Bad times. On the 4th afternoon of my last trip out I managed to snap my ACL while skiing an off piste gully. I’ll cover the circumstances of the ACL injury and try and draw on any lessons in another entry but suffice to say I felt it go before I’d actually fallen.
In this blog entry I’ve jotted the lessons I learned and some of the choices I made while going through the NHS system. I just had my ACL reconstruction, 7 weeks after the initial injury.
1. DO try and protect your knee as you fall. I felt a ‘pop’ trying to recover a situation and immediately knew something was wrong. I let myself fall and did my best to protect the bad leg, trying to reduce any extra damage to the knee. After the fall there wasn’t a lot of discomfort and I was able to ski out across an untracked powder field and an easy piste to a lift. This is not recommended due to the extra damage you might do to your knee.
2. DO go to the local medical centre for a diagnosis. The local doctor confirmed I had an ACL rupture and did an x-ray. The 99 euro was money well spent as it gave me a confirmed diagnosis with which to enter the NHS system. The also doctor prescribed a brace, crutches, paracetamol and aspirin from the local pharmacy. 250 Euro to cover this lot was less good value !
3. DO ensure the doctor gives you an ‘Fit to Fly’ letter. Without it you may not be allowed on the airplane when you hobble up on crutches. It’s also worth prompting your holiday rep to inform the airline in advance that you may need to keep the leg elevated. I didn’t do this and there was a difficult moment at check in when I thought I would not be allowed to board.
4. IMPORTANT – DO proceed to directly A&E at your local hospital on your return to the UK but DON’T be disappointed if you don’t see anyone on the day. Hand over the documents from your resort doctor and let them know you have a CONFIRMED ACL rupture. If they don’t treat you on the day ensure they book you into the appropriate ‘Fracture clinic’ at the hospital. This saves you going through the referral process via your GP and will save several weeks and remove any ambiguity regarding your injury.
5. DO ask to see the main consultant at the clinic even if it means waiting longer. A ruptured ACL will not show on an X-Ray and you will need an MRI scan to confirm the diagnosis. Let them know how important skiing is to you and how motivated you are to ski and be active again.
6. DO ask if there any any MRI cancellations on the day which you could take. My consultant kindly asked the hospital scanning department if there were any cancellations and as a result I had my scan that morning. If not, many people choose to get a private scan done but trying to score a cancellation will save you several hundred pounds and save weeks from the process.
7. The final step is to see the specialist knee consultant. Before any sensible decisions can be made the MRI results will need to be available. I was given 3 choices and I had to decide right then: A Physio program and see how it goes, Op to investigate with a view to making an ACL reconstruction decision later, or an investigation plus an immediate repair as required on the day leaving it to the surgeon to make his best decision. It made sense to me to choose the 3rd option, check and fix on the day.
8. DO be flexible. If you choose surgery your surgeon may operate at 2 or 3 hospitals. Let him know if you are flexible as to where you have the operation and this reduce your waiting time. I had mine done in via the NHS in a private hospital which was 10 miles further away than our main NHS facility.
Good Luck !
Good job – my friend had the same thing and NHS took 6 months to diagnose, and another 4 on teh pre-op waiting list.
Went for an MRI appointment and was given an Xray instead because it was cheaper, then had to wait another month for the MRI. Xray doesn’t pick up soft tissue/cartilage damage, so it’s not conclusive on an ACL, you need the MRI before they’ll put you on the op list.
Sounds like you got off lightly, if not cheaply!
Cheers. So far I’m managed to get NHS treatment except for the private physio I’ve dipped into. Luckily the insurance coughed up for the French Doc’s bill 🙂