by Dr. Judyth Reichenberg-Ullman and Dr. Robert Ullman

Sheer Perseverance Under Adversity

We write this article from up-close-and-personal, and very recent experience, having just concluded two weeks of backpacking and hiking in Chilean and Argentina Patagonia. They call it the end of the earth (fin del mundo), with good reason. The preponderance of North American, European, Asian, and other international travelers who find their way to places so remote is astounding. It is spectacular, jaw-dropping beauty, stunning views (when they reveal themselves) and hard-to-match trekking experiences that draw so many from so far. Patagonia, whose lovely name evokes an aura of the exotic, is a part of the world known far and wide for its unpredictable and quickly changing weather patterns. So, when we were basking in the 80F sun at our home in the Chilean Lake District in Pucon, it was immensely helpful that Bob consulted a fourteen-day weather forecast down south! Thank goodness for the Patagonia outdoor store in Pucon, which happened to carry the perfect airy, yet toasty, down jacket just my size (pricier than Amazon online, but I was in no position to complain) and a Doite camping store with an ample supply of extra tent stakes.

It is hard to imagine shivering when you are sweltering, but we did some last-minute repacking. A good idea. Brrrr! Think 50 mph winds and intermittent sprinkles, occasional, clearing, and cold driving rain. We ended up using every layer of our ultralight backpacking gear at one time or another, and even bailed out on two days of camping to dry out our gear in a comfy “refugio” that luckily had some spare beds after the hordes of Christmas eve revelers travelers trudged onward on the twenty-fifth. Imagine soaking wet hiking boots, socks, tent, everything! Our sincere thanks to the lovely, bright young Chinese woman, Anabelle, clearly the fashion plate of the trail, who somehow convinced her male companions to haul the packs, which allowed her to remain fresh and pristine. Her secret of putting garbage bags inside the hiking boots and outside the socks made the final half-day bearable, though barely. Our low point was when Judyth was reduced to wrapping her polar guard mittens around her feet while we huddled inside our tent. Judyth’s homework regarding ultralight gear paid off, though we still carried way more than we needed—thirty to thirty-five pounds each. Next time less stuff! This was a trip to prove to ourselves that we were not yet over the hill—at sixty-two (Bob) and a month away from sixty-six (Judyth). The twenty somethings, who were definitely the majority, skipped (and even jogged) past us. Nevertheless, we forged through mud and slippery rocks, trekking thirty-eight miles in Torres del Paine National Park in Chile with packs, and another forty-two miles in El Parque Nacional Los Glacieres outside El Chalten, Argentina. Are we counting? You bet! After mostly overcast skies, we were finally rewarded, on our final day of hiking, with the primo vistas of our journey yesterday at Laguna de Los Tres (we still can’t believe we made it sixteen miles in one day). We were treated to the most breathtaking view we have ever seen in our years of hiking and, for just one day, the sky was a brilliant, cloudless turquoise. Wow!

Our upcoming travel book, The Savvy Traveler’s Guide to Homeopathy and Natural Medicine: Tips to Stay Healthy Wherever You Go, has been on the back burner since 1984 when we first met. It is packed with user-friendly, at-your-fingertips information so that your precious vacations need not be wrecked by health mishaps and illness. This article addresses hypothermia and altitude sickness, two of the most common, and potentially fatal, conditions, encountered by hikers, climbers, backpackers, skiers, and other sports enthusiasts who, like us, are enthralled by the back country.

Hypothermia

By definition, hypothermia is when your rectal temperature falls below 95F (35C). It is not necessary to be in a weather of extremely low temperature in order to become hypothermic. In fact, any temperature less than your body temperature (98.6F) could potentially be compatible with hypothermia. Wind, wet, and cold are all key players. Judyth, who feels constrained in long pants while hiking, stripped down, on the bottom half, to zip-off shorts. Not very smart in chilling, driving rain and, during the last couple of hours she was observing herself carefully for warning signs of hypothermia. Fortunately, they did not arise.

Risk Factors

• Cold temperature
• Being thin with less body fat
• Fatigue, exhaustion
• Dehydration
• Being wet
• Inadequate food intake
• Inadequate clothing or equipment
• Wind
• Alcohol
• Children
• The elderly

Symptoms: Rick Curtis of the Princeton Outdoor Programs www.princeton.edu/~oa/safety/hypocold.shtml  discusses the four “umbles” that indicate changes in motor coordination and levels of consciousness: stumbles, mumbles, fumbles, and grumbles. Mild hypothermia: shivering, inability to perform complex motor functions like skiing, and vasoconstriction to the periphery. Moderate: dazed, slurred speech, violent shivering, irrational behavior, apathy. Severe: shivering in periodic waves, falling to the ground due to inability to walk, curling up in a fetal position, muscle rigidity, pale skin, dilated pupils, slow pulse, death-like appearance.

Homeopathy

• Arsenicum album (Arsenic): Extreme chilliness. Very anxious, restless, fear of death and of being alone. Desire to sip water constantly. These hikers want company, warmth, and reassurance. They are worriers and not typically the most likely folks to be out hiking in bad weather if they can help it.
• Camphora (Camphor):Great coldness. Blue with cold. Feeling of coldness in extremities and all body parts, even tongue. This is not a medicine that you are likely to have with you, but one to consider adding to your kit if you plan a trip to Antarctica, the Yukon, or the North Pole.
• Carbo vegetabilis(Charcoal): Icy coldness of the whole body, especially nose, hands, feet, knees. Cold skin, cold breath. Pale. Lips and skin bluish. Exhaustion. Wants to be fanned. This is the first medicine to think of in case of severe hypothermia, especially if the person is icy cold, lifeless, and near death.
• Secale (Ergot of rye): Icy cold. Shivering. Blueness of gangrenous parts.

Prevention

• Carrying with you adequate layers of warm, dry, waterproof and windproof clothing and sleepwear cannot be emphasized enough. This necessitates keeping the gear perfectly dry (garbage bags, pack covers, dry bags—whatever works. We found our pack rain covers to be fairly useless in wet, high wind conditions and will be replacing them. Judyth’s decades-old leather boots needed seam repair and, given the unrelenting rain, ubiquitous muddy puddles, and one mishap crossing a stream, are past their prime, or at least in serious need of a heavy application of Sno-Seal.
• Check in with yourself and your trekking buddies frequently about how you are feeling if you are in a situation where hypothermia is possible.
• Add layers of dry clothing as soon as you begin to feel cold, not when you are shivering with teeth chattering.
• Move around.
• Find protected shelter.
• Go near a fire or other external heat source. This was forbidden in Patagonia.
• Eat carbs for quick energy (along with proteins and fats).
• Push fluids, especially hot liquids like warm sugar water.
• Avoid alcohol, caffeine, and smoking
• Do urinate so the body doesn’t need to warm the urine in the bladder.
• Body to body contact, such as getting in a sleeping bag with dry clothing next to a person of normal body temperature who is lightly dressed.
• Wrap in multiple sleeping bags, wool blankets and clothing, Thermarest or Ensolite ground pads, and space blankets covered in plastic. We swear by our Neo Air state-of-the-art Thermarests—super light and great padding.

More Natural Tips

Cayenne foot or hand warmers or cayenne capsules can keep you warm, at least temporarily.

Life Savers

• Spot Satellite or other GPS: A couple of years ago a European couple nearly died on the mountain near our home in Pucon, Chile when a bitterly cold, unexpected windstorm blew in. How did they survive? By having a Spot Satellite emergency device and pushing the panic button, which called their Texas headquarters, a rescue was made and their lives were spared findmespot.com.
• When hiking, boating, or engaging in other outdoor sports, prepared for weather changes and take layers just in case. You never know what the sky and wind will bring! Some good friends on our island went out sailing on a catamaran one beautiful day. Though they were quite experienced, the wind came up, preventing them from navigating properly, and the sun went down. They were dressed in shorts and T-shirts. Had someone not seen them and called the Coast Guard Rescue, they would not have survived.
• If the weather takes a sudden, drastic change for the worse, stay put and wait it out, rather than putting yourself at risk. Judyth: One sunny morning, my ex-husband, a seasoned hiker, set off on a day hike. Heavy fog set in, he stepped off a cliff, broke his neck, and, tragically, died. You never know what weather in the mountains may bring!

Trip Savers

Make a pact with your travel buddies to keep checking with each other as to coldness status. Once you fall into a hypothermic state, you can no longer think clearly, so prevention is literally a matter of life and death.

Altitude Sickness (Acute Mountain Sickness, or AMS)

The name of the game is “acclimatize”. Arriving a couple of days early to your high-altitude destination can make all the difference in the world between a great experience and a miserable one. It takes about three weeks to fully acclimatize. When planning our pilgrimage to Machu Picchu and the Sacred Valley seven years ago, our first consideration was altitude. Aware that Cuzco was 12,000 feet high and Machu Picchu considerably lower, we gave ourselves several days to get used to the thin air. Bob became quite winded ascending the countless stairs to our hotel room in Cuzco, but we were unaffected by the time we hit the ruins, which was our goal.

The higher you go, the thinner the air, the less available oxygen, and the more terrible you are likely to feel. The risk of AMS generally begins a little over an altitude of 8,000 feet (2,500 meters). Anyone, of any age and health status, may suffer. Hiking above 3,500 feet (1100 meters) affects about half of all trekkers, 5% seriously, especially if you remain at that altitude for more than six hours. Mild symptoms include headache, shortness of breath, loss of appetite, nausea and vomiting, fatigue, irritability, and difficulty sleeping. If symptoms are severe, you may experience breathlessness, even at rest, coughing up pink, frothy sputum, severe headache, double vision, sleepiness, and unsteadiness. Severe AMS can be LIFE THREATENING and requires IMMEDIATE emergency medical attention.

Homeopathy

Homeopathy is extremely effective in preventing and treating altitude sickness. We recently traveled to the Atacama Desert in the Chilean Andes and were able to walk around comfortably, though briefly (with down jackets and mufflers) at 5,350 meters (17,552 feet), fully enjoying the view of eleven volcanoes! One of our patients used it very successfully during her ascent of Mt. Rainier in Washington State. This medicine may only be available in certain countries through homeopathic pharmacies

Arsenicum album(Arsenic): If you don’t have Coca. Anxiety, restlessness, heart palpitations, chilliness, weakness from slight exertion, and fear of death.

*Coca (Erythroxylon coca): “The mountaineer’s medicine.” Specific for altitude sickness. Symptoms are difficulty breathing, heart palpitations, anxiety, and insomnia. It is not available in the United States, but you can find it in India or South America, or possibly through some international homeopathic pharmacies. You can take it on the plane when flying to a very high destination, as well as the morning that you start to climb. If available, use either a 30C, 200C, or 1M potency. The herbal preparation mentioned below is widely available in Ecuador and Peru.

Prevention

• Be in the best possible physical condition before trekking.
• Allow a couple of days to acclimatize and rest after arriving at a high altitude
• Ascend slowly and gradually. Spend two to three nights at each elevation gain of 3000 feet (about 1000 meters) while trekking.
• Climb high and sleep low. Sleep at lower altitudes than you climb each day.
• Do not climb solo.
• Drink lots of fluids to prevent dehydration and avoid alcohol.
• If you develop symptoms, wait until they subside before ascending any further.

More Natural Tips

• Coca tea (mate de coca) is widely available around Machu Picchu and other high areas in South America, and helps acclimatization. You will notice the indigenous people with mumps-like swellings because they are chewing wads of coca leaves.

Life Savers

• Descend immediately if your symptoms are severe, persist, or worsen.
• Do NOT be too macho or embarrassed to admit that you are having symptoms of AMS or hesitate to tell your trekking companions.
• Do not hesitate to use oxygen if you are having trouble breathing.
•  Do NOT drive a vehicle if you are dizzy, drowsy, disoriented, or ill.

Trip Savers

• If you follow the guidelines of safe ascent, medication should not be necessary. Acetazolamide (Diamox) is a conventional medication, which can be used to prevent or treat mild AMS, but it won’t help with severe AMS, and it does have side effects.

Take What You Will Need on the Trail

Better safe than sorry! Take an adequate first aid kit for your journey and, definitely, a homeopathic kit (ours, which is a companion to our travel book, is one option). We always end up using it and it weighs one pound maximum. During this recent saga, Arnica was a godsend for sore muscles, Hypericum for Bob’s jammed toes descending trails for miles and days, Rhus toxicodendron for sore, stiff joints, and Bryonia for Bob’s severe, short-lived, last-day back pain, which was worse from any movement (a giveaway for Bryonia). All of these medicines worked within thirty minutes. Remember: the priorities are warm clothing and shelter, water, and food. Next comes your first aid and homeopathic travelling pharmacies. We also take a bit of Calendula cream for abrasions and, at least at our ages, a knee brace, just in case. (which remained, thankfully, tucked in the pack). And, of course, hiking poles are invaluable for descending steep trails, crossing streams, and traversing slippery surfaces safely. With all of the lightweight gear and freeze-dried or home-dehydrated food options, do NOT skimp on your first-aid supplies! At the least, it can make the difference between comfort and misery (like the young woman on the Torres del Paine trail who had oozing, raw foot blisters which could have been handled easily with Second Skin, which weighs next to nothing) and, in drastic conditions, between life and death. Have a wonderful time hiking on the countless magnificent trails and parks on this phenomenal planet. And keep safe and healthy as you go…naturally!

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