Lisa lived sports. Athletics played a large role both in her private and professional life, as an accomplished athlete and a respected high school physical education (and geography) teacher. Following her spinal cord injury (SCI), Lisa’s fitness and athleticism were significant contributors to her overall recovery. At 35, she regularly practiced a wide variety of sports — skiing, mountain biking, tennis, volleyball and climbing, to name a few.

Sports and athletics have always been incredibly important to me, to my relationship to the world — for my self-perception and body awareness and fitness, for the thrill and challenge of competition and for all of the social aspects. And obviously it’s played a professional role as well, in my career as a teacher — introducing sports to young people has been truly rewarding. A combination of a career I love and a life passion.

Lisa

While each of these sports carries certain inherent risks, it was a mountain climbing accident that left two of her climbing partners dead and Lisa with a complete SCI. In the rehabilitation that followed her injury, a love of sports and fitness would prove to be valuable in surprising ways.

A Climbing Catastrophe

On Thursday morning two men were killed and one woman injured in a mountain climbing accident in Switzerland… According to a report, a major rockfall occurred, with rocks falling up to 2,800 meters. The climbing team fell with the avalanche to the base of the mountain. Two climbers, ages 32 and 36, died from their injuries. One 35-year-old woman, seriously injured, was evacuated by helicopter to a trauma center in Bern…

PRESS RELEASE: Mountain climbing accident with two dead and one person seriously injured

The rockfall was unanticipated and massive; Lisa’s survival was a matter of chance. She was buried and critically injured beneath the rockfall, already aware of her paralysis and not knowing whether or how long she would live. Fully conscious over the course of the entire disaster, Lisa was separated from her climbing partners, and could only wait and hope to be rescued before she died. Fortunately, a pair of hikers witnessed the accident and were able to report the event. A rescue team arrived by helicopter and rapidly evacuated her to an acute care hospital.

Lisa was in critical condition when she arrived in the emergency department, with major thoracic and abdominal trauma, as well as head injuries, fractured ribs and multiple lacerations. She presented with symptoms of spinal cord injury and was diagnosed as having a luxation fracture at Th8 and graded with an ASIA Scale A SCI.

Acute care was undertaken to treat her pneumothorax and hemothorax (an accumulation of air and blood, respectively, in the chest cavity), a ruptured kidney, a major retroperitoneal hematoma (blood collecting in the internal space behind the abdomen), her lacerations and head injury (mild traumatic brain injury).

On the third day after the accident, Lisa’s status deteriorated due to impaired internal organs. The acute care medical team kept her on artificial ventilation over the following three days while her condition stabilized. Once the medical team was satisfied with Lisa’s stability, they were able to focus on her spinal fractures and luxation.

The next stage of her treatment involved the surgical stabilization of her spine from Th6 through Th10. The procedure was successfully completed and post-operatively her medical condition greatly improved. She was awake, oriented and her cardio-pulmonary situation was stable. She was moved to the early post-acute unit of a specialized rehabilitation center for the start of her rehabilitation program.

Rehabilitation – the first four months

Lisa began slowly and steadily recovering from her many injuries. She continued to suffer from extreme pain, primarily as a result of a number of fractured ribs. Because of the pain, the extent of her physical activity was limited. Another obstacle to her rehabilitation appeared unique to her situation. Since the accident, she had developed a fear of falling. This fear interfered with many aspects of her mobility, and activities such as transferring herself or even sitting upright became a challenge.

Despite the obstacles of pain and fear, Lisa’s recovery progressed and her physical activities increased in intensity over the course of the first four months of rehabilitation. Her cardio-respiratory functioning was normal. She became more independent in both dressing and caring for herself as well as transferring herself into a wheelchair. Her spinal cord independence measure (SCIM) score reflected these improvements, increasing from 12 to 50 (see Figure 1) throughout the rehabilitation. Given her steady recovery, the rehabilitation team planned another four-month rehabilitation period. They hoped that upon completion, she would be able to leave the facility and live an independent life, reintegrated into her community.

Since the accident, she had developed a fear of falling. This fear interfered with many aspects of her mobility...

In the second half of her rehabilitative process, the healthcare team would utilize the Rehab Cycle to identify and integrate appropriate sports and athletic activities based on Lisa’s physiological problems and her own wishes.

Table 2

Table 2: Spinal Cord Independence Measure (SCIM) Scores for Lisa at the Start of Rehabilitation and Four Months Later.