Ski Season.

The cold winter air on your face, fresh powder under your feet, stillness of the wilderness… Whether you tackle the slope on skis or a snowboard nothing quite compares to the feeling of that first run of the day. But as with all sports, injuries can ruin what started as the perfect alpine morning.  Read on to learn about the most common issues snow seekers face and what can be done to stay as safe as possible. 

Common Injuries

For winter sports enthusiasts of the skiing type, the most prevalent injury is in the knee.  With the feet and ankles locked in a hard sided ski boot, the force is directed to the knees means when you fall on the slope.  This force can cause a variety of knee issues, one of the most feared is the ACL Tear (which I wrote about in depth here… LINK), but you can also injure other areas including ligaments such as the MCL or LCL, the menisci, or even the bones (femur/tibia) as they join at the knee.  

For snowboarders, knee injuries can also occur. However, given the orientation of the board on the slope and the single-sled positioning (feet both fixed to the same board), the most common area injured is the wrist. When a snowboarder starts to fall, they instinctively reach for the ground causing injuries ranging from minor sprains to fractures of the wrist bones. 

For all alpine lovers, injuries to the shoulder can also occur.  During a fall you can easily land on your shoulder or outstretched arm causing injuries to the tendons, muscles, or ligamentous structures in and around the shoulder. Shoulders can stretch out of place (subluxate), dislocate, or break with this mechanism. 

Other areas of the body are also prone to injury from a fall on the slope including the hips, spine, and chest wall. 

The most traumatic snow sport related injuries are those to the head or neck. For experienced and novice skiers alike, barreling down a slippery slope can be hazardous. Conditions that make this worse are crowded areas and other obstacles like trees or rocks.  Hitting another person or a tree can have devastating consequences as can your head on the hard packed snow.  Injuries can range in severity from concussion  to bleeding or fractures to severe traumatic brain or spinal cord injuries.

How to stay safe

Staying safe on the slopes makes for a much better day then ending a run with an injury.  

My recommendations: 

1- know your limits and the trail maps

2- train before you ski

3- save the alcohol for the après

4- wear a helmet, always

1. Know your limits

Staying safe on the slopes requires a level of understanding of what you are getting yourself into as well as a knowledge your ability. If you are a beginner or novice, look at the trail map ahead of time and stick with the runs appropriate for your skill level. You are not competing for a spot on the Olympic team… Even if you are more advanced, remember to avoid putting yourself in a position where you feel out of control.  The number one reason I see patients in the office with an injury is getting themselves into an uncomfortable position.  If you end up in this scenario, it is best to stop and ask for help. Ski patrol is always available to keep you safe.  They would much rather help you down the slope than find you injured. 

Another great tip is to take a lesson. No matter how advanced of a skier you are, lessons can be extremely helpful! During my last ski trip, I took a lesson, and it was worth every penny. The instructor was a true gem, helping me (more novice) and my husband (more intermediate) at the same time by challenging each one of our levels safely.  He was so great that when he ran into us the next day while skiing with his daughter, he skied with us for a bit for follow up tips.  These instructors live for skiing, know the terrain, and know how to teach you to be better. Everyone can learn!

2. Train before you go

If you were going to run a half marathon you wouldn’t just show up race day and expect to finish without problems.  Same goes for snow sports. Even if you are in great physical shape at baseline, some activity specific training can be beneficial.  Skiing and snowboarding are physically demanding sports. You need strong legs, great control of your upper and lower body, and stamina to survive the day.  I can’t count the number of patients who describe their injury as something like, “I was tired, out of control and crashed but can’t remember what actually happened.” Don’t be that person. 

3. Save the Après

Ah yes, the time-honored tradition of that first amazing post-ski après beverage at the lodge. It may be my favorite part of the ski day.  However, studies have shown that alcohol increases the risk of injury for both skiers and snowboarders. (As does any illicit/mind-altering substance use). Save the après festivities for after you are done skiing for the day. 

4. Wear a helmet, always

This one cannot be stressed enough. Head injury can be a devastating outcome of a crash on the slopes. No matter how well you ski, a fall can still happen. It is sort of like driving, even if you drive perfectly, someone else can hit you or cause you to crash. So, we were seatbelts, right? Wear a helmet every time you ski or snowboard. Protect your skull and brain and decrease your risk of tragic outcomes. 

If an injury occurs

Ski patrol is always available for injured skiers. They are all over the mountain and at the base, and most resorts employ trained medical staff. Some even have physicians available. Every ski town I have been to has a local urgent care as well with a team that is used to seeing slope related injuries. If you need follow up after a day on the slopes for a bone, muscle or joint problem seek out your local sports medicine orthopedist. It is always helpful to bring any images (Xray’s, MRI’s, etc…) that were taken on the slopes or after.

And of course, enjoy the snow!

Life changes.

If you have made it over to my website today, you are probably wondering what the heck is going on in my life and why I left Los Angeles.  Or maybe you are just wondering why I have been completely off the grid for the four weeks.  Haha, I get it! But it happened. And in times of change we sometimes need to take a step back and allow ourselves time to process. So I did exactly that. Now I am ready to share.  

What you are about to read in the next few life update posts I am planning will give you insight.  Although it may seem crazy, it is the right choice for me and I know that.  The hardest part of all of this has been allowing my emotional self to catch up with my cognitive self.  What I mean by that is that even though I know it is the right choice, I needed time to emotionally catch up to what I was choosing. Hence me being off the grid.  I have learned that I can reason my way through most any problem, but being the emotional person I am my heart takes a little longer to adjust.

First, I would be remiss to not start by saying how grateful I am for the time spent in Los Angeles, the opportunities that were given and the people who made it such a special adventure.  It was quite literally the best time of my life.  After spending years in Cleveland learning medicine and also exploring who I was LA was my chance to grow fully into everything I truly am.  It was nothing short of magical.  I experienced more during my short time in LA than in the many years prior by simply feeling like ‘saying yes’ to anything and everything. Yes was always the right answer in LA. The city is such a special place and it will always have an exceptional place in my heart. I will be visiting often.  Who knows where the future will take us right? Better I stay in touch with the magic. 

Loving life this summer in LA.

The reason for leaving is complex. But drilled down when I weighed what I was doing against who I wanted to be something was maligned.  I have always believed you must follow your gut in these moments. You must lean towards who you want to be in this world and fight to go there ferociously.  That gut feeling is a guiding light.  Our instinct.  When who I know I am was clearly at odds with the nuts/bolts aspects of my day to day existence it was time to consider change.  

Lucky for me, my husband and I had started this conversation a while ago and when it came time to pull the plug per-say, we had a plan in motion.  It was a gut wrenching decision (to say the least) and the execution of what happened next moved faster than I could have imagined.  After all was said and done and I was driving away from our little beach home with the last of my belongings in the car (and Francis riding shotgun of course) I felt calm, but also still a little blown away by the fact that I was actually leaving.  


This rushed goodbye was complicated more by COVID-19 (as is everything in life right now).  The usual way I say goodbye would be having having dinners with friends, giving hugs and going to one last hoorah at all my favorite spots in town.  Because of the restrictions and pandemic closures, as well as the safety concern surrounding spread of this miserable virus, I didn’t get to do any of that.  I had to sneak away without a proper goodbye.  And it sucks.  

Last family photo before we drove away

So here we are on the other side of transition. Not much worse for wear- other than poor Francis who despite being a trooper through yet another move/roadtrip/hotel/home experience developed a corneal ulcer and had eye surgery.  We are going on 5 weeks in the dreaded cone, eye drops and medications four times per day.  We are holding it together helped immensely by the fact that I have been able to be home with him during this time.  Let me also say four times a day medications is terrible and I will never prescribe them in the future if other options are available. It’s a full time job to wrangle this wiggly bowling ball of a pup once let alone four times everyday!

Sunbathing in the cone vs new satellite dish?

I am sure the question in your mind is so “what are you doing now?”  Currently, (besides wrangling this pup) I am rebooting.  I am working from home on projects that I need to catch up on.  I am reflecting greater on where I came from and who I want to be.  And I am focusing hard on my future and creating the sort of medical experience I know I want for patients.  I am becoming more me everyday and can’t wait for you all to see it! 

With love and hope,

A new day.

“Courage is not the absence of fear, but rather the assessment that something else is more important than fear.” FDR

March 12. 

Today I awoke to find that indeed things are changing.  The NHL and many other leagues as expected followed suit to postpone seasons. It literally, and figuratively, changed overnight.  (NYPost article-sports in hybernation)  My eerie feeling of the night before was confirmed, and suddenly an onslaught of cancelations and postponements are being sent.  Changes to all of our prescheduled clinical meetings, social engagements, and all life events are happening in rapid succession.  Officially all social gatherings were limited to less than 50 people shortly thereafter. A national emergency is declared, and further global limits in other countries are reported. Just like that my, just like many others, day to day existence was unsettled.  And although my work continues it feels very different. As I stand in clinic seeing patients, it feels wrong.  Every patient I talk to shares the same fears as I.  We don’t know what we don’t know about this virus, and what we do know is very scary.  We try to be cautious with handwashing and limiting close interactions, but that feels supplemental to a bigger ominous production at hand.  It’s like watching something awful slowly unfold in front of you and knowing it needs to stop but not having the power to stop it, like seeing an impending car accident just seconds before you know the crash sound will be heard or like the moment of stillness in the air where time tics by more slowly than it should when I see a bad tackle on the football field, the kind that makes me hold my breath in anticipation of how it all ends. 

March 15.

March and April were supposed to very busy months for me.  There were games to cover every weekend and travel intermixed with other obligations. Instead, everything is on hold. This weekend, instead of being filled with back to back work responsibilities suddenly has a slower tune.  There is still that eerie sense of this new reality in the air, but we are oddly used to the feeling that these changes are imminent regardless of how we react.  Discomfort and uncertainty are becoming normal already.  

Amidst all of this, this (Sunday) morning my boyfriend has a spark of energy suggesting we go out for an adventure.  Little did I know he had been planning this day for over a month. Painstakingly he had been ring shopping while I was away covering sporting events or at work. And now, he is planning to propose.  I can’t say I didn’t know something was up because something just felt different.  But I wasn’t sure.  We went for a drive in his car and stopped to hike at the same place we first hiked as friends 11 months prior. It wasn’t going to be easy for him today though; with the COVID pandemic, most locals have taken to the hiking trails.  In order to find a more secluded spot, he decided to call an audible to strike off the beaten path, which led to a slightly more adventurous climb up the hill between the rows of switchback paths.  Muddy climbing through the bushes laughing that he is trying to kill me seems oddly apropos for how we should do this, right?  We happened on a small clearing that overlooked the coast from Catalina Island to Malibu.  He gets down on one knee and asks me to marry him.  I say yes as I reach to hug him as fast as I can. 

I had learned in my life before that grief and joy can coexist. It is today that I learned that fear and love can do the same.  Love is the most valuable thing we do as humans, and even in the time of pandemic we must choose to love. We must choose to fight for a love and a life that can spread this ultimate joy to others. 

March 19.  

I am cooking curry in the kitchen when the Mayor announces the first stay home order for LA.  (LA Mayor – safer at home).  He said, “We are all safer at home. Staying in our residences, being aggressive about hygiene, and practicing safe social distancing are the most effective ways to protect ourselves, the people we love, and everyone in our community.  Each one of us is a first-responder in this crisis, and Angelenos understand that we have to make big sacrifices right now to save lives. This isn’t forever — and we’ll get through it together.”

This week has been different. I have still been going to work and seeing patients that need to be seen. But now we have talked about a transition to telemedicine. 

What is telemedicine?  Basically, we as doctors can now treat patients by using a computer or phone.  Your face pops up on my screen and mine on yours.  We talk shop, I make my recommendations, do any orders for treatments you need, and document our visit. There are some rules and regulations:  the main one being I have to have a medical license in the state you are located… but it’s honestly that simple.  Why haven’t we done something like this sooner, right?!

(EVISIT article- how telemedicine works)

We have been discussing this type of care for years. A way for doctors to do medical care remotely. Some have started it but on small scale.  I have been reluctant to do so for several reasons.  First, I don’t do surgery (I discussed this more here… sportsdrmorgan article- what is a SM doc?), and most hospitals have started with doing these sorts of visits for visits after a surgery. Why? A couple of reasons. One, it is usually a quick visit to say look at a wound, and that is easy.  We feel bad when patients drive for hours, sit in waiting rooms and then spend 2 minutes with us saying ‘yep looks great! See you in a month!’ Two, we don’t get paid for these visits. It is complicated, but when you have surgery, the first few post-operative visits are included with the price of the surgery.  So, the insurance companies pay for them as a package deal.  We don’t charge separately for those visits. And guess what, we also don’t (or didn’t… more on that later) get paid by insurances for telemedicine visits. So, if we aren’t getting paid for seeing you in real life, there’s mutual benefit to see each other on the computer. We can save you the strife of the whole painful coming to the doctor process. And for us, we can do these encounters at odd hours like after clinic normal clinic times or during lunch breaks. This way, we get more patients seen during daylight hours. Three, the final reason why I never loved the idea of telemedicine, there is the possibility of more work after hours when I want to be home off the clock.

But with COVID-19 that all changed…  And it changed rapidly.  We can get paid for these visits now due to the pandemic emergency state.  In the pre-COVID days one needed to pay cash.  Now insurances are allowing doctors to bill for telemedicine visits like the way we do for regular office visits.  And the hospitals responded just as quickly.  Massive undertakings by our IT departments were achieved. Full telemedicine apps were developed. And for those that didn’t get that far, ZOOM has become our new best friend.  To be clear, I had never heard of a ZOOM anything until now. But it works! We don’t know how it will all shake out in the end… we don’t know the details of how we will get paid and how much. And if you have ever dealt with insurance companies you know it can be ridiculously painful. But for now, we are rolling it out all over the place. 

With the launch of telemedicine for my clinic the uncomfortable clinic visits I was having (and knowing that people should be staying home) disappeared. I can now see my patients and give medical advice via telemedicine from the safety of my home.  Elective surgeries were postponed next, and all meetings are now video calls. Even rotations for residents and staff on important services were changed to decrease the contact and overlap we have with each other. It all happened very quickly.  We are now truly trying to socially distance even in healthcare. And I cannot stress enough what an amazing feat that has been for most. While alongside of us, other frontline workers have pushed hard ahead to try to save lives.  

This next week proves more and more that adapting to change is the new normal.  Come to find out, emergent services do include vet visits. I call to confirm as my dog, Francis, needs an immunization.  I am scared to take him. Does this really need to happen?  I would’ve canceled, but it was a timed injection.  They confirmed they are open, but I find out even the vets have new special protocols in place to limit contact. We park in the parking lot, call them, and they come out to fetch (pun intended) the dog. We pay over the phone. I can see the front desk from my car window, and I wave thank you.  We are all acclimating to a new way of doing things. And we are surviving. 

March 20. 

We have been looking for a new place to live for over a month.  Our current landlord is selling our condo, and although he was kind enough to let us have some leeway regarding the lease end, I really wanted to find a new home since we were in a position of limbo.  Fortunately, or maybe unfortunately, it happened today.  Good news… We found a place to rent! Super exciting considering several other places we looked at were either not suitable for our needs or not available…  LA is a tough rental market.  Bad news… we now need to move. During the COVID-19 pandemic. If you are reading this in the future, and during another pandemic, I do not recommend a move.  We had one week to pack everything, find movers, and go. Somehow my fiancé found movers who would come (@affordable_movingllc), and they wore masks, and we sanitized everything. But my aforementioned fears and desire to lock myself in the bathroom recurred.  We needed to do this. But I am absolutely worse for wear. 

More of the same has continued with work including telemedicine visits for my patients and being as productive as possible in other areas.  The talks of reallocation of staff continue. My fiancé is back on cycle next week where he will be in the hospital doing emergency things.  I am scared for his safety, and I am scared for mine.  And I wait. I am grateful to be safe at home and hoping others feel the same.  But suddenly my little cocoon of safety will be opened up back to the outside world when he returns.  LA still hasn’t been hit hard yet, and our hospital is holding steady.  It feels like we are waiting, circling. In a holding pattern and on the brink of something very scary, the edge of the bubbling fear I felt outside the night of the Kings game before the season was canceled.  It is still bubbling up and I am waiting.    

March 30.

It has been 3 weeks.  In 3 weeks, we are here. We are at home now.  Some of us are safe. Some of us around the world and still in NYC are in a fight for their lives.  (CBSnews article)  In 21 days, we have changed our entire culture and social construct as a human race.  I pray it ends soon. I pray that the pot never bubbles over locally and we did enough social distancing fast enough to prevent the onslaught of cases that are predicted.  And if mercifully it does subside, I cannot help but think about what the future holds.  How will we react when the bans are lifted?  Will this time of social isolation have an effect on how we choose to live future forward?  I know it will for me.  I will be much more mindful of how positive the sharing of life is with others.  I will be grateful for the interactions I have with my friends and loved ones. I will be grateful for a hug.  I will smile more at strangers and cheer for everyone I can in this life.  Can we all just agree now to do better?  Let’s slow down, be mindful, enjoy life. Human relationships should never be taken for granted again. 

The field of medicine will also undoubtably change.  We now are proficient at telemedicine… the infrastructure of how we treat patients moving forward can be different.  The precipice of a new era in healthcare is upon us.