Snakes, Chacos and Brookies - a Sunday Funday down the tubes

[Morgan Cosgrove]

In Virginia, snakes are very common, but snake bites aren't. In the United States about 7,000 poisonous snake bites are reported each year, of those 7,000 bites only six were fatal. In 2018 there have been numerous snake bites reported in Virginia, and only one in Maryland. 

Hooray for me. 

In the Old Dominion, there are thirty types of snakes. Of the 30 only 3 are poisonous: Timber Rattlesnake, Northern Cottonmouth and the Eastern Copperhead. 

Timber Rattlers mostly live in western Virginia, and cover a good part of the George Washington and Thomas Jefferson National Forest, and Shenandoah National Park.

Cottonmouths, or Water Moccasins, live mostly in a small section of  southeastern Virginia covering lowland areas like marshes and swamps. 

The Eastern Copperhead is the most common poisonous snake in Virginia. They throughout the state and are fairly common. Unlike the other two, copperheads strike fast and don't like to be bothered. 

Fun internet research aside, this all brings me to my story. A Sunday funday in Shenandoah National Park with my buddies catching our favorite Virginia state fish, abruptly ruined by a damn poisonous snake and my affinity for wet wading in Chacos. 

A cool and wet start to summer, and after weeks of heavy rain throughout Virginia, the rivers of Shenandoah National Park were full and running clear. My buddies and I loaded up from DC and headed to the Mountains for a day of hiking, river lunches, and tricking mountain brook trout. Overcast and a high in the mid 80's, prefect day wet wading and dry fly action in SNP. 

We arrived shortly after 9am, parked and headed up the mountain. We hiked the trail for a few miles, and eventually decided to cut to the river. The plan was to fish and hike down river and meet eventually for lunch. Being the fisherman I am, I generally like to fish upstream and move very quickly when I fish small water for brookies. Minimal casts into pools, and if I miss a fish, I usually move on. I quickly bunny hopped by friends and fished up river a few hundred feet. The air and water temp was perfect, and there was lots of bug activity all over the river. I started with a size 16 high vis Parachute Adams, switched to Royal Wolf. By 10am I had easily caught a dozen brookies. Flies didn't seem to matter because the fish were hungry, so I switched to a Copper John nymph and caught a quick 5-6 more fish. It was almost 11am, so I decided I would try to see if I could get to two dozen fish and call it a day, hike out and find my friends and have some lunch. Around 11:30am I caught my last little brookie and it had started to drizzle, so I decided it was time to go find my friends. I pulled off the river and hiked to find the trail. As I hiked away from the river, there was a small green clearing where I stopped for a second. A few weeks prior I was in Vermont for a wedding, and while I was there or during the trip up I encountered a nasty case of Poison Ivy. I had the rash all over my body, and was really hoping to avoid that poison once again. I was surveying the green spot and thought I saw some Ivy, so I side stepped to my left, and as I lifted my foot into the air I felt a quick tingle. My foot hit the ground and I felt the tingle again. Confused and bewildered I looked to my right and saw a coiled Copperhead snake looking pissed. Freaked out I grabbed my fly rod from the ground, which I had thrown in the air while I was getting accosted, and sprinted up to the trail. I then ran as fast as I could down the trail yelling for my friends. I quickly found them a quarter mile or so down river. We gathered our things and headed to the car. Shortly after the bite I could feel the venom go up my leg, and my inner leg and thigh got super tight, and it was difficult to walk. As we hiked out the 2-3 miles my foot, shin and leg started to go numb and got significantly tingly.  My buddies rushed me to the nearest hospital. By the time I arrived to the ER I could barley walk and my leg was almost numb. 

At the hospital they did the usual, took my blood, gave me a few shots, monitored my bites and bodily swelling, and administered my heart rate and blood pressure. Based on my foot and leg swelling the doctors determined that I didn't need to take the anti venom, which was a relief. I spent almost 8 hours in the ER before they discharged me. The trek back to DC was brutal, but they pumped me full of a pain med cocktail something out of a Hunter S. Thompson novel.

The last few days have been a blur. I've been in and out of doctors offices, out of work for a few days, and the pain is the most intense thing I've ever experienced. I still can't really move my foot, or put any weight on it.  My foot has almost doubled in size with swelling, and I have bruises up and down my left leg. Almost every time I stand up blood rushes to my foot and my whole leg tingles or goes numb. It's the most painful 30 seconds I've ever experienced, and tremendously uncomfortable. The doctors told me I'll be off my foot for at least a week, and the swelling could last a month. Poison control and I have become best buds, and they know nothing about snake bites in the District. So this has been fun. 

I've spent my entire life outside. I grew up in Vermont on Lake Champlain, went to college in Montana, lived a year in Wisconsin, and have been in DC for the last 4 years. While fishing, hiking and spending my life outside I've run into grizzly and black bears, encountered Champ on Lake Champlain, chased sweat thirsty goats away from my backpack, saw a wolf the length of a car, and had a gaggle of buffalo sneak up behind me while in fishing in Yellowstone. Even with all dumb events and dangerous animals I've encountered, the most painful experience of my life was stepping too close Copperhead in SNP. 

Moral/long story short, snakes are weird, especially Copperheads. Always keep a first aid kit on you when you're fishing or spending time in the wilderness. If you're not alone, employ the buddy system. SNP has a lot of snakes, especially Copperheads. Watch where you step and be careful.  If you get bit by a poisonous snake do not ice it, or apply a tourniquet.  Last but not least, especially when you're in friggen snake country, wear closed toe shoes. 

Snake bites suck, and your ego will not only be the thing throbbing in the most pain for the days to follow. 

[Richard Farino]

Dude – this sucks and I’m sorry you got hit out there.

 

Does free beer help with snakebites?

 

 

R

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[Miles]

Are you sure it wasn't a Brown Water Snake?

Sorry - I had to do it before TurbineBlade did.

I can't imagine how much this sucks. On the plus side, I bet a flyfishing mag would pay for a fuller version of your post.

-Miles

[Sean Steele]

I’ve got a science/nature writer that might want to interview you on spec. He’s a freelancer.

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[Morgan Cosgrove]

That would be nice. Maybe some double snakebite IPA?? Ha. 

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[Morgan Cosgrove]

Certainly was a copperhead. I've seen eastern watersnakes in the park and in the rivers, certainly wasn't. After the doctor's chat, and upon further inspection of the situation I determined it was a copperhead. Apparently copperheads are very territorial, and will strike if they feel bothered. Where as a rattler or other snake will hide and chill and lash out in a last resort. 

 In the Culpepper ER they have seen 4-5 copperhead bites this year, so not terribly uncommon in those parts. Glad the care was on point. Today I finally have some mobility in my leg and foot, and hope to be able to walk in the next few days. 

[Morgan Cosgrove]

I'd be happy to chat with him. It was a pretty crazy story, and I wrote it up to shine light on the issue of snakes and to be careful in while poking around in snake coutry. Apparently they are more active in the early summer and late spring, so my timing was just right. 

I've always heard about copperheads and rattlers, and been told to be careful, but you never think it could happen to you, and unfortunately  it did. 

On Thursday, June 21, 2018 at 8:06:01 AM UTC-4, Sean Steele wrote:

I’ve got a science/nature writer that might want to interview you on spec. He’s a freelancer.

On Jun 21, 2018, at 8:03 AM, 'Miles' via Tidal Potomac Fly Rodders <tidal-potoma...@googlegroups.com> wrote:

Are you sure it wasn't a Brown Water Snake?

Sorry - I had to do it before TurbineBlade did.

I can't imagine how much this sucks. On the plus side, I bet a flyfishing mag would pay for a fuller version of your post.

-Miles

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[namfos]

Where *HAS* TurbineBlade been?

I think boots might be the superior choice in footwear. 

Mark

On Thursday, June 21, 2018 at 8:03:00 AM UTC-4, Miles wrote:

[Morgan Cosgrove]

Agreed. In retrospect that would have been smarter. Always from here on out despite the heat and humidity. 

[Miles Townes]

Oh - I totally believe you. I've been bitten by plenty of water snakes, and I never had to see a doctor. Probably by the time your leg started tingling you knew enough to make a definite claim. Water snakes tend to have a pretty messy bite, and often leave little hook shaped teeth behind in the wound. They bleed, but don't go numb.

But it seems like every year, somebody posts on here about seeing copperheads in/on/near the river. Further investigation usually reveals they were Northern Water Snakes (not Brown - my bad on the species). This is the first time I've seen a definite copperhead ID. I guess even in the context of your unfortunate mishap, it's worth reminding people that copperheads and water snakes can look very similar.

best,

Miles

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[Bob Richey]

Sorry that happened to you. Copperheads seem bad this year. They’re wrapping up their mating season soon. I worry about my dog getting bit by a venemous snake at our cabin.

[HeaveToo]

Sorry to hear about the bite and I hope that you are doing better.  I have had a few very close calls with copperheads.  The baby ones supposedly are worse than the adults because the adults control their venom.  

I am surprised about you saying not to tourniquet it.  I always thought that you were supposed to do that an elevate it.   

[John Hammill]

Copperhead populations have either risen or simply moved up from the water the last couple of years because of moisture. In Virginia and the Carolinas and NE Georgia

I have friends who have seen many more than usual, and though they have avoided being bitten, their dogs haven’t been as lucky. Friends have seen them flush against the walls of their houses and sheds while gardening. I don’t think it’s as bad this year, but last year there was a really big explosion of sightings on the East Coast south of Maryland. The jury is still out on if the increased sightings and big rise in bites is because of copperheads moving up from water sources and thus closer to humans or if their populations have increased somehow because of more rain or both. (Or neither!)

Too many articles to post, but here’s one and a couple of screen shots.

http://www.virginiaherpetologicalsociety.com/index.html

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[Richard Farino]

Where were you hiking?

 

You wrote no anti-venom?  Why?

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[namfos]

Last fall I was diagnosed as exposed to Lyme disease even though I'm showing no symptoms. Doc put me on 8 week course of antibiotics. From here on out it's long pants and socks in the woods or bushwhacking through bankside vegetation to get to the river and a spray bottle of permethrin regardless of heat & humidity

[Miles]

I'd be interested to hear the explanation for this, too. My understanding is that antivenom is extremely expensive and can cause anaphylactic shock or other bad reactions, so it only gets used in very serious bites.

Miles

[Gregg DiSalvo]

Man, sorry to hear about that.  Can't imagine that hike out and drive to the hospital.  After a hard fall last year when fishing alone in the park, I now don't go as often as I try to fish with a buddy.  Add snakes to this and I think I will think long and hard before going alone.  I always carry a sawyer snakebite kit with me, but have read that its pointless many times.  Anybody have good intel on the validity of a snakebite kit (suction)?  

I was in the park saturday and sunday and found some huge snake skins and saw a number of northern watersnakes.  I fins snakes fascinating, but man do I steer clear.  I skipped a couple of perfect pools due to snakes.  

[Miles]

A tourniquet is a bad idea because most of the venomous snakes in North America have hemotoxic venom, and applying a tourniquet concentrates the blood and tissue damage to the area around the bite.

A review study in the New England Journal of Medicine found that best practices for snake bites in North America:

"After a bite from any venomous snake, the victim should be moved beyond striking distance, placed at rest, kept warm, and transported immediately to the nearest medical facility. The injured part of the body should be immobilized in a functional position below the level of the heart. Rings, watches, and constrictive clothing should be removed, and no stimulants should be administered.

"Previously recommended first-aid measures such as tourniquets, incision and suction, cryotherapy, and electric-shock therapy are strongly
discouraged."

Other studies have demonstrated that suction alone - the Sawyer Extractor - is useless. It doesn't remove any venom.

An ounce of prevention is worth several pounds of cure.

-Miles

[Jeff Cook]

Then I’m curious what happens at the hospital? With no anti venom, no tourniquet, no anti swelling, no cuts, no suction, these new guidelines seem to have removed the treatments. (Electroshock is a new one on me.) 

Are they just saying these things need to be done under supervision?

I’m making plans to be kayaking alone often, and I don’t think I’ll be helicoptering over to the ER. Surely there’s room for a wilderness plan for snakebites in this era?

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[Miles Townes]

The same article says for hospital staff: "Victims of bites from venomous snakes require aggressive supportive care and sometimes the administrationof antivenom. Once airway, breathing, and circulation have been established, a rapid, detailed history should be obtained." It then talks about the process for deciding whether to administer antivenom.

Fwiw, it says that copperhead bites are considered less toxic than rattlesnake or cottonmouth bites, and "rarely require treatment". The article is behind a paywall but I got a copy from sci-hub that I can email, if you want to read the whole thing.

I am curious, too, what the plan would be if evacuation is not an option. AWLS says basically: get to a hospital. https://awls.org/wilderness-medicine-case-studies/our-recommendations-for-snakebite-treatment/ NOLS says the same thing: https://blog.nols.edu/2018/02/26/case-study-what-to-do-about-snakebites I couldn't find a reputable site that said anything else. 

Depending on the snake, I suppose you could wait it out. Maybe if it was a copperhead, you would recover on your own enough in a few days to paddle out. I'd take the helicopter ride. And I guess part of the thrill of the wilderness is really having only yourself to rely on.

But I wouldn't worry about it too much. It seems to me there are lots of other more likely injuries you might face, that also would require a helicopter - broken arm, dislocated shoulder, tendon rupture, severe diarrhea. Helicopter evac should be a contingency in your plans, but granted a remote one.

For me the definitive statement on the merit of helicopter rescues is this Boatertalk review, from about 20 years ago: https://boatertalk.com/review/586

Miles

[Tim Donaldson]

You buried the lede; what was your Champ encounter?

[Morgan Cosgrove]

They monitored my leg, thigh and foot for swelling for almost 6 hrs and determined that because the swelling wasn't abnormal that I didn't need the anti venom. Anti venom is pretty rare and expensive and reserved for the most dire circumstances. None exists in DC, and my DC doc hadn't ever seen a snake bite in her practice. 

On Friday, June 22, 2018 at 10:40:53 AM UTC-4, Jeff Cook wrote:

Then I’m curious what happens at the hospital? With no anti venom, no tourniquet, no anti swelling, no cuts, no suction, these new guidelines seem to have removed the treatments. (Electroshock is a new one on me.) 

Are they just saying these things need to be done under supervision?

I’m making plans to be kayaking alone often, and I don’t think I’ll be helicoptering over to the ER. Surely there’s room for a wilderness plan for snakebites in this era?

On Jun 22, 2018, at 9:40 AM, 'Miles' via Tidal Potomac Fly Rodders <tidal-potoma...@googlegroups.com> wrote:

A tourniquet is a bad idea because most of the venomous snakes in North America have hemotoxic venom, and applying a tourniquet concentrates the blood and tissue damage to the area around the bite.

A review study in the New England Journal of Medicine found that best practices for snake bites in North America:

"After a bite from any venomous snake, the victim should be moved beyond striking distance, placed at rest, kept warm, and transported immediately to the nearest medical facility. The injured part of the body should be immobilized in a functional position below the level of the heart. Rings, watches, and constrictive clothing should be removed, and no stimulants should be administered.

"Previously recommended first-aid measures such as tourniquets, incision and suction, cryotherapy, and electric-shock therapy are strongly
discouraged."

Other studies have demonstrated that suction alone - the Sawyer Extractor - is useless. It doesn't remove any venom.

An ounce of prevention is worth several pounds of cure.

-Miles

On Thursday, June 21, 2018 at 7:44:54 PM UTC-4, HeaveToo wrote:

I am surprised about you saying not to tourniquet it.  I always thought that you were supposed to do that an elevate it.   

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[Morgan Cosgrove]

I was hiking the lower Rap, up Stanton River and Bear Church Rock trail. About 2-3 miles up then the snake struck. 

After monitoring my swelling they determined that my foot and leg would be ok without the anti venom. 

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[Jeff Cook]

Thanks Miles. Yes, I’d very much appreciate getting that article. It looks like Wikipedia has caught up to those recommendations, too, and gives just a smattering of rationale, under “Outdated”: https://en.m.wikipedia.org/wiki/Snakebite

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[Miles]

I just saw this on Outside's website, about a guy who survived a rattlesnake bite: https://www.outsideonline.com/2315436/surviving-rattlesnake-bite

The guy comes off as kind of insufferable and the whole Moby Dick alternating facts and narrative thing is grating, but there's some useful info. Apparently the snake hit a vein and the venom's effects were nearly instantaneous. 

-Miles

[Bob Richey]

This weekend my wife and I were walking our dog around Lake Arrowhead outside Luray and came across two boys 12-13 years old.  There was a copperhead on the side of the trail and they were trying to catch it in their fishing net.  I told them they should leave it be and then I said "I just read about a guy who got bit by a copperhead the other day. It's no joke."  They had been messing with it for a while when we came up, the copperhead (and it was a copperhead, not a water snake) was coiled up and pissed.  We told them to leave it be and they left to join their family and we went back the way we came

[Casey Peltier]

Thank you, Bob! It takes a village...

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From: tidal-potoma...@googlegroups.com <tidal-potoma...@googlegroups.com> on behalf of Bob Richey <bob.r...@gmail.com>
Sent: Tuesday, June 26, 2018 10:32 AM

To: Tidal Potomac Fly Rodders

Subject: {Tidal Potomac Fly Rodders} Re: Snakes, Chacos and Brookies - a Sunday Funday down the tubes

 

This weekend my wife and I were walking our dog around Lake Arrowhead outside Luray and came across two boys 12-13 years old.  There was a copperhead on the side of the trail and they were trying to catch it in their fishing net.  I told them they should leave it be and then I said "I just read about a guy who got bit by a copperhead the other day. It's no joke."  They had been messing with it for a while when we came up, the copperhead (and it was a copperhead, not a water snake) was coiled up and pissed.  We told them to leave it be and they left to join their family and we went back the way we came

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[namfos]

Venomous snakes in MoCo? http://bit.ly/2N9Lrah

Mark

[tperkins]

Two heads are better than one? 

https://www.washingtonpost.com/local/rare-two-headed-copperhead-snake-found-in-virginia/2018/09/24/e69140cc-bfe4-11e8-9005-5104e9616c21_story.html?noredirect=on 

[Morgan Cosgrove]

Every person I know has sent me that article. Pretty funny. 

Those two heads are terrifying...