It's not the problem, but how you approach it...

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On Saturday, February 16, 2002 Gordon Washburn was making the approach to Chimney rock with some friends for the first climb of the day. The approach is steep and as he worked his way up towards the climb, he pulled on a large rock. The rock pulled free and Gordon fell about 8 feet, breaking his ankle in three places and fracturing his elbow.

Ankle injuries are a fairly common climbing injury. I thought it was important to document some of the pain and suffering associated with this injury and some of the consequences associated with a climbing injury.

Gordon's injury in a nutshell:

1. Gordon broke his ankle in three places and broke his elbow.
2. He spent two days in the hospital with surgery on his ankle - two pins inserted ($$$).
3. He made a return trip to emergency for blood clotting behind the knee ($$$).
4. It was six weeks before Gordon returned to work full time ($$$).

Gordon was fortunate. He had medical insurance through his employer and is a salaried worker - he received compensation, even though he missed a significant amount of work.

Gordon: That's right. It was February 16th. Ben, Kurt, Rich and I went together in Kurt's truck to climb at Chimney. We parked past the main access area, up higher on the road and we packed back down. Ben went up one area and started up where it was pretty much cliff. It looked like it was broken rock, with little pebbles and stuff, and it looked like it was going to be slick. So I said, "I'll go down a little further and I'll go up this other area that look's like it's got a well defined area to climb up." So I started climbing up...

Gordon: This is pretty much below "George's Buttress" at the access area there. As I climbed up, I don't know how far, 8, 10, 12 feet, I grabbed onto one rock that looked like it was fairly stable -a good size rock that looked like it was solid. I started putting my weight on it to go up to the next level.

Gordon: With my hands. As I put my weight on it, it pulled loose and I started falling backwards. As I was falling, I was thinking, "Try to push the rock away from me so that it didn't land on me." At least, that was my intention. Anyway, I landed and whether the rock actually landed on me or what, I don't know. I am guessing from the injuries that I landed on my ankle on the ground and this rock at least grazed my shin or landed on my shin as I landed on the ground. I also must have fallen over backwards as I landed because I fractured the elbow at the same time.

Gordon: I case down in one fall. I didn't tumble down the rocks or anything. I pushed off away from the wall.

Gordon: Yes. The access area is right on the road, so I basically landed on the edge of the road. The rock was sitting on the edge of the road as I started to move around. I turned around and sat on that rock and tried to recover from the pain of the shin being banged with the rock. Initially, I thought everything was fine other that just the pain of the shin. I didn't feel like anything was broken. I didn't notice any real pain in the ankle - it was all in the shin.

Kurt had a bottle of ice, a frozen water bottle, so I got that from him and we started putting ice on the shin right away. After the pain subsided a little bit, I took my boot off to check the ankle to see if there was any damage underneath. There were some abrasions right at the top of the boot but there was no apparent damage to the ankle - no swelling, no damage at all. So I sat there for a few minutes and I put the boot back on, thinking that everything was fine. At some point, I got some Ibuprofen from Rich and basically, I started to feel O.K., after 20 or 30 minutes and I didn't want to go home. I didn't think I was going to want to climb but I didn't want to disrupt the guys from climbing. So I said, "I'll just go up with you and watch you guys climb." At that point, I stood up...

Gordon: Yes, I didn't think that I was of the mind-set at that point to want to climb. With the pain, I didn't know if I wanted to climb but I didn't want to stop them from climbing. Everybody made the effort to get out that day and I didn't want to go home either. I had my backpack off for some time now, just laying on the ground, so I stood up and I tried to put a little bit of weight on the left ankle. I had stood up before on the right ankle and just stood there and just touched the left ankle down. But at this time, I actually tried to put weight on it and immediately there was excruciating pain. It was clear at that time that there was no way I was going to climb up that wall and get up there and watch those guys. More than likely, I had some serious damage in the ankle.

In the course of all this, Mary and Linda had shown up in Mary’s truck. They parked up by where we parked and had walked down by this time. Once we realized that there was probably serious damage in the ankle, Kurt immediately went to his truck and was going to take me down the mountain to my car. Mary and Linda discussed it for a minute after Kurt left and they decided it was much better if they took me down instead – there were two of them. One of them could drive my car across town because I couldn’t drive my standard transmission car with an ankle. So they went up and twisted Kurt’s arm into letting them take me down instead of him taking me down. And then I suppose he and Ben and Rich stayed and climbed. [This looks bad. Gordon sustained major injuries and his climbing buddies stayed up there climbing.]

Mary and Linda took me down to the base of the mountain. Linda took my car and drove me across town and Mary followed us.

Gordon: As I was getting into Linda’s truck. She pulled the truck right down next to where I had been sitting on this rock and all I had to do was stand up, turn 90° and sit down into the truck.. As I started to lean back into the truck, I used my left arm to support my weight and I could tell then that there was something wrong. I didn’t know what it was. I don’t remember now if I couldn’t straighten it completely or if it hurt to put weight on it, but I knew I had done something to the arm - to the elbow probably. On the way down the mountain and across town to the Northwest Medical Center I kept flexing the elbow while trying to keep ice on the shin and down low on the ankle while trying to muddle through the pain.

We went across town and on the way I had called Shauneen and my son and had both of them meet me at my house. My son brought some crutches for me because I knew I would not be able to walk. I didn’t know how far I was going to have to walk to get into the hospital. I had Shauneen meet me as well because my son was busy with other things. We all got there at the same time and we parked my car in the garage. I turned from Linda’s truck, sat in Shauneen’s car and she drove me to the hospital. They got me into the emergency room fairly quickly, checked everything, and eventually got X-rays. The emergency rooms doctors and nurse assumed that they were going to be sending me home, just as I did. They put a stiff splint on the ankle and wrapped it. They had called the orthopedic surgeon to look at the X-rays or to consult on the X-rays. I never saw the orthopedic surgeon that day and I don’t think he came in. I think they just talked to him on the phone. They had the X-rays displayed on a computer terminal there and Shauneen went over looked at them with them and they talked with her after they talked with the surgeon. Essentially, the surgeon said, "You had better admit him and we had better schedule surgery for the first thing tomorrow morning. The description of that fracture is not one you want to be putting any weight on or walking on or letting go. We need to do something with it."

It was 3:00 in the afternoon. I called Rich and left him a message, letting him know what was going on. I don’t know whom all I called, but I called various people to let them know what was going on since they were all concerned. Between 5:00 and 6:00 that night they got me admitted and got me a room. Then I had to do some tests, blood tests and an EKG. I had already had the X-rays so they didn’t need more X-rays (actually they did need a chest X-ray before they would admit you for surgery). There was also pre-surgery admission testing I had to have done that night. I had all that kind of stuff done that night and spent that night in the hospital. I didn’t know exactly when the surgery would be scheduled until the next morning, whether it would be 8:00 or 9:00 or 10:00 or noon or whatever.

They woke me up about 6:30 and said that surgery was scheduled for 8:00 and they would be taking me down for the pre-op about 7:00. We went to pre-op a little after 7:00 and we talked to the nurse and the anesthesiologist. The surgeon finally showed up - it was the first time I had seen him. They prepped me for surgery and went in and did the surgery, this was Sunday morning the 17^th.

Gordon: Yes, completely out. I have no recollection of anything from about 7:40 in the morning to almost noon that day. Evan after that, Sunday was a blurry day. I know that various friends came and visited for a while. People have talked with me since then and said, "We did this when we came and saw you in the hospital on Sunday." I have no idea. I don’t remember any of it.

I spent Sunday night in the hospital. On Monday, sometime during the day, they had a physical therapist come in and try to get me started with crutches. I had my own crutches but they wanted to make sure that I was able to use them, that I was going to be able to use them with the injuries that I had. They set up a special plate to support my elbow because I couldn’t put weight directly through the elbow joint (I could put weight from the shoulder down to the elbow).

Gordon: They didn’t do anything on the elbow. For that first night they put it in a sling to keep it stable. I left it in the sling for most of the day Sunday. By Monday, when the physical therapy guy came, I needed it out of the sling so I could use it to get around with. I didn’t ever put it back in the sling. That’s all that’s been done with the elbow other than physical therapy later on to get the mobility back.

Monday the guy came and got me set up with the crutches. Late Monday evening, about 9:00 the surgeon came by to check the charts and see how I was doing and he released me from the hospital Monday night. I went home from the hospital Monday night. It was 10:00 or 10:30 by the time they got all the paperwork finished.

Gordon: After the surgery, they didn’t cast it or anything. They put it in a hard splint and wrapped it with Ace bandages. The doctor wanted me to put no weight on it for six weeks and he said he wanted to see me in a week to ten days. For the first week to ten days, it was just keep your foot elevated to try to keep the swelling down as much as possible. Don’t get it wet. Don’t put any weight on it. Move around minimally. Try to deal with the pain. He did tell me that if it was possible, that any kind of flexing of the ankle joint that I could do to keep it mobile, would be a good thing. Particularly flexing the toes towards the knee. He said it naturally wants to lay out the other way, the toes going away from the knee. He said that if you could keep flexing it back the other way , it will help to get the mobility back when the time comes. So I tried to do those kinds of things while you are lying there not doing anything else – trying to stretch your toes towards your knees.

That first week was pretty uneventful. I had a lot of bruising – black and blue all the way up from the ankle up into the hip area – on the bottom of the calf, it was completely black and blue under there. The surgeon told me that most of that was from the bruising from down in the ankle area - the blood from down in there settling in the tissue because I had my foot elevated most of the time. As far as he was concerned, it was a good thing. He wanted it elevated as much as possible during the first week.

I saw the surgeon during the first week. He looked at everything and thought I was doing well. He wrapped it again without the hard splint this time, just Ace bandages and some more dressing on the stitches. He wanted to wait another week to pull out the stitches. So again, that week was pretty much spent with the foot up, immobile, and not doing very much.

After about two weeks, I went back and had the stitches taken out. I believe it was also at that time that he prescribed me to go to the physical therapist for my elbow. There was nothing for the ankle, other than continue to stay off of it. He wanted to see me in anther two weeks. He also warned me about possible blood clotting in the knee because I was having some pain on the underside of the knee.

Eventually I went back to the emergency room and spent another day in the emergency room having them check to see if I had a blood clot caused by the surgery – you are more susceptible to blood clotting after surgery.

Gordon: Yes, there was tenderness underneath my knee. There was some concern that it could be blood clotting or tissues recovering. I went in and fortunately there was no blood clot, no indication of a problem there. I got another day in the emergency room.

Gordon: I was off a full two weeks from work and then I started working here and there – part of the day here and part of the day there for a couple more weeks. I came back to work full time on March 25^th.

Gordon: Yes. I had been back at least two weeks before that – part days. Two or three days a week and working from home as well. I was pretty mobile by then with crutches and whatnot. I was still not able to put any weight on my ankle at that point. I came back to work full time on the 25^th of March. The reason I came back full time then was because the guys from Japan were here and I needed to work with them.

Gordon: Yes. The first week in April, I went back to the surgeon again. At that point, I hadn’t been using Ace bandages or any sort of splint or anything on it for several weeks. Once the stitches all healed up and the drainage stopped, I quit using the Ace bandages. I continued to exercise it as much as I could without putting any weight on it. The first week in April he said to slowly start putting weight on it and slowly stop using the crutches. He gave me four weeks to do that. Within two weeks, I was pretty much off of the crutches, except maybe for a little bit during the day. I got off of the crutches as quick as I could. During all of that time, I am continued to have physical therapy on the elbow to try to stretch the elbow and get the full range of motion back into the elbow. I don’t have full range yet. I have completed the physical therapy on my elbow but I still have a loss of three to five degrees of range of motion in the elbow – which they think is pretty minimal. The therapist told me that normally people who don’t do any kind of therapy on an elbow injury of that type end up with a 20-degree loss of mobility, 20 to 30 degrees. To lose three to five degrees is a good deal compared to 20 or 30.

This week, the first of May, I went to the surgeon again for the final check. Essentially he said everything is fine and to leave the two screws in. He said that as long as the screws don’t bother me, then leave the screws in. If they do bother me, then definitely take them out - but leave them in at least a year. He said that even if they start to bother me within the first year, leave them in. He also prescribed for me a visit to a physical therapist to make sure that I have the full range of motion in the ankle and to build strength back in the muscles around it. Get a professional to prescribe the right exercises and course of activity to strengthen the ankle back up.

Gordon: Yes. I have only been doing that several days. I could have done it sooner but that’s just the way things worked out. I have been driving it for about a week.