Posts Tagged ‘health’

Arroz integral com cogumelos, hamburguer de salmão e gergelim e salada de folhas com ovo de codorna

Arroz integral com cogumelos, hamburguer de salmão e gergelim e salada de folhas com ovo de codorna

Well, aside from the physical training, we have still been seeing our nutritionist, Isabella Alencar, regularly to discuss our food and progress with everything. We need to do some regular blood tests, just to see the levels of the various vitamins, cholesteral and everything – everything was good last time, though just to make sure that everything has stayed good and even, hopefully, improved.

Peito de Frango assado com Cenouras, Brocolis Refogado e Cuzcuz Marroquino Com Limão

Peito de Frango assado com Cenouras, Brocolis Refogado e Cuzcuz Marroquino Com Limão

Poor Natalia has, however, had to go on a diet for the next few weeks – she is into her third week of ten – to lose about 5kg. She is in good form, but Isabella and our personal trainer, Alercinho, think that it will help in all round performance. In the morning she has to drink a protein shake plus a slice of toast with something like cottage cheese. For lunch and dinner, it doesn’t mean that she has to avoid any particular foods – she just has to be limited. For these meals she can have two soup-spoons worth of carbs like rice, cuscus or pasta; two small pieces of chicken or beef or other protein; three soup spoons of vegetables, and salad. It is good because we have been eating pretty nice and varied meals after the gym in the evening.

As for me, I have to go back to a lactose-free diet for at least a month – basically there are suspicions that I have an intolerance to milk products, so no cheese, yoghurt, milk, milk chocolate or anything like that for me… shame because that pretty much covers all of my favorite foods! Have done this once before and it wasn’t too hard once I got into it… it’s just the thought of missing all these things which isn’t great! But I gotta do what I gotta do..!

From the start of the time in Bolivia, after a few days acclimatizing in La Paz, the first part of the mountaineering was from the Condoriri, where we looked to climb Pequeño Alpamayo (around 5,400m) – a beautiful mountain. But getting there wasn’t such a smooth process..

Before talking about the final journey with André, O Bicicreteiro, and his group down to Santos, it is worth a quick mention about our chat with Isabella our nutritionist the other week.

It was good to see her again, and we went through the body fat/weight/muscle measurements. The results were encouraging. Natalia’s measurements were encouraging and she is getting towards the “above average” percentage of muscle/weight measurements, while I was happy to see that my category was one below the best possible – a couple more percentage points reduction of body fat / increase in muscle, and apparently I will be on course for having a body like that of a professional athlete. Wahey! Quite funny when I think about it – this time last year, I was moderately overweight – and it doesn’t stop me from hurting after one of the long bike rides we are doing! A couple of points away sounds close, but am sure it will take a lot more work to reduce it further. It is nice to see the training pay off, though.

Aside from that, we talked more about the types of foods to eat in the course of our long biking journeys, when to eat them, and various other points. Apparently beetroot juice is good for the blood to take in more oxygen, so drinking this in the morning can be helpful. I had drunk beetroot with carrot and orange juice before in Rio and that was pretty nice, though at our local place, they have just beetroot and orange, which is okayish, just tastes a little earthy. Also it is important for us to take our protein supplements after exercise as well as energy supplements during training, to make sure that we don’t burn muscle tissue when we are doing heavy work, and that we burn the carbs instead.

A lot to think about, and we will be meeting with Isabella again soon to see how things are going.

So after a month in Bolivia it is finally back to the daily grind of what seems like five jobs – the day job and then working on the 360 Extremes project with training, sponsorship hunting, planning… the first week back and it was straight to the gym, and on the Sunday even back to Salesopolis for more rock climbing (completing grade six (5.10) climbs on the rock is always nice! Especially after a month away from it. More gym last week and then this weekend, I guess energy levels dipped completely it was a full rest, with just more planning and leisurely strolls down Paulista Avenue as well as a bit of cinema. I figured that after the last month and a half, a break would be nice. At the same time, I miss the mountains and it will be nice to climb another one soon… the problems with living in a country which relatively low and flat. 

High altitude climbs…

We are definitely feeling the effects of the training, however. I must have lost at least 3kg from the time in Bolivia – people keep commenting that I look much thinner, and indeed, I do need a new belt as there are not enough holes in my current ones to keep my trousers comfortably up – without a belt, I can easily fit a hand between my waist and the trousers, so there is a potential for embarrassment should I forget it! It is great for climbing though as I do feel lighter which helps. Also, I guess coming down from the high altitude, my breathing when I am running is better – I feel much more comfortable running for longer and don’t get breathless so quickly. Our nutritionist thinks that I might have lost too much weight too quickly and that I lost some muscular weight rather than just fat… which could very much be the case.  Burning muscle for energy is never good as you become more tired more quickly.

The training in Bolivia was meant to help us not just with mountaineering but also with working in difficult conditions that were challenging in ways that neither of us had experienced in any way: when we leave São Paulo in 2014, we are going to encounter situations that are going to be tough, so the challenging nature of these training projects will help us deal with them. Also, it helped us evaluate ourselves, physically and psychologically, in terms of what we need to do before we leave.

In assessing where we are… physically, we are doing well though definitely need to continue and build on our training. Walking up those mountains was exhausting! Okay, altitude was a massive factor (less than half the levels of oxygen than at sea level) and this was our first time at such altitudes… but to be in even better conditions to deal with this will be essential. At the Antarctic, we will be reaching altitudes of 5,000metres – in an even colder environment…. And there is a steep walk up from McMurdo to the plateau… And we will have even more weight.  I was proud of my own achievements in forcing myself to pretty much my limits in going up those mountains, and also in recognising when to turn back at Illimani… again, learning points for the expedition as a whole as safety is paramount. Better trying, turning back and trying again than killing yourself by pushing yourself too far.

Effects of illness

Illness affected our climbing – and indeed, dealing with illness is something that we will need to be prepared for: if none of us gets ill over the course of the three years, traipsing through the tropics and across the Poles… this would be a minor miracle. The importance of rest and the right treatments (not using antibiotics when we don’t need for example) again can’t be understated.

This also brings in the factor of food… the body finds it hard to digest food at higher altitudes though it is important to maintain high calorie intake in such journeys. With our guide being the guide and the cook, we certainly weren’t eating enough, regularly enough as we were dependent upon him. More varied snacks (not just twix and snickers) will definitely be important. Also, eating enough at regular intervals will help ensure that as little muscle is burned by the body for energy as possible. Lesson noted.

Psychologically, in terms of determination and working as a team, getting up early, going on the long hikes with heavy bags that seemed even heavier in the higher environment; moving onwards in spite of becoming physically drained… I might have snapped at Natalia once or twice, and vice-versa, but in general everything went pretty smoothly. Yes, I think we can give ourselves pats on backs… though this was only a month-long expedition, with breaks in La Paz every now and then; more time together on longer projects will be very important to making this whole plan work. 

Determination, however, isn’t something I am worried about too much – all of us are really working hard towards this project. I like to think that after 60 days traipsing toward the North Pole, with only each others’ company, I will still be saying this!

A happy patient!

In the larger scale of American emergency medicine, First Responders are quite low on the totem pole. Here in the United States, the general order from least trained to most is: First Aid, First responder, Emergency Medical Technician – which is then divided into EMT-B (basic) and EMT-I (intermediate). Above that you have your Paramedics, Medical Directors etc. Learning any type of emergency medicine however is a crash course in seeing the world differently. Cuts, wounds, a broken leg, how people injure themselves; it all takes on new life. Instead of seeing an accident and saying “Oh My Gosh!” you begin to say, “Cool. How can I help?”

Wrapping a hypothermic patient

Wrapping a hypothermic patient

Wilderness Medical Associates hosted a fantastic 8-day class at an Outward Bound house in northern Philadelphia, PA. The two instructors, Brian and Carl, were a plethora of information and balanced each others personalities quite well. Plus, we learned a thing or two about how to save someone’s life.

For eight days we ate, drank, slept, breathed and literally lived in a world of Wilderness Emergency Medicine. Breakfast at 8, with everyone in the class, class from 8:30 until 6pm, then dinner (again with everyone) and then study time. Study time was going back to our seats in the class room, discussing what we learned, asking questions, and throwing ideas around about different scenarios. During the day we learned the technical aspects and applications to treating and figuring out various symptoms. At night we discussed situations and how these technical aspects would apply. We began to get creative. We began to contemplate wilder and stranger situations. We learned some pretty important lessons through it.

The first: Medicine is always changing and there is no ‘never’ and ‘always’. What might work for someone, might not work for someone else. That being said, not every question has a permanent answer. The answer may change with the context.

With that, we learned about questions that cannot be answered or are unexpected. It was presented in this way.

Instructor: “If you hear hooves running behind you, when you turn around, what do you expect to see?”

Class: “A horse.”

Instructor: “Nope, it’s a zebra.”

Basically saying that not all questions will give you the answer you expect. We had a lot of “zebra questions” throughout our class.

In the end, we learned our 6 protocols for what we’ve been trained to do, and how to do it well. We learned how to deliver certain medications for pain, anaphylaxis and asthma. Spine day seemed to have made quite an impression on me as I had a dream last night that someone got into a fight and I had to “clear” his spine to make sure there were no injuries to the spinal cord.

For anyone that goes on hikes, works outside, has kids or simply is interested in emergency medicine, there is no better company than Wilderness Medical Associates. Everyday we learned something new, the instructors were honest about their knowledge base, and they took all of our questions seriously – including the zebras.

Now it’s up to us to review the information in months to come and make sure it’s fresh in my head. Unfortunately, as with many things, if you don’t use it, you lose it.

I’ll end this post with some quotes I wrote down in my notebook from the instructors. Whether odd, useful, or funny – they all have their place!

“As long as we’re eating and breathing, peeing and pooping; life is good.”

“Despite all our best efforts, good intentions and right decisions, some people just die.”

“Everybody gets one free puke. After that, it’s serious.”

“Repeat after me, ‘I will never, ever, ever, give anyone, insulin. Ever.’ It can kill even the most healthy person.”

“If you learn anything from CPR, remember one thing: Pump Hard, Pump Fast.”

“Treat what you see, do what makes sense.”

“A lot of what we’re teaching you isn’t only for being out in the wilderness. It’s just good medicine.”

“At the same temperature, water takes heat away from our bodies 25 times faster than air.”

And Lastly, one of the more important things our instructors said. It applies to just about any situation whether you’re in emergency medicine, corporate management or making life decisions.

“Do the best you can with what you got.”