An Amazing Story

After reading this story, be careful where you ski this winter - and remember to wrap up warm, because miracles don't fall off trees, and this is truly a miraculous story of life returning from an icy grave.

With the growing popularity of winter sports, total body hypothermia (i.e. subnormal body temperature) resulting from prolonged exposure to low temperatures is encountered with increasing frequency. When the onset of hypothermia is rapid, such as immersion in near-freezing water, the signs are obvious and require prompt treatment. All wet clothing is removed, and the patient, if alert, is given warm fluids to drink. Alcohol depresses shivering and promotes additional heat loss, and is therefore never used.

Patients with mild hypothermia (32 to 35 degrees Celsius) are passively re-warmed by wrapping them in warm clothes and blankets and allowing shivering to generate body heat. Active re-warming is necessary if the initial body temperature is below 28 degrees Celsius. This can be done effectively by placing the patient in a warm bath. An altered level of consciousness is the most constant symptom of hypothermia and ranges from confusion and mood changes to severe agitation and coma. The victim appears grey and cyanotic and is cool to the touch. Blood pressure, pulse, and respiration are frequently well below the norm. However, the absence of breathing or heartbeat after exposure does not exclude recovery, as Anna Borgelholm's incredible story best proves.

Anna's story of survival against the odds is amazing. She is a young doctor and a passionate skier. Originally from Sweden, she moved to Narwik in Norway because the area around this small town north of the Arctic Circle is good skiing country. In May 2000, while out skiing with two friends, Anna slipped and fell through the ice covering a waterfall. Her companions summoned help, but it was more than an hour before rescuers could pull her out. By the time she arrived in hospital she was clinically dead. Her body temperature was so low it seemed impossible she would recover. But, just a few months later, Anna was skiing again, a recovery that has amazed the international medical establishment. Anna does not remember anything about the accident, nor the two days preceding it. Her amnesia lasted for two weeks after the event.

The hospital personnel were notified immediately after the accident and started to prepare. They assumed, of course, that Anna would be extremely cold and probably without any signs of life on arrival. She arrived at ten past nine in the evening, by which time the hospital was fully prepared to receive the emergency case. Anna's body temperature fell to previously unrecorded levels. The first recorded temperature after wheeling her straight into the operating room was 14.40 Celsius. In medical literature such a low temperature had never been reported in the case of a survivor of accidental hypothermia. The doctors followed the standard procedure, which states that a hypothermia victim should not be pronounced dead until they have been re-warmed to 360 Celsius and then remain unresponsive to CPR (Cardio-Pulmonary Resuscitation) at that temperature.

Anna was apparently dead, as her consciousness, heartbeat, breathing and all reflexes were absent. Medics continued the resuscitation that had been started by the rescue team. Active re-warming was accomplished by placing Anna in a circulating water bath warmed to 400 Celsius. This surface warming brought about a rapid increase in body heat and improved heart output. Tubes were put into her blood vessels so that part of her blood volume could be warmed up outside the body and re-infused soon afterwards. After nine hours Anna showed the first symptoms of returning to life. For the following 35 days she stayed on a ventilator and in the intensive care unit for another 2 months. By then it was clear that she would pull through.

Anna survived, but her recovery continues. She has problems with the nerves in her arms and legs since they were damaged by the cold. But there is a chance of these nerve endings coming back to some semblance of normality. The mere fact she went skiing in Canada for a week, and that there has been a remarkable recuperation so far, means that she may make a full recovery. Anna does not yet know if her career as a doctor will continue. She used to work as a surgeon, but now she says there is nobody, hardly surprisingly, who would like to be operated on by her for some time. She does not want to make any decisions about her career until she knows how well her hands are going to heal and function. But the skiing will go on. One piece of advice, though - after surviving this, she should beware of the yetis.

- Darius Langhoff