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Expedition has a doctor and most leaders have first aid experience. It is important for YEs to recognise however, that they are still primarily responsible for their own health and well being prior to and during the Expedition, and that, once in AK, they may be some distance from professional medical help. If you get the chance do a recognised First Aid Course, you may save someone great discomfort in so doing. This is why optimum fitness prior to departure, and looking out for each other during the Expedition, are such important factors.
It is up to individuals to consult their own medical resources to confirm and optimise their fitness to participate, particularly where specific known problems exist, e.g. asthma, diabetes or musculo-skeletal injuries, viz. The questionnaires. This may involve discussion with your own GP, a hospital specialist, physiotherapist or special nurse. You are advised to have a dental check-up. You can get do-it-yourself temporary tooth dressings which may be useful if your fillings are prone to falling out (or get a new dentist!).
It would perhaps be wise to have clear, pre-prepared ideas on any aspect of your health which you wish to discuss with your Fire, especially if you might need particular support or intervention in a crisis.
Fitness
Fitness prior to departure will make the first couple of weeks easier to cope with and should protect you from debilitating problems which could have disastrous effects on your expedition experience. Stamina and Suppleness are probably more significant than Strength in this instance (so get moving and stretching rather than pumping iron!). Whilst at least 20 minutes of good exercise 3 times a week may seem a lot when you are studying hard, the effort will offload some stress, will help you to sleep better, and should enhance your concentration.
Hygiene
Hygiene – especially hand hygiene and the very personal sort is crucial and will need self-discipline in the difficult circumstances of an expedition. Bring some "Senekot" tablets for painful constipation! Always care for a burn or cut immediately. The use of a hand cream will help prevent the painful cracking of finger ends. All drinking water from streams should be brought to the boil for at least 3 mins. As Beaver Fever (Giardia Lamblia) is endemic in the rivers of the Alaskan Rockies, unless treated diarrhoea will occur…and keep on recurring! Toothpaste is not essential. Feet care is vital, wash, inspect, dry and massage daily. The routine use of foot powder may not be sensible; if it gets wet it forms hard crumbs which abrade the feet. The best treatment for blisters is prevention, cover susceptible dry clean places with zinc oxide tape before setting off. Short hair is often more comfortable and easier to keep clean. Always carry some loo paper. Burn loo paper following use (except the remnants do not de-grade and avoid setting the forest or alpine tundra alight!), then cover faeces with soil. Take care not to dehydrate – urine ought to be clear before you retire to bed. Air your sleeping bag regularly, wash the clothes next
to your skin. You ought to know the symptoms of hypothermia and its basic treatment. A sunblock and chap stick should prevent sunburn and cold sores especially and high altitudes and latitudes.
Wash yourself and clothing (especially underwear), regularly. Keep your washing areas away from the fresh water supply. NEVER wash directly in any water supply – stream, lake, spring etc. Collect water, more well away (20-50 m), wash body, pots, clothes etc, and discard dirty water, less food fragments etc. into an identified area well away from the water source. Suds, shampoo, soaps and toothpaste are not usually biodegradable. Humans, fish and animals downstream, may rely on the water source you are using, do not pollute it in any way.
Stomach upsets on an expedition are usually due to inadequately cooked food, or, more likely, to inadequately cleaned hands, mess tins and cooking utensils. Your cooking will improve with time, but if you do not visit the latrine in distress, washing-up immediately afterwards in hot water is ESSENTIAL. Drink plenty of fluid, (a problem if the water is contaminated with giardia lamblia, suspended rock flour etc!) medical advice is 6-8 large mugs per day. Do not share eating/ drinking utensils, do not prepare food if unwell, do not store cooked food.
Medication
Any drugs you require must be taken in duplicate, with spares, well wrapped and waterproofed. Spare glasses/contact lenses are highly recommended. You must check that Tetanus and Polio are up-to-date.
Personal Medication Kit (but see Medical Kit List and talk to the Doctor)
Paracetamol is the recommended analgesic. Take a simple antiseptic cream e.g. Savlon or Witchhazel. Take a tubigrip (rather than a bandage) or suitable size for your knee/ankle joints, probably "D" for most of you. Any supports you have needed for previous musculo-skeletal injury may be invaluable. Please also take a triangular bandage. Diarrhoea and vomiting is treated by plenty of fluid and Immodium. Overtightened boots sometimes causes foot tendonitis. Consider taking oral and/or topical antihistamines if you react to insect bites. Some of you already have lower back pain – the best way to get your pack on your back (in training and whilst you are away) is for someone else to put it there.
"For Women Only"
Remember the Expedition is for six weeks, you will need enough tampons for two periods plus spare set, which are well packed and waterproofed (they don't work very well once they have fallen into the river!). If you have problems with Thrush or Cystitis, they are likely to re-occur under these conditions. A tube of Canesten Cream/Pessaries has been recommended for the Thrush and sodium bicarbonate (i.e. Baking Powder) for Cystitis. A small amount in your drinking water tastes a bit odd but the alkalinity will make passing water a lot more comfortable, and this ismore-or -less the active ingredient in expensive over-the-counter preparations. As ever though, take what works best for you.
Keep Well and Happy!!!