Note: this post is very delayed. I no longer have giardia and I’ll be back on trail next week.

What Giardiasis is and How I Got It

The Oxford Dictionary defines giardiasis as “infection of the intestine with a flagellate protozoan, which causes diarrhea and other symptoms”. That about covers it. The incubation period is 3-30 days and it’s treated with antibiotics. You usually get it from drinking contaminated water, but you can also get it from touching contaminated water and then touching your mouth, food, eating utensils, etc. Where does it come from? Beaver poo. Gross. Yep. Other animals carry it, the beavers are just especially prolific. You can also get it from other hikers because hand-washing is not super accessible in the backcountry and hand sanitizer isn’t super effective when your hands are covered in dirt and sunscreen.

I don’t know exactly how I got it. I filtered my water, my filter had never frozen, and it was in good condition. I made sure water never ran down the side of my filter and into my clean bottles and sanitized my hands a lot. We were basically swimming in the Gila River and there was a ton of beaver activity in the area. Dirty water got all over my clothes, on and around my pack, etc. Somewhere in there I touched dirty water, my trekking pole grips, my wet clothes, my wet shoes/laces, etc. and then touched my mouth, spoon, or food. I don’t think my filter failed. Nothing about the backcountry is clean and waterborne illnesses are always a risk, even when you’re taking the standard precautions. What I know is that somewhere in there, something went wrong.

Reserve, New Mexico

Where I left off with the last post, I’d been dropped off at the clinic in Reserve. The front desk person came outside to meet me, and I told her I probably had giardia. She told me I was going to have to come back the next day because only the dentist was there, the medical staff were all in Quemado. Quemado is an hour and a half north of Reserve and I didn’t have a ride. I made an appointment for the next day and got a hotel room.

The next day, I hung out in front of the general store inquiring to passers by if anyone knew of anyone going to Pie Town in the next day or two. My plan was to go to the clinic, get meds for the giardia, and then try to find my way to Pie Town. I had googled giardiasis and according to Mayo Clinic, the test is not particularly accurate (it gives false negatives a lot) so it’s not uncommon for providers to not test and just treat in situations where giardiasis is probable, or to treat regardless of the test result. It seemed simple and clear cut to me (according to my PCP, it should have been). Nobody knew of anyone going to Pie Town, but a woman named Lee offered to call the Sheriff’s department for me and see if they would be willing to drop me off. They sometimes do this to help out hikers. I am incredibly grateful for her assistance, I have no idea how I would have gotten out of Pie Town without her. Everyone in Reserve was really nice, and they were all excited to see hikers.

I went to the clinic for my appointment. The CNP took my pulse, blood pressure, and temperature and informed me that I needed to go to the emergency room. I looked at my vitals on the screen, they were within normal limits. I asked why, and she said that she couldn’t test for giardia or prescribe antibiotics, and that I could be dehydrated, I could have an acute kidney injury (AKI), and that I was risking serious consequences if I didn’t go right then. Uhhhhhhhhhhh, false? Thanks though. I know what dehydration feels like. I also used to be an EMT and know how to assess for dehydration. She didn’t ask any of the questions I would have asked as an EMT, nor did she assess vitals outside of my heart rate, BP, and temp. There was no indication that I was dehydrated. Giardia on its own doesn’t cause an AKI. It can cause dehydration which can absolutely cause an AKI, but I wasn’t dehydrated. She offered to call an ambulance. I declined.

I’d like to give her the benefit of the doubt: she may have been trying to a) CYA and b) scare me into not going back on the trail without getting treatment. Which, yeah, if I’d gone back on trail without treating the giardia, I absolutely could’ve died. So fair. But I got off because I knew continuing was unsafe, and I was not fool enough to go back out there without getting treated first.

Why I Got Off Trail

Lee texted me while I was at the appointment and told me the sheriff’s office could give me a ride to Pie Town. I looked into what an ED visit would look like from an insurance perspective. Our out of network health insurance is kind of awful, so I would’ve had to foot likely close to or all of the bill. The antiparasitic also doesn’t always work, and I wasn’t sure how long it would take before I was fit enough to go back on trail regardless. In the meantime, I would also have to cover lodging, which could get really expensive. I looked at the cost of flights. The southbound hiking window starts at the end of June, giving me enough time to get everything together to return, and allowing me to work some in the meantime. We’d hit our out of pocket, so in-network treatment was free. Basically, it was significantly cheaper, including travel costs, for me to fly home to get healthcare than it would have been to stay in New Mexico. I was in the physical position to do so.

It wasn’t what I wanted, but getting off trail then was also the scenario that was most likely to result in a completed thru-hike down the line, because it meant leaving the door open to get back on trail this year. I wasn’t 100% sure I would be able to pull off a southbound hike this season, but there was a solid chance it was going to end my northbound thru regardless. I had to make a decision quickly, and I went with the safer call.

I went to the Sheriff’s department and got a ride from Reserve to the Toaster House in Pie Town (a well known hostel in Pie Town, New Mexico). The Sheriff’s Deputy was able to give me the hour and a half long ride because both Reserve and Pie Town are in the same county (Yes. You can drive an hour and a half at highway speeds in rural New Mexico without leaving the county. It is a different world than Ohio). As he drove, I spent most of my time with my nose to the window, watching the landscape. It was absolutely beautiful, sprawling hills and grasslands with patches of forest. Knowing I was leaving, I was not willing to let it lie, not forever. Watching out that window reinforced the need to come back, to finish. The landscape was incredible, and reminded me of the field I’d stood in two nights earlier.

Pie Town, New Mexico

Pie Town is still 2.5 hours from Albuquerque, and Albuquerque was the closest major airport. I got dropped off at the Toaster House by the Deputy, much to the amusement of the other hikers. After I got there, I started asking everyone if they knew of anyone going to Albuquerque that I might be able to catch a ride with. Fortunately, Jetta, a trail angel, had an appointment in Albuquerque the next day. Jefferson (who manages the hostel) gave me her number and told me I would probably be able to get a ride with her. I called her and she said she was giving another hiker a ride to Grants and that I could absolutely get a ride to Albuquerque with her.

Jetta makes the section of trail between Reserve and Pie Town possible. She supplies a water cache in one of the driest stretches of the CDT, shuttles hikers between trail towns, and goes out of her way to help us. I paid her for the ride, but most of the work she does is donation based. She is an actual godsend.

I hung out with other hikers on the front deck of the Toaster House, and it was so nice to get to see so many of the people I’d met along the way. I booked a flight from Albuquerque to Columbus (with a connection in Atlanta).

I didn’t want to stay at the Toaster House, but I took a lot of precautions to avoid spreading giardia and didn’t eat while I was there (I realized somewhere in there that if I didn’t eat I didn’t have symptoms. Obviously not a long term plan but you gotta do what you gotta do). Also there was nowhere else to stay. The only other lodging was an RV park which also had communal bathrooms. I slept in my tent in the yard of the Toaster House, and left early the next morning with Jetta and two other hikers.

Albuquerque, New Mexico

We took a longer route to Albuquerque that passed through Grants and it was a beautiful drive. I checked for cell reception in Grants and found out my flight had been canceled. I was now flying from Albuquerque to Portland, from Portland to Detroit, and Detroit to Columbus. My plane wasn’t supposed to leave until after 7pm. It was my first red-eye, and I’d always wanted to take one so that I could watch the sunset out the plane window, but this was not the ideal circumstance. Still, I had found a way out of the middle of nowhere and I was grateful. I had Jetta drop me off at a Home Depot in Albuquerque so that I could buy a tub to throw my pack into (Backpacking packs are really expensive and have lots of buckles and straps that can get caught in machinery and break. They are super not meant to be checked without being put in something else.).

From the Home Depot, I decided to take the public bus to the airport (it was free and I had a lot of time to kill). I was still wearing my pack because carrying it in the tub is really not optimal, so I was now wandering around a strange city carrying a backpack with a bear can strapped to it and a giant plastic tub. Super normal stuff.

At the airport I separated out what I would carry on and what I would check, and threw my pack and everything I wasn’t carrying on into the tub. I checked the tub, and shoved everything else in my bear can, which became my carry on because it was not going to fit nicely in the tub. With that, I found my gate, boarded, and flew to Portland, OR.

Portland, Oregon

I had a two hour layover. When I got off the plane, I figured out what gate I needed and headed in that direction. The only problem was that D and E gates were in the same direction as baggage claim, and the arrows were pointed toward the “Exit, no reentry” doors. Yes, you do in fact have to leave security to switch gates here. Cool. Great. Wait, are you for real right now? Yep. Yep, we are. Fortunately my layover was long enough to pull that off. I also had to get a boarding pass because I switched airlines between my first and second flight. The woman who printed my new passes was actually in the market for a bear can so I told her about her options real quick and then went through security again. Fortunately it was late and there weren’t a lot of people. It was a quick process, and I was still a little early to the gate. I ended up sitting on my bear can because there were a lot of people in the seats. Apart from looking slightly suspicious and not having any handles, it was a pretty convenient carry on.

Detroit, Michigan

Detroit was great. I wasn’t there for very long. They were kind enough to not make me go through security again.

Columbus, Ohio

My bag survived baggage handling in the tub. My aunt picked me up from the airport and dropped me off at my place so I could get my car. I went straight to urgent care and went up to the front desk lady.

“Hi, I was backpacking in New Mexico and probably have giardia.”

I was informed that they can’t run the necessary labs at the urgent care and I would need to see my primary care doctor or go to the ED. My PCP did not have Saturday hours and I was not going to deal with giardia for 2 more days. I went to the ED. I took a really good nap in their waiting room and finally got a room. I explained the whole thing approximately five times. The PA decided to test me for giardia. I asked her what the plan was if the test was negative, since the test throws false negatives a lot. “We’ll refer you back to your primary care physician and she can refer you to a GI doctor to get it figured out.”

At that point I was over 24 hours with no sleep other than the nap in the waiting room and close to 48 without real food. I was running on caffeine and anxiety, and starting to feel like it was all an insane fever dream. I just wanted to be able to eat without feeling awful afterwards. I was so, so frustrated.

Do I need to fly back to New Mexico to get the beaver? Do you need to interrogate it? Is this real life?

A physician came in a while later and said the test wouldn’t even come back for around 24 hours and that it’s not very reliable unless you run it a lot of times over a several day period. She also said that based on the information I’d provided, it was reasonable to assume I had giardiasis, and that the treatment is an antibiotic/antiparasitic that’s safer than most other antibiotics, and that the risk of not treating me was greater than the risk of treating me at that point. She gave me a script and let me leave.

It should not have been that complicated.

The antiparasitic worked within a few days. I went back to work. I’m fine now, I feel good. I will be back on trail shortly. I am grateful to be healthy, to be safe, and to have seen every single one of those 270 miles. I am grateful to have had the chance to regroup, and to work in the meantime. I am so, so grateful to have the opportunity to go back.