2 August 2009: Nancy via Nancy Pond Tr., herdpath, North Conway memorial

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jniehof

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The day started off right--banana pancakes courtesy of the Trails folks, as we'd spent Saturday on trailwork. Thanks Sarah! After washing dishes, driving, and all the usual little last-minute things we hit the trail at 9am. Since the forecast was for rain later, we still hoped to be well down-trail by mid-afternoon.

The Nancy Pond Trail is quite pleasant right from the get-go, mostly on old woods roads with excellent footing and a grade that eats up elevation almost imperceptably. It enters Forest Service property with quite the fanfare of cairns, red-blazed trees, surveying signs, boundary signs, side paths back to 302.... Not too long thereafter it become more of a standard White Mountains trail, rocky and at points steep, but by then it's next to (or high above) Nancy Brook with lots of little points of interest, leading up to the crowning spectacle of Nancy Cascade. The day was fairly muggy and everything damp--including parts of the trail--but the rain did seem to be holding off as we climbed the steep headwall beside the cascade, popping next to it for the occasional view. A lot of serious engineering went into this trail.

We topped out and entered the boggy area near Nancy Pond. Most of the bog bridges here are fairly recent, but there was still the occasional muddy foot as we passed the picturesque pond and entered the Wilderness. Here conditions changed. Still wet, large parts of the trail are now submerged in Norcross Pond, and most bog bridges are entirely decayed. Bushwhacks were necessary around the really deep stuff; some herd paths are forming and it's altogether a blot on an otherwise gorgeous spot. The ledges at the pond outlet were most welcome, allowing us to dry out feet and enjoy lunch while gazing into the Pemi. It had taken just about three hours to reach this point.

The "herd path" up Nancy is very obvious off the north side of a revegetation area--it's actually more clear than the trail! A very short distance along it forks left at a bootleg (and probably illegal) campsite. There was no brushing-in, but the Forest Service has posted a sign shortly past this campsite, warning that the trail is not maintained and any such maintenance would have dire consequences.

The path to the base of the slide is very clear, level, and has nice views to Lowell through the trees. It seems that it slabs along to the steepest possible slope before reaching the slide and ascending. We chose to climb the slide, even though it's the loose sort that I dislike, and refound the herd path at the top. A brief moment of confusion five minutes beyond the slide was quickly resolved, and we resumed the very steep climb to the summit, reaching it at 1pm. The Presidentials were socked in, but Crawford Notch is very impressive from this vantage.

Views, pictures, and a snack later, we scampered back down, bypassing the slide for descent. I removed my socks and waded through the drowned sections of trail,, not wanting to bother with bushwhacking. At the wilderness boundary I dried off and resumed socks.

From here it was a fairly relaxed cruise through the bogs and down the steeps next to the cascade. We saw another hiker enjoying the falls from the pool at its base. Perhaps five minutes later it happened...something slipped, I fell with a loud snap from my right ankle, and let out a bloodcurdling scream until my lungs were empty. As best I can tell, I lost footing but my right foot found good purchase on a high-angle rock, holding there while the rest of my body went down and effectively turned the bottom of my right foot towards my left side.

Erik dropped his pack and helped remove mine, then got me face-up. Already the swelling ankle was obvious and we loosened that shoe as much as possible, then Erik provided in-line traction while I poked and prodded a bit. My initial fears of a fracture subsided slightly, as the worst tenderness seemed isolated to one side. I started to get out my first aid and repair kits when the hiker we'd seen at the pool came down the trail.

Fortunately he was willing to stay and help, and was also carrying a foam sleeping pad that made for a far better splint than anything we could have done with spare clothing. Erik cut some branches to provide stiffness and we splinted up good and tight with some REI sport wraps and p-cord. We did a round of cell phone checks--none of us had coverage. Don (our new hero) offered to run out, but I wanted to try self-rescue first. I managed to stand up by leaning on both of them and, with a fair bit of pain, could take some small hobbling steps. Erik cut me a staff, padded with a vest, and I used that as a crutch while leaning on Don on the left. Satisfied that we could move, however slowly, we split my gear between the two mobile hikers and Erik wore my pack over top of his. At some point in this process I glanced at my watch. It was 3:30 and we were just under 2.5 miles in, 1500' or so up.

It was a very slow, painful, hobbling process, but the splint made me feel a lot better and the motion seemed to help as well. Maybe moving improved bloodflow, maybe it just loosed the endorphins, maybe I was focussed on the task at hand rather than the pain. But as I gained practice with the makeshift staff I was able to move mostly under my own power, leaning on Don for difficult sections and going down the occasional rock staircase with effective use of my posterior. The stream crossings were grim but I managed without soaking my foot or splint. The worse had a deadfall across that I could sit-and-scoot. Probably the most annoying part was forgetting that the splint made my foot about three times as wide as usual, so brushing a rock with the splint would jerk my ankle and draw a fresh yelp of pain. At least the rain was mostly holding off, just a light mist.

We reached the car about 7:30, just as the rain really hit. Don went on his way with our thanks, and we drove to the hospital in North Conway, arriving just after the ER walk-in rush began and just before four ambulances with life-threatening cases. By the time I was X-rayed, poked, and splinted, it was about 1am. We retired to a motel and I ate the cold Burger King Erik had picked up. With food in my stomach I could finally take the first painkiller since my fall and go to sleep (which lasted about 4 hours before the meds wore off and woke me.) This morning we drove back to Boston.

No clean break showed in the X-rays. I may have torn a piece of bone off with a ligament, but everything's too messed up to tell. I have to let it heal a bit before seeing an orthopedist.

It could have been far worse. Our original plan for the day was Scar Ridge, but we decided a brutal bushwhack in the rain would be no fun. Being injured up there would be even less fun. That rain held off while we were in the field. We were very glad to be off the brutally steep sections before the incident. Although we probably could have managed without, Don's serendipitous presence made a huge difference, both practically and for morale. It was nice to have someone new to talk to on the way down.

I don't think I was going too fast. It was a good steady pace, but well below the fastest I would have felt comfortable and I was slowing down when spots got tricky. Perhaps, given the wet rocks that were prevailing, I could have taken more care to clean out the mud from my soles after wading through the pond. I don't think ankle-covering boots would have made a difference vs. the trail runners I was wearing. My trail runners certainly have better grip in those conditions than my leathers, and I've managed some pretty nasty twists while wearing fairly high leather boots. I also find the lighter weight and better "feel" of trail runners to be a huge advantage in maintaining balance in poor footing.

Sadly that did affect my decision-making to some extent. F&G seems fairly against anything but full leather boots, and with the ambiguity of recent decisions I didn't feel like being a test case. Attempting at least a partial self-rescue was pretty much a given, knowing how slow litter carries are and how long it would take to get some sort of help up there. Normally I'd rather call early, at least as a heads-up, instead of waiting until self-rescue had obviously failed. The threat of a large bill pushed that idea back to "last, LAST resort." Maybe that's part of the idea? At any rate, I'm glad we didn't have the option of making a call, as it spared me a hard decision and allowed us to simply focus on getting out.

Much thanks to Erik for putting up with this as just another in a long series of "interesting" hikes, to Don for donating a lot of time, strength, and a sleeping pad to a stranger, to my various WFA instructors, and to the staff at Memorial Hospital in North Conway. Amusing side note: a SOLO W-EMT student was following along with the doctor for training.
 
Wow, what an adventure. Glad that everything turned out as well as could be expected, given the circumstances. (And how wonderful that Don was such a Good Samaritan.)

Your comments about what you might have done if a rescue was needed are sobering. Until either the courts or the legislature pin down a definition of "negligence" once and for all, all of us who get hurt on a hike will have to ask the difficult questions you were prepared to ask yourself. Thanks for tying your situation into the larger picture. It's really thought-provoking.
 
Now with pictures

As I feared, I failed in my attempts to get a picture that conveyed the scale of walking far above the brook, but there were several nice shots of the cascades.
1-cascades.jpg

These are made even more impressive in the middle of the (steep) climb when you realize you're above everything you could see below, and the waterfall is essentially still going.

The high area around Nancy and Norcross ponds reminds me of the Boundary Waters. I particularly like the view from the Wilderness boundary:
2-norcross.jpg

although the vista from the other side has beauty on a much larger scale.
3-pemi.jpg


I'm not sure why I took my summit photo with my right foot up on a rock, but it makes me wince now.
4-summit.jpg


The beavers have done their work, and this is the treadway for the trail:
5-muck.jpg


Here's the rock what done it:
6-rock.jpg

I believe I had my right foot on the sloping rock upper center and my left foot slid out somehow (to viewer's right). That left me face down in the drainage, up against the rock bar, but my right foot stayed planted on the sloper, folding my ankle right over. Less grippy shoes actually might have helped.

A very poor picture of the "walk" down:
7-hobble.jpg

and the biggest stream crossing:
8-deadfall.jpg


Finally, the splint:
9-splint.jpg

You can see my second crutch, lower right. Erik found this one halfway down and replaced the much heavier first one. The splint itself is Don's pad with a solid branch wrapped on each side (Erik did a lot of work with the Gerber saw.) One stick poked up a bit so I used a packtowel to keep from scraping that knee. As the foam compressed (and the swelling went down a little), I had to repeatedly tighten the sport wraps. The p-cord wraps were much more difficult to get tight. I was very annoyed that the length of webbing I usually carry in my repair kit was nowhere to be found. When my girlfriend helped me unload the pack, I added a few more sport wraps and that webbing to the repair kit. Those things are useful.

I still don't have a definitive diagnosis. I go to the BMC "fracture clinic" tomorrow, which I hope will start things towards actual definitive care. In the meantime I'm still on crutches and in a lot of pain; I'm saving the last pill of the good stuff in case it gets too painful to sleep. I have had a very hard time convincing doctors that this really is a serious, painful injury because I self-rescued. I'll probably bring the photos to the clinic. Unfortunately we didn't get one when my ankle was hideously swollen.

Thanks for the kind comments, The Feathered Hat. Obviously once I'm back on my feet I'll be in sturdier footwear for the recovery (I usually switch to leathers for shoulder season anyhow), but I'm still chewing on the boots vs. trail runners question a bit, both practically and w.r.t. red tape.
 
Wow, the photos really make viewer feel like s/he was there. I hope you're able to make a fast and full recovery!
 
Sorry to hear about the injury. Heal fast and well!

The p-cord wraps were much more difficult to get tight. I was very annoyed that the length of webbing I usually carry in my repair kit was nowhere to be found.
Take a look at the trucker's hitch. One can tie ropes very tight with this knot. (It is my standard knot for tying boats to car racks.) Can be used on both webbing and rope.

http://en.wikipedia.org/wiki/Trucker's_hitch
http://www.netknots.com/html/truckers_hitch.html
Lots more:
http://www.google.com/search?hl=en&q=trucker's+hitch&aq=f&oq=&aqi=g-s2g1g-s4

Doug
 
Thanks for posting your story, and good luck with the recovery. I am very impressed with the amount of first aid equipment the three of you had. The foam pad seemed like it was key to your being able to hobble out on your own, with help. I always carry some tape, but not webbing or cord. I think I will add some to my pack, just in case.

It is a shame that F&G levied such a huge fine on the Mt. Wash boy scout. That seemed really over the top, even if he didn't make all the right choices. I hate to think that hikers will hesitate to call just because they are afraid of being charged. :(
 
I will second what Betsy says, the foam pad came in really handy! I had never considered it as a safety/splint device, great thinking and hope you heal up soon!
Closed cell foam pads make great magazine splints. I have stabilized a knee (not mine) with ligament damage with one--we were able to walk the victim out on the stabilized knee. The older, stiffer ones (no longer available, AFAIK) are better than the current softer ones (eg REI blue foam). Closed cell is better than inflatable or self-inflatable.

And, of course, a pad is a safety "necessity" in winter.

Doug
 
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Wow - that was quite an adventure! I'm sure it was far more than you had anticipated at the outset.

Thanks for all the pictures - it really does make me feel like I was there.

I always carry a Sam Splint with me when I hike. It's very light weight (similar to an empty soda can) and can be molded very easily around an ankle (or leg). It's not bulky at all. I have never used it, buy my daughter who was a WFR and is now a paramedic, has and says it should be part of any hiker's first aid kit.
 
Hope it heals quickly. We were at Memorial Hospital the previous sunday for a fractured clavicle, which was the result of slippery rocks on another trail! We also left sometime after midnight, and had trouble finding food to take with the meds.
 
Verdict from the doc on Tuesday is no fracture, just some odd calcification that is likely from an old injury. He gave me chapter and verse on sprains and kicked me out the door. So it's range of motion exercises, air cast, and weight the foot as much as is comfortable. My foot no longer turns white when I sit down and purple when I stand up.

Doug: thanks for the trucker's hitch links. I've come across it a few times (there are variants in Jacobson's books) but have never quite understood it, despite messing around with some cord. Am I correct in understanding that it's less of a knot per se and more of a means of building a "pulley" system on the line, with the final securing being via the half hitches?

Jabberwalk: I wasn't carrying terribly much...maybe a pound between my first aid and repair kits? When you have a few people each carrying a little, you can get a lot done. One of the advantages of hiking in groups, and with people who are serious about preparedness. I carry more when I'm co-leading a trip, including a SAM splint. LittleBear's right; they are really handy devices and leaving it out of my pack wasn't smart.

I use Gossamer Gear pads although I usually don't carry one on summer dayhikes. They do seem a little stiffer than most of the blue pads these days. I have heard stories of using self-inflaters as splints, including a little air. Unfortunately you can't do that and also cut the thing down to fit!

Thanks all for the kind thoughts.
 
Verdict from the doc on Tuesday is no fracture, just some odd calcification that is likely from an old injury. He gave me chapter and verse on sprains and kicked me out the door. So it's range of motion exercises, air cast, and weight the foot as much as is comfortable. My foot no longer turns white when I sit down and purple when I stand up.
Glad to hear that it is improving. Hopefully the ligaments are not permanently damaged.

Doug: thanks for the trucker's hitch links. I've come across it a few times (there are variants in Jacobson's books) but have never quite understood it, despite messing around with some cord. Am I correct in understanding that it's less of a knot per se and more of a means of building a "pulley" system on the line, with the final securing being via the half hitches?
IMO, there are variants, IMO the key is tensioning the line threaded through the loop and tying off with half hitches. I view it as a system:
* If both ends are loose, tie a loop in the far end, thread the near end through the loop, pull tight, and secure with two half hitches. 2:1 leverage.
* If only the near end is loose, tie a loop (I use a butterfly knot**, but any good loop on a bight will work), thread the line around the anchor and back through the loop, pull tight, and secure with two half hitches. 3:1 leverage.

** A butterfly is a climber's knot--very good for tying a loop in the middle of the rope. Takes tension from all three directions well and is easy to untie. http://en.wikipedia.org/wiki/Alpine_butterfly_knot http://www.netknots.com/html/butterfly_knot.html

Yes, the final securing is done by the two half hitches. It is very easy to tighten and tie under tension: just pull until the line to the desired tension and pinch the line around the end of the loop while tying the first half hitch.

I use Gossamer Gear pads although I usually don't carry one on summer dayhikes. They do seem a little stiffer than most of the blue pads these days. I have heard stories of using self-inflaters as splints, including a little air. Unfortunately you can't do that and also cut the thing down to fit!
I always carry a pad in winter but not usually in summer. But as you are no doubt aware, they can be useful at any time of year.

Self-inflaters are better than nothing, but closed cell pads are lighter (but bigger to carry).

Doug
 
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although I usually don't carry one on summer dayhikes. They do seem a little stiffer than most of the blue pads these days. I have heard stories of using self-inflaters as splints, including a little air. Unfortunately you can't do that and also cut the thing down to fit!


Self-inflaters are better than nothing, but closed cell pads are lighter (but bigger to carry).
Doug

During my Wilderness First Responder course in June we used our Therm-a-Rest pads for leg splints. We did have to fold the pad in half because of the length, but once we secured them with cravats and inflated the pads it was amazing how rigid it because. After the course I didn’t want to carry my pad all the time so I did a search and was able to find a child’s Therm-a-Rest that was only 36” long and 8 oz. Once deflated it folds up nicely and fits inside my pack sleeve without taking up much room. It is now part of my first aid kit.
 
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During my Wilderness First Responder course in June we used our Therm-a-Rest pads for leg splints. We did have to fold the pad in half because of the length, but once we secured them with cravats and inflated the pads it was amazing how rigid it because. After the course I didn’t want to carry my pad all the time so I did a search and was able to find a child’s Therm-a-Rest that was only 36” long and 8 oz. Once deflated it folds up nicely and fits inside my pack sleeve without taking up much room. It is now part of my first aid kit.
OK.

An REI Standard Blue Foam (3/8x24x56 inches) weighs 7.5 oz. One could certainly cut it down to something a bit smaller and lighter (certainly narrower). (I simply line a large internal frame pack with a (~3/8x18x72 inches) pad. It looks big, but most of it is air... The pad is also big enough for a victim to lie on it.)

As noted earlier, I have actually used a (stiffer old style*) closed cell foam pad to stabilize an injured knee (one of the internal ligaments was severed) in the field. We folded it in two or three and bent it to make a magazine splint, added a bit of padding and secured it with some wide buckle straps (much better than the cravats we used in FA class). The knee was stabilized very well by this rig. We started to walk the victim out on an iced and 1/8th inch cord wrapped** XC ski plus two helpers. After a while, the victim stated that he thought he could walk on the bad leg so I prepared his other ski and put it back on him. We got him 1-2 mi out before the ski patrol arrived***. (The accident occurred near the height of land on Greely Ponds Tr and we had sent an accident report form requesting an evac out to Waterville XC ski patrol with some skiers.) They took one look at the splint and loaded the victim into their sled and took him to their medical center. The doc replaced our splint with a plaster cast and we took the victim home to see his own doc, who operated that night to reattach the ligament.

* This event occurred back in the late 1970s or early 1980s.

** The icing and cord wrapping turned the slippery ski into a long, thin sticky snowshoe.

*** We would have been able to get him all the way out under his/our own power had the ski patrol not been available. It just would have taken a bit longer...

FWIW1, my biggest problem in the entire rescue was crowd control...
(For instance, the leader of another party offered to help, but a quick look at his people showed that they didn't have enough insulation to hang around.) I also had some jerk trying to force some 1/8 nylon cord on me to lower the victim down a short steep spot. (I'm a technical climber--1/8 nylon is not appropriate for the job...)

FWIW2, we were an XC ski party of 3, led by me. We got some brief help from 2 snowshoers to get the victim down a short steep spot. And one solo old-timer XC skier stuck with us for the entire rescue. (He was a tremendous help.)

Doug
 
Nice self rescue, and thanks for the detailed TR and photo. Many folks with lesser injuries have required 12-18 persons for litter carry outs.

I wiped out the ligaments on both ankles about a year apart a few decades ago. The same doc joked that I must have subconsciously injured the second ankle to keeps things in balance. But, after a few weeks on crutches each time, both ankles were healed enough for me to resume hiking, running, etc. However, I now need heavy boots for ankle support on rough terrain, so no trail running for me any more.

Good luck with your recovery.
 
Update...

A couple of people have kindly asked elsewhere how I'm doing, so rather than polluting other threads, here's an update.

Over the past two weeks I've gradually worked from walking with two crutches, to walking with one, to trekking poles for long bits and either one pole or nothing around the house. I can even walk short distances without the air cast, which makes visiting the facilities in the middle of the night a lot more convenient. It also means I can shower again! That was awfully nice. I can stand on tiptoes, and almost stand on my injured foot alone--can't hold the balance for long--but can't stand on the toes of just my injured foot.

I can walk the mile to campus in just over half an hour, which isn't too bad. I made the mistake yesterday of walking maybe 2.5 miles total...in to campus, then over to FitRec to try and get on an exercise bike. Unfortunately the main bike room is "closed for maintenance," so I walked home. That was a bit much. I also broke a trekking pole and need to get over to REI to fix it. Maybe not today. I really want to get on a bike to have some nice low-impact exercise, but am not very confident dealing with traffic in this state.

I can't point my toes up very far, so that's a stretch I'm working on a lot. Using warm packs a couple times a day to keep things limber and encourage circulation. Avoiding ibuprofen because it can limit blood flow, and ligaments in a far extremity already have problems with that.

Some things I wish I'd done with the first aid: Definitely should have spent the first half hour RICEing and worried about splinting later. The brook was right there and I could have had someone soak a bandana and use that to cool the ankle. I suspect that would have improved the swelling a fair bit. Once back at the car, an ibuprofen might have been in order, and I definitely should have kept a stretch on that achilles, uncomfortable as it was. When they splinted in the hospital, they had to splint with my toes pointed down a bit--my foot just refused to level out. That's probably a large part of my difficulties now.
 
A couple of people have kindly asked elsewhere how I'm doing, so rather than polluting other threads, here's an update.

Over the past two weeks I've gradually worked from walking with two crutches, to walking with one, to trekking poles for long bits and either one pole or nothing around the house. I can even walk short distances without the air cast, which makes visiting the facilities in the middle of the night a lot more convenient. It also means I can shower again! That was awfully nice. I can stand on tiptoes, and almost stand on my injured foot alone--can't hold the balance for long--but can't stand on the toes of just my injured foot.

I can walk the mile to campus in just over half an hour, which isn't too bad. I made the mistake yesterday of walking maybe 2.5 miles total...in to campus, then over to FitRec to try and get on an exercise bike. Unfortunately the main bike room is "closed for maintenance," so I walked home. That was a bit much. I also broke a trekking pole and need to get over to REI to fix it. Maybe not today. I really want to get on a bike to have some nice low-impact exercise, but am not very confident dealing with traffic in this state.
Glad to hear that recovery is under way.

You might find a cane to be very useful (perhaps even more useful than poles) at this stage. I certainly did for part of my recovery from a broken leg.

Some things I wish I'd done with the first aid: Definitely should have spent the first half hour RICEing and worried about splinting later. The brook was right there and I could have had someone soak a bandana and use that to cool the ankle. I suspect that would have improved the swelling a fair bit. Once back at the car, an ibuprofen might have been in order, and I definitely should have kept a stretch on that achilles, uncomfortable as it was. When they splinted in the hospital, they had to splint with my toes pointed down a bit--my foot just refused to level out. That's probably a large part of my difficulties now.
A pressure bandage can also be very helpful in minimizing the swelling. And you can wear one while walking/hobbling out. A full boot can also provide some compression and support. (Just make sure that the bandage/boot does not constrict circulation.)

I also try to avoid taking drugs if I anticipate medical care or possible surgery. I wouldn't want to take anything that would interfere with my treatment. They also prefer that you haven't eaten in past 6? hours to minimize the chance that you will vomit while under anesthesia. (Not sure of the exact time, but it is something like 6 to 12 hrs.)

Doug
 
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