Selflessness

The NPS likes to stress this point as often as possible.

The NPS likes to stress this point as often as possible.

On Sunday, September 15, 2013 I had the privilege of joining Rob Miller and Crystal Hall in a rim-to-rim hike across the Grand Canyon. But, more importantly, I had the privilege of experiencing true acts of selflessness.

Our day started early, waking at 4:00 AM. We had boldly reasoned that we would stay on east coast time and be able to get up at that hour and be chipper and ready to go. We were wrong. None of us slept well. It turned out to be worst on my friend Dave who was joining us as well. He lives in Phoenix and normally sleeps much later than that. He felt so bad from the lack of sleep that he determined it to be in his best interest to forego the hike. Though we felt bad that he would miss out, we totally respected his decision. It was a shame too because this was his first time meeting Crystal and Rob and we had all gotten along so well the day before that we knew we all “clicked” together.

We caught the hiker shuttle at about 5:15 AM and we were off to the South Kaibab trailhead. After arriving and doing our final preparations, we were on the trail by 5:45. The trip down was mostly uneventful . The only exception being that Crystal twisted her ankle about two hours in, but she was determined to not let this stop her. We reached the bottom around 9:30. We made a brief stop on the sandy banks of the Colorado to allow Crystal the opportunity to feel the river. From there we continued on to Phantom Ranch, arriving at 9:45. We stopped briefly to rest, eat lunch, and fill up our water.

The hike on the North Kaibab out of Phantom Ranch is a relatively flat hike for several miles. I say relatively because it only gains around 2,500 feet of elevation in the first nine miles. In contrast it gains over 3,200 feet over the final four and a half miles. The first portion of the hike is through a narrow section of canyon that offers alternating shade and sunshine. This allowed us brief opportunities to stay cool. The next section of the trail did not offer such luxuries. The next several miles were spent with few opportunities to escape the sun as the temperature climbed to 94F. We did eventually find a small stream that we were able to use to cool off. It was at this point that my fatigue started to manifest. Rather than dip my feet in the cool water, I chose to lay in the shade with a bandana that had been soaked in the stream on my forehead. Right about the time we were ready to get moving again some dark clouds that we were hoping to catch up to for some shade decided to gift us with a brief period of rain. Luckily the rain was light and we didn’t have to break out the rain gear.

Upon finally reaching the turn off to Ribbon Falls (a part of the trip we had been so looking forward to), it became evident to all of us that we were more interested in getting on with the hike than taking the half mile detour to enjoy the falls. It was a unanimous decision to bypass the falls. We pressed on.

Once we reached Roaring Springs, it was time to really start the uphill portion of the trail. It quickly became evident that my fatigue was getting the better of me. It had gotten to the point that I was resting as much as I was hiking. Crystal and Rob, in an effort to lighten my load, insisted that I allow Rob to take some of the weight from my pack. I initially declined, but relented the second time. I really didn’t have that many heavy items in my pack. I wound up transferring my water pump/filter (I had packed it just in case of a failure of the normally available drinking water sources), my clean change of clothes, and a bag with most of my food to Rob’s pack. I wish I could say this act of selflessness was the last necessary one for the trip.

Something I hadn’t mentioned to either of my fellow hikers was the fact that I had been nauseated for several hours. I had been drinking water the entire time, but as the hike progressed I had eaten less and less after our lunch break. In an effort to at least keep some salt in me, I had taken to sucking on some pretzel nuggets I was carrying in my pocket.

At this point while Rob had been staying back with me, Crystal had hiked on ahead. Even though she had previously been the one most worried about making it, she was feeling great. It didn’t make sense for her to stay back with me if she could use her energy and growing self-confidence to make it out ahead of us and get the room at the lodge and maybe even find a ride to come back to the trailhead to pick us up. An important note here is that it is 1.7 miles from the North Kaibab trailhead to the lodge on the North Rim.

At about 4:00 PM is when things really started to unravel. As I was bent over resting, I threw up. There really wasn’t much to it. It was almost completely liquid. Once I had stopped retching I remember looking up and saying to Rob, “Well, that’s not good.” Even after this, we did continue on for a bit, but I could tell things were not right. I then told Rob that I thought it best that he should go and catch up with Crystal and tell her that once she reaches the lodge to call the park rangers and let them know that I was in distress, that I had vomited on the trail and was nauseous, but still attempting to slowly hike out.

I assumed he would catch her pretty quickly and I said that I would eventually meet up with him where he caught up with her. He took off at a very quick pace and I continued to struggle up the trail. My pace had slowed such that I was resting more than I was hiking at this point. I did eventually make it past the Redwall Bridge, the next to last major landmark northbound on the North Kaibab. Since first throwing up, I had been drinking more of my water and it seemed like it was staying down. That held true until I decided to suck on another pretzel. Almost as soon as that salty delight touched my tongue, I was bent over literally spilling my guts again. This time, it was all liquid.

It was now after 6:30 PM and I had reached about 6,300 feet in elevation. The sun was setting, the air was growing colder, and what had earlier been a pleasant breeze was becoming a bone chilling wind. I stopped to rest and took the opportunity to zip the legs back onto my pants and put on my warmer hat and headlamp.  My pace had slowed such that I required several minutes of seated rest after only a minute or two of actual hiking. I was tired and getting weaker. I kept thinking I would happen upon Rob sitting on a rock patiently waiting for me, but it hadn’t happened and I couldn’t continue. I did try yelling his name a few times, but the only replies were the echoes of my calls from the canyon walls.

By 7:00 I found myself at the corner of a switchback that had some nice big rocks that were well placed for blocking the wind. It was here that I decided I would stop. I was thinking that maybe if I could get an extended rest I would feel better and could make it out on my own. I moved some small rocks out of the way and managed to create a space where I could lay down and have most of my upper body out of the wind. One of the items I had made sure to have in my pack was an emergency space blanket (it unfolds into a five foot by eight foot sheet of what seems like very thin aluminum foil). I grabbed it and eventually had myself wrapped in it trying to stay warm. I laid back and tried to relax and see if my body would respond well to an extended rest period.

Trying to relax, however, was a struggle for several reasons. Obviously there were the physical issues. The ground was cold and rocky. I was still nauseous. And even though the space blanket did help, I was still chilled. Then there were the mental and emotional aspects to deal with. I had no idea when/if someone may be coming. Had Rob caught Crystal at all? Was he waiting further up the trail? Had either of them made it to the lodge yet? Had the rangers told them there was nothing they could or would do at this time? Assuming no one comes, what are my next steps? Will I be able to rest enough to feel better? I worked hard to remain calm. I did find myself able to drift off and actually sleep a couple of times. Unfortunately I also vomited two more times. I had no idea what time it was. I was purposely avoiding checking the time. I didn’t want to become demoralized if time wasn’t passing as I felt it was. I did have the forethought at one point to pull out my phone and disable the passcode lock on it. Should I be found unconscious or incoherent this would allow someone who found me to at least access my contacts and find whom they may need to contact.

Even though I did have spare batteries for my headlamp, I had turned it off to save the current ones. Being alone in the dark is a surreal experience. Several times I thought I heard the telltale sound of trekking poles, but none of these ever manifested into an actual person on the trail.

I had no idea what time it was when I looked up and saw a headlamp heading down the trail toward me. The figure called out “Todd?” I responded “Yes.” It was a park ranger and he introduced himself to me as Jamie. He immediately began a cursory assessment of my condition and then sat down in a rock across from me. He told me that I was only about 50 yards from the Supai Tunnel and his initial plan had been to move me up there. However, based on my current condition he decided that I was in no shape to move. He called into his dispatch to let them know that he had reached me and that based on my condition they needed to dispatch a park medic. He then let me know that it would probably be an hour and a half to two hours before the medic could make it down to me. He attempted to make me more comfortable by offering me a jacket to help stay warm and an MRE from his pack to use as a makeshift pillow. He let me know that Rob and Crystal had made it out and he had spoken to them both and he also asked his dispatch to contact them at the lodge and relay that I had been located and was being cared for. It was just after 10:00 PM. I had been here for three hours.

Over the next hour and a half Jamie and I talked quite a bit. Doing so kept me in good spirits and he had all kinds of interesting stories to tell. I attempted to lay down and rest a few times, but I wound up throwing up twice more during the wait.

Around 11:30 PM the park medic, Brian, arrived. It became obvious that he and Jamie worked together and knew each other well. They were both professional, but were keeping things as light as possible for my benefit. When Brian arrived he completed his own initial assessment of my condition as well as collecting my vitals and then informed me of his game plan. He would give me a dose (or more, if needed) of the anti-nausea medicine Zofran as well as getting me started on a saline IV with the goal of my hiking out under my own power by 4:00 AM. I thought this to be a pretty audacious goal, but he said it with such confidence, I bought into it as well. He gave me my initial dose of Zofran. It was a small tablet that I was supposed to let dissolve on my tongue. It had a taste reminiscent of cotton candy but with an orange flavor. While waiting to see how well the Zofran would work, he and Jamie set about getting the IV started. The IV turned interesting when, upon inserting the needle, blood started pouring out of the puncture and running down my arm onto the space blanket. But it quickly stopped and the saline was flowing. I still think this a great feat considering it was being done with headlamps in windy, cold conditions. Brian also offered me an additional jacket to help keep warm, which I gladly accepted. 15 minutes following the initial Zofran I was asked to rate my previous and current nausea on a scale of zero to ten. I stated my previous to be a seven and current to be a two. Based on this I was given a second dose. 15 minutes following this second dose I was asked to rate my nausea again. This time I was happy to report it as a zero. Brian and Jamie offered me food from their own packs to see if I could handle it and keep something down. My choice? Oreos. Which Brian decided sounded good to him as well, so he joined me in having one.

I don’t recall how much longer I sat there after that waiting on the IV to finish, but I was feeling better and better by the minute. Brian and Jamie were relaxed and cracking wise which gave me the confidence that they felt I had made it over the hump. After 600cc of saline Brian decided I had had enough and proceeded to remove the IV. One of the other issues I had mentioned to them earlier was a hitch in my right knee caused by my IT band issues. They offered to wrap it with an ace bandage and also rub down my legs to help limber up and get the blood flowing after having sat there for over five hours.

We all agreed it was time that I could try to get going. I felt good, much better than I had felt since much earlier in the day. They informed me that the remaining hike out was approximately two miles. Jamie would be carrying my backpack so that I would only be burdened with the weight of my own body. If I had to guess, I would say we left around 12:15 AM. We made a brief stop at the toilets just past the Supai Tunnel and then continued on. During the hike out Jamie, Brian and I continued to keep up a lively conversation and they kept me informed of the progress we were making. I was feeling well enough that we only took four short breaks over the rest of the hike. I successfully completed my rim-to-rim hike at approximately 1:30 AM, almost 20 hours after we had started and well ahead of Brian’s 4:00 AM goal.

Once we reached the trailhead, Brian had me get in his truck for the ride to the lodge. Our first stop once we reached the lodge was the main lobby. Brian was required to call in to the Park Service’s on-call doctor in Fresno and relay the information about my condition to him. It is standard procedure that anyone rescued from the Canyon is supposed to be transported on to a medical facility. However I was advised that I could choose to not do so as long as I signed the form saying I was doing so against medical advice, which I did. After this they escorted me to our room at the lodge where I was greeted by a grateful Crystal and Rob. Before letting Brian and Jamie leave, I took a moment to personally thank them again for their assistance and shake their hands. I don’t believe I could have been in more capable hands.

Once I was in the cabin with Rob and Crystal, I relayed all of the above that occurred after Rob had left me and they told what had transpired for each of them. It turned out that Crystal had made excellent progress and it took Rob quite a while to almost catch up to her. He managed to relay my issues to her at a point where he was several switchbacks below her. Unfortunately Rob had pushed so hard to catch up with her that he was now having issues of his own, specifically his legs were starting to cramp up. At this point, without a map and based on information from Crystal, he was under the impression that it only another 30 minutes to hike out.  He agonized over the decision, but decided to hike on out hoping to have cell signal as he approached the top.

Crystal had reached the top a little after 7:00 PM. Not knowing exactly what to do or how to reach the rangers she had turned on her phone and was hoping to call 911. But, being an AT&T customer, she was out of luck as they don’t have any coverage at the North Rim. With a 1.7 mile hike looming ahead of her, she flagged down the first car that passed. As luck would have it, it was a park ranger named Jessica Pope who was just returning from her own vacation. She calmed Crystal down and took her to the backcountry office hoping she would have signal there, but she didn’t.  So she gave Crystal her phone to make the call.  Jessica then, voluntarily, took Crystal to the lodge and then returned to the trailhead to pick up Rob who had already emerged and was waiting there.  He didn’t have cell service at this point either and figured this to be the best spot to wait so as not to miss anyone. Based on Crystal’s report, the rangers were hesitant to proceed with any action. They wanted to speak with Rob since he had been the last person to actually see me and understand my condition. Once Rob arrived and answered all of their questions they agreed to provide assistance. By this time it was 8:00 PM and at least Rob and Crystal knew help was on the way to me and they did the only thing they could at that point, wait.  Jamie made sure to have dispatch relay back to them major updates as they occurred.

Was I worried and scared as I sat alone in the cold and dark that evening? You bet your ass I was. But, it was due to the selfless acts of my friends Rob and Crystal that everything turned out as well as it did. I feel bad for having put them through the stress and worry as they waited to hear back or for me to arrive. This is something that will stay with me forever and I will always consider myself in debt to them.  I’m sure others will see fault in what happened during this little adventure (e.g. we should have stayed together the whole time and only one should’ve gone ahead for help, etc.)  But, speaking from my position, I think things worked out fine given the conditions and I am supremely happy to be none the worse for the wear thanks to my friends.

I also want to say that are no finer examples of public servants than Jessica Pope, Jamie Westfelder, and Brian Watson of the National Park Service. They went above and beyond the call of duty in being professional, caring, and empathetic.  As we were hiking out, I asked about how the budget sequestration had affected them.  They said that it had kept them from hiring seasonal rangers and their ability to upgrade some equipment.  I consider this a travesty.  These people are out there, helping to maintain our public treasures and keeping visitors like us safe.  They deserve better.

Happier times before the hike started.

At the South Kaibab trailhead.

Almost there

I’m writing this post from the plane on my way to Arizona. This is the weekend of my big hike. My penultimate quest for my recovery is to be able to hike across the Grand Canyon. Based on my training hikes, I’m feeling good about this trip. This is my first trip back to the canyon in several years, but this is, by far, the best shape I’ve been in for a canyon hike since I moved to North Carolina eight years ago.

Catching up

It’s definitely been a while since I posted anything, but I really didn’t have much to post recently.  I successfully completed the training hike I mentioned in my previous post.  Though I was really wiped out by the end of it.  Still, it felt great to be out and to have accomplished that.  It made me feel much more confident about completing the Grand Canyon hike.

I was on vacation a few weeks ago and during that I time I got to have dinner with Kerri and Bryce again.  I had a nice discussion with them about whether or not I would like to meet my recipient.  And following that discussion I thought about it some more and I have decided to do it.  Regardless of how the meeting actually goes, it will give me an opportunity for closure.  As for other kidney related items.  I’m still doing great.  I still only have a slight area of numbness and my scars are still a little tight, but nothing I can’t live with.  I did call my transplant coordinator yesterday and spoke at great length.  My recipient is doing great (he was actually coming yesterday for his check-up).  I let her know that I would like to meet him, but not until after my Grand Canyon hike.  She said we could arrange something for October.  She also said that we both needed to complete a questionnaire prior to our meeting.  I’m not entirely sure of the questions or the purpose of it, but I’m sure it’s to protect both our interests.

In addition to discussing that with her, I also offered to volunteer to provide whatever support or advocacy I could to others.  She asked if I was interested in the Transplant Center’s patient advisory council she had mentioned previously and I said “Definitely.”  She is also going to put me in touch with someone from LifeShare of the Carolinas.  It will be interesting to see what, if anything, comes of that.

Nine weeks

Today marks nine weeks post surgery.  Not much new to report.  I went hiking again this past Sunday as part of our training for the Grand Canyon hike in September.  We did Mt. Mitchell which is the highest point in North Carolina.  To simulate the Grand Canyon experience, we started at the peak (~6600 feet) and hiked down to a campground that was at 3200 feet elevation and then hiked back out.  I did pretty well, I was pretty tired at the end though and I think the elevation near the top had a lot to do with it.  I still need to work on my stamina and energy, but I felt accomplished having completed this hike.

Eight weeks

Today marks eight weeks since my donor surgery.  I went for my first get back into shape/training hike two days ago.  It felt good to be out.  However, due to my previous lack of activity I was definitely winded earlier than I should have been for some portions of the trail, but I managed to keep up with my hiking partner, Rob.  I was also very, very sore in the aftermath of the hike.

Other than that, there’s not a lot to report.  I’m still feeling better and better.  I’m hesitant to call myself 100% back, but I think I’m very close.  I was tempted to call my coordinator yesterday and tell how good I was feeling, but I didn’t.

Labs

The lab results are back from my second follow up and everything looks great.  My creatinine levels are really good, so my lone kidney has picked up the slack.

Second follow up

As promised, here are the updates from my second follow up appointment earlier today.  First I met with my surgeon, everything checked out fine and my restrictions have been lifted.  I can now resume all normal activities, and that I just need to listen to my body and not overdo it.  They did take blood and urine samples to run labs on to make sure all is truly well.  I should have the results from those tomorrow.

Following that I met with my coordinator and got an update on my recipient.  He’s doing well and is getting back to his normal activities.  He apparently is an outdoorsman who enjoys fishing.  She did say that he mentioned wanting to meet me and I let her know I’m still on the fence about whether or not I would want to do that.  Additionally she asked about my whole thoughts on the experience.  And I let her know that I gladly tell anyone about my experience.  I told her how valuable it had been for me to have Kerri’s donor Amy available to answer my questions along the way.  She then asked if she could use me in that fashion for future donors and I said I would be happy to do so.  She also offered other opportunities for me to help.  She said they have a patient advisory council for the transplant with whom they consult on different topics and that I would be more than welcome to participate in that.  She also mentioned that, assuming it’s successful, would love to use my Grand Canyon hike story as well, possibly even through the hospital’s press/PR department.  She also gave me some goodies.

SWAG

My next follow up appointment won’t be until early December, six months post surgery.

Testing, testing

Today I decided to test things a little and see where I’m at physically.  I did one pull-up and a few push-ups.  Hanging for the pull-up, I could still feel the tension around the large incision.  But, other than that things felt okay.  I felt really out of shape after, meaning I’ve got a lot of work to do.