blizzards and scoreboards

Tuesday, December 9, 2008

Sports isn’t the only venue that uses a scoreboard. Find an emergency department on the first big snowfall of the year and there may be a running tally of a few common injuries and illnesses. Morbid humor sometimes allows the nurses and doctors to deal with the next patient rolling through the door. While the calendar may technically reside in autumn, an early December blizzard will stretch emergency services from first responders to emergency departments and operating rooms.

A large amount of snow usually means a large amount of shoveling and the first listing on the scoreboard is, with apologies to Fred Sanford, the big one. Cleaning a sidewalk or driveway is an aggressive exercise and requires plenty of aerobic capacity to lift and toss shovels full of snow. It’s like taking a stress test without all the medical people around. If there are blockages and narrowing in the coronary arteries, those that supply the heart muscles with oxygen, the extra effort required of the heart to push blood to those exercising muscles may be enough to outstrip the heart of its own blood supply causing a heart attack or myocardial infarction.

Snow and sliding go hand in hand. Unfortunately, snow and sliding also equal falling and the broken bones that result also can be listed on the scoreboard. While kids bounce, that ability is gradually lost as we age. When older folk get the mail or try to sweep the porch a fall landing backwards or on their side might break a hip, while falling forward on an outstretched hand may cause a wrist or elbow to fracture. Remember that break, crack or fracture all mean the same thing; the integrity of the bone is lost. The big question is whether an operation is needed. For hips, the answer is almost always yes. Regardless of how the injury is treated, the sad result is some loss of independence while healing and rehabilitation occur.

Number three on the scoreboard are finger injuries. While heart attacks and broken bones aren’t often foreseen, this injury is almost always preventable. The story goes like this: while using a snowblower, the patient reaches into the chute with his hand to remove a snow clog and quickly loses the tip of a finger or two. Even if the machine is turned off, the impeller has enough force to chop things when it is relieved of the snow and ice buildup. The injury usually requires the damaged tissue and parts of bone to be cleaned and removed. A shortened finger usually has a good functional outcome, but there may be a cosmetic downside.

With snow storms starting to blanket the upper half of the country, it’s no wonder that cardiologists and orthopedic surgeons want to lose this contest. The hospital is a place nobody wants to visit (except for the newborn nursery) and while injuries and illnesses do pay the bills, most doctors would rather practice preventive maintenance instead of emergency repair work.

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