The Depths of Illness - Fainting (On the Appalachian Trail)

When getting blood drawn, I have always been prone to what's called vasovagal syncope (click here for a description from the Mayo Clinic) - a condition in which the body overreacts to certain triggers, causing heart rate and blood pressure drop and threatening the loss of consciousness.  I never actually passed out during one of these episodes, and it remained isolated to getting blood drawn, until 2005 when it would become a prominent force in my life.

I was hiking the Appalachian Trail, skirting the border of Tennessee and North Carolina.  I had not been feeling particularly well, fatigued, and had taken an extra day of rest at Elmer’s in Hot Springs, North Carolina.

Elmer's was a gorgeous inn on a small hill. It had two floors, each with a porch, and a plaque out front proclaimed it the Sunnybank Inn, built in the 1840’s.  The kitchen was richly adorned with dark wooden cabinets, a stainless steel refrigerator, an antique gas stove, tiled counter tops, and an island in the middle with an iron pot rack hanging from the ceiling.  The halls had richly-grained, dark wood paneling or accents next to decadent deep purple and gold or green and cream flower print wall paper. Framed news clippings of the Appalachian Trail, maps, and artwork adorned the walls. In addition to rooms, the inn had multiple bathrooms, two libraries, and two staircases - taking me to a time when these luxuries signified wealth.  It was comfortable and so I stayed, partaking of the organic vegetarian meals prepared in-house from ingredients grown on Elmer's farm.  But like all places on the trail, Elmer's was nothing more than a way station.  After the extra day of rest, despite the fatigue, I moved on.

In Erwin, Tennessee, my fatigue found a friend – digestive issues. I stopped for a night but no more. I crossed over a damp and snow-covered Roan Mountain, then through the trail-friendly town of Damascus, Virginia, before heading up into the Virginia Highlands.  As I neared Mt. Rogers (the highest point in Virginia) the trees grew sparse, giving way to grassy plains with large rock outcroppings. Sitting atop the first visible knob was the Thomas Knob Shelter, a three-sided structure that reminded me of an old prairie home.
  

I stopped to chat with some of my fellow hikers, Peeps, Morel, and Montana, but was so tired that I laid down on the picnic table for a restless nap.  I awoke a short time later in a cold sweat and pushed on, passing through Greyson Highlands State Park, where wild ponies grazed between the rock formations and scattered trees, to the next shelter where Peeps, Morel, and Montana had already arrived and set up camp.  Halfway through my dinner of instant stuffing my stomach twinged and twisted as if begging me to stop eating. I obliged and laid down in the shelter to rest. Sleep came quickly.

A few hours later, I woke up in a sweat, overheated, nauseated and desperate to find the privy. I scrambled to get my shoes on, grab my headlamp, and stumble out of the shelter. Within fifteen steps I was so dizzy that I crashed to the ground, landing in a pile of rocks beside a bush. The stars swirled, then darkness came. After a minute or so I came to and waited for my head to clear. I stood again and stumbled through the darkness in the general vicinity of the privy, which I hadn’t been to yet and didn’t know exactly where it was. Another couple steps and dizziness caused me stumble and fall to the ground once again. I did not pass out this time - I only laid in misery until the stars stopped swirling and I felt able to walk.  After another attempt, I made it to the privy but found a new dilemma – the privy had no walls. It was a toilet on top of a stage – common enough for a composting toilet, but leaving me unsheltered from the freezing mountain air. So as I sat, the wind blew across my sweat drenched body, quickly taking me from overheated to shivering. Too cold to remain at the privy, I went back to the shelter, doomed to go through this ritual once more. When morning came, I felt a little better though my stomach remained fragile. I put a few breakfast bars in my pocket, packed up my gear, and set off for the next town, some eighteen miles away.

This was my first fainting episode but not the last...