Identified! FL - Big Cypress Natl Preserve, Male Hiker, Denim & “Mostly Harmless” July 2018 - Vance Rodriguez #3

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A quick google search shows: "The combination of diphenhydramine and ibuprofen is used to treat occasional insomnia associated with minor aches and pains." Advil PM contains both ingredients. Was Advil PM found or any other OTC medications with him? It he had overdosed, it would have been a slow and painful death. It could have been an accident, he might not have been dealing okay with some form of pain. The autopsy report says he was fine physically except for the mention of his genitalia, feces (still in the body), urine (still stored). If he had overdosed, he would have had trouble relieving himself, he probably would have been delusional right before he died.
 
This was one of the reasons why I thought about diabetes type 2 and diabetic neuropathy - patients who have these diagnoses ought to check their feet daily.

Other symptoms of diabetic neuropathy include:
  • "Slow stomach emptying (gastroparesis), causing nausea, vomiting and loss of appetite
  • Severe pain in a hip and thigh or buttock
  • Eventual weak and shrinking thigh muscles
  • Difficulty rising from a sitting position
  • Severe stomach pain"
There are multiple different symptoms depending on the type of neuropathy a patient is diagnosed with (you can have more than one type at the same time). These are just some that could match MH's condition.
My source is not the best one but here you go - Diabetic neuropathy - Symptoms and causes.
I don't think all diseases related to nerve damage show on autopsy - they only performed an x-ray, didn't they? For nerves you would probably need something more in depth. (IMHO)

ETA: I suppose the state of decomposition could have prevented the medical examiner from digging much deeper.
Earlier I posted that I thought some of the symptoms matched up with Type 1 diabetes (which he may not have known he had). Your post got me thinking - would that be able to be ascertained during an autopsy. I think the short answer is "yes" but the longer answer seems to be that you would have to do some sort of advanced testing. The really long answer:

"In the realm of forensic pathology, acute complications of diabetes mellitus as causes of death may be difficult to diagnose due to missing characteristic macroscopic and microscopic findings. Nevertheless, when biochemical investigations complement autopsy and histology, fatal DKA can be easily diagnosed despite unknown disease history and even in corpses with advanced decompositional changes" BBM

Postmortem diagnosis of diabetes mellitus and its complications

It also looks like the small testes could be a complication of diabetes if untreated - from a quick search.

I still think he died of depression. JMO
But something about his face in all his pictures makes me think depression is not out of the question.

ETA - Such a hauntingly sweet face - I’m sure that is why we are all so invested.
 
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It now appears there was no evidence in the autopsy showing a terminal illness ravaging his body/destroying organs. JMO

ETA: Again, did he actually tell another hiker of a fatal diagnosis... what did he say, exactly?

I don't know if he specifically said he had a fatal illness, but he did mention to several individuals about a health concern that may have hindered his ability later.

I know the information is somewhere in these threads from long ago, but you can see in this link a woman called Beverly Keen, who spent time with him in Feb 2018 said he mentioned his health.

True Crime Society - Unidentified and Mostly Harmless
 
Am I missing something here??
I thought MH cause of death was given to be starvation??
In school, we were taught all about WWII, Anne Frank and the Concentration Camps- and 'starvation diarrhea'. How it was rife throughout the camps. I know those poor souls were kept in squalid conditions, but I'm sure it it was due to them being starved as opposed to sickness spreading amongst them!! (If that info is wrong, I swear I will type a review on their school website!!) But that would not fit with MH Autopsy Report. I find his mysterious death to be all the more upsetting since reading how his brain, all his organs were in perfect condition, showing no abnormalities internally. Except of course for that one word "Cachexia"! Which is the medical term for muscle wasting. Sometimes called The Last Illness since it happens to those in the last stages of cancer. But not just in cancer- he defo suspected a diagnosis of some sort though. Because, when not in cancer patients, Cachexia can be caused,, by lack of exercise, not eating enough protein etc. And although Cachexia is irreversible, plenty of exercise, more proteins and whatnot all go towards helping in slowing the muscle wasting down. - Could of been out there on the good advice of a Doctor?- Now, if he were a naturally lean guy, the process would occur more rapidly than say in a bodybuilder! Cachexia has been linked to other underlying medical conditions over the years eg. Motor Neurone Disease, Anorexia and lots more, including genetic disease. Perhaps MH knew of the muscle wasting in him and although not displaying symptoms of any underlying illness, more than likely was expecting a diagnosis of some sort in the future! His autopsy report was lacking in many findings that would usually be associated with the result of a starvation victim, ie, the collapsing of the stomach, shrivelled or shrinking of the heart and lungs etc. It doesn't add up to me X
 
And also this article describing how gastric motility slows during starvation.

"When a person is starving, motility can become sluggish (Robinson et al., 1990). This is because the body is trying to preserve vital functions; everything not crucial for staying alive is either slowed or stopped."

Disordered Digestion - Eating Disorders Catalogue

In my experience, although a few days of a liquid diet or no solid foods does create diarrhea, long term starvation results in a lack of bowel movements. The body starts to slow down all systems & processes that are not essential for immediate survival, including passing stools and urine. This is only my experience with loved ones in their final days.

ETA this is why I don't think it is unusual that MH's autopsy showed fecal matter and urine still present in his body. IMO
 
What Happens To The Body And Mind When Starvation Sets In? | WAMU

Interesting article about what happens to the body & mind during starvation
Both your article and the autopsy describe shrinking of the testes as a side effect of starvation. I don't see any mention of any type of evidence of other ailments/illnesses. I know we don't want to believe MH could have starved himself, but it's not difficult to do with any motivation to do it. I've only seen one nonspecific comment about MH mentioning his health. IMO we don't have to think outside the box on this one. We should take this at face value.
 
Both your article and the autopsy describe shrinking of the testes as a side effect of starvation. I don't see any mention of any type of evidence of other ailments/illnesses. I know we don't want to believe MH could have starved himself, but it's not difficult to do with any motivation to do it. I've only seen one nonspecific comment about MH mentioning his health. IMO we don't have to think outside the box on this one. We should take this at face value.

You are right. I missed that about the testes shrinking. Sadly, I think MH set about at the end to intentionally starve himself. I do wonder if he wished he had a terminal illness. Maybe that would've made things easier on him psychologically. IMO
 
No, there should be a lot more internal shrinking have taken place than just that of the testes. IMO the autopsy report does not reveal the trauma that takes place throughout the entire body during starvation. The persons insides are destroyed. The brain itself would show a shrinking in size. The fact that the stomach contents were zero basically means his last meal had digested already. And Cachexia is what tells you that something else was going on here that causes the muscles to shrink. It will happen despite the person being healthy and still eating. There is something underlying which caused this to happen X
 
"Loss of organ weight is greatest in liver and intestines, moderate in heart and kidneys, and least in the nervous system."
Dietary factors and health and disease
Starvation - an overview | ScienceDirect Topics


"The main autopsy finding is an extreme emaciation with loss of body weight and organ weights (Fig. 2, Table 2). Nearly all organs except for the brain are reduced in weight. Loss of weight is very rapid in the first place, but becomes slower after approx 3 months (22,38,54,58,59). Loss of body weight mainly results from the loss of subcutaneous adipose tissue and adipose tissue surrounding internal organs, atrophy of internal organs, and atrophy of muscles. The loss of about 35– 50% of body weight may cause death. Quite characteristic is also the loss of Bichat’s fat pad (Corpus adiposum buccae). Furthermore, the atrophy of endocrine and reproductive glands (testes) is quite characteristic."
upload_2020-6-16_14-3-2.png
WARNING: GRAPHIC PHOTOS: http://eknygos.lsmuni.lt/springer/663/3-23.pdf

MH's organs are on the small side. We don't know how much organ weight he lost. Doing the math for how much weight he lost during a period of starvation is difficult because he was losing weight from the time he started hiking, but it sounds like he didn't begin to starve until after he started on the FT. If he was 130 pounds (BMI 19) when he began starving, then he lost approx. 35% of his body weight. If he weighed any less, then he would have lost less of a percentage of body weight. Using the Uehlinger numbers as my reference, he would have lost 30% of his liver weight (910 g), making his original liver weight 1300 grams (avg. 1561 g). His heart (210 g) would have weighed 300 g (avg. 331 g). Kidneys (90 g and 110 g) would be ~128.5 g and 157 g (avg. 129).
Normal Organ Weights in Men: Part I—The Heart : The American Journal of Forensic Medicine and Pathology
Normal Organ Weights in Men: Part II—The Brain, Lungs,... : The American Journal of Forensic Medicine and Pathology
*edited my numbers for his original organ weights, used the wrong equation the first time. Current equation is final weight/.7=original if anyone wants to check my work.

He could be showing those organ shrinkages without them being "markedly small" like his testes were noted to be. Unless any of us are pathologists, we can't say whether his condition is consistent with starvation or not. IMO it is consistent with what I know and have learned about starvation. Of course, everyone is free to disagree and seek their own answers. Just wanted to put the numbers out there to see if they line up, which I believe they do.
 
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The brain is the fattest organ of the body - 60% fat or thereabouts- and since the body survives on its fat reserves during starvation, one would think that, the fat in the brain would not survive starvation intact?!
 
The brain is the fattest organ of the body - 60% fat or thereabouts- and since the body survives on its fat reserves during starvation, one would think that, the fat in the brain would not survive starvation intact?!
The rest of the body is trying to feed the brain. The brain is what's "eating" the body! Survival is the brain's job as the body's main control center. The first source I quoted from in the previous post has some info on it (I think that's where I saw it). I think it has to do with the type of fat stored. The language I've seen to describe it is very medical, so I'm not sure if I'm understanding this part of it correctly, but all the sources I saw said the same thing about the brain not shrinking. One source (maybe the second one I posted) said the brain can even be enlarged (I think) because it's trying so desperately to function, and the rest of the body allocates its fat to the brain so it can keep running.

Seriously though, this is totally fascinating to me. I feel like a nerd reading about it lol
 
"Loss of organ weight is greatest in liver and intestines, moderate in heart and kidneys, and least in the nervous system."
Dietary factors and health and disease
Starvation - an overview | ScienceDirect Topics


"The main autopsy finding is an extreme emaciation with loss of body weight and organ weights (Fig. 2, Table 2). Nearly all organs except for the brain are reduced in weight. Loss of weight is very rapid in the first place, but becomes slower after approx 3 months (22,38,54,58,59). Loss of body weight mainly results from the loss of subcutaneous adipose tissue and adipose tissue surrounding internal organs, atrophy of internal organs, and atrophy of muscles. The loss of about 35– 50% of body weight may cause death. Quite characteristic is also the loss of Bichat’s fat pad (Corpus adiposum buccae). Furthermore, the atrophy of endocrine and reproductive glands (testes) is quite characteristic."
View attachment 251444
WARNING: GRAPHIC PHOTOS: http://eknygos.lsmuni.lt/springer/663/3-23.pdf

MH's organs are on the small side. We don't know how much organ weight he lost. Doing the math for how much weight he lost during a period of starvation is difficult because he was losing weight from the time he started hiking, but it sounds like he didn't begin to starve until after he started on the FT. If he was 130 pounds (BMI 19) when he began starving, then he lost approx. 35% of his body weight. If he weighed any less, then he would have lost less of a percentage of body weight. Using the Uehlinger numbers as my reference, he would have lost 30% of his liver weight (910 g), making his original liver weight 1300 grams (avg. 1561 g). His heart (210 g) would have weighed 300 g (avg. 331 g). Kidneys (90 g and 110 g) would be ~128.5 g and 157 g (avg. 129).
Normal Organ Weights in Men: Part I—The Heart : The American Journal of Forensic Medicine and Pathology
Normal Organ Weights in Men: Part II—The Brain, Lungs,... : The American Journal of Forensic Medicine and Pathology
*edited my numbers for his original organ weights, used the wrong equation the first time. Current equation is final weight/.7=original if anyone wants to check my work.

He could be showing those organ shrinkages without them being "markedly small" like his testes were noted to be. Unless any of us are pathologists, we can't say whether his condition is consistent with starvation or not. IMO it is consistent with what I know and have learned about starvation. Of course, everyone is free to disagree and seek their own answers. Just wanted to put the numbers out there to see if they line up, which I believe they do.
I can't edit it again but final kidney numbers should be f/.9=x so x=100 g and 122 g
 
Is "failure to thrive" a possibility? Basically just deciding you want to be dead? I've read about it but not having any medical background, I don't know whether it's real. I know I've read about it for infants and young children in neglectful situations but this was the first I'd heard about adults getting it.
 
Found this article about the process of dying interesting and straight-forward, fwiw
Physical and Emotional Changes as Death Approaches
''As death approaches, you may become less interested in the outside world and the specific details of daily life, such as the date or time. You may turn more inward and be less socially involved with others. You may want only a few people to be close. This introspection may be a means of letting go and saying good-bye to everything you have known.''

''The kidneys often gradually stop producing urine as death nears. As a result, your urine will become dark brown or dark red. Also, the amount of urine produced by the kidneys decreases.

As your appetite decreases, your bowel habits may also change. The stools, or feces, may become hard and difficult to pass (constipation) as your fluid intake decreases and you become weaker.''

''You may hear sounds or see things that no one else experiences (hallucinations). Visual hallucinations are very common as death approaches.''
 
The autopsy IS frustrating. Everything was normal, extraordinarily so, so his death doesn't seem related to an illness like cancer or heart issues. The only other thing that may have been a factor is some sort of neural disease or genetic disorder that may not necessarily show on autopsy.

Some of the wasting issues are very strange. Example, the wasting of the muscle in the temporal area of the face which would have hampered his ability to chew. It's much smaller than say, the calf muscle, but would wasting occur more quickly on smaller muscles than larger ones?

I'm thinking about the large amount of urine in his bladder. One of the symptoms of ALS is the inability to pass urine due to spasticity of pelvic muscles. It's also a symptom brain disorders like MS and Parkinson's disease called neurogenic bladder. Retaining that much urine could definitely cause an infection. Both of those disorders should show on autopsy, though.

Same with tetanus. Tetanus used to be called lockjaw due to paralysis of the jaw. I wondered if he had some infection, through a cut or abrasion. But again, it would have shown on autopsy. His brain didn't seem to have any abnormalities.

Someone earlier mentioned the death of Chris McCandless and that he may have succumbed to poisonous plants. There are poisonous plants in Florida. There are two trees, the poisonwood and manicheel tree that emit a sap that has proven to be fatal in some cases.

There is also a virus found in south Florida called the Everglades Virus. There's not a lot of info on it other than it can cause neurologic manifestations. Here's a link:
Serologic Evidence of Widespread Everglades Virus Activity in Dogs, Florida
I tried to link to another site regarding Everglade virus but I keep getting kicked out. It may be because I'm not the US. The site is www.lcmcd.com

Years ago, a friend of mine, ended up with impacted bowels after childbirth. She was afraid to go, and lied repeatedly to the nurses when asked if she'd had a bowel movement. She ended up being hospitalized to remove what she characterized as 'gravel' since the body removes much of the moisture. Something called GBA (gut/brain axis) affects the ability to pass stool.

I was wondering about the drugs or lack thereof in Denim's system. I don't suffer from allergies, thank goodness, but I don't remember anyone discussing whether Denim had any symptoms of allergies on the trail. Hiking through forests and grasslands would definitely be a high risk for allergies. Because of Florida's warm climate they have high pollen counts all year long. I wonder if fellow hikers could affirm Denim discussing allergies or witnessed him taking the medication.

The reason I'm curious about the allergy meds is that Diphenhydramine is used to delay or slow down early symptoms of Huntington's disease. We've always thought that the health issue that Denim mentioned to his fellow hikers was something that made the hike a bucket list item. HD is a terrible disease that can only be detected by genetic markers before the illness presents. I remember the conversation Denim had with a fellow hiker when he discussed his father's pugilistic attitude toward his son and that they didn't get a long. One of the early symptoms of HD is a belligerent attitude and anger management issues. HD is pretty much a death sentence, once that takes a long and tortuous journey through the body and mind.

Here's a link to a story about a women who chose to starve to death rather than be ravaged by the disease.
Kim’s Choice: Inside one woman's decision to starve herself to death

I felt like a voyeur reading the most personal aspects of Denim's death. I have a hard time correlating the friendly engaging man seen in all those photos and his anonymous, lonely death. It's nearly two years since he died and we are no further ahead in terms of his identity.

I think you're on to something with Huntington's. I believe Huntington's can be confirmed on autopsy, but what if his parent had it and so he assumed it was inevitable that he would also suffer the same fate? But a positive result really only means you are "very likely" to develop Huntington's. Maybe he was in the small percentage that would go on to live a normal life, but he just assumed his date was sealed.

As for the abdominal scar, that sounds like an exploratory laparotomy. Maybe he had a hx of abd pain and so further investigation was needed. I feel like if something was found during that procedure, it would have also been noted on autopsy. Clearly no abd organs had been removed. And if a mass or cyst was removed from them, I would assume, that scarring would have been seen on autopsy. Another possibility would be a car accident or some kind of trauma. Some times a laparotomy is used to find and stop internal bleeding. But, again, I feel like healed organ damage would have been noted on autopsy.

That autopsy is extremely frustrating.
 
I think you're on to something with Huntington's. I believe Huntington's can be confirmed on autopsy, but what if his parent had it and so he assumed it was inevitable that he would also suffer the same fate? But a positive result really only means you are "very likely" to develop Huntington's. Maybe he was in the small percentage that would go on to live a normal life, but he just assumed his date was sealed.

As for the abdominal scar, that sounds like an exploratory laparotomy. Maybe he had a hx of abd pain and so further investigation was needed. I feel like if something was found during that procedure, it would have also been noted on autopsy. Clearly no abd organs had been removed. And if a mass or cyst was removed from them, I would assume, that scarring would have been seen on autopsy. Another possibility would be a car accident or some kind of trauma. Some times a laparotomy is used to find and stop internal bleeding. But, again, I feel like healed organ damage would have been noted on autopsy.

That autopsy is extremely frustrating.
Welcome to Ws NurseRatched, thanks for chiming in!
 
As for the abdominal scar, that sounds like an exploratory laparotomy. Maybe he had a hx of abd pain and so further investigation was needed. I feel like if something was found during that procedure, it would have also been noted on autopsy. Clearly no abd organs had been removed. And if a mass or cyst was removed from them, I would assume, that scarring would have been seen on autopsy. Another possibility would be a car accident or some kind of trauma. Some times a laparotomy is used to find and stop internal bleeding. But, again, I feel like healed organ damage would have been noted on autopsy.

That autopsy is extremely frustrating.

Somewhere in there it mentions peritoneal adhesions from the surgery.
 
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