Advanced Wilderness Life Support: Riverman: New River Gorge, WV
August 17-19th
About 30 minutes after making it back to my parent's house in Charlotte from Seattle - Mike and Rose came to pick me up to head up to WV. My mom made a great dinner - and then we were off. Mike had rented a truck - and tied our bikes in motorcycle style in the back. Fitting as we were headed to WV :)
I really enjoy AWLS - its a great time to hang out with my friends from ACWM - plus meet many others interested in wilderness medicine. It really becomes a small community after a while. The new river gorge is awesome as well - great climbing, rafting and mtn biking.
We got in pretty late and settled in for the night. Our next day started with some local fare - from the biscuit place - some local culture too...
During the weekend I taught several small group breakout sessions and lectured about wound care. Got to boulder with Pat and Sean. Got to Mtn bike with Henderson and mike. More to come.
Sunday, August 19, 2012
Friday, August 17, 2012
Washington pass - rock climbing
So this is just a place holder for something I need to finish.
Stephen and I ended the Washington trip climbing at Washington pass with Dave Ahrens- a guide from mountain maddness. We did the becky route up liberty bell and another route up Concorde.
It was relatively uneventful - with the exception of a very large herd of goats... Which were a bit intimidating.
Stephen and I ended the Washington trip climbing at Washington pass with Dave Ahrens- a guide from mountain maddness. We did the becky route up liberty bell and another route up Concorde.
It was relatively uneventful - with the exception of a very large herd of goats... Which were a bit intimidating.
Saturday, August 11, 2012
Mt Shuksan
Seems like the longer I wait to update this the more details I begin to forget...
So the last portion of our DiMM course was a 4 day trip with Mountain Maddness. We met at the Second Ascent store in Seattle - quickly did a gear check and hit the road - after grabbing some awesome coffee from a local shop a couple doors down.
There were 12 of us total - 3 guides and 9 students. My brother was able to come out and join for this portion of the adventure!
(Side learning point - do not try to cut climbing cord and burn the edges in your downtown hotel room - seems to make a lot of smoke and the windows only open about 2 inches - luckily to my surprise the smoke alarms did not go off)
We hit the road - and headed up to the ranger station to get permits and stopped at Hagan's (the guides' favorite local grocery chain). After several hours of driving we hit the dirt road. This was the driest dirt road I've ever seen. The dust was like driving through a really dense fog - you could see a couple feet at most in front of the window. Our chevy impala was not the all terrain vehicle my xterra is.... but we made it.
With the group gear divided up we hit the trail. My pack was a little heavier than ideal - but fresh legs and beautiful scenery made it all seem easy. The first couple miles were typical dirt and rock trails - then we hit an area that desperately needed some maintenance - we were bushwhacking through downed debris and climbing over trees that were at least 3 ft in diameter. At this point I had a much better appreciate of what it feels like to be about 50 lbs overweight...
After a couple breaks we made it to the beginning of the snow. I traded in my lightweight Merrell's for mountaineering boots - which felt sorta like stiff lead bricks at first - but did offer a lot more support. A little prophylactic duct tape and I was good to go. I was pretty sure I would end up with blisters as my training hikes prior to this trip had ended that way - however with the duct tape and sock liners I survived sans blisters.
The hike up across the snow was pretty steep. I was sure one missed step would mean I'd be tumbling a long, long way. I was also starting to have some concerns about how we were going to get back down. The funny thing is after summitting my perspective of "steep" changed drastically and I actually enjoyed walking on the snow much more than the dirt on the descent.
Eventually we made it to a saddle - which would be our "home" for the next couple of days. The plan was to set up camp and eat dinner. Initially we were supposed to do some skills - but everyone was beat from the hike in - so instead we opted to sleep and try to tackle all the skills the next day. Then after doing skills all day we'd aim for an early night, awake around 3 am to head for the summit. After summitting we'd pack up camp and head back down to the cars.
Camping on snow is very different than dirt. First its hard to find a "dry" place to sit - even to do things like cook. Second the ground is VERY cold. The plus is you can melt the ground for water - however that takes longer than you'd imagine. We found walking to the steam of melting snow was much more efficient. As a girl its also a bit trickier to find a concealed place to pee... there was a porta jon for certain activities - however not for peeing. I found it best to walk down over the crest of the hills letting it hid me.
One of the guides suggested piling all the clothes we weren't wearing under our sleeping pads to help insulate us. You'd think having a an engineering degree and having taken an entire course in heat transfer I'd have a good concept of what to do to prevent being cold. Lets just say a warm weather thermarest filled with air works as a very poor insulator. I would wake up every couple of hours with a new frozen body section and would have to rotate. I hear the trick is to use a foam insulator pad with the air pad on top... lesson learned.
Skills day was jammed packing with information and practice. It was quite warm as well - with sun blazing on your from every direction! No shade on a glacier. We practiced walking in crampon, self arresting while sliding ( feet first, head first, prone and supine). We also went over knots and rigging crevasse rescue systems and discussed concepts of work as a rope team. It was a very full day.
After a quick dinner we packed our summit packs and climbed into sleeping bags for a quick nap before summit time. Despite having my ipod shuffle turned all the way up, I did not get much sleep over stephen's snoring - or with the cold ground (my pack was packed - so much less insulation). I was actually happy to get up at 3 am and start moving. With a little hot water and some oatmeal (I'd run out of grits - very hard to find in Washington state) - and after realizing Stephen didn't bring his share of coffee so we'd had all of mine the morning before - we were off.
It was sort of surreal. You could see a little but moonlight but the path was lit mostly by head lights. We were tied together in groups of 4, our guide and 3 of us. It was sorta of meditative. Just one step after another. Trying to keep the rope just barely dragging the snow in between you and the person in front of you.
We stopped a couple times for breaks - and we all sat down quickly in our spots. Seemed sort of like we were dogs on a dog sled team. We didn't break long as it got cold quickly. I started out with just a pair of lightweight convertible pants, long underwear top and shell jacket. It was great when I was moving. Not so much sitting still. A little after 4am the sun began to rise. It really made you realize how big the world is - and how small you are. What an experience. Those moments of peace are the reasons people go out into the wilderness.
Eventually we made it off of the snow - and onto rock. We shed our crampons and ice axes. I don't know how many of you have ever worn mountaineering boots - but they make you feel super awkward, like you don' t have much control of your feet as they are bulky and stiff soled - which is great for crampons and keep your feet warm - however isn't great for trying to climb on rocks. We were using a technique called short roping where we were tied very closely together. The theory is on this terrain you'd slip and the team could arrest you before you'd fall. Luckily we never had to test it. I think I might have just liked to take my chances...
Each team climbed up behind us - following a similar route. There was some gear and anchors that had been left by prior groups - which we used. Finally we made it to the top and enjoyed some lunch. Summer sausage and cheddar cheese have never tastes so good! The way back down ended up taking far longer than the way up as we waited for all the groups and one of the ones behind us ran into some technical difficulties, getting their rope stuck, etc.
So the last portion of our DiMM course was a 4 day trip with Mountain Maddness. We met at the Second Ascent store in Seattle - quickly did a gear check and hit the road - after grabbing some awesome coffee from a local shop a couple doors down.
There were 12 of us total - 3 guides and 9 students. My brother was able to come out and join for this portion of the adventure!
(Side learning point - do not try to cut climbing cord and burn the edges in your downtown hotel room - seems to make a lot of smoke and the windows only open about 2 inches - luckily to my surprise the smoke alarms did not go off)
We hit the road - and headed up to the ranger station to get permits and stopped at Hagan's (the guides' favorite local grocery chain). After several hours of driving we hit the dirt road. This was the driest dirt road I've ever seen. The dust was like driving through a really dense fog - you could see a couple feet at most in front of the window. Our chevy impala was not the all terrain vehicle my xterra is.... but we made it. With the group gear divided up we hit the trail. My pack was a little heavier than ideal - but fresh legs and beautiful scenery made it all seem easy. The first couple miles were typical dirt and rock trails - then we hit an area that desperately needed some maintenance - we were bushwhacking through downed debris and climbing over trees that were at least 3 ft in diameter. At this point I had a much better appreciate of what it feels like to be about 50 lbs overweight...
After a couple breaks we made it to the beginning of the snow. I traded in my lightweight Merrell's for mountaineering boots - which felt sorta like stiff lead bricks at first - but did offer a lot more support. A little prophylactic duct tape and I was good to go. I was pretty sure I would end up with blisters as my training hikes prior to this trip had ended that way - however with the duct tape and sock liners I survived sans blisters. The hike up across the snow was pretty steep. I was sure one missed step would mean I'd be tumbling a long, long way. I was also starting to have some concerns about how we were going to get back down. The funny thing is after summitting my perspective of "steep" changed drastically and I actually enjoyed walking on the snow much more than the dirt on the descent.
Eventually we made it to a saddle - which would be our "home" for the next couple of days. The plan was to set up camp and eat dinner. Initially we were supposed to do some skills - but everyone was beat from the hike in - so instead we opted to sleep and try to tackle all the skills the next day. Then after doing skills all day we'd aim for an early night, awake around 3 am to head for the summit. After summitting we'd pack up camp and head back down to the cars.
Camping on snow is very different than dirt. First its hard to find a "dry" place to sit - even to do things like cook. Second the ground is VERY cold. The plus is you can melt the ground for water - however that takes longer than you'd imagine. We found walking to the steam of melting snow was much more efficient. As a girl its also a bit trickier to find a concealed place to pee... there was a porta jon for certain activities - however not for peeing. I found it best to walk down over the crest of the hills letting it hid me. One of the guides suggested piling all the clothes we weren't wearing under our sleeping pads to help insulate us. You'd think having a an engineering degree and having taken an entire course in heat transfer I'd have a good concept of what to do to prevent being cold. Lets just say a warm weather thermarest filled with air works as a very poor insulator. I would wake up every couple of hours with a new frozen body section and would have to rotate. I hear the trick is to use a foam insulator pad with the air pad on top... lesson learned.
Skills day was jammed packing with information and practice. It was quite warm as well - with sun blazing on your from every direction! No shade on a glacier. We practiced walking in crampon, self arresting while sliding ( feet first, head first, prone and supine). We also went over knots and rigging crevasse rescue systems and discussed concepts of work as a rope team. It was a very full day. After a quick dinner we packed our summit packs and climbed into sleeping bags for a quick nap before summit time. Despite having my ipod shuffle turned all the way up, I did not get much sleep over stephen's snoring - or with the cold ground (my pack was packed - so much less insulation). I was actually happy to get up at 3 am and start moving. With a little hot water and some oatmeal (I'd run out of grits - very hard to find in Washington state) - and after realizing Stephen didn't bring his share of coffee so we'd had all of mine the morning before - we were off.
It was sort of surreal. You could see a little but moonlight but the path was lit mostly by head lights. We were tied together in groups of 4, our guide and 3 of us. It was sorta of meditative. Just one step after another. Trying to keep the rope just barely dragging the snow in between you and the person in front of you.
We stopped a couple times for breaks - and we all sat down quickly in our spots. Seemed sort of like we were dogs on a dog sled team. We didn't break long as it got cold quickly. I started out with just a pair of lightweight convertible pants, long underwear top and shell jacket. It was great when I was moving. Not so much sitting still. A little after 4am the sun began to rise. It really made you realize how big the world is - and how small you are. What an experience. Those moments of peace are the reasons people go out into the wilderness.
Eventually we made it off of the snow - and onto rock. We shed our crampons and ice axes. I don't know how many of you have ever worn mountaineering boots - but they make you feel super awkward, like you don' t have much control of your feet as they are bulky and stiff soled - which is great for crampons and keep your feet warm - however isn't great for trying to climb on rocks. We were using a technique called short roping where we were tied very closely together. The theory is on this terrain you'd slip and the team could arrest you before you'd fall. Luckily we never had to test it. I think I might have just liked to take my chances... Each team climbed up behind us - following a similar route. There was some gear and anchors that had been left by prior groups - which we used. Finally we made it to the top and enjoyed some lunch. Summer sausage and cheddar cheese have never tastes so good! The way back down ended up taking far longer than the way up as we waited for all the groups and one of the ones behind us ran into some technical difficulties, getting their rope stuck, etc.
Eventually we all safely made it down, quickly packed up and headed for the cars. It was one of the longest hikes of my life. For the first time ever I had not packed too much food and enjoyed my very last food item - a peanut butter snickers bar - on the way out. It was almost dark (after 9pm) by the time we finally made it to the car. The plan initially was to drive a couple hours to mt. Erie and campout to do rock climbing the next morning. We were all tired and hungry - with wet gear. With an overwhelming majority decision we decided a hotel and hot shower were in the future. After a long drive down the dust road we ended up back in town - after stopping at one hotel and calling several others we ended up at Candlewood suites. It was the best shower and night of sleep I'd had all trip :) I don't even think I ate dinner - just slept.
What an adventure!!
From Wikipedia: http://en.wikipedia.org/wiki/Mt_shuksan
Mount Shuksan (9131 ft) Mount Shuksan is a glaciated massif[3] in the North Cascades National Park. Shuksan rises in Whatcom County, Washington immediately to the east of Mount Baker, and 11.6 miles (18.7 km) south of the Canadian border. The mountain's name Shuksan is derived from the Lummi word [šéqsən], said to mean "high peak".[4] The highest point on the mountain is a three sided peak known as Summit Pyramid.[5] There are two named subsidiary peaks: Nooksack Tower and The Hourglass.
Wednesday, August 8, 2012
Some litters and carries
In addition to cool trips and class room based learning a big part of the mountain medicine course is hands on practice. Here are a couple photos demonstrating some of the skills we tested out! Here I am getting a free ride using the mountaineer's coiled rope as a chair! 
Another cool trick is using a 20ft piece of webbing tied into a loop. It is crossed to form 3 loops (looks sorta like a snowman). Then padding is placed on top and 6 rescuers can each grab a loop to create a makeshift litter. Not ideal from someone you are concerned about having a spinal injury. 
Another cool trick is laying down a tarp and wrapping it around some skis or long sticks which makes something with a bit more rigidity. Using the rope wrapping technique from a hypothermia wrap you can make a pretty secure litter.
(Thanks for the pictures Jaime!)
Saturday, August 4, 2012
Mount Rainier
On Saturday August 4th as a part of the DiMM course we headed up to Mt. Rainier. This would be my first opportunity to try out my mountaineers boots and ice ax! I'd watched several youtube videos about how to self arrest with the ice axe - so it was time to give it a try. The hike up was absolutely beautiful. A lot of wildflowers were in bloom. Our group hiked up together and found an area off the beaten track to practice self arresting with ice axes and glissading (basically sledding on your butt, using an ice ax as a rudder). The elevation where we did this was about 6,000ft - and we could feel it - as we'd just come from sea level that morning.
After practicing glacier skills several of us decided to continue up to Camp Muir, the furthest point up you can go without a climbing permit. 3 of the guys in my group has actually secured a permit and planned to camp at Muir and attempt to summit the next morning. Camp Muir is 10,080 ft. Being a "medical trip" we had a portable pulse oximeter with us. My pulse ox was around 99% in the parking lot prior to the hike, at 6000 ft it was still 96-98%. However by the time I made it up to Camp Muir it was 85% and my heart rate was 140. Now I know how some of my patients feels. Luckily after a couple of minutes my heart rate dropped back down in the 80s and my pulse ox rose to about 90%. On the way back down my strategy of just not really drinking anything began to fail. Ben (one of my classmates) and I were both out of water. We weighed the pros and cons - and ended up drinking out of a little glacier stream. So far almost 2 weeks later I'm still not regretting it :)
Despite a wrong turn and a bit of extra hiking we made it back to the car before dark :)
On the drive out a car went into a pretty substantial ditch. After brief discussion of the irony (I was riding with two other EM docs) we stopped and ensure the driver was ok - and ended up giving him a ride down to the ranger station to get some towing help. Never a dull day!
I'd definitely recommend Rainer to anyone in the area!
Thursday, August 2, 2012
DiMM
The Diploma in Mountain Medicine was established by the medical commissions (Medcom) of UIAA and ICAR with the International Society for Mountain Medicine (ISMM). The minimal requirements were established in 1997. The DiMM is intended as continuing education for doctors, midlevel providers, nurses and medics with an interest in austere environments. The coursework is a blend of didactic and practical education about wilderness medicine, technical rescue, expedition medicine and self sufficiency in the backcountry. Until recently the Diploma was only available overseas. http://www.theuiaa.org/mountain_medicine.html
I started this course work with the WMS, however got the opportunity to take the military mountain medicine course, which is also a diploma course.
The course was held at Fort Lewis/ McChord Joint Base near Tacoma Washington.
The course covered: | Altitude Physiology |
| Hypothermia |
| Immersion/near drowning |
| Bites/Stings |
| Lightning |
| Pediatrics in the wilderness |
| Patient assessment |
| Wound Care |
| Trauma and TCCC |
| Eye problems |
| Trauma Pract:Pt assessment |
| Trauma Pract: fractures/dislocations |
| Trauma Pract: C-spine |
| Trauma Pract: femur/pelvis |
| AMS |
| HAPE/HACE |
| Preexisting medical problems at altitude |
| Frostbite |
| Other Altitude Conditions |
| Latest Altitude research |
| Altitude Cases |
| Austere Pain Control |
| Heat Illness |
| Personal Medical Kits |
| International Mountaineering and threat assessment |
| Wound/Foot care practical |
| Map and Military Map Reading 101 |
| Map/Compass/GPS Practical |
| Day Off |
| Avalanche |
| Nutrition and Hydration |
| Water Treatment and Purification |
| Musculoskeletal Injuries UE/LE |
| Knots for Climbing practical |
| Rope Handling practical |
| Helicopter Operations |
| Plant Dermatitis |
| Mountain weather 101 |
| Stress Management |
| Preexisting medical Conditions in the mountains |
| Clothing for the mountains |
| Clothing and Equipment Hands on |
| Austere Site Scenarios (Med Wars Type) |
| Climbing Practical |
| Altitude Practical |
| Hypothermia Practical |
| Avalanche practical |
| improved patient transport |
| Mountain Map and GPS practical |
| ID Prophylaxis and immunizations |
| ID Overview and Cases |
| ID fever in the returning traveler |
| Legal Aspects of Wilderness Med |
| Solar Injury |
| improvised/organized rescue The experience was capped off with a 4 day trip with Mountain Madness with included glacier and alpine skills and rock climbing. |
Wednesday, August 1, 2012
Olympic National Park
A little less than 1 month ago, I headed out to Seattle for another Diploma in Mountain Medicine course through the military. Prior to starting the course I went out with Adam Dewitt on a mini "expedition". We flew into seattle - wrangled my 2 (48 lb) check bag and my carry on and larger personal item through the airport. It looked like I was moving to Washington.
After a little mix up at the rental car place we ended up in a black chevy impala. With our bellies full of chipolte, we picked up some essentials from REI (TSA doesn't like flying with fuel...) and hit the grocery store. We decided to take a scenic tour to the olympic peninsula to do some camping. After exploring the beach for a while and enjoying a sunset- it was off to find a camp spot. Our lack of planning didn't pay off. Most of the beach campgrounds were full - and the inland ones required some sort of discover pass you could only buy during business hours... plus there was also the bear canister issue...
We finally headed to "oil city" which was a primitive camping area about 1 mile from a parking area on the beach. We found it by head lamp - and left all of our food and other bear attractions in the car.
The next morning we realized what an awesome place we'd discovered. It was beautiful. Very different from the carolina coasts - with many large rocks and logs scattering the coast line.
After enjoying the beach a bit we packed up and headed inland to the Hoh Ranger station where we obtained backcountry passes to hike along the hoh river and camp on the gravel bar at the Olympic guard station. Initially we planned to hike in a do a day hike the next day up towards Mt. Olympus. After doing a bit more investigation and realizing how cloudy it was we decided to hike up to a lake instead.
The old growth forests were beautiful. The trees made you feel very small and insignificant.
One of the "new" things we were going to try this trip was a steri pen. I'd heard good things - so I convinced Adam to buy one. Hiking it seemed to work well. The water was clean appearing - so we just swirled it around and enjoyed. Unfortunately the second time we tried to use the steripen it stopped working. No warming just wouldn't work. We were then forced to switch to old fashioned iodine tabs. Lesson learned - always bring back up.
So on day 3 of our adventure we hiked up to a lake, which was still mostly frozen and surrounded by snow. While getting ready to enjoy our lunch - we noticed 2 black bears on the other side of the lake. I think they noticed us too - as they looked and started walking our direction. This scared me - I started to head down the trail. Adam wasn't scared - and we ended up continuing to watch them for a bit and they wandered back away from us. We also saw a river otter catching fish on the lake! Very pretty area!
Day 4 we packed up and headed back towards the car. My feet were pretty sore - there were not used to walking 10 miles a day or carrying a pack. We finished the loop of the olympic peninsula stopping in Forks - which is now the Twilight capital of the USA. I have to admit I read the books - never realized the town would be somewhere people would visit for a "twilight" tour.
Day 5 - Adam flew back to SLC. I started the DiMM course. More to follow about the course!
After a little mix up at the rental car place we ended up in a black chevy impala. With our bellies full of chipolte, we picked up some essentials from REI (TSA doesn't like flying with fuel...) and hit the grocery store. We decided to take a scenic tour to the olympic peninsula to do some camping. After exploring the beach for a while and enjoying a sunset- it was off to find a camp spot. Our lack of planning didn't pay off. Most of the beach campgrounds were full - and the inland ones required some sort of discover pass you could only buy during business hours... plus there was also the bear canister issue...We finally headed to "oil city" which was a primitive camping area about 1 mile from a parking area on the beach. We found it by head lamp - and left all of our food and other bear attractions in the car.
The next morning we realized what an awesome place we'd discovered. It was beautiful. Very different from the carolina coasts - with many large rocks and logs scattering the coast line.
After enjoying the beach a bit we packed up and headed inland to the Hoh Ranger station where we obtained backcountry passes to hike along the hoh river and camp on the gravel bar at the Olympic guard station. Initially we planned to hike in a do a day hike the next day up towards Mt. Olympus. After doing a bit more investigation and realizing how cloudy it was we decided to hike up to a lake instead. The old growth forests were beautiful. The trees made you feel very small and insignificant.
One of the "new" things we were going to try this trip was a steri pen. I'd heard good things - so I convinced Adam to buy one. Hiking it seemed to work well. The water was clean appearing - so we just swirled it around and enjoyed. Unfortunately the second time we tried to use the steripen it stopped working. No warming just wouldn't work. We were then forced to switch to old fashioned iodine tabs. Lesson learned - always bring back up.
So on day 3 of our adventure we hiked up to a lake, which was still mostly frozen and surrounded by snow. While getting ready to enjoy our lunch - we noticed 2 black bears on the other side of the lake. I think they noticed us too - as they looked and started walking our direction. This scared me - I started to head down the trail. Adam wasn't scared - and we ended up continuing to watch them for a bit and they wandered back away from us. We also saw a river otter catching fish on the lake! Very pretty area! Day 4 we packed up and headed back towards the car. My feet were pretty sore - there were not used to walking 10 miles a day or carrying a pack. We finished the loop of the olympic peninsula stopping in Forks - which is now the Twilight capital of the USA. I have to admit I read the books - never realized the town would be somewhere people would visit for a "twilight" tour.
Day 5 - Adam flew back to SLC. I started the DiMM course. More to follow about the course!
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