Top right: Tres Binkley relaxes on the couch at his girlfriend’s in Del Norte while recovering from the rattlesnake bite. Right: From the four fang marks (center of lower inked circle) just above his ankle to where the ink marks reach the groin area and disappear up into his shorts, the lines indicate how doctors monitored the swelling and noted the time as it moved ever upward toward his torso. Photos by John M

DEL NORTE – Each ink line on his orange and purple leg, marks the time of how the swelling advanced from his ankle up to his torso. At one point, his thigh measured 24 inches around. His waist size is 30 inches. “Pretty gnarly huh?” asked Tres Binkley, half jokingly.
Binkley was bitten twice in a fraction of a second by a rattlesnake, as he ran on the northeast side of Lookout Mountain, shortly before 5 p.m. on Thursday, April 25. This interview was conducted one week later.
From the four fang marks just above his ankle to where the ink marks reach the groin area and disappear up into his shorts, the lines indicate how doctors monitored the swelling and noted the time as it moved ever upward.
The first marking on this fateful day was at 5:20 p.m., shortly after he arrived at the ER
Binkley had been running off trail on a ridgeline to maximize his strength training regimen and had been watching out for cactus as he stepped gingerly over rocks and vegetation going up and down the steep terrain. As he was stepping down over a rock he felt a sharp pain.
“At first I thought that’s what the pain was,” said Binkley. “It took me two or three strides before I could stop. I started to look for cactus spines and realized that it was definitely not cactus. That’s a snake bite.” He never saw or heard the snake.
“I knew there wasn’t much you could do in the field for a snake bite, except stay calm,” said Binkley. “I didn’t know how much time I had to get help, so I was a little anxious.”
Binkley didn’t have his phone with him, so he ran down the mountain to 11th and Spruce Street, then further north to a friend’s house. They weren’t home. Next he ran to the Alta convenience store. In all, he ran less than a mile from where he was bitten to get the help he needed.
Binkley saw a forest service worker parked in the lot.
“I told him I need to go to the ER, can you take me?” said Binkley. “First I need to get my phone and my I.D. though.”
The forest service employee drove him two blocks away to his girlfriend’s place to get his things. She wasn’t home either.
At this point, Binkley hadn’t gone into shock, but he was starting to feel the effects.
“I started to feel this vibration in my hands, in my face, in my teeth, in my – everything,” said Binkley.
He called his mom and his girlfriend as they were on the way to Rio Grande Hospital (RGH), a short distance from town. He also posted to the social fitness network site Strava, to let his followers know what had happened. (Strava connects runners and cyclists).
Binkley was starting to go into shock. He later learned that a snake bite victim only has only one to two hours to get help before very serious consequences are possible. It had now been about 40 minutes.
Upon arrival at RGH, Binkley said the hospital staff first gave him a shot from an EpiPen that is used to treat allergic reactions and hooked him up to an IV to give him fluids. He said he was informed that the only way to tell if it was a venomous bite was to monitor the swelling. That’s when the ink markings on his leg began.
Binkley’s memory understandably started to get a little clouded at this point as he was going in and out of consciousness, but remembers the pain coming in waves and being driven to the Del Norte airport and getting on a plane to Mercy Regional Medical Center in Durango.
“I remember flying and the humor of the EMTs onboard,” said Binkley. “Everybody was great.”
Arlene Harms, CEO of Rio Grande Hospital in Del Norte, filled in some information as to why Binkley was sent to Durango.
“RGH and other San Luis Valley hospitals stock initial emergency doses of anti-venom to administer to emergency department patients,” said Harms. “However, because rattlesnake bites typically require additional follow-up anti-venom therapy, and both the snake venom and the anti-venom can result in serious and even life-threatening allergic reactions and complications requiring a higher level of care, it is common for small, rural hospitals to transfer snake bite patients to hospitals with higher levels of care and the specialized capabilities to manage such reactions and complications that are not available at small, rural hospitals.”
Binkley said his doctors in Durango kept in close consultation with toxicology experts remotely.
“Every time they drew blood, they were checking platelets and other things and checking in with the toxicologists every six hours.” The doctors also administered an antivenin called CROFab every six hours. Binkley thinks he was administered five vials.
“The doctors said there is a way to determine how big the snake was,” said Binkley. “They measured the fang marks and came to the conclusion the snake was about two feet long.” Not a big snake, but big enough.
Binkley said he never really feared for his life during the ordeal because he knew adequate care was available nearby and he wasn’t in a remote area like in the wilderness.
“What I was most concerned about was what the complications would be during recovery and am I going to be able to use my leg in the same way,” said Binkley. “The doctors told me at this point, there should be no long-term muscle damage.”
Binkley was also about to start a new job that would have happened on Thursday May 2, if not for the snake intervening in his plans.
He was going to move from Austin, Texas to Grand Junction for a position as a regional sales manager for Freestone Sales Group that markets outdoor sports equipment. Binkley was most recently a Patagonia sales rep for Texas and Oklahoma. Fortunately, his new bosses are willing to work with him and are supportive of his recovery however long it takes. “They are a great group of people.”
He was in Del Norte to visit his girlfriend, who he has been dating for some time and has also visited Del Norte many, many times.
Being between jobs, Binkley has no health insurance.
As of this writing, the latest blood test results came back positive (meaning good). Doctors have recommended he keep his leg elevated to reduce the swelling and to stay off it as much as possible for the time being. A nurse practitioner visits him at his girlfriend’s place in Del Norte while he is recuperating.
“At this point, it’s just a matter of waiting for the swelling and pain to go down,” said Binkley. “Most of the pain now is on the inside along the hamstring.”
Binkley said that since it has been a week from when the bite happened and the blood test results are looking good, he should be in the clear to no longer need additional antivenin.
“That means that now I can potentially be located anywhere that gives me access to monitor my blood work and to be able to maintain a comfortable pain level,” said Binkley.
As often as he runs trails, Binkley said he can’t remember the last time he even thought about getting a bitten by a snake before this incident or what the consequences would be.
“Its way more complicated than I knew and it really surprised me for sure.”
Arlene Harms, of RGH, gave this update on how often venomous snake bites have occurred recently:
“I can tell you that we have treated five (snake bites) including the most recent, since January of 2015. One in 2015, one in 2016, none in 2017, two in 2018 and one in 2019.  We do not transfer all rattlesnake bites because not every bite results in envenomation (about 20 to 25 percent are ‘dry bites’ without the snake venom being released into the tissue of the person). If the patient requires anti-venom, then he or she is always transferred to a higher level of care. We have transferred four of the five to a higher level of care.  We also call Poison Control on every potential snake bite for expert consultation. We have eight vials of CROFab on hand and generally the first dose of anti-venom is four vials. A full dose during recovery from a snake bite with envenomation can be 16 vials or higher. To my recollection, only one bite has occurred on the trails around Del Norte of those patients coming to the RGH ER.”
Harms continued:
“The anti-venom is extremely expensive (our cost - not the patient charge, is around $3,250 a vial) and it does expire in a relatively short time. Our main reason for transferring a patient is because the venom can cause many severe complications to several systems of the body and it is better for the patient to have the experts that deal with it more often, giving them the utmost care and outcome possible.”

Update from Binkley on Monday, May 6
“It’s better. I was able to sit up and let my foot rest on the floor,” said Binkley. “I also started some physical therapy by beginning to rest my foot on the floor while standing, supported by crutches. It’s going to be a slow process, but I’m so glad it is headed in the right direction!”
Binkley also had an interview scheduled with CBS4 Denver for a story to be aired on Monday night May 6, at 5 p.m.