Renal failure: a wilderness emergency!

Even in the 35-degree water I can feel the throw rope burning a bloody groove into my tightened fists. “Don’t let go,” I tell myself. “This is your only hope.” Seconds earlier I’d been bobbing in the swift-moving current of the South Yuba River, wearing a leaky dry top with a fleece under layer and thin capilene pants, trying unsuccessfully to swim my numb body to the flooding banks. In a flash I’d seen the rope bag come sailing into my out-stretched arms and now I’m holding on for dear life. Under the frigid water my lips are pressed as tight together as an undercooked mussel. I refuse to swallow any water until absolutely necessary.

I feel my body sinking. I wait. I dig my fingernails into the rope fibers for extra grip. “If I can just hold on,” I tell myself. “I’m going to be alright.” I wait some more. My body starts to bounce against the bottom of the river, but I don’t go anywhere. “Something isn’t right,” says a voice in my head. “You have to let go.” And in a flash, I do let go. Within seconds my pfd buoys me up to the surface and I take a deep, frantic gulp of warm air before smacking face first into another frothing hydraulic that takes me under again. My whole body is numb. I hear the voice again and this time it sounds faint. “It’s OK to go to sleep,” it says. At this point I may have been in the water about two minutes – max – but I’m tired. Some of that time has been spent re-circulating in the violent ledge hole that forced me to swim out of my kayak in the first place and some of that time has been spent swimming downstream or holding onto the throw rope underwater. Before swimming out of my kayak I’d unintentionally surfed the heck out of that sticky, stupid ledge hole – cartwheels, loops, window shades, the whole bit – for maybe another minute that felt like eternity. I’m exhausted. Sleep sounds good. I start to relax.

Suddenly my body is on the wavy surface of the river and I allow another gulp of oxygen into my lungs. “What are you thinking?” I ask myself. “You can’t go to sleep now!” I snap back into reality and notice a kayaker coming toward me. With all my strength I lunge for his boat and grab onto the back. I pull my body as far onto his stern as I can and try kicking my legs behind us as we head into another rapid and meaty hole in the center of the river. I feel a “pow” as we plow into the hydraulic and once again, I go deep underwater, but with new vigor. The hole takes a hold of me like a fast-pitch softball pitcher and whirls me to the bottom of the river so fast that I almost immediately pop back up to the surface downstream. And there, to my right, is an eddy.

I can see the mica glimmering in the sand just underneath the sliver of clear, slow-moving water next to the bank. It’s only an arm’s length away. My left eye catches a glimpse of the white wave train beyond this six inches of still, slow-moving safety and a Samson-ian strength overcomes me as I pull myself to the wonderful, dry, warm shore. “I made it!” I say to myself. “I made it through the hard part! I’m alive now!”

After surviving the river, I was sure my struggle was over, but that couldn’t have been further from the truth. On the bank, I felt the urge to vomit but nothing much came out, just a little water. I looked around at everything – the sky, the ground, the trees, the river, my buddy Jay who was sitting in his kayak gear on the bank – and every single thing looked to me to be the same, neon green color. I didn’t feel right.

“I need to get to the hospital,” I told Jay. “After surviving the river I’d feel stupid if I went and died on the banks.” Some of my other kayaking buddies had gone to get the shuttle vehicle while I’d had my ordeal in the river; we hadn’t gone more than a half-mile from the put-in after all. Todd and Dave drove me to the hospital. On the way, I had a screaming headache. At the hospital they rushed me through emergency for a chest X-ray, after an intense swim they suspected secondary drowning. They didn’t find anything. They sent a special nurse in to draw blood from an artery in my arm, which is different than the standard of getting blood drawn from a vein. They use a bigger needle and it’s more challenging to hit the artery. The nurse missed. He asked me if he could try again. I asked him if the test was absolutely necessary. He left the room to the check with the doctor. When he came back he said that I looked like I was recovering nicely and the test wasn’t necessary. My sister and boyfriend, Greg, came to the hospital to pick me up and three hours after the ordeal started, Greg and I ordered a pizza and went home.

Even though I was hungry, I couldn’t eat much of the pizza. I couldn’t sleep either. I just kept throwing up, all night, even after all the pizza was out of my stomach. I tried to sip on water but that wouldn’t stay down. I tried to go to sleep but I felt delusional. We called the hospital. They told us it was probably just nerves. I kept throwing up all night and in the morning I had no choice but to re-check myself into the hospital. They drew some blood and put me on an IV. I started to feel better. That was until the internist paid me a visit.

“Do you have any history of kidney problems?” he asked. In fact, I had had a kidney infection about seven years prior to this incident and when I was a little kid there was some kind of rumor my mom told me about me having “three kidneys” or some nonsense of that nature (which turned out to be untrue). I explained this to the doctor. “We’ll have to get more information about that if we can,” he said. “Because right now you have what we call acute kidney failure. I’m admitting you to the ICU immediately.”

For the next two days I laid in a hospital bed in the ICU while they pumped me so full of fluids that I literally gained 20 pounds. Greg took a picture of me with his phone and you would have sworn that I had been stung by an entire beehive my face was so puffy. My kidneys started working again after a couple of days of treatment and I was released from the hospital. My headaches continued for the next two weeks and my strength also improved very slowly.

Looking back on the incident it’s difficult to make sense of everything. Putting on the river that day – a 75-degree day in the middle of May that snapped the snowmelt off the mountain in a sudden rush of runoff – I hadn’t felt completely myself. Sure, I was nervous about kayaking the swollen river, but I was also weak. The day before I had had unexplained diarrhea on a routine three-mile trail run by my house. Did that contribute to my kidney failure? Was it the exertion of the swim? The cold water? The lack of oxygen? The fear?  A combination of all factors? Had the emergency medical professionals at the hospital ruled out all the possibilities before they released me? Or was there something they had missed? And, if so, what information can be learned from this incident to help another cold water swimmer in the future?

Account by Wendy Lautner