Date: 2011-06-01
From: McAfee Knob

To: 200 yards short of Daleville, VA
Miles today: 16.1
Weather: clear sky

Day 72 - This day's report is going to be a little unusual. I am not only going to relate to you what happened to me but hopefully, it will contain some medical information that might be educational to others some day. The night under the stars was great, with no rain fly covering the tent every time I woke I could see the big dipper above me. I did wake up early, around 5:00am and the easterly horizon was already showing some light. Sunrise was to occur a little after 6:00am. Around 5:30am I heard voices, some day hikers had ascended the mountain to be on the knob at sunrise. I thought it was smart to go ahead and break camp and get my gear off the knob. I took numerous pictures of the sun rising and again, like so many times on my journey, I just sat in awe of God and His creativity. After packing up, I sat down in the quiet of the morning and read my devotions (Sarah Young). The opening paragraph read, " I am involved in each moment of your life. I have carefully mapped out every inch of your journey through this day, even though much of it may feel haphazard. Because the world is in a fallen condition, things always seem to be unraveling around the edges. Expect to find trouble in this day. At the same time, trust that My way is perfect, even in the midst of such messy imperfection. Stay conscious of Me as you go through this day, remembering that I never leave your side. Let the Holy Spirit guide you step by step, protecting you from unnecessary trials and equipping you to get through whatever must be endured." These words were numbing to me knowing the number of miles that I needed to cover. I knew I had a long day, 16.3 miles total to reach Daleville, U.S.220 and Howard Johnson. I had added an extra mile to the day since I had elected to stay on the knob and not go to the shelter last night. I was on the trail at 6:20am and was sweating by 6:30am. The early morning forecast called for a high of 97*F, so I knew I just had to pace myself, keep hydrating and not worry about my speed. I had all day to get to the Howard Johnson and the 3 Little Pigs. There was one slight problem with which I had to contend, there was no water source indicated on my guide for the last 9 miles into Daleville. Knowing this, I made a concerted effort to drink while I could, stopping when necessary and mixing my Gatorade and NUUN drink and taking my potassium tablets. The morning hike was uneventful, I was along Tinker Cliffs around 9:30am after hiking 5.4 miles. The trail actually goes along these cliffs and looks back west/ northwest toward McAfee Knob. I can't imagine hiking this at night with just a head lamp on. I was feeling OK, I stopped and ate since I had skipped breakfast and had only been snacking on raisins and almonds. After strapping on my pack, I was off again with 10.9 miles to go. The terrain through this area is not bad, some ups and downs along the rocks but for the most part I was under the canopy of the shade of the trees. Right after Lambert's Meadow shelter was the last water source. I drank as much as I could directly from the spring, loaded up my 3 liter bladder in my back pack, my two 700 ml water bottles, took several potassium tablets and a Motrin. I was totally drenched in sweat, I could have wrung sweat out of my pants. I was adding a lot of weight with this amount of water but I also had a bunch of miles to go and I wanted to stay hydrated. Even at this point, I was feeling OK and was not fatigued. Around 2:00pm, as I approached the Hay Rock area ( 12.3 miles from the knob) I encountered my first signs of cramping, starting in my hands. It has been starting there first because I am holding on to the trekking poles and do not get a lot of movement in the hands. I still felt OK, I only had 4 more miles, a little more than 2 hours and I was doing just fine. Just to be safe, I continued to drink Gatorade every 15 minutes and took several breaks sitting down on rocks. All I could think of was getting to the HoJo, showering, getting something cold to drink and eating. As you progressed on the trail toward Daleville, you go under high voltage power lines five times. That was a good mental game, keeping track of how many I had transversed under and calculating the remaining miles. Finally, I crossed the final power line, crossed the railroad track and the concrete bridge over the creek and I knew I only had 0.7 miles left, so I really perked up. I walked another 0.5 mile from the bridge and observed that the exit from the trail at U.S. 220 was up a hill on a old, gravel road. It was 4:00pm and I told myself just sit down and rest for a minute and we will be there by 4:30. I was beginning to feel tired, not so much cramping but just fatigued. There was nothing to sit on so I just sat down in the middle of the road, leaning up against my pack. After a few minutes severe cramping began in my hands, forearms and calves. The cramping was more like the muscle was pulling taut and I would have to take my hand and straighten it out. The pain in the left leg calf muscle began to be excruciating, so much so I would yell out every time it pulled tight. Every time it would do that I would dig my left heel into the ground, flex my foot and attempt to stretch the calf muscle. Soon, after doing this several times I was laying on my back on the ground and had no leverage with my heel. I told myself that this was not good and that I was in trouble. Never, in all the years that I had experienced this had it hurt the way it was currently hurting. I convinced myself that I needed to get up and into an air conditioning environment and get some additional liquids in me quickly. However, I could not move; I could not rollover and I could not lift myself up. It was now 4:30pm and I had been there 30 minutes without seeing any hikers. I knew Cog was behind me because I had seen him at the last water stop and he had said he was going to the Super 8 to spend the night. However, as I looked up and down the road, I could not see any white blazes, so I wondered to myself, if I was even on the trail? At 4:45pm, I had no other option but to call 911. I could not move to get up and the cramping was getting worse and not better. I was able to get my telephone out of my pouch and turn it on, even though my hands were cramping. I called 911 and told the operator my situation. I told her about the last landmark that I had passed, the bridge, but that I was not totally certain if I was on the trail. During this time I had to lay the phone on the ground because I could not hold it and I had to apologize to her for yelling as my calf would pull tight. She had to transfer me to the Botetourt County EMS and I had to go through my situation with them as well. At 5:10pm, I saw one of the responders walking down the hill and he asked me if I had called 911. I am laying there, in evident pain, gripping whatever muscles I could, yelping out in pain every 1-2 minutes and I said, "yes." Soon, there were several men surrounding me, they were unable to get a vehicle down the road, so they had to carry me up the hill in a cloth stretcher, plus someone else had to carry my back pack. At the top of the hill, the trail exited behind the Howard Johnson, I could not believe I was that close and had this happened. It has taken me over a week to get to U.S. 220 and I am still technically not there yet. They loaded me into a 4 wheel drive pick up truck, sliding me length ways in the back seat. I was able to put my left leg against the door and push down with my heel to relieve some of the cramping of my left calf. From this location, they drove a block down the road to where the ambulance was parked. I was loaded into the ambulance and Ian attempted to get an IV started. However, my arms were cramping to the point that this was most difficult but he finally succeeded. They were never able to get a blood pressure reading because of the arms cramping. My pulse rate at this point was 166 bpm. After they got the IV and oxygen started, Ian asked me what I would like to do. He said that could take me to the HoJo or transport me to a hospital. Knowing that I was in trouble, I asked them to take me to the hospital. So off to Roanoke along I-81 we went. James, another EMS, had to hold up my smelly, left foot the entire way to prevent it from cramping any worst than it was. I appreciated every one's help from the EMS group that assisted me, it was not easy hauling my wet, smelly body out of the woods in 95*F weather. I arrived at Roanoke Memorial and was given quick attention. They were able to start another IV, draw blood and finally gave me a shot of Valium which relaxed my muscles and prevented me from hyperventilating any further. I was hyperventilating which caused anxiety, messing up my blood gases and causes muscle cramping, none of which I needed at the moment. During the first 30 minutes or so, I had 4-5 nurses and the attending ER physician, Dr. Harless, at my side. After the blood test and EKG results came in, Dr. Harless said that I was experiencing hyperkalemia,had acute kidney injury, elevated liver function test results, was dehydrated, lenkocytosis, lactic acidosis and muscle spasm. He said he was admitting me to the hospital until we got this straighten out and under control. My potassium level was 6.1, and from what I have read since Wednesday night, anything above 5.5 can be very detrimental to one's heart. In fact, this was picked up on the T wave on the EKG. All of this has been further confirmed by my two sisters, who serve as my medical staff. Since I had nowhere else to go that evening and I knew that the 3 Little Pigs would be closed that was OK by me to be kept over night. The staff and attending physicians at Memorial were superb. So, not to prolong this any further, I was a very, very ill individual and very, very fortunate and blessed. Certainly it was a blessing to have been in cell phone range and to be brought to a hospital where the staff recognized what was going on. Throughout this whole ordeal, I kept recalling my morning devotions. As Dr. Harless commented to me when he left, "you need to get this under control or the next time they carry you off the trail it will be in a box." I understood. The medical staff concluded that it was multiple events that took place that caused me to experience this. I had been taking one Alleve and when necessary a couple of Motrins during the day. Both of these medicines by themselves are fine, but they each have the potential to effect one's liver. I had been taking the 550mg of potassium gluconate, 4-6 a day, believing I was replenishing my potassium level, which I was but to an extreme. During this journey, I had continued to take my cholesterol medicine, a statin, which can also cause liver issues and muscle cramping. Not because of any one thing but because of the wear and tear on the muscles while hiking all this in combination was felt by Dr. Sweet, the attending physician, and his staff to be the reason I was experiencing this. Fortunately, Megan only lived 3 hours away and she was able to come get me when I was released on Thursday morning. I will recoup another couple of days and will try this venture one more time starting Sunday afternoon. I will not take any of the NSAIDs drugs, only Tylenol if needed. I will alternate between water and Gatorade, as I had been drinking almost all Gatorade and I will cease taking my Vytorin for lowering my cholesterol. The lipid panel test that they ran showed my cholesterol level lower than it has been for years. I am sure that is the result of diet and walking 8-10 hours a day. Additionally, as I did on Tuesday, I will find somewhere to sit for an hour to two in the heat of the day if the temperature and heat index is too high. For those of you that have been praying for my safety, don't think for one minute that your petitions have not been heard and answered. I know that I was very, very fortunate and that this could have had very detrimental results for me and for that I remain very thankful and indebted to you for your prayers. Thank you.