Right at the moment that European summer has finally seemed to start, we have an ice cold message for you. You may be familiar with the phenomenon that as soon as the winter wetsuits are stored back in the garage, the surfers who only surf in summer -and therefore might be less experienced- show up. But although snow has disappeared from the beaches in this time of the year, hypothermia is as common as in winters. A breezy summer day on the coast of Ireland, with a water temperature of 13 degrees can still provoke hypothermia and unexpected cold related injuries. At our next conference, Ove Oksfold, MD, from Sweden, will share his knowledge about cold induced injuries and hypothermia in surfing.
I was born in Norway but raised in Sweden, and graduated from Medical School in Uppsala in Sweden in 2002. For the first few years I worked myself up through Sweden and Norway as a “remote area GP” until I came as far north as there was land. In 2006 I started my emergency physician career, initially in the Northern parts of Sweden but later in emergency departments in Australia and New Zealand. I had plenty of odd jobs like ski resort doctor, sport physician for a “Division 1” ice hockey team, motorcycle doctor in the Himalayas, expedition medic in Costa Rica, and all-round-doctor in Tanzania. I returned to Sweden in 2011 to round it all up in a training program in Family Medicine.
When did you start surfing?
In 1994 or 1995 while passing Biarritz on a road trip through Europe. Although I continued to try surfing back home and away as often as I could, it took me at least 10 years before I really rode my first wave. And I am still an amateur.
What kind of specific injuries occur in cold waters?
If you have a proper modern wetsuit that fits you well, you should be reasonably comfortable, even if the water temperature is down. That said, there are a few odd things that can happen to you in cold water or if you get cold. You can get a general cognitive impairment. Or in other terms, being cold makes you more stupid, weaker and slower. If you rupture a tympanic membrane you will get an extreme vertigo. It is like an augmented version of the caloric reflex test. Furthermore you can get motoric and sensoric dysfunctions in your hands or feet. Standing up on a board is very difficult if your feet are numb, and using your fingers and hands are difficult if they are cold (like holding onto something, or picking up your car keys). Last, but not least important, you may become be very tired once you reheat and get into your car. Poor driving can kill.
As a doctor in general, which typical Arctic experiences do you have?
Apart from traffic accidents, I have seen surprisingly few cold related medical conditions in the Arctic. I guess people dress up and know their weather and conditions pretty well. The main medical problems up here are related to being many hours away from secondary or tertiary medical care, and the mentality that people don’t show up at the doctor’s office unless they are very sick. I find more cold related injuries at winter resorts where tourists get lost while cross-country skiing or snowmobiling. Frost bites are very common, caused for example by using too small ski boots. Multisport is a class of its own, particularly orienteering (one of the most popular sports in Sweden). During the spring competitions there are often people getting lost while wearing little more than running clothes. In cities hypothermia is a problem foremost among mentally ill (including dementia), homeless, elderly and the occasional ice-skater or drunken boat user.
How do you prepare for expeditions as a leader of these expeditions?
Communication is a medic’s best tool in case something really serious happens. I have been surprised of how often there is a working cellular network even at very remote locations, so don´t leave your (smart) phone at home. It might be a good idea to get a local SIM card. Some countries demand that you leave a passport photo in order to get a SIM card, so check that up prior to departure. A modern phone can also be used as GPS. The big bulk of medical problems are the common ones like athlete’s foot, minor infections, aches and pains, foreign bodies in eyes or ears, and minor injuries. Many of these problems can be prevented. Bring equipment and medicine for severe but treatable conditions (anaphylaxis, acute coronary syndrome, etc). Split up your medication and the medication of the participants, so all medication is not at one location. If you have the chance, get a crash course in basic emergency dentistry (at least in Swedish medical schools we don’t get that much hands-on experience in dentistry). There are quick fix kits that are cheap and useful. Why not consult your own dentist?
How did you get involved in the European Association of Surfing Doctors?
I heard about the association while on a surf trip to Guadeloupe in 2011.
How do you think the European Association of Surfing Doctors can make a contribution to the surf community?
I think we contribute to the surf community by being doctors. But we might contribute even more to the doctor community by surfing. 😉