Drinking Water at Philmont

Date: Sun, 04 Aug 2002 22:59:37 -0400
From: John Sucher <jdsucher@alltel.net>
Subject: Re: [Philmont]: Was "Water Treatment"

I would like to make some comments on the discussion of water needs.
  1. Dehydration is and will always be a bigger problem than iatrogenic hyponatremia. Here in the south particularly we are starting football camps. We had several hospital visits and one rather severe admission with kidney failure- may well leave life long repercussions. Last year even at the pro level there was a death. We should know better, but it happens every year.
  2. Hyponatremia can be but is rarely life threatening IF recognized appropriately. Even doctors have often assumed that dehydration was the problem and made the matter worse by treating with IV solutions. On the trail look for even mild mental changes.
  3. The body has an amazing ability to correct the problems it encounters. In this case given a huge free water overload, the kidneys can produce up to 15 L of urine in a "normal" 70 kg person. (I stopped being normal sized a while back). All of the cases of hyponatremia leading to severe symptoms or death required someone to push fluids even more than this. Yes, it can be done but it requires hours to do. See next.
  4. Philmont- Most treks are simply not in the category to produce this problem. It requires several hours of CONTINUOUS and RIGOROUS exercise. Yes, I've been there three times, last in 2000 with a crew of antelopes. We hiked over a hundred miles and were always into our next camp by noon. The only longer day was when we side hiked Baldy and even that without packs was not that bad. Bottom line if you work the weather- get up early and he as much as possible in the cool of the day, this should not be a problem.
  5. "Knowing yourself"- Be very careful with this one as there are many changes that can occur with altitude, hormonal changes, medications, " minor" concurrent illnesses, thyroid status, quantity and quality of food intake, temperature and humidity to name a few. One of the simplest that is taught, and part of the reason for pushing water in the first place is that thirst IS NOT a good indicator of water needs. It is true that as you gain experience in a variety of settings that you will better be able to interpret what your needs were, then put that in context with what other changes may be going on.
  6. Decontamination- Here you are looking at systems that in some way will take care of any nasties that are there. The first rule is always dilution is the solution to pollution. This means that the more CLEAN water you can use to wash and rinse will reduce the contaminant load- whether viruses, giardia, or anything. If the part can be placed IN boiling water and left there for long enough to heat the areas where the critters are, this is best- requires at least 160 degrees. A follow up rinse with a polar pure treated water would also help. If the contamination were severe you may want to make a very concentrated solution with your polar pure- 2 capfuls/pint to rinse with.

John Sucher, MD
SM, Troop 69

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