Tips for surviving an injury in the high country
First-aid kits, locator beacon and training make the difference when things go wrong
Jamie Ash was high up on the Deer Creek Trail in the Columbine-Hondo Wilderness on a recent May day. She had hiked alone from the trailhead at the Columbine Campground all the way up more than six miles to about 11,600 feet where the snow was five feet deep. She reached the ranger cabin that was built about 1919 that still stands in a forest clearing; it was almost completely buried in snow. She had snowshoes and was wellprepared, having hiked the trail many times.
As she descended, there was less snow and she was just below a large aspen forest when she reached a loose, dusty part of the trail on a steep slope. The thought flashed through her mind that she should take it slow because this part of the trail can be dangerous. Then she fell.
“My foot went under me. My torso and 25-pound pack landed on top of the twisted foot. I heard a crack,” says Ash.
Accidents happen
Like many of us who are out in the backcountry frequently, Ash was concerned about getting hurt while alone high up on a trail out of cellphone reach. She trains hard and is extraordinarily fit and well-prepared, but still she fell and broke her ankle while 4.5 miles and 2,700 feet away from the trailhead.
“The first thing I did was to sit on the trail, get my first-aid kit out and take 1500 mg of acetaminophen [Tylenol] as I knew the pain was likely to get worse,” says Ash. “I had a topical anti-inflammatory with me and I put that on my ankle without taking my shoe off as my ankle was starting to swell significantly. I stood up to assess how bad the pain was: it was bad but not horrid. Using my hiking poles to help support my body weight, I started walking slowly. I thought if it became too painful to walk, I could crawl.”
Ash carries a personal locator beacon with her so that she can contact search and rescue, but because she could walk even though it was painful, she thought it would be quicker to get down under her own power. She didn’t want to call out Taos Search and Rescue (TSAR) unless she really needed to.
Lightening her load, she poured out some of her water and left her snowshoes on the side of her trail and kept walking. She didn’t have cellphone reception but knew she would have a signal about a mile down the trail. An hour and a quarter later, she reached that spot and let her partner know that she had tweaked her ankle and wouldn’t be able to drive home. Ash didn’t know that she had broken her ankle.
“I kept walking; never taking a break, trying not to think too far in the future, breathing out with each step as a way to manage pain,” says Ash. She got to the intersection with Columbine Trail and reached the first large meadow at the same time her partner and a friend arrived. The friend took her pack, but Ash kept walking using her hiking poles. It was 6:30 p.m. The group reached the trailhead at 8 p.m. that evening. It had taken her 5.5 hours to cover the four and a half miles and 2,700 feet of descent – more than three times as long as it might normally take her – but she made it.
Training to prevent injuries
Ash was in good shape because she had been training hard for a planned trip to the Arctic like the one she took last summer. She had been doing lifts with weights on her ankle to improve her strength and balance. “The doctor said she thought the reason I was able to walk so far with a broken ankle was that my ligaments were so strong,” says Ash. “Training and training hard and being prepared is very important.” Because she was in good shape, knew the trail and a spot where she could get cellphone reception and kept calm, there was a successful end to the story.
Recovery process
Two days later, Ash saw Dr. Lindsy Allen at Animas Foot and Ankle. “I didn’t think my ankle was broken, especially as I walked on it for five and a half hours, but I was concerned about torn ligaments,” said Ash. “Dr. Allen was caring, smart and laid out my options, but backpacking in the Arctic in August was not one of them.”
Allen wrapped the ankle in layers of soft foam and bandages and immobilized it in a boot-type cast, which stays on 24 hours a day. She instructed that no weight be put on the ankle. Ash was in bed for the first few days with her leg elevated above her heart on pillows and did her best to cool the ankle by putting ice on the blood supply on the back of the knee.
Ash can feel the swelling of her ankle is decreasing and she hasn’t been in pain. Since the fall, she has had to use crutches to get around and avoid putting weight on her foot. After about two weeks, she did find she was able to use a rowing machine by putting her cast off to the side. “It felt good to get my heart rate up and move a bit,” says Ash. “I went from training 18 hours a week to nothing.”
When she saw Allen for a follow-up appointment, four weeks after the break, the X-rays showed the bone was starting to knit together but not very quickly. Allen said that for another week, Ash should avoid bearing any weight on the ankle and then introduce partial weight-bearing with another X-ray in three weeks.
Ash is planning to begin physical therapy at the beginning of July, slowly adding range of motion as she can bear more weight.
“My more realistic goal is to be able to backpack in the Paria Canyon Wilderness [on the border between Utah and Arizona] in early November,” says Ash. “I’ve been there before and want to go place somewhere where I know what to expect.”
Looking to the future
When asked if there is anything she will do differently in the future, Ash says, “I was moving pretty quickly and I knew that specific area of the trail was more difficult. I could have slowed down as I walked through the area and I will do so in the future. If you are hiking and you realize that you should slow down and be cautious – pay attention to that wise voice inside.”
The experience showed her that she was doing all the right things: she had a first-aid kit with her, hiking poles, a personal locator beacon, a headlamp for when it got dark, extra warm clothes, food, water and a cellphone, and she had let someone know where she was going and when she was due back.
She’s happy that she didn’t need to call search and rescue since she could walk and get herself out of the situation under her own power. She adds that if she had shattered her femur and was unable to walk she would not have hesitated to call for help.
Chris Kodey of Taos Search and Rescue says, “We are happy Jamie was able to self-extricate herself off the trail. Being properly trained and self-reliant, in combination with the proper equipment, is the best way to be safe in the mountains.”
He adds, “With that being said, if Jamie felt she was unable to walk out alone or needed help otherwise, we would have happily come to her aid. The last thing we want is for folks to hesitate to call SAR because they feel it is unwarranted. If you are truly in a threatening situation or getting close to one, getting the call out to 911 sooner rather than later is a tremendous help for us. It takes time to mobilize a SAR team, and once daylight fades, missions become much more complex for us, although we will respond to a mission any time of day.”
Positive focus
In order to stay in a positive frame of mind, Ash had to first accept what had happened; that she was not going backpacking in Alaska and that her life had changed. She was able to focus on some issues in her plastering business that she couldn’t get to before, between working full time and training. She chose to take advantage of the situation and was back working after a week.
“It took me a couple of days to turn my focus from disappointment about the Arctic to recovery. Keeping my optimistic outlook is key,” says Ash. “Hiking and backpacking are some of the biggest pleasures of my life. I want more in the future, not less. I plan to heal, rehab well and be back on the trail by the time the aspens turn orange, red and gold.”