Medicine:

Insect repellent

Aspirin

Bandages

Water purification tablets (such as iodine tablets)

Prescription medicines and copies of prescriptions (including for eyeglasses)

Sunscreen

Malaria pills, such as Mefloquine, taken once a week, one week prior to trip, during the trip and then for four weeks after returning, Vitamin supplements

Antibiotics for traveler’s diarrhea, such as Immodium AD and , Cypro (not to be taken preventatively), Pepto-Bismol (preventative), and rehydration solutions to replace lost fluids and salts Motion sickness medicine, such as Dramamine

Empty film containers to store pills

Clothing

Quick drying clothes (like those made of CoolMax) will make it much easier if you are caught in a rain storm or in a hot, sweaty climate. Find the most durable and comfortable clothing.

Warm-weather gear: Shorts and Tshirts for active wear and lounging

Cold-weather wear: Sweater or fleece jacket, long pants (preferably chinotype. Avoid jeans because of their bulk and lengthy drying time)

Rain gear: waterproof pants and jacket Hiking boots or trail running shoes One pair of lightweight shoes or waterproof sandals

Long underwear or tights

Socks, both thin and thick

3-5 pairs of underwear

Hat

Bathing suit

Pajamas

Women should bring a long skirt or dress-several countries either require such clothing (such as to enter Italian churches) or recommend it for cultural respect and safety (as in Muslim countries)

Camping Equipment:

Lightweight tent

Compact sleeping bag

Camp stove and fuel

Water purifier

Eating and cooking utensils Lighter or waterproof matches Flashlight

Pocket knife with scissors

Extra backpack straps or bungee cords

Sewing kit with heavy thread

Nylon rope

Water bottle

Documentation:

Vitamin: An Organic nutrient (as opposed to a Mineral, which is inorganic) essential for normal physiological and Metabolic functions of the body. Most vitamins cannot be synthesized by the body and must be ingested in food or supplements.

Vitamin A: An important fat soluble Vitamin that helps in the formation and maintenance of healthy teeth, skeletal and soft tissue, mucous membranes and skin. It is also known as Retinol, as it generates the pigments that are necessary for the working of the retina. It promotes good vision, especially in dim light. It may also be required for reproduction and lactation. Beta-carotene, which has Antioxidant properties, is a precursor to vitamin A. Because it is fat-soluble, it can accumulate in the Liver, so overdosing is possible. a

Vitamin B12: Also known as Cyanocobalamin, is a water soluble Vitamin involved in protein, carbohydrate and fat metabolism, as well as blood formation and nerve function. Sources are liver, kidneys, fish and meats. Deficiency, commonly called megablastic anemia, can occur in strict vegetarians and also in those who have a problem absorbing B12 due to a lack of intrinsic factor, a substance secreted essential for absorption of vitamin B12. This can also occur as we age.

Vitamin B2: A water-soluble Vitamin (also known as Riboflavin) required by the body for health, growth and reproduction; part of the vitamin B complex. It is important for red cell production and helps release energy from Carbohydrates. Dietary sources include lean meats, eggs, Legumes, nuts, green leafy vegetables and dairy products. Breads and cereals are often fortified with Riboflavin. Oral contraceptives can reduce riboflavin levels.

Vitamin B3: Also known as Niacin or Nicotinic acid, it is used to treat various medical conditions such as high Cholesterol, peripheral vascular disease and Migraines. If supplementing with Niacin, be sure to get the flush-free variety. High doses can stress the Liver.

Vitamin B6: Also known as Pyridoxine, this water-soluble nutrient plays a role in the Immune System’s synthesis of Antibodies, helps maintain normal brain function and form red blood cells. It is also required for the chemical reactions of proteins. Vitamin B6 is found in beans, nuts, Legumes, eggs, meats, fish, Whole grains and fortified breads and cereals. The higher the protein intake, the greater the need for this nutrient. Deficiency of this Vitamin is not common in the United States. Excessive doses can cause neurological disorders and numbness.

Vitamin C: This water-soluble Vitamin, also known as Ascorbic acid, is an Antioxidant that has been shown to play a role in boosting the Immune System. The Recommended Daily Intake RDI) is 60-75mg per day, but Linus Pauling and other complementary practitioners recommend considerably higher doses for preventing the common cold. Sources of vitamin C include strawberries, peaches, plums, tomatoes, celery, onions and cabbage.

Vitamin K: A fat-soluble Vitamin that plays an important role in blood clotting, vitamin K is found in vegetables, including cabbage, cauliflower, spinach and other leafy greens, as well as in cereals and soybeans. The bacteria lining of the gastrointestinal tract also makes vitamin K. Vitamin K counteracts the effects of oral anticoagulant drugs such as Coumadin.

VLDL (very-low-density lipoprotein) cholesterol: The type of lipoprotein made primarily by the liver cells to transport Lipids to various tissues in the body.

Magnesium: A silver-white mineral, the element magnesium is involved in nearly every essential bodily function, from the healing of the heart to the creation of bone and the regulation of Blood sugar. It helps to burn Fat and produce energy and is also known as the “gatekeeper of cellular activity.” Magnesium is abundant in foods such as Wheat, bran, almonds and tofu.

Maltitol: This Sugar alcohol is used by food manufacturers as a replacement for Carbohydrates such as Sucrose. It contributes only 2.1 Calories per gram as compared to sucrose’s 4 calories per gram; nor does it raise blood glucose as sucrose does.

Maltodextrin: A type of Sugar, and therefore a Carbohydrate, found in packaged foods.

Manganese: A trace element, this Mineral is essential for growth, reproduction, wound healing, peak brain function and for the proper Metabolism of Sugars, Insulin and Cholesterol.

Melatonin: A hormone secreted by the brain’s pineal gland, a small gland in the center of the brain that regulates body rhythms and, thus, sleep. Studies have shown that those with low melatonin levels who suffer insomnia are best helped by supplemental melatonin. It has also proven useful for jet lag and seasonal affective disorder (SAD).

Mercury: A toxic metallic element found in old thermometers, some fireworks, paints, hair dyes, antiseptics and fungicides. The ingestion or inhalation of mercury-containing products or food such as fish contaminated by polluted water can cause mercury poisoning, which can lead to death.

Metabolic advantage: The benefit gained by switching the body from a glucose metabolism to a fat metabolism, thereby allowing the consumption of a greater number of Calories than is possible on other weight-control programs.

Metabolic resistance: A state in which it is extremely difficult to lose weight, despite restricted dietary consumption.

Metabolism: The process by which foods are transformed into basic elements that can be utilized by the body for energy or growth; the sum of all chemical reactions that go on in living cells. Metabolism includes all the reactions by which the body obtains and spends all the Calories it gets from food.

Milligram: A unit of weight used in the metric system (abbreviated as mg). One thousand micrograms equals one milligram. One ounce is equivalent to 28.4 mg.

Mineral: In nutrition, a compound nutrient that contains an inorganic substance, such as a metal or other trace element found in the earth’s crust. For example, sodium chloride (table salt) is a compound of Sodium and chlorine. Minerals play a vital role in regulating many of the body’s functions.

Molybdenum: A trace element that in supplemental form is known to cleanse the body of toxic compounds, generate energy, help manufacture hemoglobin and relieve symptoms of Arthritis and Asthma. This Mineral can be poisonous if ingested in large quantities.

Monosaccharides: Simple sugars, such as Glucose, Fructose and galactose.

Monounsaturated fat: A Fatty acid with only one double or triple bond per Molecule, it is found in such foods as fowl, almonds, pecans, cashew nuts, peanuts, avocado and olive and canola oil.

A Guide to the Effects of Cold and Altitude

Each year, several visitors to our mountains die needlessly. They fall victim to the problems discussed here because they didn’t know how to protect themselves from the mountain envir-. onment. The San Luis Valley Emergency Medical Services Council has prepared this pamphlet for free distribution–not to scare you, or to make your stay in the Rockies less enjoyable, but in the hope that by reading this, you will become better prepared to cope with some of the hazards of the mountains. We hope that your trip to Coforado has a happy ending, and if by means of this message to you, we prevent just one unhappy ending, we will consider our efforts well rewarded. Please read this-think about what we are saying-consider for a moment whether you are prepared to handle the situations we describe here…

Acclimatization

Acclimatization to high altitude involves complex changes in your body’s regulatory mechanisms. For example, breathing auto-matically becomes more rapid, and the blood increases its proportion of oxygen-carrying red blood cells. These changes enable the body to function properly even though the amount of available oxygen is much less at high altitude. Your body starts adapting to this lack of oxygen upon reaching altitude-about 90% of acclimatization occurs in 10 days, and about 98% occurs in 6 weeks.

You may notice any of the following symp-toms, which indicate that you are not yet completely adapted to high altitude: shortness of breath, general malaise (a “run-down” feeling), loss of appetite, nausea, vomiting, dizzi-ness, and headache.

Mountain Sickness

Rapid ascent by persons not used to altitude, as by automobile, to altitudes over 8000 feet usually results in what is known as “Mountain Sickness”. In addition to the symptoms listed above, you may experience drowsiness, yawn-ing, weakness, and chilliness. You may notice a whitish pallor of the face, and a bluish tinge of the lips and fingernails. Headache is frequent and may be severe. Even slight physical effort can produce troublesome shortness of breath. You may notice pounding or palpitations of the

heartbeat. Sleep can be difficult, and respira-tion may assume the pattern of several very deep, rapid breaths followed by a. period of shallow or even ab!ient breathing, then deep, rapid breaths again. This type of breathing is known as “Cheyde-Stokes” breathing, and is so common at high altitudes that it should not be considered abnormal. Dizziness, ringing in the ears, irritability, and memory defects may appear. Most of the symptoms of mountain sickness are due to the effect of oxygen lack in the body’s central nervous system and should disappear when you become better adapted to altitude. Most of them stop within 24 to 48 hours after arrival at altitude, although the shortness of breath, lack of appetite, and headache may persist.

Rest, or at most very light physical activity during the first 24 hours at altitude is helpful in preventing mountain sickness; more serious symptoms can often be alleviated by descent to a lower elevation for a day or two. Proper diet and fluid intake also are very important–the success of the 1973 American Everest Expedi-tion was attributed in large part to continuous, conscientious efforts to consume adequate amounts of food and liquids in spite of loss of appetite. At least two quarts of liquid should be drunk daily, and four quarts are preferable.

High Altitude Pulmonary Edema

Mountain sickness is caused by lack of oxygen and, although extremely disagreeable, is not life-threatening. A disorder called High Altitude Pulmonary Edema (HAPE) is also caused by oxygen lack, and although apparently rare is extremely dangerous-deaths have resulted in within 6 to 10 hours from the onset of symptoms. Although the set of conditions which result in HAPE are very complex and poorly understood, diagnosis is not difficult. The classic symptoms are rapidly increasing shortness of breath and a dry cough which later produces a white, frothy sputum which may be streaked with blood. The victim is usually cyanotic (that is, blueness of the lips and nails is present). Bubbling sounds may be heard, as if the victim is breathing through liquid-as indeed he is; pulmonary edema means that blood plasma has leaked into the air sacs of the lungs.

Adequate acclimatization seems to be the best protection against HAPE. Above 1 0,000 feet, at least one day should be allowed for each thousand feet of altitude gained. As with mountain sickness, adequate fluid intake is extremely important.

The treatment of choice for HAPE is IMMEDIATE AND RAPID DESCENT! Instances have been reported where normal breathing was restored only 2000 feet lower than the altitude at which symptoms appeared. If oxygen is available, give it at 4 liters per minute while descending,

Hypothermia

Most deaths of victims lost in the mountains that are called “exposure” by the media are really due to a condition called hypothermia. Simply put, this is a loss of body heat faster than it is being produced, causing a drop in the body’s inner-core temperature. Usually, it results from a loss of the body’s store of nutrients in a situation where the victim is subjected to severe chilling. Hypothermia can occur well above freezing–deaths have been recorded when the temperature never dropped below 50 0 F.

When clothes become wet, they lose about 90 per cent of their insulating value. Wind drives cold air under and through clothing and refrig-erates wet clothing by evaporating moisture from the surface.

Cold affects the body slowly and subtly–it can produce lapses in memory, errors in judgment, clumsiness and loss of coordination. THE VICTIM IS UNAWARE THAT THESE MENTAL EFFECTS ARE HAPPENING!

There are signs and symptoms that indicate the victim is in the process of dying from hypother-mia-these can be divided into three consecutive

stagev

1. Uncontrollable shivering–which is an attempt by the body to generate heat and maintain a normal body tempera-

ture. This stage will last as long as the body has readily-available nutrients, for practical purposes, this consists of sugars and starches (fats and proteins cannot be used by the body fast enough to help).

II. Shivering stops-the body no longer has the fuel necessary to produce heat. The victim will be listless and indifferent. HE WILL NOT BE MOTIVATED TO SAVE HIMSELF. He will be clumsy, forgetful, and he cannot make the decisions neces-sary to save his life.

III. Unconsciousness, coma and death can follow Stage 11 in a matter of minutes.

A hypothermia victim, even in the first stages, will usually deny that he is in trouble.

BELIEVE THE SYMPTOMS, NOT THE VICTIM. You must act quickly and drastically to save his life! Get the victim out of the wind and rain and into the best shelter available. Remove his v4et clothing and replace it with dry, insulate him from the ground, and warm him the best way you can. If he is fully conscious, give him warm, sweetened liquids. Get him into a sleeping bag, if one is available, which has been pre-warmed by another member of the party. (Placing a hypothermia victim in a cold sleeping bag will do him no good–remem-ber, he cannot produce enough heat to keep his inner-core body temperature at a survival level.) Skin-to-skin contact is the most effective treat-ment, with the victim in a sleeping bag with another person. If the victim is able to eat, give him anything that is high in carbohy-drates–candy bars, hard candy, or dextrose tablets are easy to carry. Under no circum-stances should a hypothermia victim be given alcoholic beveragesl Alcohol dilates the blood vessels near the surface of the skin, and will in effect chill the blood, causing a further drop in inner-core body temperature. .

Fortunately, with a minimum of knowledge and preparedness, hypothermia can be prevented. Dress for WARMTH, WIND, and WET-the three W’s of hypothermia. Although clothing does lose much of its insulating value

when wet, wool retains more insulation value than any other fabric. Put on rain gear before you are wet; put on wool clothes and wind gear before you are shivering. Protect the insulating value of down clothes by keeping them dry–a wet down garment amounts to two layers of thin nylon.

Any time you or your party is exposed to wind, wet or cold, carefully watch for signs of hypothermia: uncontrollable shivering; slow, slurred speech; irrational actions; memory lapses; immobile, fumbling hands; frequent stumbling; apparent exhaustion; and drowsiness (to sleep is to die). Remember that a person can slip into hypothermia in a matter of minutes and can die in less than 2 hours after the first signs of hypothermia are detected.

Carry emergency food that is high in sugars and is used only for emergency, eat regularly, have rain and wind gear with you, and THINK!

Alcohol and Altitude

It is difficult to predict exactly, but one alcoholic drink at altitude, in an unacclimatized person, is at least the equivalent of two or three at sea level. The lack of oxygen at altitude strengthens the sedative and disorienting effects of alcohol-and also the effects of sedatives and tranquilizers. USE CAUTION with alcohol and with these drugs until you are acclimatized.

PREVENTING AND TREATING INJURY

Here are some tips to help you avoid ankle sprains, as well as steps for treating the inevitable… Use common sense, and apply any or all of these steps to ankle injuries when traveling, to get you up on your feet and moving around quickly.

What You Can Do to Prevent Sprains

To help prevent strains, avoid unsupportive shoes/boots, (definitely leave the high heels at home), and always wear the right foot gear for the activity you’re engaged in.

You can strengthen your ankles by doing the following exercise: Rise up on the tips of your toes 20 to 25 times. To keep your balance, hold on to a wall or the back of a chair. Try this with both feet first, and, when you’re ready, with one foot. This will greatly improve the strength around the ankle joint, and help define calves too. Another exercise is to stand with one foot still, (Firmly planted), and rotate the other foot

If you sprained your ankle before, you are more likely to sprain it again. Always warm up before participating in any sport. If you’ve had a previous ankle injury, you may want to tape your foot or wear an elastic bandage, and wear high-top shoes/boots for additional support.

Know the Signs

You will probably be able to tell if you sprain your ankle. After the original twist that causes the pain on the outside of your ankle for a few minutes. Then the pain will go away for a few minutes. Within a half hour, the pain will return and your ankle will begin to swell.

You can treat most ankle sprains at home. Use the R.I.C.E. method described below.

Be sure to see your Primary Care Physician if the pain lasts for more than a day or two.

R.I.C.E.:

REST: Stay off your feet if possible. At the very least, cut back on any activities that might aggravate the sprain.

ICE: Wrap ice in a towel and gently place it on the affected area. Apply ice for 20 minutes at a time, and wait 40 minutes before applying it again. Do not apply heat to the ankle during the first 48 to 72 hours after the injury, or as long as there is swelling.

COMPRESSION: Wrap an elastic bandage around the affected area until the swelling goes down. Be careful not to wrap the bandage too tight.

ELEVATION: Keep your foot elevated so that it rests higher then your heart.