When Injury Sidelines You

There is nothing more frustrating than experiencing an injury that keeps you from doing what you love to do. Especially hiking. After completing a three-week journey on the Allegheny Trail, I came home, did too much, and ended up with severe hip pain and sciatica. Diagnosis - hip separation and muscle overuse (possible piriformis syndrome). Right now I have a tendinitis issue from compensation due to a fracture in my toe after stubbing it on a rock. My third AT completion attempt is now on hold.

So now I am sidelined. I am no longer a happy hiker, enjoying what the trail has to offer, but resigned to icing, Physical Therapy, and simple walks. I’ve had injuries that have given me issues for many years. It’s not an easy thing to deal with when you are active.

So what do you do when injury strikes?

1.      First off, if you’ve suffered an injury, don’t be brave and keep hiking on it. You’ll just do more damage. Pain and swelling is your body's way of trying to tell you to STOP. So stop hiking. Period. (I only got off trail when the humidity and foot pain became too much. Later, I found out I had hiked over 70 miles on a broken big toe!).

2.      RICE. Rest, ice, elevation, compression.  DO it immediately after an injury happens. Don’t wait 24 hrs. It impedes the healing process. And be sure its ICE. Don’t ever put heat on an injury. If your stomach can handle it, taking ibuprofen (Advil) helps ease the inflammation. If you can’t, Tylenol helps with pain. Turmeric is also an anti-inflammatory.

3.     See the doctor. Many times, you can try to deal with the injury at home. But in my case, I did not wait as things were not improving. Sometimes it's good not to wait, to ward off other issues (like scar tissue forming). In severe cases with major swelling, pain, etc., you need a doctor to evaluate it. You may need x-rays to make sure something isn’t broken (I could walk with my injured toe, but only an X-ray showed I had indeed fractured it). You may need physical therapy to get back in the groove as soon as the injury allows. With the cost of medical care, sometimes this is put off. Only you know how bad it is.

4.       Eat nutritious food. If you are going to be sidelined for a while, be sure the food you eat is good for you. Don’t eat sugar and useless carbs thinking it will make you feel better. It won’t and may even worsen things. Protein, fiber-based foods, and lots of water are important to the healing process and for your well-being.

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5.      Try not to get depressed. Easier said than done, especially when you see your buddies hiking and you’re sitting. But most have suffered like you have in one form or another. Most have been sidelined. Think of this as rest time to do other things that maybe you haven’t done. Think of the projects you can accomplish while you’re mending. Be sure to be outside too as sunshine is important to elevating your mood. Talk to others who have had injuries. Above all, give yourself time to heal by giving your body (and you) a break.

6.       Engage in other physical activities that don’t aggravate the injury. I have an exercise bike. Yeah, I hate the thing. But it’s better than nothing for cardiovascular means. A swimming pool works wonders also. Do some strengthening exercises (check online for exercises that have to do with your injury to begin rehabilitating it when the pain allows). Stay involved. When you are able, return slowly to your activity. Don’t push it or you could find yourself back at square one.

7.       Above all, be patient. It takes time to heal ligaments, tendons, and bones. Let your body do its job. Then you will be raring to go and ready to tackle that trail in no time. Remember, the trail is going nowhere. You will be back when the time is perfect.

Related Blogs

Ankle Injuries
Oh My Aching Knees

When Plans Change

First Aid and Trail Medicine

The Virus Thing and Hiking – 8 Ways to Protect Yourself and Others

UPDATE - 7/23/2020 Please consult the local, state and federal areas for these closures and please obey the regulations. Change your hiking plans. A thru hike can still be accomplished in a calendar year by some creative ways once the emergency is over. Be flexible, and most importantly, don't give up on your dream!

Every year viruses do plague the trails, esp the AT which comes down with its annul norovirus bug every spring. So of course hikers are going to wonder whether the Coronovirus will hit too.

First off, be sensible and take simple steps to safeguard yourself and those around you. A good hike in the woods is actually therapeutic for the mind and body. Cardiovascular exercise makes you feel good and releases good hormones like endorphins. Fresh air and getting away from crowds are other good things.

But be sure to follow some simple, common sense steps as there are other hikers out there and towns are also on a hiker’s list of stops for resupply. But right now avoid the heavily used areas. Seek other lesser known trails. Seek solitude. And hang in there. This too shall pass.

1.       Carry hand sanitizer with at least 70% alcohol on the trail but handwash as much as possible in towns.

Practice social distancing on the trail at all times.

2.      No staying in shelter areas. Some areas like on the AT are closed to backcountry camping too. Plan ahead and avoid closed areas. Have guidebooks and maps to tell you where campsites are if it is allowed.

3.       NO sharing of food at any time. Do not take food from hiker boxes. Plan accordingly so you have enough food for your hike. As resupply is limited in some towns, do mail drops.

4.       When in town, avoid communal and gathering areas. A motel room or a separate room when offered at hostels might be good for now (though many hostels are now closed. Budget your money so can prepare to spend a little extra for a single room. Hand wash frequently and use your hand sanitizer in town. Call ahead with hostel and other providers to see if they are open (many are not).

5.       It may be hard to find rides (hitchhike) right now as people may be reluctant to pick up hikers. Plan to walk or call for a shuttle. Budget to pay for the shuttle rides. Call ahead on shuttles though as some providers are canceling services for now.

6.       If you hear in the trail grapevine there is sickness ahead, avoid staying in the affected area by slowing down or speeding up.  Carry extra food in case you must spend extra time on the trail and can’t get to town right away.

7.       Carry good foods to eat (less of the empty sugars, etc), Vitamin C tabs, Zinc. Get enough rest. And watch the alcohol, etc.

8.       If you feel sick and especially have the norovirus or a fever, get off the trail and stay away from others. Know the symptoms of each type of virus. (Noro for instance is the stomach bug with runs and vomiting. Coronovirus is a fever and dry cough with chest irritation. The common cold is a sore throat and runny nose and usually no fever). 

   Related Links:  The Virus and Maildrops. 

     Check out my Blissful Hiking Adventure and my series of books on the Appalachian Trail - Mountains Madness and Miracles and the Florida Trails - Gators Guts and Glory!

What Worked and Didn’t Work for Me on a Long Distance Trek

Things I have heard to take on a long distance trek that just don’t work for me. Sorry.

Case in point -

1. Duct Tape – this is the proverbial go-to for first aid on all types of blisters, holes and / or broken gear, 

I’ve used it for years with poor results. I’ve put it on only to have it fall off, rub my other toes or skin, bunch up, causing more issues. I’ve tried to repair gear with it to have it fall off or bunch up. 

The stuff stinks. Period. And can leave glue marks on gear, sometimes negating a warranty

Solution: For hot spots I have been using moleskin which does pretty good, doesn't irritate like duct tape, can though it can also come off if it gets wet.
For bombproof Rx of blisters, my treatment is the Band-Aid Advanced Healing Blister bandages.

There is nothing like it out there (including stuff I have seen sold in outfitters)! I used them in the swamps and sand of the Florida Trail. They are awesome. I tried other blister brands too. They fell off. Not these. Well worth the money and may save your hike. They are waterproof. When they begin to peel back after a few days, remove the bits slowly, a little at a time. When they fall off, the blister area is healed. Amazing.

As for gear? Tear-Aid Type B works for holes in tents. Carry some. Dental floss and a needle could repair tear in a pinch. Wait for an outfitter or call the manufacturer from the trail to have gear replaced up the trail (lots of manufacturers will work with you).

2. Trash bag liner to line your pack and protect gear from getting wet.

Been there, done that. A cheapo version that protects in light rain, sure. But if you are a long distance backpacking, you’re gonna get soakers. As a ridgerunner I have seen hikers pull out their wet stuff from a trash bag liner in their backpack after enduring a heavy thunderstorm. I’ve had my stuff soaked on the Long Trail in a heavy, three inch all day rain. 

Solution: Try to go with the heavy duty contractor's bag if you go that route. Better yet, invest in Z Packs cuben fiber liners and /or stuff sacks. They are awesome. I have had a puddle inside my pack and the stuff in these is dry. Worth the money.

3. Sawyer Mini to filter water.

TOO slow for me. The regular Sawyer squeeze filter is bigger and works faster – letting you quench that thirst for an ounce more. And I also used the Evernew water bags. They work awesome with the Squeeze filter. No more blowing out Sawyer bags!

Conversely, things I said – “Nah” only to find DO work -

4. A map app on a cell phone. 

I’ve argued – Inaccurate. Wastes your phone charge. Hard to read. May fail.

Nope!

I used it exclusively for the Florida Trail. Worked great. You do need to know how to work it and read a map, though. On recommendation from hikers, I got a good Anker charger for my phone so I can now keep it charged (the cords are light too for recharging everything when in town). I love phone map apps. They are awesome.

5. Darn Tough socks. Everyone raves about them. I’ve used all kinds of other socks. Are they really that great?

YES they are.

These socks are Bombproof. And they have an unlimited guarantee. They dare you to wear them out. No joke. They have an amazing warranty.

Anything you care to share about gear you now like or don’t like? 

Overuse Hiking Issues

Overuse issues cropping up among hikers and especially those doing long distances. Unfortunately hikers sometimes believe the hike is a competition and they need to keep up with the flock. Or they feel the miles they do is too low and they ought to do more. Thus they end up doing too much for ligaments and tendons unaccustomed to the stress. Because of this, hikers end up with overuse related issues that can jeopardize their hike.

Foot and lower leg tendonitis - Just today I developed an anterior tendonitis in my right lower leg radiating to the right side of my foot from increased exercise and a flexion issue. Pain on the top of the foot may be extensor tendonitis and could be because your laces are too tight. If you have pressure point pain over a bone, a stress fracture may be developing.    

Shin Splints – I have seen many hikers developing this issue, usually after long days of hiking, doing

high miles their limbs are not used to it. Shin splints refers to medial tibia stress syndrome over the shaft of the tibia. It is directly related to doing too much too soon. The pain is felt along the thick bone of the tibia of the lower leg. Sometimes it can be in the calf muscle itself.  There could also be swelling.

Knee issues – this is probably the most common joint that suffers from overuse. The ligaments around the knee become sensitive to the loads we carry, not only of our backpacks but the stresses of uphills,   downhills, and rocky terrain. That plus longer distances puts a good deal of stress on them, leading to pain and sometimes even ligament tears.

Muscle and Body Pain and Fatigue – again, doing too much too soon can lead to weariness in the

body, especially in long distance hikers who are not adequately taking in good nutrition needed for the miles hiked. Or they skimp on drinking water. The body can turn to muscle to burn - a very poor place to find the energy needed to keep things going. Muscle wasting leads to weight drop, fatigue, and health issues once the hike ends.

What to do?

First of all, CUT the miles! If you are developing an issue like tendonitis, shin splints or knee issues, rest is important. RICE – Rest, Ice, Compression, Elevation until symptoms subside.  Take a few days off. Ice the affected extremity. Take Vit I (Advil) or Meloxicam works well too (a prescription). Taking tumeric with pepperine helps with inflammation. I have had very good results with an ointment called Penetrex. Applying an ace wrap or brace to the area sometimes helps (for me, it tends to aggravate things). Search out exercises online to help stretch the affected areas. If you are having foot pain, try relacing your shoes. If there is no relief, get checked out by a good sports medicine doctor.

Check your shoes. I’ve seen hikers that have come 800 miles in trail runners which are only meant to 

do 3-400 miles. Change your shoes ad insoles, and when you do, make sure they are the proper shoes for your foot type. Good insoles and good socks are important. And don’t forget hiking poles.

Make sure you are taking in adequate fluids and nutrition. Eating just ramen or potatoes is not going to provide the protein needed to help your muscles recover. Skimping on good foods means your body may turn to muscle of energy, and that’s not good. Eat a well-balanced meal that also contains dehydrated veggies and protein. Also take a multi vitamin. Water is needed to lubricate joints and prevent that achy feeling.

When you are ready to begin hiking again, ease back into your hiking. Do not be tempted to do too much too soon. Or you will be right back where you started. Be patient and your body will reward with with an awesome hike.

Related blogs:

Hiking and Ankles, the Whole Story

Oh My Aching Knees

When Injury Sidelines You 

The Ticks Are Out! Get Defensive Now

It's tick season and they are out in full force! Now more than ever it seems new diseases and other issues are evolving concerning this pest. I see more hikers worried about bears in the Appalachians, but what they really need to be concerned about is this very tiny menace that can wreck havoc on your body and cause a variety of illnesses. 

Here are the top ten ways to prevent this pest from ruining you from the Tick Borne Disease Alliance (and I add in a few tips also): 

Ticks are most active in the spring and summer months when they’re typically in their “nymph” stage.  Because of their small size at this stage in their lives, these ticks can go feeding—unnoticed—for days, allowing greater time for infectious bacteria to travel from the tick to its human host.  

Lyme disease is the fastest growing infectious disease and the most common tick-borne disease in the country, according to the Center for Disease Control, but there are numerous other diseases that ticks can pass along. There is currently no full-proof diagnostic tool for Lyme disease, causing thousands of people to often go misdiagnosed and without appropriate treatment.  Many sufferers of tick-borne illnesses are not even aware that they are victims of these diseases because they don’t have the facts. 

Below is the list of Prevention Tips:

1.    Purchase tick-repellent clothing, especially clothing treated with permethrin, an insecticide that repels and kills ticks. You may spray your own clothing with permethrin or seek out brands such as Insect Shield. Any article of personal clothing can actually be sent directly to Insect Shield in Greensboro, NC, where they will treat it with permethrin in their patented bonding process.  The treated clothes will look exactly the same as the clothes that were sent in, but will have the ability to repel and kill ticks, as well as repel other insects, for up to 70 washings.  See their web site for details. (I sent mine in and they were returned in a week).

2.     Reduce the amount of skin exposed by sporting long pants, long-sleeved shirts and a hat

3.     EPA-approved insect repellent should be applied to exposed skin. check this website from REi on different kinds. I like Picardin.  

4.     Venture in the center of woodland trails, and avoid walking along any deer paths

5.     Every time you’ve been outside, check for ticks while you are out and as soon as you get back

6.     Never wait to shower.  Bathing as soon as possible will help in removing unattached ticks from your body.   Bath time is the perfect time to carefully inspect for any unwanted hitchhikers.

7.     Take your clothes off and put them in the dryer at high heat for about 30 minutes to kill any ticks.  If clothes cannot be put into the dryer immediately, they should be placed in a Ziploc bag until a dryer is available.

8.     Inspect your pets when they come inside from the outdoors, as they may be transporting ticks that can then transfer to you (Note: This is really important. Be sure your pet has been vaccinized for Lyme disease. And use a tick killing collar, drops or a pill. Don't skip this. I've had a dog with tick-born illness)

9.     Opt for light-colored clothing to make it easier to spot ticks

10.   Tuck your shirt into your pants and your pants legs into your socks when possible to provide an extra line of defense against ticks

**Important - If you do find an embedded tick, remove it promptly with tweezers or a tick-removal tool and seek out a doctor. This is important for ANY tick, not just the deer tick. A one time dose of doxycycline 200 mg can be taken to prevent Lyme Disease if done with 36 hrs of the bite. If you are unsure when you got bit or start to have a fever, headache, joint aches, get to a Dr asap.

More information about TBDA, Lyme and tick-borne diseases, and prevention and protection can be found at www.TBDAlliance.org.

Another helpful site American Lyme Disease Foundation

The Hiker Medicine Chest

So what do you carry on a backpacking trip with regards to supplements and other medicines? I’ve touched on this briefly in my blog on first aid, but I wanted to add in a few extra ideas that I found helpful on hikes.

Supplements

Drink Water!

While it would be nice to get all our nutrition naturally from what we eat, as backpackers it’s rare we can do so. Additional supplements helps the body recover quicker from the damage caused by hiking and provide more energy and less issues with health. Herbs can also help with inflammation and pain. Do not underestimate water consumption. Water is your best defense against achy joints.

These are supplements worth taking (some will be different with men and women)

A Multi Vitamin- some prefer to carry a chewable kind, but if you do, they usually have sugar on them. All vitamins should be hung then in your bear bag. I take just the plain pill form. Women, make sure yours contains adequate iron.

Turmeric for Inflammation

Joint supplement – this can vary, but to help with joints and knees especially, glucosamine sulfate, at least 500 mg and up to 1000 mg a day works well. So does Eggshell membrane that contains MSM and chondroitin.

For Inflammation – I carry Turmeric in pill form. Also Boswellia Serrata. Ginger has also been used for anti-inflammatory issues as well as the chief component in Cayenne pepper, capsaicin. Green Tea helps fight pain, which you can bring in pill form or as teas to drink.

For women, I highly recommend carrying calcium carbonate, extra Vitamin D 3 (helps absorb the calcium), and cranberry tablets to control urinary tract issues

Other Medications

Sometimes other pain relievers are needed. If you don’t have ulcer issues, you can bring some of the standard Vitamin I – commonly known as Advil, to help with inflammation and pain. I usually try to control pan with plain Tylenol though and use the other herbal supplements to help with inflammation. Do not plan to bring other kinds of narcotic pain relievers with you. If you feel the need for a narcotic, then the pain you are having is NOT normal and you should get off the trail and to a doctor.

Doxycycline – 200 mg of this, taken when you first discover a deer tick bite, can help against the development of Lyme disease. Talk to your doctor about having this prescription in your first aid kit. And carry a tick key too for tick removal. Use permethrin to treat your clothing, shoes and socks (do not apply to your skin!).

Stomach Aids – I do not recommend any kind of stomach aids for diarrhea such as lomotil. Diarrhea is the mechanism the body uses to flush out harmful bacteria and viruses. If you are experiencing constant diarrhea for a week or two that does not go away, you may have contracted the water borne illness giardia, and then, you need a prescription antibiotic to cure it. If you suddenly develop an onset of the runs and vomiting, you may have contracted norovirus. No stomach aid can help with this, but only time as it is a virus. Be sure when you are able, drink electrolyte solutions (such as Gatorade) to replace the fluids lost. Coconut water, if available, is helpful also. Try also broths and bananas. Carry with you a good hand sanitizer such as Purell with at least 70% alcohol content, and use it freely to help prevent contamination.

If you plan to be on the trail long term and are on prescription medication, use mail drops to mail the meds to your stops. Having a reliable person at home to help send them to you is a good idea. You can also get a vacation refill from your pharmacy so some drops can be made up ahead of time. Drops can be sent to a host of locations such as outfitters, hostels, motels etc besides just post offices. Check recent guidebooks for where to mail them. And always send your parcels Priority Mail.

 Related Blog

Sickness on the Trail - what to do, prevention

Oh, My Aching Knees

 One of a hiker's chief complaints is knee issues that can spring up on the trail. A knee is a rather intricate joint with many ligaments and tendons interspersed through it to make it work as a "hinge" joint. It carries quite a load, and combined with a backpack, on uneven or steep terrain, with long miles, the load on this joint can be incredible. The knee offers a variety of complaints, so much so that is can force a hiker off the trail. 

But there are tricks to keep the knee joint functioning if a hiker treats the joint with the respect it deserves.  

 

Before a backpacking trip, get into a regimen of strengthening this joint. Do knee bends with a pack on your back. Do stretches for your hamstrings and quads. Knee pain often results from these muscle groups that are too tight. Learn the stretch too for ITB (illiotibial band syndrome). Runners World give a nice article on good knee stretches for the athlete.

 

Nutrition is a key element to healthy joints. A balanced diet is best, especially on long backpacking trips. Don't skimp in this area. Up your protein which assists in muscle healing after a hard work-out (and hiking is hard on your muscles). When you stop to rest, don't reach for a candy bar. Eat some cheese or nuts instead. Keep an adequate, consistent intake of water on your hike which helps the body lubricate the joints and brings blood to the area. Consider glucosomine, chondroitin, and msm

supplements. A product I found that is working wonders on my knee is eggstraflex that contains eggshell membrane. I have used this in place of glucsomine with good results. By far the best remedy for inflammation is Tumeric (Circumin). Be sure it contains 95% curcuminoids and Piperine for better absorption. I take it twice a day.

Use good hiking poles. They take the strain off knees, especially on downhills.

Make sure you are wearing adequate footwear and insoles. It's best to get fitted by a professional shop that knows foot types.

Watch your pack weight. An overweight pack can add more stress load to the knees. Try to cut down on any unnecessary weight.

Watch your daily trail mileage. Forget keeping up with others. Take the hike at your pace, even if that means a 6 mile day. If other hikers run past you down the hill, let 'em.

If you have done bicycling and switch to hiking, it will take time for your muscles to adapt. Give them that consideration.

For pain, an ice pack can help as well as NSAIDS (non steroidal, anti inflammatories such as Aleve or Advil).  I found the cho pat duo knee brace works well. But I try hard to limit its use. Once your knee adapts to it, it's hard to go without it. Prevention is best.  

 
If you find after a hike your knee is quite swollen, or you have crippling pain or the pain persists, be sure to get checked out by a sports MD. There may be other issues involved, such as strained or sprained ligaments or even Lyme Disease (which can affect joint health). 






Related Blogs:

Ankle Injuries
When Injury Sidelines You
First Aid Kit and Wilderenss Medicine
Sore and Achy

Foot Care

Caring for your feet while hiking is a vital part of the trail experience. Take it from one who had to abandon a hike for a small irritated blister under one toe – issues with feet can wreak havoc on your

plans. Proper care of feet ahead of time can help avoid a lot of misery on the trail and also avoid injury.

Shoes

Hiking shoes are really a personal preference in many instances. I have worn both boots and trail runners and am now a convert when it comes to using trail runners for East Coast trails. The lightweight ability of these shoes, the quick drying capacity in wet, soggy conditions, and the ability to navigate rocky terrain have all helped me remain with this type of footwear. But I also made sure I got checked by a professional when buying shoes. I went to a professional running shop and had them evaluate my foot type for the type of shoe I needed. I ended up with what is called a motion control shoe because I pronate. Different shoe types, based on construction, can make your foot, then your leg and hip, move differently. Ill-fitting footwear can affect not only your foot but can cause knee and hip issues and even injuries. Hence the need for a foot professional to make sure you are wearing the right type of shoe for your foot. I also go with a size larger shoe than my foot size as well.

Trail Runners dry ultra quick after being in slush

Insoles

I am a big believer in proper insoles. This can take some doing as there are so many to choose from. A professional can help you determine what type will work. I actually worked with a physical therapist after having some nerve issues in my calf, and he recommended the blue Superfeet. I have worn them ever since. Get a professional opinion on the right insole to match your foot type. It adds to the support of your foot and makes for a better journey and less injury.

Socks

Socks are very important to help minimize pressure points and blister formation. Going with a good merino wool blend helps to wick moisture way from your foot which can cause blisters. DO NOT wear cotton “gym” type socks. As your foot sweats, they get wet, stay wet, and the moisture will make you suffer with blisters that will pop up after only a few miles of walking. In a follow-up blog I will rate a few socks I have tried.

Foot Care

Make sure you are doing proper foot care on your journey. Whenever you stop, take off your shoes, remove the insoles, and take off your socks. Let them all dry in the sun if possible and air out your feet. You will find instant relief if they are feeling hot and tired. Also, be sure you are carrying a proper first aid kit (with duct tape, band aids, etc) should there be issues with hot spots and blister formation. Check out the blog on blister care should they happen.

Your feet will take you wherever you need to go on your hiking journey with some proper care and TLC

My Serious Infection Trailside

A simple sting begins to blister, which is not a good sign

(Be Warned - Injury Pictures) On my most recent hike along the Foothills Trail, I had the unfortunate experience of developing what could have been a severe infection. It began fairly tame enough – what I thought to be a simple hornet sting on the trail. That evening I looked at it to see a rather small round circular mark. I put some sting eze type prep on it. Over the night it appeared to be getting better. I did no other first aid,

put on my rather dirty sock (I had no clean socks as it was the end of my journey) and proceeded to finish the hike.

Guest Blog - Dehydration

A follow up on the previous blog about heat related illnesses is a guest blog on dehydration from a medical standpoint and what it means in your body.

Don’t Get Dehydrated This Summer! 

With summer temperatures rising high, it is critical to keep in mind what may be causing you to feel dehydrated and also how you can spot dehydration before it becomes a serious hazard.

The first tip is to know the signs and symptoms of dehydration. Usually, the first signs are neurological; headache, dizziness, nausea, confusion, increased thirst, and dry mouth. After that, if dehydration has not been treated, the signs may progress on to GI symptoms such as nausea, abdominal pain, vomiting, and cramps. Medical signs physicians look for include tachycardia, fever, tachypnea (increased breathing), decreased urine output, and hypotension. On rare occasions with severe dehydration coma, seizures, and death can occur.

In order to avoid dehydration, prevention is key. Especially in preparing for any long outdoor physical activity, you should decrease alcohol, coffee, and tea, intake. The common factor in many sports drinks and sodas is caffeine, which is also a big contributor to dehydration. They are diuretics and diuretics will cause inhibition of ADH (antidiuretic hormones) made in the pituitary gland, which is needed for the sodium active transport system in your kidneys. When the transport system is blocked, water does not get reabsorbed by the kidneys and is lost through urine. This is the reason for the frequent urination when drinking these products.

Even more important than knowing what can make you feel dehydrated, is knowing ways to help you stay

properly and fully hydrated. When choosing a beverage that will keep you hydrated, the two main ingredients to look for are Salt (NACl) and Water(H2O). Plain water will be absorbed via the GI Tract but is very inefficient. Have you ever drank plain water and still felt dehydrated? It is the active transport system, specifically, the sodium (Na) active transport system in the kidneys that is the most efficient system in the human body in reabsorbing water. When we drink a high sodium drink in the form of NaCl (salt) and H2O (water) during dehydration, the kidneys will actively transport the sodium (Na). When this occurs, the H2O will follow passively into our body. This is why when a patient comes to the ER (emergecny room) for dehydration issues, they are given a Normal Saline IV. 1 Liter normal saline has 9000mg of Salt (NaCl) and Water (H20). The only ingredients found in a normal saline is Salt and Water.

Don’t short yourself of fluids you need to stay hydrated. While this is difficult to measure, generally for non-active consumers, 2-4 BANa’s per day will keep the doctor away. 4 bottles of adult BANa is similar in salt content as a normal saline IV bag. When hydrated, your body will naturally filter out out the excess salt and water. Doctors also tell non-active patients in clinic the 8x8 rule. Eight - 8 oz glasses of plain water per day. Have fun this summer, but stay safe by staying hydrated!

For more than a decade, Benjamin Yoo, MD has treated patients in the emergency room for dehydration. Dr. Yoo is the founder of BANa Bottling Co., an industry-leading rehydration beverage company. Born in South Korea, Yoo moved to the U.S. at the age of six and was raised on his parent’s farm in western Kentucky. Dr. Yoo earned his medical degree from the University of Louisville in 2001, then began working in emergency rooms across Georgia and South Carolina. He moved to Charleston, S.C. in 2004 to work at HealthFirst Rapid Care in North Charleston. It was there that Yoo had the idea for BANa a rehydration drink inspired by saline IVs given to patients in the ER or urgent care for dehydration

Related Blogs

Heat Related Illnesses

Alternate Summer Adventure

Tick Related Issues

Bears

Blissful Hiking's Ten Essentials for Hiking

I came across this post on REI of their updated Ten Essentials for Hiking.

Updated Ten Essential "Systems"

1. Navigation (map and compass)
2. Sun protection (sunglasses and sunscreen)
3. Insulation (extra clothing)
4. Illumination (headlamp/flashlight)
5. First-aid supplies
6. Fire (waterproof matches/lighter/candles)
7. Repair kit and tools
8. Nutrition (extra food)
9. Hydration (extra water)
10. Emergency shelter

Here is my take on the Ten Essentials for a Hike

1. Navigation. Maps, maps, maps. Consider a guidebook for the area too if unfamiliar with it. A compass is good to have but at least a map is essential.

2. Replace sun protection with insect protection (unless you are desert hiking or hiking in trails out west without trees like Utah). Ticks are a primary concern with the spread of Lyme Disease. Mosquitoes and deerflies can make life miserable.

3. Extra clothing, yes, including a good hat. I would add in rain gear. That can help shield you from wind as well as protect you if the weather turns nasty. And throw in a pack cover for your pack to keep the contents dry. And a small poncho could be used as a shelter in a pinch.

4. A trusty headlamp is a good idea to have if you run late on the trail

5. A first aid kit is a must. See my first aid kit contents.

6. Yes, you can throw in matches for a fire, but what if it's wet out? Extra dry clothing and extra food is good to have.

7. Repair kit and tools? Not sure why a repair kit is essential. I add in my first aid kit duct tape and safety pins. That will likely get you temporarily fixed until back n civilization. Perhaps a small pocket knife, but it isn't likely to help you that much.

8. Extra food is a good idea. A good trail mix has a mixture of fats, carbs and protein from the nuts, seeds, fruits, and chocolate bits.

9. Hydration. Instead of toting large amounts of water, bring water purification and a map and guidebook to let you know where the reliable sources are located. But if there won't be any (like desert hiking) then carry the water you need for the climate. 

10. Shelter is a necessity in bad weather and I would also add in Safety too. Bring a charged cell phone, tell someone at home about your hiking plans and when you are expected home, bring some extra cash for a ride. If there are places to sign in at trail registers, do it. Bring a pen for this and some paper too in case you need to leave a note somewhere. Add a small whistle.

First Aid – Fundamentals for Survival

So you are ready to head to the outdoors, but have no medical background to handle those injuries that might come your way. Or what to do about a sudden bee sting. Encountering poison ivy. Or knowing the signs of hypothermia before it is too late. 

Look no further than this handy guide that gives a fine outline of common maladies affecting hikers and what to do. The book is divided into sections dealing with the issues that can arise. It gives a short easy to understand description of the condition, the signs and symptoms, and how to treat. 

Topics covered include first aid supplies, resuscitation, hydration, exposure, skin wounds, reactions, bones and joints. 

 

A bee sting reaction

While not a substitute for actual training like taking a Wilderness First Aid course or in place of seeking medical attention, this manual is a valuable tool for a hiker to know what to do when the unexpected can and will happen. It should be required reading before any major hike.

Living Ready Pocket Manual – First Aid, Fundamentals of Survival

by James Hubbard, MD

Dr. Hubbard is a long time family doctor of 35 years. In addition to his MD, he also has a Master’s in Public Health. On his website Dr. Hubbard shares how to treat medical problems when medical professionals are unavailable. He is also the author of The Survival Doctor’s Guide to Wounds and The Survival Doctor’s Guide to Burns. All books are available through his website.

Related Blogs:

First Aid, Trail Medicine and other Issues

Take Wilderness First Aid!

When Injury Sidelines You

Know About Hypothermia!

Cold, wet conditions can bring about hypothermia

After learning the tragic news of a scout dad and his boys who died because of hypothermia on a hiking trail, I felt the need to post this information, taken from the CDC government web site. Please know the signs and symptoms of hypothermia, especially when hiking in cold conditions. It can be an issue even in temperatures in the fifties with a cold wind and especially if it is raining and you become wet. If anyone in your party starts acting strange and the weather is conducive to hypothermia, suspect it and act quickly.


"When exposed to cold temperatures, your body begins to lose heat faster than it can be produced. Prolonged exposure to cold will eventually use up your body’s stored energy. The result is hypothermia, or abnormally low body temperature. Body temperature that is too low affects the brain, making the victim unable to think clearly or move well. This makes hypothermia particularly dangerous because a person may not know it is happening and won’t be able to do anything about it.
Hypothermia is most likely at very cold temperatures, but it can occur even at cool temperatures (above 40°F) if a person becomes chilled from rain, sweat, or submersion in cold water.
Victims of hypothermia are often (1) elderly people with inadequate food, clothing, or heating; (2) babies sleeping in cold bedrooms; (3) people who remain outdoors for long periods—the homeless, hikers, hunters, etc.; and (4) people who drink alcohol or use illicit drugs."

Recognizing Hypothermia

Warnings signs of hypothermia:
Adults:

• shivering, exhaustion
• confusion, fumbling hands
• memory loss, slurred speech
• drowsiness

Infants:

• bright red, cold skin
• very low energy

What to Do

If you notice any of these signs, take the person’s temperature. If it is below 95°, the situation is an emergency—get medical attention immediately.
If medical care is not available, begin warming the person, as follows:

• Get the victim into a warm room or shelter.
• If the victim has on any wet clothing, remove it.
• Warm the center of the body first—chest, neck, head, and groin—using an electric blanket, if available. Or use skin-to-skin contact under loose, dry layers of blankets, clothing, towels, or sheets.
• Warm beverages can help increase the body temperature, but do not give alcoholic beverages. Do not try to give beverages to an unconscious person.
• After body temperature has increased, keep the person dry and wrapped in a warm blanket, including the head and neck.
• Get medical attention as soon as possible.

A person with severe hypothermia may be unconscious and may not seem to have a pulse or to be breathing. In this case, handle the victim gently, and get emergency assistance immediately. Even if the victim appears dead, CPR should be provided. CPR should continue while the victim is being warmed, until the victim responds or medical aid becomes available. In some cases, hypothermia victims who appear to be dead can be successfully resuscitated.

Take Wilderness First Aid!

Me (in the black coat) helping a teammate tend the injured in a scenario

I had the opportunity last weekend to participate for certification the Wilderness First Aid course. This intense 10 hour a day, two day course focused on delivering first aid to those in wilderness and urban disaster settings when help from rescue personnel are not available. I originally decided to do this as it was a requirement for those seeking possible ridgerunning employment. But afterwards I saw how valuable this is just for the amount of time I like to spend in a wilderness setting. There were ideas shared on various medical issues that could benefit those we meet in a trail setting. I also added a few things to my fist aid kit.

New Additions to my First Aid Kit (adding to what I posted on the First Aid Blog):

a small plastic syringe to irrigate a wound - weight prob less than an ounce. After seeing hikers with infections that went systemic from cuts, it makes sense to use this to irrigate wounds
Various gauze pads to clean wounds with, bandaids of course
Pieces of moleskin, not just duct tape
safety pin
small film canister of hibiclens - soap of choice (can get at a drug store) for cleaning wound; they are not big on antibiotic cream which was new for me. Says it attracts dirt, but I carry a small tube anyway
Carry a watch (I do anyway. Good for checking heart rates and for noting time of injuries, etc for rescue and others)
two triangular bandages - good for lots of first aid, weight negligible
several ziploc bags for stream water and / or ice 
a small tick removal device
Other Medicines besides the ones mentioned - 
some salt - for sun issues and rehydrate - look for the restaurant packs
some sugary jello (maybe have in food bag, just be sure you hang it) - good to rehydrate, hypothermia and diabetic issue, liquidfied
some aspirin - 325 mg, for heart issues
benadryl for allergy reaction (it can happen to anyone at any time) - and consider getting a prescrip for epipen from dr
Tylenol (sometimes Vit I but Tylenol is the drug of choice)
some small ziplocs to put on water and / or ice packs for injuries



Why Take Wilderness First Aid? (From MEDIC SOLO Wilderness First Aid outline)

Accidents can and do happen in rural and wilderness areas (including the 'wilderness' of concrete rubble in an urban disaster), and all-too-often members of a group are not capable of dealing with the emergency. Not only does this lead to improper care of the patient, but it also endangers the entire group. Studies have shown that many recreational accidents are preventable, and that improper care of trauma can compound even the simplest of injuries. Through our involvement in emergency medicine and rescue efforts, we at SOLO feel there is a need for training for all outdoors people - training which stresses preparedness and prevention; training which encompasses all phases of off-road emergencies; training which focuses on extended care issues in prolonged transport situations. Very few first aid programs actually address the issues of providing emergency care in a rural, wilderness, or extended care setting.  In this course, lectures and discussions are interwoven with practical work and problem-solving exercises. The emphasis is always on hands-on experience. Scenarios are a major part of this training. 

Here is what is offered:

Hands-on learn how to save life and limb during the critical minutes or hours before ambulance / hospital hand-off.   This 16- to 18-hour course is designed for anyone who may find themselves away from immediate help, having to rely on their own skills to help others survive and thrive in case of injury or illness, before help arrives. The learning blends classroom instruction, hands-on rescue scenario practice, and Q&A, resulting in SOLO Wilderness First Aid Certification (valid for two years).  Open to all, this course is recognized by the American Camping Association as the minimal standard for camp counselors -- both day hiking and overnight hiking leaders, and is approved by the Boy Scouts of America (BSA).

To find out more and where a class will be held in your area, check the SOLO website.