Susan Alcorn’s Backpacking & Hiking Tales & Tips is a monthly email newsletter from her website at Backpack45.com. Susan and her husband Ralph have done hikes on the Pacific Crest Trail, the John Muir Trail, the Camino de Santiago, and more. Every month I review her newsletter for tips and information that I can share with my readers. I encourage you to check out her website and subscribe to her newsletter.
Only once before in the 15 plus years of publishing an email newsletter and this blog have I shared information that has the potential to save a life. Please read on and take this information to heart.
In the December newsletter, Susan shared a story they experienced while hiking the John Muir Trail. They met a hiker with a sobering tale he shared with them. He and his wife had reached Palisades Lake when she was suddenly hit with nausea, fever, and weakness. Initially he thought it was exhaustion, but the next morning his wife was worse so they did a layover day. She was even worse the following day so they decided to exit at Bishop.
His wife became so weak that she could no longer walk – even without her pack and with help. She collapsed on the attempt to descend the Golden Staircase. Her vitals were a temperature of 105, blood pressure of 90/50, a resting pulse 135 – and she was unaware of her surroundings. He and two others tried to carry her out, but found it impossible because of the narrow trail. A helicopter was brought in and she was airlifted out in a basket to Deer Meadow, where she was put inside the helicopter and taken to the hospital.
The Alcorn’s met the husband as they were leaving the John Muir Trail over Bishop Pass. He was going out on the east side and then going to find a way over to the hospital in Fresno. We wondered for days how this had played out and were happy when they heard a subsequent report. After four days in the hospital on antibiotics, the lady was ready to be flown home – not entirely well, but no longer in danger. The hospital did not do tests to determine the cause, but only treated symptoms, so the cause of the problem was up for speculation. Her husband thought that an infection had probably entered her blood through blisters in her feet – most likely the source was open blisters and their soak in hot springs.
Susan says, This is a reminder of the importance of avoiding infection in any open sore – especially under trail conditions.

I agree. In 2007 I wrote an article about another hiker on the Pacific Crest Trail who had to be evacuated out and spend a long time recuperating from a serious infection. Her infection was also caused by an infection through an open blister. This first photo shows her infected foot after she reached the hospital.
Bacteria causing the infection can come from your skin, from the environment, or from anything that gets inside the blister. The web spaces between the toes have more skin bacteria and open blisters here present an increased risk of infection. The second photo shows the redness common to an infection.

The take-away here is that we need to understand how to properly clean and care for blisters, have the right materials to patch them, and know the signs of infection.
All open blisters should be watched for redness, streaks up the leg, pus, heat to the touch, pain and/or swelling around the area, and fever. When any of these are present, prompt medical care should be obtained.
In my 2007 Fixing Your Feet newsletter I wrote, I think this is the most serious and important issue yet. It has in-depth focus on infections as a result of blisters. First read my editorial, Blisters Can Lead to Serious Infection, and then the feature article, My Infected Blister – Almost My Life! where Cari Tucker “Sandals” tells her story. I think you’ll agree with Denise Jones, the Badwater Blister Queen, who told me, ‘This is indeed sobering and shocking (literally). I think people need to see this because I do not think they take blisters very seriously!’ I urge you to fully digest the articles, then read the articles on Blood Blisters and Infections, Staph Facts and Cellulitis Facts.
Here’s the link to the July 2007 Fixing Your Feet newsletter with the articles.