting the brace in Bständig shop; review German learning and had a A1-1 language exam; submitted two papers which I delayed for a long time; wrote two abstracts for EMC conference; and at the end of the first week I managed to tell my parents what happened.
Indeed it was a task to tell my parents what happened. I expected their responses would be strong, and actually my mother's reaction was even stronger than I expected. She was angry about me going to ski, as she considered it a dangerous sport, so she complained it was my fault to try it. She even shouted to me saying "Do not go ski anymore", in the tone she has not used on me for many years since I demonstrated I hate orders. My aunties also complained about me going ski. I know that they worried about me, but their complains did bring me a lot negative emotion.
I understand that my family all grow up in south China where hardly snow, so ski does seem to be a risky sport. Therefore I have explained many times that ski is a national sport for Austria, just like Pingpong in China. From 1 year old baby to 80 years old people all ski here, and some elemental or middle schools even organize students to ski as sport courses. My mother just starts to accept it, then this injury spoiled my effort.
⬇️kids learn ski right after they can walk

Dropped into negative emotion 
I did not expect the second week would be so difficult. I was surround by down negative emotion: upset about the complains from my family, the visit of woman's period in the most inconvenient time, and that the slow recovering speed made me start to accept the fact that I would have to walk with crutches for a long time. I was in a very depress mode and not interested on anything. Apart from seeing the doctor again, the entire second week I was lying on bed reading novels, hiding myself from the real world. It was my birthday in the end of the second week, and Tim has already booked a restaurant we were interested to try, but at the end I decided to stay at home. I am coming out from the down mode slowly since the 3rd week, at least became again productive in writing blogs....
But the most critical psychology trouble is still there: I do not know how did all these happen. I was never a brave person about speed, therefore I always tried to slow down on ski and wasted a lot of muscle. Although this time I did try to speed up a bit more, but I was till the slowest one on the mountain. Besides, I have skied on the same trip earlier and I handled it well. Tim was just praising me that how much I improved, and then I broke my knee. Later I asked the doctor how bad is the rupture of my ligaments, completely or partially? The doctor said completely. I really do not understand how possibly I can hurt myself so badly. 
I have kept thinking about it even in dreams. What I remembered was that after a tuning I lost control, failed to stand up, and stayed in a squat position for a few second. In the direction I slipped to, the slope has a change in gradient and becomes steeper. The unexpected gradient change made me rolling on the steeper slope, I remembered I saw the sky rotating, although I do not remember how exactly did I roll and how did I hurt the knee. After my brain stayed blank for a few seconds, I rolled back to a position that my head was above my legs again, but I was still gliding down the hill. I was scared of gliding faster and faster, so I pushed the snow with skis when my legs were already in a twisted angle. I don't know if it made my knee worse, but I had to stop gliding down.
For my losing control on ski, there was no external reasons, no others hit me, no trees, no bump on the slope; maybe the snow was sandy but I managed it earlier, so the only left reason is that I was not good enough in controlling. And I did not do a good job on reacting to the unexpected situation either. However, I felt I could not be more careful, and could not learn ski more attentively, so the only thing to blame is my talent then. Maybe I am simply not good enough to learn ski?
This hurts my confidence a lot. I am not keen on sports, especially sports with competition. Before I learnt ski, the only sport I can insist doing for years was yoga. I was happy that I found a sport I like so much, which is not that easy for lazy me. I do not want to give it up.
But the fact is in my whole life I might not be able to find out what exactly happened, and how did I manage to hurt so badly. Then how could I avoid it happening again? This leaves a shadow in my heart, which I do not know how to deal with.

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