The One with the Surgical Speed Bump [AT Mile 1104.6-1123.9]

Day 90: 7.3 miles from Pine Grove Furnace State Park to James Fry Shelter

Day 91: 12 miles to campsite just outside of Boiling Springs, PA

Day 92: zero miles, aka the day I went to the hospital

Miles total on the Appalachian Trail: 1123.9

The TL;DR Version

The short version of this story is that I am currently off trail for a little bit to recover from having surgery. I am not quitting the trail. I will be back on as soon as I’m not at (as high of a) risk of popping something in my head and causing bleeding/infection. But currently I’m at home in SC, resting and dreaming of the second half of the trail that awaits me. Continue reading for the longer version of this little (OK, not so little, but also not massive) speed bump momentarily delaying my hike.

Returning to the Trail

On day 90, I returned to the trail after spending a week zeroing and slackpacking with my family. I was still on medication from the ear infection I’d been diagnosed with, and was still experiencing headaches, primarily in the left side of my head. But I did what all hikers do and carried on, figuring the headache would go away as the antibiotic did its job.

When my parents dropped me at Pine Grove Furnace State Park, I was reunited with two great trail friends, Pluto and Triple T, who I hadn’t seen in a while. We caught up, I helped Triple T eat the burger and fries he was too full for (he ordered it after completing the half gallon challenge…), and then we took a swim in the lake before hitting the trail. The lake felt absolutely AMAZING! So cool and refreshing. I also met a few other hikers my friends had been hiking with who, obviously, were pretty awesome people.

Since I still wasn’t feeling 100% and got started pretty late (didn’t leave the lake until about four p.m.), I only hiked seven miles to the first shelter where I set up my tent, excitement high for the next day when I hoped to catch more friends in Boiling Springs.

Boiling Springs

The next day, my headache raged the entire 12 miles to town, making hiking pretty miserable. Instead of the whole left side of my head hurting as had been the case the last few days, now the pain was concentrated around my left eye, which hurt slightly to move around. But I sucked it up and hiked to town, angry at the few rock scrambles blocking my path rather than enjoying them as I usually do.

When I finally arrived in Boiling Springs, I was greeted not only by Pluto and Triple T, but also Truffles, Hangman, Cimba, and Pimento, more trail friends I hadn’t seen in weeks. It was so great seeing everyone again and being surrounded by friendly faces. Turned my day right around despite the lingering pain.

Since the next 14 miles of trail were rumored to have no water and no campsites, we decided to spend the night at the campsite just south of town and knock out the waterless section first thing in the morning. Or at least, that was the plan.

The Chaos Begins

When I woke the following morning, my headache and eye pain were more severe than ever. Using the camera on my phone, I realized my left eye was very swollen. It hurt to move, especially to the right and up. I facetimed my mom and we decided I should do a virtual doctor visit because that was pretty quick and easy and had worked for me once pre-trail.

Unfortunately, the virtual doctor said I needed to be seen in person immediately. Which, as a thru-hiker, is much easier said than done. I don’t have a car, and the only medical care place within walking distance was closed because it was Sunday (Father’s Day to be exact. Sorry dad, this definitely didn’t end up being the cheapest Father’s Day). I called the only shuttle driver I could find in my guidebook that served the Boiling Springs area, who said he was busy that morning but could get me later. I said I’d keep looking and call him back if I couldn’t find anyone else. My only other option was Lisa’s Hostel, the only hostel in town. According to the guidebook, they didn’t offer shuttle services, but I figured I’d call and ask just in case they were willing to help.

When Lisa answered, I explained my situation and said I knew they weren’t a shuttle service so I understood if they were too busy to help. She asked me to hold for a minute, before returning to say that her husband Shawn could pick me up in 30 minutes. After thanking her, I hung up and threw all my stuff in my backpack (who I’ve named Clifford by the way, because my pack is big and red like the beloved children’s character). Shawn arrived right on time and drove me to the urgent care center 15 minutes away. And didn’t charge me a cent even though I offered to pay him whatever he thought was fair. I thanked him over and over, so grateful for him taking time out of his day to give me a ride even though that wasn’t included in their usual services (and I hadn’t even stayed with them the night before).

The urgent care wasn’t busy at all, and I was called back to a room very quickly. I should’ve known it was too good to be true. The doctor examined me, and demanded that I go to the emergency room immediately. She said I needed blood tests and a CT scan to figure out what was going on inside my head to cause such swelling and pain in my eye. We also learned that I had slightly blurry and double vision in said eye, which further concerned the doctor. The doctor asked how I planned on getting to the ER, and if I needed an ambulance called. I definitely didn’t want all the trouble and expense of an ambulance, so I texted the shuttle driver I’d called earlier and prayed he’d be able to pick me up (I didn’t want to bother Lisa and Shawn again, as I figured they were plenty busy running their hostel). Thankfully, he said he’d be there in 10. No ambulance for me. Yet.

Strike Three

I waited for five hours in the emergency room before finally being called back to be examined. During that time, however, Lisa from the hostel texted and offered me a place to stay that night at a reduced rate. I thanked her and said I would really appreciate that—it was so relieving to know I had somewhere to go when the I finished at the hospital, that I wouldn’t just be dumped on the street. Because at the time, I still thought I’d be in and out of the hospital relatively quickly. They’d look at me, give me a stronger dose of antibiotics, and I’d be on my way. Which ended up being the exact opposite of what happened.

Eventually my name was called, and I exited the waiting room to finally be examined. Under the guidance of an excellent PA named Joey, the nurses drew blood for tests and started me on IV fluids (Joey said she always puts hikers on fluids, ’cause we’re all at least a little dehydrated). I also was taken for a CT scan, and Joey discussed the results with me after they came through.

She explained that I had some kind of mass in my left ethmoid sinus that had eroded the bone between the sinus cavity and the orbit (fancy name for eye cavity) and was now pressing on the ocular muscle (eye muscle), which was the reason for the pain and swelling in my eye. Possible identities for the mass, as far as she knew (but she admitted that this wasn’t her area of expertise), included infection, a fungus, an amoeba, and cancer. As this was a relatively serious issue, Joey decided I needed to be transferred to a larger hospital with an ENT specialist. Thankfully, I didn’t have to arrange my own ride, as transportation was included with my treatment since the hospital treating me couldn’t fix me. And so I left my third doctor and was transported via ambulance to Hershey Medical Center.

A Long, Long Night

Despite the late hour, lots of tests awaited me at Hershey Medical Center. The absolute worst was when an ENT specialist put a camera up my nose to try to see the mass better. He gave me lidocaine to numb everything up in there, and we joked about the gross taste. I said it wasn’t the worst medicine ever, that that was the liquid form of amoxicillin. To which he replied, “But it tastes like bubble gum!”

“That is the biggest lie you people tell children. Amoxicillin doesn’t taste anything remotely like bubble gum!” I said.

“Sure it does!” he said.

“Have you ever had bubble gum??” I asked skeptically. I got put on the liquid form of amoxicillin many times as a kid before I could swallow pills, and still to this day the slight smell and taste of the pills makes me gag.

At about this point in the conversation, Dr. ENT decided the lidocaine had sufficiently numbed me and began putting the camera up my nose. I was not sufficiently numbed. It was the worst pain I have ever felt in my entire life, and I have a pretty high pain tolerance. Never before have I felt pain so strongly that I involuntarily screamed, but I did when the camera got up toward my sinus cavities.

I don’t blame Dr. ENT, he was actually very patient with me during the whole thing. He pulled the camera out after a few seconds of my screaming (well, I assume it was a few seconds, my memory says it was a couple minutes), and gave me more lidocaine, saying he was sorry, but he really needed to go back in. He said that my nasal passage and sinus cavities are abnormally small and tight, which, coupled with the inflammation from the mass, was increasing the difficulty of maneuvering the camera and therefore also increasing my pain.

After allowing the extra dose of lidocaine time to do its thing, the camera returned to invading my skull, thankfully less painfully this time. It still hurt, and I was pretty traumatized by the first exploration (and it was around midnight so I was exhausted), but finally Dr. ENT got what he needed. He showed me the video afterwards, and I nodded along like I could see what he was pointing to, even though it all just looked like pink stuff to me. It honestly didn’t sound to me like he’d actually gotten the pictures he wanted, because he said couldn’t get to the place he needed to be. But I didn’t offer to let him try again, and he didn’t ask.

Sometime after Dr. ENT left with his torture device, an eye doctor (I’m not even going to pretend I know how to spell the correct term) came to check out my left eye and evaluate what damage the unknown mass had done. Thankfully, after dilation and lots of bright lights, the doctor announced that the mass was pressing against my ocular muscle but had caused no damage to it yet, and that my optic nerve was completely unaffected so far. And even more thankfully, Eye Doc was the last set of tests I had to endure before morning (he finished with me around 2 a.m.).

Diagnosis and Surgery

My parents arrived around five or six a.m. after driving through the night from our home in South Carolina. After more waiting, the ENT attending doctor (the head honcho guy of the ENT department) arrived to finally explain what was in my head.

He said I had what was called a mucous seal in my ethmoid sinus, which was, from what I understood of his medical speech, essentially a sinus infection that got trapped in my sinus cavity because all my passages up in there are freakin’ tiny. This was literally the best case scenario of all the possible things the mass could’ve been.

Unfortunately, it did require surgery for removal, but they were able to squeeze me in the next morning and the surgery went very smoothly. All of the fluid mass was removed. They made me stay overnight for observation and insurance reasons that I don’t understand, but I was finally discharged from the hospital four days after entering.

Back to SC…For Now

After being discharged, I returned with my parents to SC because the doctor said I can’t hike right away because too much straining/pressure could pop blood vessels in my nose/sinus cavity, or rupture the small bone between my sinus cavity and brain cavity causing major infection, or lots of other unpleasant things. I’m scheduled to return to PA July 2nd so the doctor can check everything out and make sure I’m healing properly, and I will be back on trail shortly thereafter. For now, I’m trying to rest and allow myself to heal, but I’m not very good at resting. So we’ll see how the next few days go.

Surrounded by Support

So far throughout my hike I’ve shared many stories about the amazingness of the trail community, and I want to take a quick moment to hit that topic again. First off, Lisa from Lisa’s Hostel in Boiling Springs did not end her kindness with offering me a place to stay for a discount. She also offered to come visit me in the hospital and bring whatever I needed, and let my parents stay at the hostel for a discounted rate. She’s never met me, we only spoke briefly on the phone and I rode in the car with her husband for 15 minutes. But she was willing to go way out of her way to help me if needed.

I also had so many trail friends texting to check on me, offering to come stay in the hospital with me until my family came, to bring me whatever I needed. If any of y’all read this, I am so thankful for each of you. Though I was a long way from home, I was never alone. If I needed anything, so many people had my back. Which makes having an unknown mass in your face a lot easier to deal with. So thanks guys. Y’all are the best.

So I’m home unexpectedly early, less miles under my belt than I thought I’d have when I returned to my own bed. But this is only a speed bump slowing me down, not a stop sign.

I will summit Katahdin, just a week or two later than I anticipated. And maybe I can hike faster now that I’m more ultralight—no more fluid mass in my face to weigh me down. Every ounce counts!