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Meagan Orton is watching her health slip away, drop by drop.
The Goose Creek woman with a rare and complicated syndrome needs constant IV infusions to keep her blood pressure from bottoming out, potentially leaving her unconscious and falling to the floor or with a splitting headache and debilitating brain fog. But Hurricane Helene devastated the factory in North Carolina where a majority of IV fluids are manufactured in the U.S. The Baxter factory is in an odd and inaccessible place where a single bridge allows its shipments out of the plant. That bridge was damaged in the storm.
While the company and federal officials scramble to import and find alternative ways to get the vital bags of fluid, Meagan is down to a handful and is trying to ration what she has. She has orders in with companies from Texas to Illinois to San Diego but no promise of delivery anytime soon.
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Baxter's plant is located in McDowell County, N.C., where the Piedmont and mountains meet. Speaking by phone from the county seat, Marion Mayor Steve Little said Helene was the county's worst disaster in memory.
The rush of debris-filled waters from swollen streams -- "it was like shooting a cannon," Little said -- washed away residences, including at least one two-story home. Many roads were impassable. Rail lines through the county had the dirt swept from beneath them, leaving tracks suspended in air. One river's course changed by 40 feet. Cell service was out for a week. Many were without power and internet for even longer.
"To see this level of damage is just bewildering," Little said.
The county of about 45,000 had more than 100 rescued by helicopter who weren't reachable by any other means. Hundreds more were plucked from isolation by boats, ATVs and various other means.
With the level of devastation, Little thought it miraculous that McDowell County recorded just two Helene-related deaths. And Little is sure of that number. There's no one missing or isolated who's not accounted for, and he said drones with infrared cameras scoured the county's larger lakes to make sure no ghastly scenes were hidden in their depths.
His city, the county seat, was spared from the worst because of its geography. Marion is in the Piedmont portion of the county with valleys around it, shielding it from flashfloods that pummeled surrounding mountain communities.
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Still, fallen trees from winds atop rain-saturated soil were plentiful in the city of about 7,500, snarling traffic and relief efforts. And Little said the National Guard had to remove boulders as big as a bus so city crews could make their way to the water treatment plant with a needed generator, finishing the task just hours before 11,000 customers would have lost access to clean water.
But the city fared far better than its neighbors, including North Cove, which is home to Baxter's plant. That remote location puts it above a giant aquifer that supplies all the water the 1.4 million-square-foot facility needs to produce IV fluid, Little said.
It also makes it isolated. A single bridge allows shipments to flow from the plant to a mountain highway. That bridge was damaged. So were bridges on the highway in both directions. And the facility itself was waterlogged. At places, flooding reached 4 feet and left 12-18 inches of mud inside Baxter's facility, Little said.
That plant supplies 60 percent of large-volume fluids nationwide. When it went offline, it sent a ripple through the supply of IV fluids. Some distributors' allotments dropped by 90 percent and the FDA added three solutions principally made by Baxter "to not be commercially available in adequate supply to meet national demand." That includes the Lactated Ringer's Solution that Orton relies on.
In response, the Biden administration has invoked the Defense Production Act to aid in getting the North Cove facility reopened. The administration has also made it a priority to get other Baxter facilities approved to produce the IV fluids that would have come from the North Carolina plant.
The company declined to speak with The Post and Courier about damage at the facility, referring the newspaper to its frequent web updates about its progress.
Work has been swift, Little said. Just two days after access to the facility was lost, engineers had erected a temporary rock bridge and trucks started rolling off the site, carrying more than 450 loads of finished product that were undamaged in Helene.
The company reported that this helped ease short-term distribution problems, with hospitals and distributors getting 60 percent of their normal supply from the company -- but still well short of what's needed.
N.C. Department of Transportation crews are installing another temporary bridge to ensure site access until the permanent one can be replaced.
Most Baxter employees are back to work with specialty contractors to clean the plant. But it's grappling with other problems. For instance, there's no longer enough parking on site in Helene's wake. Instead, the county is letting Baxter use a nearby, storm-battered ballfield for parking and the company agreed to restore the park to its former condition when it's done.
The company hopes to return to full production by year's end. Even then, it'll take time before distributors and hospitals return to their normal supply. In the meantime, top South Carolina health care providers say they are trying to conserve IV fluids and watching the situation closely for updates.
Which affects patients like Orton.
Left in limbo, with worsening conditions
This is the latest health challenge for Orton in a long and harrowing stretch of them dating back to at least 2009, when she was a College of Charleston student and suddenly lost her hearing. She would eventually recover and, in spite of it, went on to earn a degree in psychology while minoring in dance. She also was chosen as Miss College of Charleston. Orton later went on to get a Master of Science degree in leadership from The Citadel.
But her own body would keep betraying her and significant health problems piled up. Orton suffers from a rare genetic disorder called vascular Ehlers-Danlos syndrome, which affects connective tissue in the body like ligaments and, in her case, blood vessels and organs, leaving them weaker and more susceptible to rupture. There have been around 1,500 patients identified with it by genetic testing and there may be 6,000 to 8,000 people in the U.S. who have it, according to one estimate.
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In 2014, Orton was diagnosed with a condition known as postural orthostatic tachycardia syndrome, or POTS, where quick changes in position, such as standing up or sitting up in bed, can lead to a sudden drop in blood pressure and cause unconsciousness and fainting, a condition she struggles with daily. In 2018, she had major surgery at Medical University of South Carolina for a ligament that was choking off a large blood vessel in her abdomen as well as a bundle of nerves affecting the aorta, the major blood vessel running through that part of the body. Orton said she was given a low chance of surviving, "but I did."
While all of that was going on, she developed an autoimmune disorder sometimes associated with her syndrome where her body can begin attacking itself after being triggered by food or medication or other things, leading to rashes, breathing problems and low blood pressure, among others.
To help relieve all of that, Orton takes a liter a day of the Ringer's solution IV fluid, a concoction that includes electrolytes and also helps to reduce acid in the bloodstream more than saline would. It helps to keep from activating her body's autonomic nervous system -- the "fight or flight" response -- that can leave her with an overwhelming allergic reaction, a racing heart and crippling headaches, Orton said.
The IV solution is "very necessary treatment" that is now dwindling before her eyes, she said.
Orton recently tried to get by on about a third of her normal dose but watched as her pulse shot up to between 120 and 150. A normal resting range for adults is usually between 60 and 100, according to the American Heart Association. She increased her heart medication to help lower that, but it also lowered her blood pressure. That made her other conditions worse, which normally the IV solution would help maintain but now doesn't. That has already made her more vulnerable to passing out.
"I've had two falls in the last three days," Orton said. She had gone a year without one previously. She also now has this "horrible headache" and is dealing with brain fog, which normally the solution would help keep at bay.
Her care is mostly managed at home, where her mom, Cindy, is a retired nurse, and her father, Mark, is getting little sleep as he calls around tirelessly to try and find what she needs. Her home care management agency is "awesome," she said. But they can't give her what they don't have and all of their patients are out now. Orton and her family are still making desperate pleas to other suppliers, and they have orders in with companies at three different sites in three different states. But it is always the same answer -- they can take the order, but can't promise when they will fulfill it.
"Their hands are just tied," Orton said.
She is now left with a few days' supply and faced with having to stretch that out over at least 30 days. She gets that hospitals would be a priority for the dwindled supplies. She understands some patients need those solutions to eat and absorb nutrition. Thankfully, she can do that on her own.
"Basically, I have to wait for everyone else who is in more desperate need" to get those precious fluids first, Orton said.
But she also knows over the last 10 years, she has never gone that long without it and doesn't know what will happen to her body the longer she has to wait.
"This is uncharted territory for me," Orton said.
She also knows she is already seeing an impact.
"The longer I go without these IVs, the sicker I am going to get," Orton said.