Dale Sparks  /  AP
West Virginia University Hospital's Dr. Julian Bailes, discusses miner Randal McCloy, Jr.'s medical condition and the damage to McCloy's brain. 
updated 1/12/2006 11:41:44 AM ET 2006-01-12T16:41:44

Catherine Mormile was competing in her third Iditarod race in Alaska when she stopped at a tent along the route to change her wet socks. Minutes later, she felt nauseous. Hours later, she would be unconscious.

"I tried to stand up and I had to hold onto the frame of the tent," she said of her 1994 carbon monoxide poisoning from a propane heater in the unvented tent.

The 51-year-old physical therapist breathed the odorless gas for three hours. She said it took her years to recover. Her IQ plunged. She had to relearn skills such as reading and writing, and said it took longer to recover emotionally.

Randal McCloy Jr., the sole survivor of the Jan. 2 disaster at the Sago Mine, could face similar challenges as he tries to recover from more than 41 hours spent trapped inside the mine. A state official has said 11 of his co-workers died from carbon monoxide poisoning, and doctors believe McCloy suffered some brain damage from his exposure.

"He is likely one of the longest survivors of this sort of exposure, not only carbon monoxide, but the other circumstances in the mine," Dr. Julian Bailes, a neurosurgeon treating McCloy, said this week.

On Wednesday, McCloy remained in critical condition. He's still in a coma, and little has changed in several days. Doctors don't seem concerned that the 26-year-old hasn't fully awakened yet and say it could be a lengthy, gradual process.

Several doctors said this week they had never heard of anyone breathing carbon monoxide as long as McCloy and surviving. They note it's possible McCloy also inhaled other toxic gases in the mine as well.

Carbon monoxide is found in combustion fumes, such as a car's engine, and can be poisonous if breathed in closed spaces. Symptoms can include headache, dizziness, weakness, nausea, vomiting, chest pain and confusion, and can vary depending on the concentration and severity of poisoning.

500 carbon monoxide deaths each year
According to the Centers for Disease Control and Prevention, about 500 people die in the United States each year from unintentional carbon monoxide poisoning, and about 2,000 people commit suicide using the gas, often by inhaling car fumes.

When inhaled, it binds with hemoglobin, a substance in the blood that carries oxygen through the body. When carbon monoxide is attached to 10 to 15 percent of the blood's hemoglobin, a person might start feeling dizzy, confused and achy, said Dr. Rutherfoord Rose, director of the Virginia Poison Center.

At 30 to 40 percent, a person becomes drowsy, lethargic and can slip into a coma. At 60 to 70 percent, carbon monoxide poisoning becomes fatal, he said.

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A note left by miner Jim Bennett included a timeline with a final entry about 10 hours after the blast, his daughter has said. But the timeline seems to add to the confusion about why McCloy survived, and the 11 other trapped miners died.

Rose said it doesn't make sense that McCloy alone would have lived for 30 additional hours, raising the possibility that the other men were alive for 20 to 24 hours after Bennett recorded his last entry.

"They could have been unconscious and certainly breathing for a while, pretty sluggish and out of it, but sort of incapacitated," Rose said.

Studies have suggested such long-term effects as impaired thinking and reasoning, said Dr. Kenneth D. Katz, an assistant professor at the University of Pittsburgh Medical School's department of Emergency Medicine.

"But it's not conclusive," he said, and noted that some people might be more susceptible to long-term harm from the gas. In the case of Mormile, the Iditarod competitor, others had been in the same tent without getting as sick as she did.

Less severe cases can remedy themselves when the source of the carbon monoxide is removed, he said. In more severe cases, patients are often treated in hyperbaric chambers, which forces pressurized oxygen into the body to fight carbon monoxide poisoning.

McCloy was treated in a hyperbaric chamber last week at Pittsburgh's Allegheny General Hospital. Doctors there said the therapy was a supplement to other treatments McCloy is undergoing, and the effects would not be immediately known.

Dr. Richard Moon, the director of the Hyperbaric Center at Duke University Medical Center, said there is strong evidence that using the hyperbaric treatments can stave off long-term effects. But he said those treatments must happen early on, because often those poisoned by carbon monoxide can experience bumps in their recovery.

"People can be fine for a few days," Moon said, "then can deteriorate."

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