Friday, June 10, 2016

A Backcountry Accident

Well, I suppose that no proper Alaskan life experience is complete without a life-threatening accident in the backcountry, right?

Memorial Day Weekend 2016 started innocently enough... we gathered provisions and supplies and headed out from Douglas Harbor around 6pm on Friday evening. We were headed to a friend's cabin up the Taku River. This area is located south of Juneau and is surrounded by mountains, glaciers, creeks, wildlife, and general Alaska wilderness. It is only accessible by small watercraft and float planes.

Loading Jeff's boat in Douglas Harbor

The plan was to stay up the river until Monday afternoon, and we had a couple of fun, mosquito-bitten days of drinking, laughing, wake-boarding, fishing and exploring the area. There are several glaciers in the area, lots of creeks to explore, and the river continues up into Canada. We may have snuck across the border and invaded another country for a few minutes. Don't tell the RCMP!

Straddling the Canadian border. (taken about an hour before the accident)

One of the Twin Glaciers

Rainbow over the Taku River

Jeffie & Suzi

So here's how my weekend ended. On Sunday afternoon, my friends Jeff, Suzanne and boyfriend Jordan and I were setting up for a scavenger hunt of sorts that was to happen that night, and we got to the last location: a log jam/beaver dam on a creek that is known to many of the "river rats." We placed the scavenger hunt clue, and Jeff and Jordan got off the skiff to explore the woods nearby. Needing to go to the "bathroom", I got off the skiff to search for a private spot to do the deed. I tried to cross the creek by walking on a submerged log. I immediately slipped and fell onto a 6" remnant of a branch (caution: link contains mild gore!) that caught my left leg below the knee.

What I saw next was horrifying: my leg was split open and I was reminded of gutting a salmon full of roe. My first thoughts were that I was going to lose my leg or even bleed out. I grabbed my leg with two hands to keep it "together." I started yelling, "Emergency! Emergency! Emergency!" That's all I could think to do in that moment. Jordan and Jeff came as fast as they could (again, this was a treacherous log jam on a creek). It took several minutes to find appropriate materials to use to stabilize my leg.  I remember being offered a beach towel as a tourniquet, but very calmly I insisted that it would be adequate as we would be able to tie it tight enough.. We ended up using a pair of rain pants as the tourniquet (tied above the knee), but we wrapped my leg in the beach towel. Jeff used a chainsaw to cut away some debris to bring the skiff closer to me to help my transition into the boat. I didn't remember this detail until four or five days later which leads me to believe that there are other details that I blocked out, too. The mind does funny things while in crisis mode!

We were very far away from Jeff's cabin, let alone civilization and medical help, and there is no cell service in that area at all so the only thing to do was to get to the Taku Glacier Lodge: a popular tourist attraction which is serviced by watercraft and float planes. They have a dozen or so people on staff, and we knew that they would be able to contact Juneau via radio or sat phone. I sat in a rather precarious position on the bow of the skiff; holding as much pressure as I could on my leg. It took us approximately 20-30 minutes to reach their docks, but before we got there, I needed Jordan to help apply pressure to my leg and to keep me upright as some larger jet boats blew by us; generating some bad wake for us. We safely made it to Taku Glacier Lodge anyway, and their staff came down to meet us, and luckily, one of them was an EMT. Greg the EMT was able to provide some more advanced first aid on my wound while they radioed for a float plane to come get me from Juneau. Throughout all of this, I remained very calm. I was also in very little pain. Everyone thought it was remarkable how tough and courageous I was. I've received a lot of training in outdoor leadership, backcountry survival and wilderness first aid for my activities with Wilderness Volunteers, and I believe that training and experience contributed a lot to how I handled everything. I knew we had to solve one problem at a time while also thinking four or five steps ahead.

View from the Taku Glacier Lodge (taken on a trip there in 2013)
Pilot Randy of Ward Air arrived about 45 minutes later, and with a fair amount of difficulty, I got into the small 4-seat plane. Thankfully, Jordan was able to accompany me back to Juneau. The flight to Juneau took approximately 25 minutes, and what a way to travel in an emergency?! We flew over two big glaciers and lots of snow-capped mountains before descending into Juneau by way of the Salmon Creek reservoir. I enjoyed looking at all of the wolf and sheep tracks in the mountain snow as we flew over. I was beginning to feel like everything was going to be okay.

We landed at the Juneau airport water runway and were met at the dock by my Uncle Tom. He also works for Ward Air, and Pilot Randy had radioed back to Juneau to tell Tom that I was coming in injured. Tom drove Jordan and I to the emergency room at Bartlett Hospital where the next adventure was to begin.

At this point, approximately 2 hours had passed since the accident. My leg wasn't bleeding much, the wound was covered up by a substantial bandage that Greg the EMT had applied, and I was really calm so I think the hospital staff did not quite understand the severity of the wound when I first wheeled in. Again, I was not in much pain, but I STILL needed to pee! I was also freezing cold. I fell into creek water when I slipped, and my pants and underwear were still wet. Jordan was able to take me into a bathroom where I learned for the first time in my life just how handy those handicap rails by the toilet are when you are incapacitated. Ah, the sweet release of going to the bathroom after having to pee for more than 2 hours. One problem solved.

Shortly thereafter, they took me to an examination room. The nurses and doctors removed the bandage and immediately determined that I needed surgery. Being the Sunday of Memorial Day weekend, they had to call in a surgeon and operating team to the hospital. Word of my wound got around the ER, and I was visited by several nurses who wanted to check it out for educational purposes. I thought it was very funny how everyone wanted to see it! One nurse commented, "Wow! You are one TOUGH chick!!" Meanwhile, I was shivering like crazy from the wet clothes. They brought me warm blankets, but I still couldn't get quite warm enough. We ended up cutting off my pants. That helped some.

The surgeon and team arrived a little while later. Their big concern was to make certain that all of the foreign matter was cleaned out of the wound. They said my bone looked okay (it was exposed), but there was some damage to the muscle and I had a severed vein. I was put under general anesthesia, and the surgery took a little over an hour. When I woke up, I had 26 stitches and a penrose drain in my leg. I remember that I started shivering again, but some more heated blankets and a shot of Demerol fixed me right up! I was released from the hospital a few hours later with a pair of crutches and a prescription for some serious antibiotics.

Throughout all of this, I've had Jordan at my side. I've been so lucky to have such a caring and attentive companion with me! He's been driving me around, taking care of Butters, carrying my coffee to work and my trombone to symphony rehearsals. He's played the role of nurse in helping me with the daily change the dressings on my leg and making sure I take my antibiotics on time. I'm very lucky to have him!

I think the two of us have mostly recovered from the emotional trauma that followed the accident, but for several days, I couldn't stop thinking about the accident, how my leg had looked, and how close I was to severing a major artery. The accident could have had a much worse outcome. The day after the accident was Memorial Day, but I wanted to get right back to work on Tuesday as well as Juneau Symphony rehearsals. I felt a strong need to stay busy to keep my mind off of things. I also felt well enough to function at work and rehearsal. It just took me a while to get around.

Kitty Nurses on duty!

Juneau Symphony rehearsal 2 days after the accident

For those of you who aren't too squeamish, you can see some progress pictures of my leg: HERE.

You will notice a triangle-shaped area that was doomed from the beginning. About 9 days after surgery, the doctor needed to remove that necrotic tissue. We are trying to avoid the need for a skin graft on that area, and they installed a negative pressure-wound therapy system (Wound V.A.C.). The idea is that the machine applies gentle negative pressure to a deep wound which promotes blood flow and tissue regeneration. It should also help to close up the wound area. I have to have it attached to me 24/7 for several weeks. I will also need to see the doctor every other day so that he can change out the dressing. I am really thankful for this because Jordan and I had a really hard time dealing with the leg hole while I had it for about 2 days! Coincidentally, one of my old classmates from Rice University has been working for KCI, the manufacturer of these devices, for the past 7 years! We have already had an interesting chat about it! With a little luck, I will be able to avoid another surgery.

So there you have it. A true story of wilderness survival in Alaska. I'm so legit now. I've included an interactive map below with a few key locations from this story. The map shows where we left from in Juneau, Jeff's cabin (yellow house icon), accident site (red skull and cross bones) and the Taku Glacier Lodge location (float plane). The red line indicates the flight path of the float plane ride back to Juneau (approximately).