You may be the best doctor for you. Or, you may be the worst doctor for you. I can't tell you, but maybe I can help you figure it out. After all, even the best M.D. has to get a lot of facts filtered through you. So you're definitely part of the doctoring process, like it or not. Here are some examples:
Potassium Stuff: In 1989, on the fourth day of our trek, I started out hiking briskly. Soon, I began to feel weak; my heart was beating fast, and I felt tired. What was wrong? In a few minutes the leader caught up, and I asked what was wrong. He took my pulse, and my heart rate was indeed high by 2×>—"tachycardia." He looked in a big (35 oz) book of mountain medicine and decided to give me potassium pills. After a while, walking slowly, I got better. I finished off the day just fine.
Seven days later, camped up at 14,600 ft, I crawled into my sleeping bag and got the worst case of leg and foot cramps I'd ever had. Misery. At the time, I didn't realize that the cramps were another symptom of potassium shortage. A few days before the trek, I'd had a small bout of diarrhea, and I learned that diarrhea depletes your body of potassium. Babies with diarrhea especially need potassium, salt, and sugar, or the diarrhea can kill them. In Nepal, you can buy this mixture in a little envelope called "Jeevan Jal." Just add water.
While hiking in future years, I sometimes got tachycardia and became very weak. I figured out that taking potassium* pills (3 pills × 550 mg of potassium gluconate, sold at most drugstores or groceries in the U.S.) could prevent and banish both the tachycardia and the leg cramps. My wife wondered if I was taking too much potassium. So I wrote up what I was doing, showed it to my doctor, and asked him to sign off on it. And he did, indicating that it was okay.
It seems most people are surprised to learn of the link between leg cramps and potassium. Sadly, most medical books give no advice on this topic. But it's quite useful to know how to prevent cramps in the first place, and cure them if they begin—in just MINUTES! Now when I'm hiking hard, I take one or two potassium pills per hour to prevent leg cramps.
On our recent bicycle trek, we were on a long easy upgrade on the last day. But I ran out of potassium pills, so by 3 p.m., I could just barely walk up shallow hills without getting cramps. Every time I tried to ride, the cramps attacked my legs. Then it began to rain. I kept walking. After an hour, I decided to try a little more riding—and the cramps did not attack me! Then I slowly, carefully rode out the day.
I realized that because my legs got well cooled off, that may have chased away the leg cramps too! So, getting wet and cool was a cheap price to pay for such a good, but not obvious, educational experience! If you have a health problem, take a few pills and correlate the results. You also might come to a good solution, and your doctor may be able to explain why it works.
Mountain Medicine Books: The good, small book that we bring on treks is A Comprehensive Guide to Wilderness and Travel Medicine, by Eric A. Weiss, M.D., published by Adventure Medical Kits, Oakland, Calif., ISBN 0-9659768-0-7. About $7, 4.5 oz.
The large book, suitable for an expedition, is Medicine of Mountaineers and Other Wilderness Activities, 4th edition, edited by James A. Wilkerson, M.D., published by the Mountaineers, Seattle, Wash., ISBN 0-89886-331-7. About $19, 19 oz. This book came with us as far as Kathmandu. An excellent book, but too heavy for a trek where we really didn't expect much medical trouble.
These days, most first aid courses just tell you to give the patient an aspirin, "call 911, and hold the patient's hand until the ambulance arrives." When trekking in mountains, or backpacking in the wilderness, that advice is no help. We use those mountain medicine books to plan a good first aid kit, and to plan how to treat ourselves when the nearest doctor is DAYS away.
We probably won't publish many comments on this, but comment away. Meanwhile, we laymen—you and I—should think about what supports our health. Thinking may be more helpful than just asking your M.D. It's not reasonable to expect doctors to know everything. More observations in Part 2, in two weeks.
All for now. / Comments invited!
RAP / Robert A. Pease / Engineer
Mail Stop D2597A
P.O. Box 58090
Santa Clara, CA 95052-8090
*Bananas are a good source of potassium. But you'd have to eat 14 ounces of bananas to equal my minimum daily requirements of three pills weighing 0.1 ounce. /rap
This discussion is just related to my reasons for and my choices of when it's a good time to be taking certain over-the-counter supplements. Using your own judgement to make your own personal choice is always your right. But be aware that over-the-counter medications can adversely interact with some prescription drugs you may be taking. Don't do anything suggested here without checking with your doctor first—and don't do it unless it also makes good sense to you. /rap