Saturday, November 7, 2009

I'll Never Have to Worry About Appendicitis Again


In May I was at a hotel in Fremont, CA on a business trip when my stomach started hurting...badly. While writing in pain I managed to phone my wife and ask her to look up symptoms of food poisoning. I had eaten sushi the day before, so I assumed I must have food poisoning. I even had her call our friends who had also eaten sushi with us. Nobody else was sick, and I did not have the symptoms of food poisoning. I reluctantly asked her to check the symptoms of appendicitis, which led to me calling the nurse helpline. The nurse told me I needed to get to a hospital within the next four hours. But the pain abated somewhat, I was able to grab a few hours of sleep, and I flew to LA the next day for meetings. I didn't feel great, but the worst was over. (Note: I know for a fact that at least 80% of men would have also have ignored the nurse on the phone)

Fast forward to early September. Due to my busy work schedule my 8-year-old daughter and I had not taken our annual backpacking trip. So even though the weather forecast for Labor Day weekend wasn't ideal, we decided to head out on an overnighter to a lake near the Montana/Idaho border.

We did not pack fishing equipment because a lot of times at these high mountain lakes you don't have room to backcast, and I didn't want to dig my spinning gear out of the basement. Also my daughter, although good at it, is not exactly gonzo about fishing.

The hike in was around 4 miles and moderately steep (as gauged by my daughter's moderate level of fatigue). Bear Poop or Clif Bar?Upon reaching our destination, we found that there were no good places to camp; however a group of three men with their camp already set up told us there was a nice spot with good views just down the trail near a smaller lake. We made our way around the first lake and down to the second lake. The spot for a tent was on a slight incline and there was a pile of bear scat next to our cooking area (picture), but the views were great and we had the lake to ourselves.

After setting up our tent, we explored the perimeter of the lake, grazing on huckleberries and scouting for animal tracks. We scrambled up a ridgeline to scout our next day's day hike the top of a nearby peak. Back at our campsite, we collected firewood, built a nice fire, ate dinner, told stories and fell asleep under a clear sky and rising moon.

The next day did not go as planned. At around 2:30am I woke up either to the sound of a strong wind, evergreen needles falling on the tent, extreme stomach pain, or all three. Once awake, the excruciating pain kept me awake all night, and every time I changed positions to try to better my situation I would break friction and slide down towards the foot of the tent (remember the incline). Squirming back up into position was not easy or pleasant. I knew what was wrong: it was my appendix. I hoped it was salmonella in my Clif Bar; or perhaps my water filter had not filtered out some giardia. But the symptoms were the same as I had experienced in California a few months earlier, the pain I ignored, the pain that went away. The only difference was, this time the pain was not going away.

After 6 hours of excruciating pain, I woke my daughter and told her there was a problem. I told her she had to hike up to the two campsites at the other lake and ask for help. Needless to say she was a bit scared, and started to weep. I was scared too. I was worried for my life, and worried about sending her off alone. I told her if she saw a moose (I had heard one at some point during the night) to wait for it to leave the trail and give it a wide berth. She asked about bears and I told her that they would run away. So she bucked up, put on a few layers of clothing, stepped out of the tent into a cold morning rain, and hiked up the trail.

After a while I started to worry that my daughter had been gone too long, and that perhaps in order to save myself I had sent her into the waiting jaws of a mountain lion. The guilt combined with the pain was almost unbearable.

Then I heard a voice: "Hi, my name is Kerry. Your very brave daughter tells me you might be having a problem with your appendix?" A man from Idaho and his two cousins were outside the tent. They told me that I needed to get to a hospital, and asked if I thought I could hike out. I wasn't sure I could, but at this point I knew I had to move. I swallowed some ibuprofen, stuck my contacts in my eyes, got dressed, packed a few things in my daughter's backpack, handed our food bag to Kerry (I remembered the bear scat), and exited the tent. I considered packing the tent, sleeping bags, etc. in my backpack and packing it out but was told in no uncertain terms that was a bad idea. So I buried the pain, and with my brave daughter and our escorts, hiked out.

Kerry and his cousins hiked the entire way out with us to make sure we were safe. The hike was wet, and slow, but we had the right clothing and made it out without incident. Back at the trailhead, one of the three men drove our car to the nearest point of civilization, with their vehicle following. I started feeling feverish, getting chilled, and needed to warm up. I called a nurse friend and she told me (in very un-medical terms) that knowing me, if something forced me out of the mountains there was probably a real issue; and by the way, my symptoms were classic appendicitis. I called my wife and told her about the situation and that I was going to start driving west, she needed to start driving east, and I would call her when I thought we were going to cross paths or when I pulled over, whichever came first.

My daughter and I made it about thirty miles and I had to pull over. I called my wife and she took the proper exit and picked us up. I was in and out of sleep for the seventy minute drive to the hospital. The pain was still there, though not at the levels I had experienced earlier. I was admitted to the ER, and after a few tests and a CAT-Scan I was told my appendix was "nicely enlarged". The nurses added an antibiotic drip to my IV, and few hours later my appendix was removed via arthroscopic surgery.

After the surgery as I lay awake in my hospital bedroom, a thought came to mind: I would never have to worry about appendicitis on another backpacking trip or fishing trip outside the service area of modern civilization! Then I thought: when did I ever worry about this before?

My goal with this blog is to impart some fishing advice in every post, so here are two pieces of advice.

It turns out Kerry has a friend who almost died recently of appendicitis, and now is enduring other long-term health issues as a result. After my surgery I called my parents to let them know what happened and my father told me his cousin died from a burst appendix. My advice: learn the symptoms of appendicitis and if you are fishing and you have a flare up of appendicitis -- even if there is a once in a lifetime hatch and the fish are rising everywhere around you -- stop fishing and seek medical care immediately. That way that great hatch won’t actually be a once in a lifetime hatch.

Finally, If you are on a piece of water catching fish, go out of your way to help others with the right fly selection or technique. Call it karma or the golden rule, but you will be richer in the end. You will catch more fish, because teaching and sharing reinforces your own learning and you will become a more pensive fly fisherman. I believe that the fact that Kerry and his cousins were there to help and did help was in part a result of many seasons of sharing flies and giving advice on the water. I told Kerry I wasn't sure how to thank him, and he told me if I'm ever in his shoes, just do the same thing. I would and I will.

Wednesday, April 29, 2009

Three Clinch Knots, Including a "Better" Clinch Knot

Fishing knots number in the dozens, but for the majority of fly fishing situations there is only one that you need to know in order to tie your fly to your line – the clinch knot. This article and accompanying videos will discuss and show you how to tie my three favorite terminal tackle knots – the clinch knot and two variations of the clinch knot -- my “better” clinch knot, and the Trilene knot.

I learned to tie a clinch knot as a boy fishing for catfish at a lake in New Hampshire. One night we were laying down on the beach at our favorite catfish hole, looking up at the stars, waiting for our rods to be dragged towards the water. An old-timer apparently knew about our not-so-secret spot and joined us. He asked me if I knew how to tie a “fisherman’s knot”. I told him I wasn’t sure (“fisherman’s knot” was kind of a generic name) and held his flashlight while he showed me the knot. “Five wraps,” he said. “Then pass it back through and pull it tight.”

Clinch Knot

The clinch knot is an all-purpose knot for tying on terminal tackle (tippet to fly). The knot is easy to tie, pretty strong, and great for the majority of situations when tying a fly onto tippet. The following video shows how to tie a clinch knot.



One tip that may save you some flies (and lost fish) is to vary the number of times you wrap the line back around itself. The standard is five, as the old-timer in New Hampshire taught me. Over time I’ve learned that five is an average; more or fewer wraps will make a better knot depending on the size of the tippet and hook eye. I will wrap six or seven times when the hook eye is outsized in relation to the tippet diameter, and only four times when the hook eye is undersized in relation to the tippet diameter. For example, with 5x tippet and a size 12 fly I may use 6 wraps; with 3x tippet and a size 8 fly I will typically use 4 wraps. Time on the water and a few broken tippets will tell you what’s ideal. This strategy applies to the following two knots as well.


A Better Clinch Knot

An “improved” clinch knot exists, and it’s a fine knot. However, I came up with my own version which, in addition to the improved security (from knot slippage) afforded by the improved clinch, is stronger than either the clinch or improved clinch. The following video shows how to tie my “better” clinch knot, including a slow motion replay of the secret sauce.



I use my “better” clinch knot for tying on almost all my flies. The exceptions are when I’m using 3x tippet, in which case I’ll usually go with a standard clinch; and when I’m using flies with really big hook eyes or stripping streamers, in which case I’ll use a Trilene knot (explained below).


Trilene Knot

I’m not sure if Trilene (Berkley) fishing company invented this knot, but apparently they get credit. The Trilene knot is tied the same way as the regular clinch knot, with one difference – you loop the line through the hook eye twice to start the process. Watch the following video to learn how to tie the Trilene knot.



I find that the Trilene knot is superior when tying on a big bead-head wooly bugger with 3x or 4x (and especially 5x if you have to go that light). Sometimes I’ll use it when I have to go with 4x or 5x to a big dry fly, which I don’t like to do unless the fish are really leader shy.

Give all three of these knots a try. I recommend practicing a few times at home using tippet and flies (not just bare hooks) because the “better” clinch and the Trilene knot can be a bit awkward to tie at first. Hopefully you’ll lose fewer flies to snags and you’ll land more fish. And be sure to share your skills with a kid!