'Survivor 46' star Randen Montalvo recalls anger and devastation around medical evacuation

Survivor can be a gruelling and dangerous game, but for Survivor 46 star Randen Montalvo, simply trying to sleep resulted in the ultimate consequence — a medical-related exit from the island.

As we saw in this week's episode, Dr. Will thought Montalvo had woken up with a pinched nerve, but came back with concerns about a shifted disk in his neck, pushing on a nerve, which would require an MRI to accurately diagnose. That meant he had to be eliminated from the game.

"I remember being in excruciating pain and ... I knew something was wrong," Montalvo told Yahoo Canada. "I started to become kind of delusional, I started to not really know where I was ... I had a very, very strong pain behind my neck that gave me this migraine, and it was blurring everything."

"One thing in my head, I was like, if you show weakness, they're going to pull you from the game. Maybe this will pass, and I'm a very hard-headed kind of person. ... I thought that it would go away."

It didn't pass. Then Montalvo lost feeling in his arm. He said it felt like "electricity" up the back of his head.

Knowing he had the Beware Advantage, he sat out of the challenge. Examining him, Dr. Will pressed on what looked like a large abscess on his neck, and Montalvo screamed.

"I saw a little monitor with some neurologists and ... I knew at that point, when it was next to the disk and it was connected to my arm, that my time's up." he said. "It was probably one of the hardest things to accept, that my game was going to end like that."

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'It was an exercise in immense self-control'

Now that he's feeling better, moving both his arms and hands with ease, he is able to look back at how he felt when he received the official call that he would be leaving the island. Montalvo said he was "angry" and "devastated."

"I was very very angry because you've got to understand, like, I would have made merge, I'm very confident that I would have made merge, there's not a doubt," he explained. "I just formed that alliance with Venus [Vafa] and I was trying to get into the Tevin [Davis] and Hunter [McKnight] alliance, I felt like I was in good position, strategically."

"I really wanted to start flexing my my social game because in the Nami tribe, a lot of this is sit back, observe, and then you play based on what you see happening. ... To find out that my game was going to end like this, I'm not even voted out, I've never even seen my torch. That was crazy for me. And I was really angry. It took me a long time to kind of get over that, I'm not going to lie. It was an exercise in immense self-control."

'To see it on TV, I was struggling'

Since Montalvo left Survivor 46, there have been questions about whether or not he thought about giving his Beware Advantage to Venus Vafa, with the rule being that an advantage or idol can only be passed on to someone else before they are officially removed from the game. But Montalvo admitted he didn't exactly understand those rules.

"I thought it had to be handed physically over to her, so I thought I needed to get my parchment paper and give it to her," he explained. "She already knew where the location was because I told her, I made a specific design next to the tree, with two palm fronds in an X, and I told her the coconuts are in an X as well, super easy if you know what you're looking for, and guess what? Nobody else found it."

"I was trying to get it to her, but I would say by the time Jeff [Probst] hit that beach, I could not physically give it to her. I didn't know I could have verbally done it. ... But I didn't want to do that in front of our teammates either. ... You know how you tip somebody, like a valet, that's how I wanted to give it to her."

Montalvo said it's been "very hard" now that he's home and sharing exactly what happened with his friends and family, and of course audiences around the world,

"Just to give you some context, nobody's never seen me cry or be defeated and it's like, I defeated myself," he said. "I defeated myself by doing things, like sleeping wrong, I mean what a way of showing your age."

"I wanted to really inspire somebody who was in my shoes. I'm there for my grandmother, I was going to give all the money to my grandmother. I'm there to move her out of where she is, nothing was for me. I felt like I let my tribe down and other people down. ... I'm in pain, I'm the one I should think about myself, but I'm just not built like that. ... I would say one of the hardest things I've ever done in my life and to see it on TV, I was struggling."