My heart stopped for more than two hours after being trapped under ice

As heatwaves draw more people to the water, scores of people drown in the UK every year. 

For many, the greatest danger is not hypothermia but the body’s immediate response to sudden immersion in cold water: cold shock, which can trigger involuntary gasping, panic and rapid breathing within seconds.

Yet under very different circumstances, the same cold water that can kill can also play a remarkable role in saving a life. 

27 years ago, as a woman became trapped beneath ice, profound hypothermia slowed her body’s functions enough to make an extraordinary recovery possible.

Then 28, Anna Bågenholm was skiing in Norway, with friends and fellow junior registrars Torvind and Marie. The trio had hiked 30 minutes from the ski lift to a frozen waterfall gulley in Narvik, in May 1999, which the experienced skiers had descended many times before.

‘It wasn’t a dangerous spot, but I started to slip, turned on my back and slid with my skis uphill. I hit a hole in the ice, my head went under and the water filled my clothing, pulling me down’, the 56-year-old radiologist tells Metro from her home in Tromsø.

Anna doesn’t remember anything after getting trapped under ice in May 1999 – the details were later filled in by her friend, Torvind.

Wedged between rocks and overlying thick ice, the area around Anna’s head continued to flood with icy water. 

Marie grabbed Anna’s hands until the cold meant she lost her grip, then she and Torvind tried to pull her out by the ski boots, with no luck. 

The running meltwater pulled Anna under, and at 30cm, the ice was too thick to break. After seven minutes of struggling to get her out, the friends called the nearest hospital – 100 miles away – and volunteers nearby. 

For 40 minutes Anna struggled beneath the ice – then she stopped moving. Suffering from hypothermia, her body temperature was later recorded at 13.7 degrees. 

‘After around 60 minutes, there were people on skis who had come to help. They had a rope and tried to pull me out by the legs, but that didn’t work,’ explains Anna.

‘Then a local volunteer brought a steel shovel and made it possible to make a hole further down in the ice, so, connected to the rope, they could let me go down under the ice and come back up through the new hole.

‘Then they took me up onto the ice.’

By this point Anna was clinically dead. She had been trapped for almost 80 minutes and her heart had stopped. 

‘I looked dead, due to hypothermia. I had small pupils, I was pale and had no heartbeat and no respiration. Torvind and a volunteer started CPR.

The rescue helicopter arrived shortly after, a medic intubated her and the team took her to the University Hospital of North Norway in Tromsø, 100 miles away, and they carried out manual CPR throughout the hour-long journey.

Following similar accidents the previous years, medics, led by Dr Mads Gilbert, decided not to take her to the emergency room, taking her straight to the operating theatre instead, where they could connect her to cardiopulmonary bypass and a life support machine and blood rewarmer. 

By this point, her heart stopped for two hours and 45 minutes. Yet remarkably, the fact that Anna’s body had been cooled so dramatically, saved her life and her survival proved to be breakthrough in accidental hypothermia.

‘Fifty years ago, when a mountaineer fell into a crevasse and became deeply hypothermic with a severe drop in body temperature he could sustain hypothermic cardiac arrest,’ explains Dr Beat Walpoth, professor of Cardiovascular Surgery, Emeritus at the University of Geneva. 

‘These victims were in cardio-respiratory arrest, had no heart action and no brain function, and therefore, unfortunately, they were declared dead.

‘Around the same time cardiac pioneers, working with children with congenital heart defects, cooled children’s body temperature to around 20°C, at which temperature they could be operated and successfully rewarmed by cardiopulmonary bypass. 

‘The team in which I was working decided to attempt to rewarm these mountaineers using the same technique of cardiopulmonary bypass rewarming and found it worked, with many making a full recovery.  This opened a new era of treatment for accidental hypothermia victims.’

Dr Walpoth published his findings in the New England Journal of Medicine, detailing  the treatment which helped doctors in Tromsø save Anna.

Mike Tipton, one of the world’s leading experts on human survival in cold water immersion, hypothermia and drowning, adds: ‘The thing that kills the brain, is a lack of oxygen availability, and partly that is how quickly it’s using it. If you cool it, hypothermia becomes protective.’ 

Anna’s recovery was a remarkable success. After nine hours in the operating room and with help from around 100 medics, she started to regain consciousness a week or so after the accident.

‘It was a big effort. I was among the first people in the world saved following cardiac standstill after hypothermia. Since then, they have used this method on many others, who now have around a 40% survival rate. 

‘It is significant because while we are really aware of this in Norway, you read stories in the newspaper from around the world where people have died when they should have been rewarmed.

‘If people are on the scene are not aware of hypothermia, they can declare you dead without rewarming you,’ she says. 

It is why many medics follow the maxim – you’re not dead until you’re warm and dead. 

When Anna regained consciousness, she was confused and paralysed from the neck down. She thought she had been hurt in a sailing trip she was due to take in Greece.

‘I couldn’t move anything. I couldn’t breathe by myself. I had to stay on the respirator,’ Anna remembers. 

But she wasn’t scared – just utterly exhausted and focussed on survival. 

‘You are so ill. You have no energy. But I was really well taken care of.

‘When I could talk, the first thing I told Torvind was that I thought it was a very bad decision to save me because it was going to be very expensive to have me hospitalised and paralysed.’ 

But sitting at her bedside, Torvind and Marie read her Dr Walpoth’s article to reassure her that she could make a full recovery. 

‘After some weeks I could move a finger, and then suddenly move a shoulder. It came very slowly back.’

Four months after the accident she was walking in the mountains again and two months later, she was skiing again. Anna was eventually able to return to work after a year. 

In 2002, she and Torvind started dating and now lead a full life dominated by outdoor pursuits and travel and extreme water sports like kitesurfing and wing foiling. 

The couple have since travelled around giving lectures, with Anna used her experiences to inform her PhD – A description of the potentially severely injured patients met with trauma team activation at the trauma centre in northern Norway in 2015 – in tribute to the hospital that saved her. 

Despite coming so close to death, she was largely unaffected psychologically. 

‘I was dead. And then I was awake. Things got normal again pretty soon,’ Anna says simply. 

‘When you are in your twenties you are in the undeadly age. You can do everything. But now in my fifties I am more careful. I don’t want to get ill or hurt myself so I avoid things that I think are stupid. 

‘I’m not afraid of skiing. I’m afraid of getting in a position where I can’t take care of myself, because I was hospitalised for so long. So I try to stay healthy.

Apart from that, Anna’s philosophy has not been changed. 

‘You might think when you have been through something like that that you should be very happy to be alive, but that feeling ends really fast. Suddenly you’re just back in normal life, and you get irritated by exactly the same things,’ she laughs.

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