Walking with pain

[Taurë-rana]

How much pain is it possible to endure to avoid a helicopter ride? I've wondered sometimes but had firsthand experience 3 weeks ago.

I walked into Lake Myrtle, then up Rogoona. My knee was starting to get a bit sore, but coming down was agony. The next day we were to walk to Junction Lake and up the Mountains of Jupiter. I had dosed myself on anti-inflammatories the night before and decided to see how far I got and pull out if I got too sore. Making very good use of walking poles I pushed through the pain which was very on and off, but by the time we got to Junction Lake I decided that I might get up the Mountains of Jupiter but certainly wouldn't make it back down, so I headed back to Lake Myrtle, drugged up on paracetamol, ibuprofen and codeine which really only took the edge off the pain. It hurt, at times a great deal, but because that particular walk isn't too steeply downhill I could cope with it - constant pain but severe pain only on and off.

The next day we walked out. The first bit through to Lake Bill was not too steep and not too painful, but once we started down the steep hill back to the car, it became the most painful walking I have ever done. Leaning heavily on the poles, and frequently stopping to give myself a break from the pain, I kept going because I had no choice, and because I knew it was only going to last for an hour or two. If I'd been in the middle of a multi-day walk, I don't think I would have been able to make it out. As it was I could barely walk down the hill to my favourite coffee shop for a couple of weeks, and I won't be going bushwalking anytime soon

[GPSGuided]

One American guy cut his arm off and walked out of a canyon... Not sure which is more painful, an injured joint or losing a limb.

[Jaala]

Props to you for walking out rather than calling it in. Many people believe rescue services are a convenience rather than a last resort. I hope your knee gets better soon and you are back in the bush!

And I don't believe somone would remove their limb if they had the means to raise the alarm, in which case it's not a matter of 'coulda shoulda woulda' or using resources inappropriately.

[wayno]

can be a hard call, if you suspect you're going to do yourself serious damage by continuing, i'd be calling for help..., and if you're in "agony" I think it may have been a good idea to get rescued.. you just don't know what damage you're doing...

[GPSGuided]

Subjective call. No right or wrong. For all we know, a knee in pain could well put the walker in danger from a serious fall or other mishaps. Life is at risk.

[Strider]

I recall a story of someone "doing the right thing" and walking out on a broken ankle rather than call for rescue. The recovery and rehabilitation was measured in months (from memory) and emergency services were apparently dismayed why anyone would do such a thing with help so readily available.

[wayno]

i know someone who fell off a bunk, broke ribs and wrist and walked out... broken ribs i would have thought could risk puncturing a lung, almost anything broken risks internal bleeding, and or soft tissue damage if you keep moving the affected area...

[davidf]

Pain is no need for rescue.

Chance of death, permanant disability (maybe) and puting others at risk by delaying a rescue are.

[wayno]

and blood loss is a reason to call for help. i saw a walker fall and scrape their shin o a tree root.... immediately their shin ballooned up in front of my eyes, a bulge the size of a billiard ball grew out of her shin.
i'm pretty sure she had ruptured a blood vessel and was bleeding internally, she was walked out... questionable thing to do if she was bleeding internally and had complications from blood clots.. luckily she didnt break the skin badly or blod loss would have been an issue

[Bubbalouie]

can be a hard call, if you suspect you're going to do yourself serious damage by continuing, i'd be calling for help..., and if you're in "agony" I think it may have been a good idea to get rescued.. you just don't know what damage you're doing...

On the money here... Having done this once myself (though not as hard core as Taure-rana) I now have permanent joint damage whereas I may have avoided permanent problems had I been less obstinate.

[davidf]

I agree with the two posts above.

Sprained ankles and chronic problems you may forsee such as doddgy joints or backs, you tell the people you let know where you are going the trip may take longer.

I do this all the time. The missus knows if I'm not home sunday night by monday morning ring my work. Come wednesday raise the alarm.

[Jag]

So where is the rest of the story? is there a diagnosis or is it still a sore knee?

imo you should have stopped immediately , rested & returned to starting point as slowly as need be. Why did you go on knowing the rest of the terrain was difficult ?

Everyone , even in a group should carry emergency bivvy & a book & of course be self suficient in food & fuel . i daresay someone inyour group would have stayed with. you & helped carry your pack tandem back to base.

[neilmny]

How much pain is it possible to endure to avoid a helicopter ride? I've wondered sometimes but had firsthand experience 3 weeks ago.

I walked into Lake Myrtle, then up Rogoona. My knee was starting to get a bit sore, but coming down was agony. The next day we were to walk to Junction Lake and up the Mountains of Jupiter. I had dosed myself on anti-inflammatories the night before and decided to see how far I got and pull out if I got too sore. Making very good use of walking poles I pushed through the pain which was very on and off, but by the time we got to Junction Lake I decided that I might get up the Mountains of Jupiter but certainly wouldn't make it back down, so I headed back to Lake Myrtle, drugged up on paracetamol, ibuprofen and codeine which really only took the edge off the pain. It hurt, at times a great deal, but because that particular walk isn't too steeply downhill I could cope with it - constant pain but severe pain only on and off.

The next day we walked out. The first bit through to Lake Bill was not too steep and not too painful, but once we started down the steep hill back to the car, it became the most painful walking I have ever done. Leaning heavily on the poles, and frequently stopping to give myself a break from the pain, I kept going because I had no choice, and because I knew it was only going to last for an hour or two. If I'd been in the middle of a multi-day walk, I don't think I would have been able to make it out. As it was I could barely walk down the hill to my favourite coffee shop for a couple of weeks, and I won't be going bushwalking anytime soon

Pain is an in the eye of the beholder thing. We all have our own threshold of pain but
a bung knee on a down hill scramble is *&%$#! painful, probably 9.5 on the richter scale.
A very gutsy effort, but it is not not wise to go deeper when you've got a serious problem.
Not a rescue chopper incident for mine.

[corvus]

Once walked out of the OLT via Lees Track (Venetian Blind) from Kia Ora via Pelion (we went up Hartnetts Track ) with a torn hammy does that count (could have hitched a ride on the BYT from Pelion that was evacuating a well known Outdoor writer who had come a cropper ) however that would have left my, at the time teenage son stranded so I managed with Panadol Forte and a lot of pigheadedness
corvus

[Scottyk]

No I wouldn't say you should have called an emergency rescue in the situation you describe
If your life isn't under threat then don't do it.

[zac150]

I walked for 5 days last year with what turned out to be a stress fracture in my foot, yes it cost me an extra 6 weeks in rehab but I think it was worth it. I also recall reading a post in the Schlick Hilton log book about a guy who broke his collar bone walking the kerries, he managed to walk out.

I guess for mine it depends on the injury. If the pain is caused by an event, such as a fall etc then yes you probably should take more care as there could be unforeseen injuries.

I always say to the guys I walk with, if we press the button we have to be comfortable that the helicopter may be diverted from a car accident and we need to be comfortable with that decision. For mine I would only flick the button if it is life or death. But then I walk in a group of 5 and 2 of us are long distance runners so could run for help if needed.

[alanoutgear]

Yeah, I agree. I think it has to be life threatening to press the red button.

I blew the meniscus out in my right knee at the WoJ a couple of years ago and the walk down the hill was "memorable" to say the least. The pain was bad enough, but it was when my knee started collapsing under me as we neared the carpark I started to really worry.

But pain and a dodgy knee are not life threatening, and like others before I'd hate to press the red button and divert rescue from something that was really life threatening, maybe just because I got to the button first.

I got to the bottom, the pain didn't go away, and a few weeks later I had arthroscopic surgery to repair my blown meniscus. It took about 12 months for it to get back to normal.

Would I do it differently next time - I don't think so. As my Rogaining partner and I used to say when we got hurt - unless there's bone through skin, we keep going.

[MickyB]

i know someone who fell off a bunk, broke ribs and wrist and walked out...

I've had bruised ribs and it hurt to not only move but to breathe. Must have been extremely difficult for him to walk out.

[icefest]

Taurë-rana, what's the plan for next time?
Would you do it (walk out) again? Will you take some tramadol? Or would you activate the EPIRB?

[Tortoise]

I used to think I'd be able to move a fair distance if necessary, with a bad but not life-threatening injury. But since then I've had a couple of experiences of strong pain when I've passed out - eg when I had an avulsion fracture of my ankle (not on a bushwalk). Low pain threshhold.

I'd do everything I could to immobilise the injured part, and take pain killers, but I can't guarantee that I'd be able to make it out with severe pain. I guess that situation could in itself eventually become life-threatening. A fair bit would depend on the group if in one, and plenty of variables.

I've heard it said that if it's going to be a rescue situation, then call the chopper sooner rather than later. But I guess there's always going to be a grey area where it might not be so clear. It'd be nice to have mobile reception for a land rescue if that would do...

[jjoz58]

I have a different view to the people advocating it's got to be life threatening before calling for help. Yes a chopper ride should be a last resort, but if there is no other evac means then use it. What I would like to see is every use of a PBL/EPIRB investigated after the use and if it is found that it was because of stupidity or not really necessary then the offenders should be made to pay the full cost and I include starting a walk with injuries in the stupidity category. I could cite a few cases from these blogs, such as splitting the group when some didn't have navigation equipment, starting a walk without the equipment for that area and conditions etc should be billed. If you suffer a legitimate injury that precludes you continuing, and I certainly include blown joints and fractures, then you should activate the PBL, if you can't contact anyone by other means. Not to do so is risking worsening the injury or causing long term or permanent damage. These services, which are all at least partially funded by our taxes, are there to be used.

[Strider]

If PLB "resources" (all of them) couldn't cope with increased PLB usage associated with free trade of these units, wouldn't they have a permit system in place for their usage? It just seems that with these tools being so freely available, to not use them makes little sense.

Would you hesistate to call an ambulance if you fell down a well at home, but knew someone would be along the following day? Rhetorical.

[alanoutgear]

I think you've missed the point a bit with your analogy Strider. There are many more road ambulances than there are rescue helicopters in most parts of Australia, and as a member of an emergency service, I can tell you that helicopter rescues are a limited resource.

In Vic you can get two or three ambulances at an MVA, but we only have one HEMS helicopter covering a large chunk of north western Victoria.

If I hurt my knee and press the red button and the helicopter comes to me, the poor sods who may be trapped and injured in their car at an MVA might have to wait for road transport to get the to medical services, and recovery is time critical in serious injury events. I'm not saying there's anything wrong with pressing the red button if you are in pain but its a matter of personal prioritisation, and wondering about the possibility of more serious needs than your own. Everyone will make a decision based on their unique set of circumstances.

Access to ambulances and helicopters is not the same though.

[Strider]

Perhaps a poor analogy, but when you need help you need help. I can't see too many people conducting an in-house risk-assessment for the operations of the rescue helicopter while they are laying in a heap suffering some horrendously painful injury. There is always the risk that someone else will need the services more than yourself, but that is the risk that you take in employing any emergency service. Obviously this changes to some extent when the extent of injuries are unknown to anyone but the patient, however.

I just can't understand why units could be so freely available, if the powers that be might frown upon the appropriateness of their usage.

Many small communities only have access to one ambulance. If any at all.

[jjoz58]

I will be borrowing my clubs, not bush walking, In Reach device for our walk on the AAWT later this year. I think this device is better than an PLB because it allows you to text the nature of the emergency and the gps co-ordinates are appended to the text. This would allow emergency services to prioritize services. As it is two way text you can get some medical advice as well or other advice (up to 160 char). Also allows you to send texts, for a fee, to friends. You can let everyone know you are ok every evening. Works world wide and although it may not be cost effective for an individual it certainly is for a club or some business to rent out. I don't know how it works, but apparently friends etc, can ping you and get a location, which could come in handy if food drops or meets need to be organized. Here is the one they bought - http://www.alwaysinreach.com.au/index.p ... 5&catid=10. Have a look it may suit you or your clubs needs.

[wayno]

PLB's are a lot more reliable at connecting with satellite, I used the newest generation Findme Spot GPS tracking device recently, it pretty consistently failed to make contact with satellites when i was in the bush with a complete canopy cover, and only made contact out of the bush. I cant say PLB's would have always succedded to make contact, but teh satellites are located at a higher angle in the sky and PLB's have a much bigger antenna

[zac150]

I totally agree with Alanoutgear.

Strider, I think you may have missed my point a little. Plb's are reasonably new technology 15 years ago we had to go for help in other ways. I know there are a few places in kosciouszko you can get mobile reception for instance.

I think the answer lies in how many people are in the group, what the conditions are and would these exaserbate the injury or make going for help dangerous, how popular is the track (overland track as a good chance of meeting someone), how far is help, how far is the walk out. Obviously an injury on the southwest track is more serious than on a 3 day walk in kosciouszko as help is closer.

[wayno]

rescue helicopters often work to back each other up... if a helicopter is busy for a certain area, helicopters can come in from other regions to help out. i'm not condoning hitting the button on a PLB every time you have a sore knee.. but when youre in "agony" something reasonably serious at least is going on and SAR themselves wouldnt disuade you from activating a beacon in those circumstances, they'd rather pick someone up before a situation deteriorates over time and a rescue may be more difficult. ie if you avoid activating a beacon when you could do it in good weather during the day then find later on you really do need to activate a beacon and the weather has deteriorated then trying to spare calling for rescue will have been counter productive. to a certain extent different people will make different decisions.

[zac150]

Wayne you make a good point re weather.

I guess my point is there are other options for rescue than helicopters. If you have 5 people in your group and 3 can continue safely whilst you sit it out in say a hut with a friend why would you press the button.

[wayno]

depends on the injury and whether you think the condition of the person is deteriorating as time goes on... sar often prefer to send a helicopter rather than a ground party anyway if they have to effect the rescue.