Clinic Stories

The End of the Earth - Part 6

The Recovery

More on Dr. Morris's Yukon River Trip

All along this trip I knew I was my own enemy, pushing too hard in the face of dangerous conditions and too long with constant daylight, not resting nearly enough. I resolved by the third day that I can never undertake another trip of this type without a guide or companion to keep me sane. The after effects provided an exclamation point to this resolution.

First, an inventory of my condition: at the end I had no feeling in any of my toes nor in my fingertips, my face was cracked, scabbed and flaking from sun burn and I was profoundly exhausted. What I thought was nausea, possibly from motion sickness, continued. The first night home I awoke in the morning with no energy, stayed up for an hour or so and went back to sleep. The next three days I rested and gradually regained my strength. Then an unexpected condition emerged. An hour after going to sleep I woke to tremendous pain in both feet as if they were being stuck with a thousand needles. My first thought was gout but I am an unlikely candidate for it. In the morning I made an appointment with a podiatrist friend who confirmed that I had decreased sensation in my toes though the feeling was returning and I did not have gout. He suggested that with signs of peripheral neuropathy I should be checked for diabetes. The next night was just as painful and by the third night it decreased but I could feel the path of every nerve in my feet and sense that the fibers were extending outward. For several days the most subtle things - wearing socks or a watch - would cause loss of feeling in my hands or feet. I checked my own resting blood sugar, high at 178. I made an appointment with my physician.

By the time I saw the physician it was 12 days since I got home, my signs were decreased by 75% and I was back to exercising. None the less I was still recovering and my glucose in the office was 122. The doctor prescribed blood work and I waited a week to recover further. My blood work, including glucose and A1C were normal.

A long list of possibilities for peripheral neuropathy were given focusing on a prediabetic condition or “frost nip”, from exposure to cold and wet conditions. After six weeks I am fully recovered and knowing the pattern of the onset and recovery have a better understanding of what occurred. Here goes:

From the start of the trip it was cold and I was constantly wet, especially my feet. My legs were not moving around and all of my effort was on my upper body. It was also stormy and stressful, I was in warrior mode and I was not resting. To adapt, my body shunted all resources away from my legs and my nerves and leg muscles were simply starved. The nausea resolved gradually and turned out to be inflammation of my abdominal muscles where they attach to the ribs.

In short, my body struggled as best it could to keep up with the demands during the kayak trip, then worked overtime to recover from the exertion.

Next – Advice Ignored and Lessons Learned

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