[pct-l] Some Lessons Learned the Hard Way

Wed Aug 25 17:31:29 CDT 2010

**His hospital Doc told him his lymph system was involved. A friend who is a
PA said it sounded like "Lymphedema" to her. It is all Greek to me.

On Wed, Aug 25, 2010 at 3:03 PM, <ned at mountaineducation.org> wrote:

>  David,
>
> Sounds like your son, Dan, did exactly the right thing and wasn't careless
> or unwise at all. Like you said, from now on he will be all the more wise
> and careful regarding his on-trail treatment of future blisters. Thankfully,
> he was able to get off the trail and find (with your help) medical aid
> before things could get worse. I had no idea cellulites could be so bad!
>
> Halfmile pointed out that "Sandals" suffered a very similar experience:
> http://trailjournals.com/entry.cfm?id=188333
>
>
> Ned Tibbits, Director
> Mountain Education
> 1106A Ski Run Blvd
> South Lake Tahoe, Ca. 96150
>     P: 888-996-8333
>     F: 530-541-1456
>     C: 530-721-1551
>     http://www.mountaineducation.org
>
> ----- Original Message -----
> *From:* david woods <dkwoods33 at gmail.com>
> *To:* ned at mountaineducation.org
> *Cc:* PCT MailingList <pct-l at backcountry.net>
> *Sent:* Wednesday, August 25, 2010 2:27 PM
> *Subject:* Re: [pct-l] Some Lessons Learned the Hard Way
>
> I do not want to get too defensive here but I will say that Dan has walked
> almost 6K miles on the trail including a supported 90 day thru hike last
> year and this is his first problem. Of course your first problem can be your
> last but I would not describe him as careless or unwise. In retrospect he
> was probably a bit careless and unwise about his blistered heel but based on
> past experience he thought he was doing OK with it at the time. He was wise
> enough to stop walking as soon as he saw what was going on and that is why
> he never got to the point of septic shock or a bone infection both of which
> are much nastier than Cellulitis.
>
>
>
> On Wed, Aug 25, 2010 at 11:45 AM, <ned at mountaineducation.org> wrote:
>
>>  Dave,
>>
>> Yes, confidence can come with experience, but without wisdom it leads to
>> the carelessness you refer to. This ordeal, this experience, will have added
>> that wisdom to his quiver and he'll be the safer for it.
>>
>> That is why we try to encourage all wilderness travelers through our
>> "Hands-On" school's courses to "Get Experience" by going out there and
>> applying whatever Understanding they may have, perhaps only acquired thru
>> the reading of Trail Journals, cautiously and slowly at first to find out
>> for themselves the wisdom in each thing they do (and not do) and situation
>> they encounter in order for it to be realized and cemented-in. That is why
>> we talk to the thrus at the Kickoff about the realities ahead of snow and
>> the challenges it will demand of them.
>>
>> Dehydration is very common in the snow at altitude whether the sun is out
>> or not. Infection, even when from a spider bite which sent me to the
>> hospital on my PCT thru in 1974, is something not to be disregarded or
>> trivialized when you're way back in the backcountry.
>>
>> However, most thru hikers, unfortunately, romanticize the dream, do not
>> have the requisite experience going into it to know the realities of the
>> trail ahead and, therefore, how to plan and prepare for it (meaning both
>> what "works for them," i.e., what to bring and why, borne out of on-trail
>> trial and testing, and what skills they need to have to get through safely),
>> and often hastily and blindly invest a lot of time and money that leads them
>> to the first few weeks on the trail that become so hard--and many are forced
>> to leave the dream for awhile until they "get wisdom" enough to try it
>> again.
>>
>> I'm sure your son did and will!
>>
>>
>>
>> Ned Tibbits, Director
>> Mountain Education
>> 1106A Ski Run Blvd
>> South Lake Tahoe, Ca. 96150
>>     P: 888-996-8333
>>     F: 530-541-1456
>>     C: 530-721-1551
>>     http://www.mountaineducation.org
>>
>>  ----- Original Message -----
>> *From:* david woods <dkwoods33 at gmail.com>
>>   *To:* ned at mountaineducation.org
>> *Sent:* Tuesday, August 24, 2010 7:13 PM
>> *Subject:* Re: [pct-l] Some Lessons Learned the Hard Way
>>
>> Ned,
>>
>> Yes you may use our story. If it keeps this from happening to one person
>> it is worth it.
>>
>> 1. He did not have septic shock nor did it get into the bone. It was
>> confined to his skin and lymph system. He was lucky in that regard.
>>
>> 2. It seems most probable to me that it came through the blister but that
>> is just my opinion. I do not understand the mechanism by which the gut can
>> leak but the colon has large blood vessels close to the surface which are
>> used to remove water from the feces so it may not take much of an injury to
>> allow a leak. Perhaps dehydration allows stools to stick a bit and tear the
>> tissue a  when they finally move. You will have to ask a doctor to get more
>> than my uneducated guess.
>>
>> 3. He was wearing the standard thru hike footwear, low cut trail running
>> shoes (Montrail Hardrock) and black nylon dress socks. Since 2005 he has
>> hiked over 5000 miles on the PCT including one successful 89.5 day thru hike
>> in 2009 using the same kind of footwear. This is his first problem. Is he
>> getting more confident and hence careless about blisters and water? Did he
>> just get unlucky and step in the wrong place? Who can say BUT I will bet he
>> will not ignore a blister and hopefully his water supply in the future.
>>
>> Dave
>>
>> On Tue, Aug 24, 2010 at 11:07 AM, <ned at mountaineducation.org> wrote:
>>
>>> Hi, David!
>>>
>>> We're so sorry to hear of your ordeal, but we're glad that you were
>>> directed to the right end.
>>>
>>> Since we teach our students that planning and preparation for the
>>> realities of the trail can make their trips safer and more fun, would you be
>>> willing to let us repeat the description of your son's lesson in dehydration
>>> and septic shock?
>>>
>>> Sounds like the Docs weren't too sure how the infection found its way in,
>>> either via the blister (open wound) or the intestine. How does the intestine
>>> rupture based on dehydration? What type of shoes was your son wearing such
>>> that they allowed animal feces inside to contaminate the blister?
>>>
>>> Any info you pass on to our school will be used to help future students
>>> learn of and avoid the circumstances that led to your son's illness.
>>>
>>> Thanks so much for your time on this; I'm sure you have lots of other
>>> things to do...
>>>
>>>
>>> Ned Tibbits, Director
>>> Mountain Education
>>> 1106A Ski Run Blvd
>>> South Lake Tahoe, Ca. 96150
>>>   P: 888-996-8333
>>>   F: 530-541-1456
>>>   C: 530-721-1551
>>>   http://www.mountaineducation.org
>>> ----- Original Message ----- From: "david woods" <dkwoods33 at gmail.com>
>>> To: <pct-l at backcountry.net>
>>> Sent: Monday, August 23, 2010 5:19 PM
>>> Subject: [pct-l] Some Lessons Learned the Hard Way
>>>
>>>
>>>
>>> This is a cautionary tale for all hikers and especially the long distance
>>> type.
>>>
>>> My son, Dan, set out from Mount Ashland in OR on the afternoon of July
>>> 25,
>>> 2010, on a PCT section hike to Whitney Portal. I was playing the support
>>> role meeting him at roads with supplies, etc.
>>>
>>> On Tuesday afternoon, August 10, I was waiting for him at Packer Saddle
>>> just
>>> north of Sierra Buttes and above Sierra City (no cell signal). I was
>>> expecting him in the evening and was reading when a car pulled in next to
>>> me. I was in a very peaceful place and was a bit annoyed that the car had
>>> parked so close to me.  I glanced over and the driver, a woman who said,
>>> “I
>>> have your son.” At first it did not register then he got out of her car
>>> and
>>> showed me his left ankle, which was the close to the size of a football.
>>> The
>>> swelling was also part way up his shin. This was the first act of a
>>> 12-day
>>> adventure nobody wishes or needs to repeat.
>>>
>>> He had left Beldon Town late in the afternoon of the 8th and had walked
>>> 45
>>> miles to Quincy-La Porte Road on the 9th to be sure of making our
>>> rendezvous
>>> the next day. When he woke up on the 10th his ankle was swollen and he
>>> could
>>> not walk well enough to continue. He also had a raw blister on his heel.
>>> He
>>> was able to hitch to Quincy then to Highway 49 where the woman who
>>> delivered
>>> him to Packer Saddle picked him up. She is a PCT hiker and was willing to
>>> go
>>> way out of her way to bring him up to me in the boonies. Thank you whom
>>> ever
>>> you are.
>>>
>>> The woman told us there is a clinic in Graeagle and hospitals in Quincy
>>> and
>>> Portola. At this point we thought he would take a few antibiotics for a
>>> few
>>> days and then we would resume the hike so we headed for the closest
>>> place,
>>> Graeagle. The nurses there took one look at his ankle and heel and told
>>> us
>>> to go to the emergency room in Portola which was only 10 miles away.  The
>>> doctor there ordered an ultra sound to check for clotting and gave him a
>>> dose of two antibiotics and a dose to take in the morning and a
>>> prescription
>>> for a 10 day supply and sent us on our way with instructions to come back
>>> if
>>> the swelling spread, etc.
>>>
>>> After checking out the motels in town we decided to go to Reno to get a
>>> better rate on a better room. We checked into the Motel6 near downtown
>>> and
>>> waited for the antibiotics to kick in. This was Tuesday evening. By
>>> Wednesday evening the swelling was above his knee and he was experiencing
>>> vomiting and diarrhea (probably an allergic reaction to one of the
>>> antibiotics). His oldest sister who I was in touch with by phone wanted
>>> me
>>> to take him to the ER then. He wanted to wait to give the antibiotics a
>>> chance to work. He woke up at 3:00 Thursday morning and was sick enough
>>> to
>>> want to go to the ER so we looked on the web (thank goodness for cell
>>> phones
>>> and laptop computers) and found the nearest hospital which is St. Mary’s
>>> and
>>> is about a mile from the motel.
>>>
>>> Within an hour of arriving at the hospital he was in the ER on IV
>>> antibiotics, had had an X-ray and blood drawn for culture. Later in the
>>> day
>>> he was admitted to the hospital and had an MRI. To make a long story a
>>> bit
>>> shorter, he was in the hospital 9 ½ days during which time the swelling
>>> progressed as far as his armpit and out onto his rib cage. He had surgery
>>> on
>>> his heel and was infused with many doses of several different
>>> antibiotics,
>>> first generics then “designer”. He is now at home taking expensive oral
>>> antibiotics for 2 weeks. Of course this all scared the heck out of his
>>> family and the bill is sure to be a thing of beauty.
>>>
>>> A doctor friend of Dan’s sister told her that this type of infection can
>>> result from the bacteria (Enterococcus) leaking from one’s own gut due to
>>> constipation and/or dehydration. Of course walking in animal or human poo
>>> with an open wound is also a possibility.
>>>
>>> Dan had at least 2 instances of walking long distances with no water on
>>> this
>>> hike. He also had an untreated or marginally treated blister for 1-2
>>> weeks
>>> (we cannot agree on when it first appeared).
>>>
>>> The moral is to take care of your blisters, drink plenty of water, even
>>> if
>>> you have to go off trail to get it, and make your diet as fiber rich as
>>> possible. This party had a happy ending but it could just as well have
>>> gone
>>> the other direction. We are all very glad it did not.
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>>
>