Bagged Arms Go Numb

A question that comes across my desk semi-often is this: why do my arms go numb from the elbow to the hand after a night in my sleeping bag? The numbness usually can be explained by the fact that people sleep differently in their bags. With less room, they curl their arms at the elbows and often at the wrists as well, especially if they snooze with their hands tucked under their chins. This position, if prolonged, will irritate the median and/or ulnar nerves, and the result is numbness. On the positive side, nothing serious is happening, and soon after the arms are straightened, the numbness goes harmlessly away. If folks had rather avoid the problem, they can try a bigger and/or more insulated bag. Bigger, of course, means more room and less need for elbow flexion. More insulated could mean sleeping warmer with less need to curl up to hold in body heat.

Charlie Houston

On September 27 Charles Houston, MD, slipped away peacefully in his Vermont home at the age of 96. As a pioneering mountaineer, he had few equals. First ascents of Foraker and Nanda Devi were his, and numerous other climbs in Alaska and the Himalayas. A fine writer, Houston's book, K2: The Savage Mountain, chronicling his second expedition to the world's second highest mountain, is a true classic in mountaineering literature. But Charlie Houston contributed most profoundly to the world through his unprecedented research into high altitude medicine. He is indeed credited with the first identification of high altitude pulmonary edema. Houston established and for ten years directed altitude medicine research on Mount Logan in Canada. Much of what we know today and depend upon when we acclimatize to high altitude or treat those who have not acclimatized can be traced to roots on Logan. A classic in wilderness medicine literature, Going Higher: Oxygen, Man, and Mountains, was written by Houston. I remember him best as a kind man who generously answered all my questions when I was young in the field of wild med. I will miss him.

Sprained Ankles

Sprained ankles remain one of the most common wilderness injuiries--and if you're surprised, you haven't been paying close attention. A recent study strongly suggests that severely sprained ankles recover more quickly when the ankle is completely immobilized in a rigid cast that keeps the ankle in the position of function--for a short time. The study does not specific exactly what a "short time" is, but you can read more about it at www.healthline.com/blogs/outdoor_health. In the meantime, we can rest assured that properly applied elastic wraps fall far short of immobilization. Elastic wraps, however, are far better than nothing. And if you've mastered, or at least partially mastered, the art of "immobilizing" a sprained ankle with athletic tape, we can extrapolate and say that a great ankle-taping job, a job often performed by athletic trainers and less often by Wilderness First Responders and WEMTs, will speed healing and promote usefulness far better than an elastic wrap. Sprained ankles are going to remain common for a long time, but we can add even more weight to the skill of taping a sprained ankle in the wilderness.

Two-Step Disinfection

The lapse in blogs, and please forgive me, arose from classes starting back at Central Wyoming College where I teach. I was asked today about two-step water disinfection processes. There are several, but of specific interest this afternoon was the combo of filtering and adding chemicals. Which should you do first? No hard science tells us. Here are some thoughts: If you use your filter first, you'll remove quite a few "things," including larger germs, leaving your chemical with less demand being put on it. Speaking much more practically, it's simple to filter some water, say, out of a lake, and then add a chemical. Not so easy, it is, to collect water, add a chemical, and then, after waiting the appropriate amount of time, use a filter. But throw this into the mix: if your filter has a charcoal (carbon) stage, using the filter second will remove the unused chemical--and its taste and smell.

How to Die

My newest book, How To Die In The Outdoors: 110 Grisly Ways to Croak, can be ordered pre-publication now at www.amazon.com. Here is an excerpt:

"One of America's greatest losses, bison (Bison bison) once flowed like a vast, hairy sea, numbering in the millions, from the Alleghenies to the Sierra Nevada, from southern Texas to the Great Slave Lake in Canada, wandering in search of grass and water. Resembling old world buffaloes, North American bison are a different species distinguished by massive, shaggy heads and shoulders and relatively small hindquarters. A mature bull may reach 6.5 feet in height and weigh in at more than a ton. Unmolested, they are a docile group, what remains of them, not given to harming humans.

Often viewed with pet-like affection by tourists to areas where they are protected, bison are sometimes pressed too closely by humans, arousing their sense of preservation, a survival instinct that has caused bison attacks in parks to outnumber bear attacks by more than four to one. Thundered into by the huge weight and muscle of a bison, you'll go somersaulting, coming to a stop battered, bruised, probably broken, and often dead. In addition, a horn or two will have gored you, in the butt if you’re running away, in the abdomen if you face the charge. Your day will really fall apart if you happen to disturb an old bull whose herd follows nervously after him. In such a case of trampling, depending on the size of the herd, what is left of you may be difficult to recognize and separate from the chips of dung that typically litter bison feeding grounds.

To Live: American bison rarely charge a human unless they approach to within 25 feet or less.

To Paste or Not

Leon Nelson, dentist and mega-avid backpacker, recently shared a few thoughts about toothbrushing, and I found them highly informative--and interesting. When thinking of your teeth, start by remembering that the source of all gum disease and tooth cavities is plague, a film of bacteria that forms on your chompers. Healthy teeth and gums require you to disorganize the plague at least once every 24 hours. To do this you do not need toothpaste--but you do need to brush, says, Leon, for at least four (4) minutes. And you do need to floss once a day. Brushing should be with a regular toothbrush, and you should clean the cheek side of your teeth for two (2) minutes and the tongue side for two (2) minutes. Flossing, continues Leon, should be up and down and not back and forth. But, hey, is it okay to use toothpaste? Sure, but leaving the paste at home you save weight, attract no bears with your minty white stuff, and the paste, according to Leon, does not make your teeth cleaner if you follow Leon's Dry Brushing Plan. He does further suggest, however, that a 30-second dry brushing now and then removes food sticking to your teeth, undoubtedly to some benefit--at least socially.

Stroke? Stick Out Your Tongue

A stumble and fall on the trail could have numerous causes including, more likely of course in older hikers, a stroke. Remember an individual can fall, rise up, seem fine (without a closer check), and collapse later. For years the first three letters of STRoke have served as a reminder of ways to check the patient for indications of stroke.
S: ask the patient to Smile.
T: ask the patient to Talk, to repeat a simple sentence such as "It's a sunny day today."
R: ask the patient to Raise both arms.
A fourth indicator of stroke should now be added to your checklist. Ask the patient to stick out his or her tongue. If the tongue goes to one side or the other, instead of straight out, if the tongue looks "crooked," you have another sign that a stroke has occurred. If any one of the four subtle indicators is present, the patient should be kept at rest and help should be summoned ASAP. The sooner the patient arrives at a hospital, the greater the chance of survival!