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After the Fall More than 20 million medical visits are made each year due to in-home injuries - here's how to play it safer 
I knew I was in trouble as soon as my right foot began to slip off the smooth, painted step. The stairway to the basement of my historic condominium building is twisty and tricky to maneuver even when not carrying a week's worth of dark laundry. Adding slippers to the mix was simply not a good idea. In an instant, I was in the air - and then bouncing down the remaining eight steps on my back. I landed at the bottom covered in jeans and sweatshirts, and with the wind completely knocked out of me. I paced the basement, trying to catch my breath while gripping my left ribs, which had taken the brunt of the fall. My back was tightening quickly and already tender. I knew I was in trouble. The emergency room doctor confirmed my suspicions three days later - on Thanksgiving morning - bruised ribs. After a shot of something powerful for the pain (which had an added side effect of improving the family holiday dinner), he promised that the muscles spasms would end in a couple of days, but it would be at least a month before the soreness from those bruised ribs subsided. I couldn't help but wish that I'd made two trips down to the laundry room that day and traded my worn slippers for a pair of soled shoes. After all, I knew better. "Most of the time, younger people that have had trauma, falls at home, falls on the outside of the house, they almost always say, 'Oh, it was so stupid. I shouldn't have done that. I knew better,'" says Dr. Geoffrey Westrich, an orthopedic surgeon at the Hospital for Special Surgery, a specialty hospital for orthopedics and rheumatology in New York City. "Accidents are accidents, and I think that, obviously, a lot of these things can be prevented." The Home Safety Council estimates an average of 21 million medical visits were made each year due to home injuries between 1996 and 2000. Falls, like mine, accounted for 41.2 percent of all non-fatal unintentional home injuries, with struck by/against, cut/pierce, overexertion and poisoning rounding out the top five, and making up 80 percent of these injuries. Between 1992 and 1999, there were nearly 20,000 unintentional home injury deaths per year, according to "The State of Home Safety in America: Facts about Unintentional Injuries in the Home," published in 2004 by the non-profit Home Safety Council. Its research points to falls and poisoning as the leading cause of unintentional home injury deaths during those years. Older adults - men and women - lead all groups in the highest rate of unintentional home deaths, although across all ages, men experience substantially more than women. Nighttime falls are especially common, notes Westrich. "A lot of people tend to get up in the middle of the night, and when they do it's usually dark," he says. "They don't turn on all the lights because somebody else is usually sleeping. A lot of times that creates a dangerous situation because ... they fall and trip over things." Plus those who wear glasses or contacts typically don't slip them on in the middle of the night, making midnight excursions to the bathroom even more treacherous, adds Dr. Westrich. He advises that people always make sure to clear a clutter-free path out of their room and have night lights in the hallway and bathroom. But Dr. Westrich also has seen falls off step ladders, step stools and even on recently waxed floors take down a perfectly healthy adult in the light of day. Robyn Drake, of suburban Houston, had purposely chosen a lightweight, collapsable aluminum ladder so she could do more home projects herself. Even though she had already successfully completed a plethora of do-it-herself jobs, like painting, the day she propped the extra long ladder against the wall of her two-story entryway to place knickknacks on shelves would be her last solo endeavor. "The last thing to put up there was a tiny little silk plant," Drake says. "I got a little way up the ladder, and I didn't step right in the center of the rung, and it just basically flipped and caught my feet up, so as I was headed toward the tile. All I could see was my feet, and I landed on my back, on the tile. That was after I put my left arm down to brace myself, which wasn't a good idea." Drake shattered her wrist, ribs, two bones in her arm and two vertebrae in her back in the fall. She spent a week in the hospital and a month in home-recovery, and it was many more months before she was fully recovered. Luckily, Drake was in excellent physical condition at the time of the fall. "I've always been really athletic, I've always been in really good shape, which is probably why my injury wasn't as serious and devastating for me long term," she says. "I already had a strong back." Healthy people rebound more quickly from most accidents, and even recover faster from surgeries, notes Westrich. "The stronger the muscles are, the more command people have over their body, and they're able to bounce back that much faster." Four years later, Drake has a new, heavy-duty ladder that she can't lift alone - and she doesn't set foot on it unless someone else is home to hold the bottom. "I don't climb up on the roof anymore and put up Christmas lights like I used to," adds Drake, now 50. "You get a little safer, you just don't think you're indestructible anymore."
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