John Bednar, MD, hasn’t been on a snowmobile in years, but he’s seen firsthand what can happen to drivers and passengers if they don’t take proper precautions on the snowmobile trails.

Every year, 14,000 injuries and nearly 200 deaths are the result of snowmobiling accidents, according to the National Institutes of Health (NIH). The main causes are excess speed, alcohol, driver inexperience and poor judgment.

Snowmobile accidents range from ankle sprains to serious injuries such as brain, back and neck injuries, says Dr. Bednar, an emergency room physician with OSF HealthCare. He compares these accidents to the trauma seen in motorcycle mishaps.

“Snowmobile crashes can be absolutely horrendous, life threatening and such a tragedy if you have an unexpected accident, like we see every year,” he adds. “Deaths, severe spinal injuries, pelvic fractures, multiple broken bones that can be devastating, devastating injuries and totally unexpected when you're out there to have fun.”

The biggest danger, without question, is consuming alcohol or drugs while using a snowmobile.

“I've seen very few snowmobile accidents that did not have some sort of intoxication involved or other preventive kind of reckless behavior,” says Dr. Bednar. “Intoxication, number one, by far, seems to be most involved in the crashes I've seen over the decades.”

Dr. Bednar says if it’s not alcohol related, the other common factor in snowmobile accidents is not being familiar with the surroundings. That’s especially the case for snowmobilers who travel away from home to ride in other parts of the Midwest.

“Know your trail and stay on your trail,” Dr. Bednar says. “If it's a well-known, well-marked trail, then you're much less likely to hit a stump, hit a rock, get off course, hit the tree, because that's when we see the crashes. When they don't know their trail, they use excessive speed, or they get off course, that's when they hit the tree or the rock, and those things don't like moving, and our heads don't like sudden stops.”

Whether you’re driving your snowmobile day or night, it’s imperative to watch your speed – especially if you’re inexperienced or driving at night when visibility is limited.

Always wear proper protective gear when riding a snowmobile. That includes a helmet, goggles, gloves, wrist guards, shoulder pads, chest protectors, knee protection and supportive footwear. Your equipment can keep you safe but also serves as protection from frostbite and hypothermia.

“Most snowmobilers have great gear, including their helmets,” says Dr. Bednar. “But if you are going to go on ice, if you think it is safe ice, please consider wearing a life vest underneath your gear. We’ve seen multiple tragedies on thin ice.”

The Michigan Department of Natural Resources offers the following tips:

• Dress for the weather.
• Check the weather forecast and road conditions.
• Carry appropriate equipment for your activity, such as a flashlight, rope, ice picks or ice claws.
• Have spare equipment available in case something breaks.
• Stay hydrated and fueled – bring water and snacks.
• Bring a buddy.
• Tell others where you will be, how long you plan to be gone and schedule check-in times.
• Carry a two-way communication device that receives service in remote areas.
• Take an honest assessment of your health – if you’re not feeling well, don’t go out.

Whether you’re a weekend warrior or a sled head, these tips will ensure a safer trail ride this season.

Interview Clips 

It can be an embarrassing ailment, but experts say it’s time to talk about it.

Urinary incontinence is when a person leaks urine by accident.

Uwais Zaid, MD, a urologist at OSF HealthCare in Alton, Illinois, says urinary incontinence can wreak havoc on a person’s social life and intimacy with partners. In other words, you can’t go out and have a good time with friends if you don’t know when you’re going to suddenly “go.”

“It can be associated with medications. It can be associated with aging,” Dr. Zaid says. “It can be associated with certain surgeries. A lot of our cancer survivors, whether they're from prostate cancer, cervical cancer, uterine cancer…they can have effects to their urinary control.

“Things as normal as having children,” Dr. Zaid adds as a cause.  “Over time [childbirths] can wreak havoc on the pelvic floor and on the urinary sphincter, and you can have urinary accidents as a result.”

While incontinence is often associated with older people, Dr. Zaid says all those precursors apply to any age.

Dr. Zaid says urinary incontinence breaks down into four groups.

• Stress: This is when the bladder sphincter does not work as well. Simple things like coughing, sneezing, laughing or bending over could provoke a release of urine.
• Urge: “When the bladder has a mind of its own,” Dr. Zaid remarks. This is when you have to go and you just can’t make it to the bathroom in time. Dr. Zaid adds that hearing or seeing certain triggers like running water or jingling of keys as you rush to enter your home might provoke urge incontinence.
• Overflow: This occurs when your bladder is full. This is the opposite of urge incontinence, Dr. Zaid says, and is associated with infections and kidney issues.
•  Functional: This applies to someone who may have normal bladder control but can’t get to the toilet in time due to physical limitations like arthritis.

A health care provider will ask you about your symptoms and health history to see which type of urinary incontinence is ailing you. Testing would typically follow. Each type of incontinence, generally, has its own treatment plan.

• Stress: A provider may recommend pelvic floor physical therapy as treatment. For women, a small device can be inserted to stop leaks. Surgery is also an option.
• Urge: You may be told to cut back on caffeinated food and drink, spicy food and alcohol. Medicine and surgery are also options.
• Overflow: “That's where we need to make sure we're not missing anything like a blockage - for women, a prolapse and for men, an enlarged prostate.” Dr. Zaid says.  “A stone in the bladder. A tumor in the bladder. And we also need to make sure the kidneys are functioning okay.”
• Functional: Since people with this type of incontinence may have a normal bladder, external solutions are necessary. For example, keeping your route to the bathroom clear of obstacles like chairs and doors. For older adults with physical limitations, have a walker handy for when the need to go arises.

Other tactics include urgency suppression, when you distract yourself from thinking about urinating. You could take long, relaxing breaths or sit completely still.

Timed voiding is when you schedule times to urinate. Dr. Zaid says this can work in both directions. If you are urinating too frequently, set a timer on your phone to go every hour. Then when you get comfortable, you can increase the time. If you are holding on to your urine too long, set a plan, get comfortable then decrease the time.

The bottom line: if something seems off about your bathroom visits or if friends or family remark “You’re sure in there a lot,” see a doctor.

“If you’re chronically wet down below, it increases your risk of fungal infections and skin breakdowns,” among other serious health issues, Dr. Zaid says.

Interview clips

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Gotta go? Try these six bladder tips