Talk to me, Babe

I like to think of this blog as a medical consultation. No appointment necessary, no white coat, and the opportunity to explore issues related to the run and your health.
If you hit this, read this, please comment! I want keep it up and ‘running’.

I was fishing through an old blog and found a great question that I never responded to.
It was written on 6/26/07. Isn’t that two days after the race? So, I would like to address this question now, and ask that you also go back to read the blog on altitude sickness.
Marti said “I have always heard that if you can’t get there several weeks ahead to acclimate, that you should run your race within 3 days of arrival. Can you say more about your recommendation?”

There is an INITIAL acclimatization to altitude and there is the LONGER TERM acclimatization that occurs over weeks. Again let me say that the initial response to altitude is based on rate of assent, absolute altitude and individual predisposition. The physiologic response is very complex. In the initial response, ventilation increases in response to hypoxia. This blows off the carbon dioxide and results in an alkalosis. Then the kidneys kick in to correct the alkalosis by excreting bicarbonate. This happens in the first 24-48 hours. There is a 12% reduction in plasma volume in the first 24 hours (your peeing it off) and the heart rate and the blood pressure go up. Also, the pulmonary artery pressure goes up. The blood flow to the brain increases and returns to normal in 3-5 days. The long term acclimation over weeks is the development of an increased red blood cell mass and improved exercise tolerance.

Arrival the day before the event is adequate, although AMS may be a problem. The headache is an unpleasant symptom and accompanied by nausea, fatigue and sluggishness, …. NOT my ideal way to start a major race. The symptoms of AMS have been described as feeling like a hang over.

The WS race peaks at just under 9000 feet, but if I was one of the 20% of persons who will get AMS, I would opt to stay in Tahoe for 3 days prior to the race, before I climb an additional 2500 feet.

Hope you’re out there Marti and I hope I answered your question.

Left, right, left, right,
Linda Lee

Welcome 2008 Runners

I’m getting pumped up about the up-coming lottery and the months prior to the 2008 Western States! I understand that there are a record number of entrants, indicating the growing popularity of ultra running.

My mission as medical advisor is to provide accurate medical information to you, the runner, the staff of volunteer medical providers, and the trustees. I enjoy the “hands on” approach. This year started with stocking the medical supply boxes for each of 10 medical check-points. Assessing possible needs combined with practical supplies, we make every effort to be prepared for the unexpected. Last year, we started the ‘Ask a Medic’ blog, posting topics related to health, possible injuries, metabolic abnormalities, and environmental conditions. Education is the best way to prepare a runner for the unexpected.

The Western States trail is both magical and diverse. There are extreme changes in elevation and temperatures. The wilderness areas are home to many animals including black bear, cougar and rattlesnake. The trails are steep, rocky, sometimes snow covered, dusty, or slippery with oak leaves. It is a tough 100 mile race! Not only does the participant need to be physically ready, but also there should be a high level of self- reliance. Knowledge is power. The more you learn about the trail, how to take care of yourself and how to recognize when you are in trouble, the closer to success you will come.

With every effort, each medical volunteer will assist you to that goal, bandaging blisters and nursing an upset stomach. In the case of severe illness or injury, we will do our best to stabilize and transfer you to appropriate medical care. Please remember that much of the trail is inaccessible to vehicles and helicopters can only land in acceptable landing zones. I encourage you to buy the flight insurance, should an accident occur and air transport is needed.

I will be available from now until the race, through the blog. I will be at the Michigan Bluff aid station during the training weekend and on race day. And yes, my favorite place is the finish line, brimming with joy for every one of you that accomplishes this phenomenal event!

Left, Right, Left, Right,
Linda Lee MPAS, FNP-C