Getting MRSA While Thru-Hiking
Warning: This article discusses my treatment of a serious MRSA skin infection. If you may be sensitive to medical topics, please pass on reading this one!
It all started in Shenandoah. It was a beautiful summer afternoon and I had just run into my friend “Jon with no H” for the first time since the Smokies. In the previous 72 hours, I had arranged visits with one of my closest friends, brother and sister-in-law, and sister. I had visited my first waysider in the Shennies, and finally got to taste one of those famous blackberry milkshakes. The 900 mile marker was just ahead of me, and I was feeling great. Until, I felt immediate pain on my calf, looking down to see a yellow jacket stinging me. I had been stung by bees before, sure, but the pain of the yellow jacket sting felt unreal. You see, unlike bees, yellow jackets don’t leave their stinger in you, rather, the stinger stays attached to them, meaning you can get stung multiple times from a singular bug.
Naturally, I turned to Google to see how to treat my throbbing leg. Unfortunately, I hadn’t packed meat tenderizer in my thru-hiking kit and had to settle for a few doses of Benadryl I had with me. 36 hours after the initial sting, I had a giant, fluid filled blister on my leg at the site of the sting. The blister, approximately three to four inches long and at least one inch high had me spiraling. I was so afraid that it would pop either when I was hiking, or while I was sleeping. One afternoon, I had squatted down to pick something up at lunch, and it popped on its own. I was so relieved! I cleaned it off really well with alcohol wipes and applied antibiotic ointment, covered it with several bandaids, and went about my day. The next evening, I got into town and was glad to take a shower and clean it off properly.
I was glad to be done with the whole ordeal. Little did I know that this was just the beginning.
Taking a Turn for the Ugly
Over the next two weeks, I didn’t really think about my sting. After it popped, the skin underneath the looked red, but it didn’t alarm me as I figured it was raw, new skin forming. I was able to hike good mileage, and was successful in completing the Half Gallon Challenge. Then the white spots showed up. Large whiteheads appeared, and localized pain reared its head. The pain so bad, that it was waking me up at night, interrupting my already poor sleep on trail. My hiking partner and I had decided we had no choice but to see a doctor.
We hiked four miles into Boiling Spring, PA the next morning, and got a shuttle to an urgent care clinic. The doctor took one look at it, immediately said it was infected, and prescribed me a broad-spectrum oral antibiotic. He also gave me a tetanus shot, swabbed a culture, and checked to make sure there wasn’t an abscess formed. Luckily there wasn’t, and he said that my leg would take three to four days to start looking better, but made it clear, if it got worse, I had to go back to the doctor. I filled my prescription across the street, and spent the weekend at my brother’s house, who lives somewhat locally.
The pain over the next day was awful, bringing me to tears. I counted down until I could take my next dose of high strength ibuprofen. When I peeled back my bandage the following morning, my wound looked worse, with a small black spot. I took my brother’s car to a local urgent care, where the doctor assured me that everything was fine, and that the antibiotic I was on was appropriate. In fact, he explained that the reason I had not scabbed up was because I had been wearing a bandaid, so when I got to camp, I needed to let my leg breathe.
24 hours later, I was in the Emergency Room.
From Bad to Worse
The pain in my leg continued, to the point where I was limping to the bathroom at the hostel. I was in no condition to hike. My hiking partner (God bless him) peeled back my bandage and told me I shouldn’t look, knowing that I was already going down a rabbit hole of scary thoughts. My wound had grown significantly bigger in 24 hours. After consulting with a retired doctor turned section hiker/trail angel, he advised us to go directly to the hospital.
Within about two hours of being seen in the Emergency Room, I was put on three different IV antibiotics and learned that I would have to stay the night in observation to make sure my body was responding to medicine. I was told that surgery would be consulted, and thought, “oh crap, surgery?? This is a lot worse than I thought.” Luckily, this did not mean actual surgery, rather, surgeons who are trained in opening wounds would have to open the fluid filled abscesses that had formed under my skin to let the infection drain out. This was done as a bedside procedure on two spots on my leg (although I had the procedure done three times total, as an over-eager Emergency Room doctor preformed it first, and incorrectly, so it had to be corrected by the surgeons). The wounds had to be “packed,” meaning strips of gauze were inserted to wick out the infected fluid. Thankfully, the first round of packing helped a ton, and additional did not have to be placed after leaving the hospital (as the doctors initially instructed). The surgeons took great care of me and made sure I was in as little pain as possible. Still, these procedures were super uncomfortable, at best. As the doctors explained it, the oral antibiotic I had been taking is effective in treating my type of infection. However, the IV antibiotics work much deeper, and the draining of the abscesses is the key to letting the infection out.
I was released from the hospital the next afternoon with a prescription for a different oral antibiotic. I had instructions on when I could return to the trail, and a follow-up appointment with the surgeon scheduled. I got a call from the hospital a couple of days later confirming what everyone had been suspicious of all along: my cultures tested positive for MRSA.
MRSA… What Now?
MRSA is a serious Staph infection that is difficult to treat because it is resistant to many antibiotics. Over the next two weeks, I was diligent to change my wound dressings daily and set alarms to take my antibiotics. All in all, I ended up taking twelve full zeros before getting back on trail. I took lots of naps, visited with family, and explored the Harrisburg area. I went to the follow up appointment at the surgeon’s office in my hiking clothes, and when he gave me the all clear, I got back on trail in Boiling Springs that afternoon. Another patient in the waiting room saw our packs and recognized us as thru hikers and even gave us a ride back to trail. My instructions were simple: continue taking the course of antibiotics until they run out, and “wash” the wound on trail. Luckily, my surgeon and his team were familiar with the Trail, and the realities of keeping things clean (or lack thereof) in the woods. Each morning before hiking, my hiking partner would help me rinse suds of Dr. Bronner’s unscented soap over my wounds (away from the water source, of course), pat dry with a clean piece of gauze, and apply a new bandage. My wounds did not scab up until midway through New York, so this was part of the daily routine for weeks.
Everything was looking good…until it wasn’t. I finished my last dose of antibiotics, and 48 hours later, my wound was looking bad again. I called the nurse at the surgeon’s office and sent her photos of my leg, and heard a familiar tune: I needed to get off trail and go back to a doctor. Once again, I got shuttled to an urgent care, and got prescribed yet another antibiotic. This doctor was very sympathetic to the whole ordeal, and took a swab of my leg just out of precaution. I’m glad she did, because a couple of days later, when taking a snack break on top of a mountain, I got another call: the culture came back and while MRSA was no longer infected my leg, I had picked up a secondary infection, likely while in the hospital. You guessed it, the antibiotic I was currently on did not cover the new infection, so I had to get off trail again to pick up my new prescription in town.
All in all, I visited three urgent cares, took eight antibiotics, had my leg cut three times to drain abscesses, and saw countless doctors and nurses in a span of about three weeks. After weeks of being afraid my infection would come back, and I would be forced off trail again (potentially permanently), I felt a rush of relief wash over me when my wounds finally scabbed up, and furthermore, when the scabs fell off and minor scars were the only indication of the previous two months. Sure, having a potentially life-threatening MRSA infection during my thru hike was not what I had planned. However, I choose to see the positives that came out of it, and how much different it could have gone.
I’m thankful this happened where it did on trail, where I was able to take Ubers to and from the hospital, and also an area with an abundance of shuttle drivers. I’m thankful to have a brother who is a physician specializing in infectious diseases who was okay with daily photos texted to him of my open, draining wounds to assure me it looked like it was healing normally. I’m thankful that I got to rest my body at the exact halfway point of a 2,200-mile journey. I’m thankful my surgeon’s best friend thru hiked in 2022 so he was familiar with the realities of the trail. I’m thankful that in the several weeks I had open wounds, it didn’t rain a single day while I was back on trail, allowing my bandages to stay dry, in what is otherwise known as one of the rainiest AT years to date. I’m thankful that I did not wait any longer to go to the hospital, knowing the outcome could have been significantly worse had I waited only another day or two. I’m thankful that in October, I summited Mount Katahdin, with only two small scars, completing all 2198.4 miles of the trail. Anyone who completes a thru hike has overcome some adversity during their trek. That’s why touching that sign means so much. I knew I was tough before this, but the scars on my legs, physical depictions of my saga with MRSA, made Katahdin so much sweeter. I had to fight to earn my spot on Momma K. So I’m thankful for it all, including the scars.
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