Ryan Paterson, MD DTM&H

Traveling across Cambodia by foot, sleeping, hanging from a tree in a hammock and swimming in jungle rivers with massive waterfalls all while providing medical direction and support to the 40 runners running 220KM. This is Expedition Medicine. 

Global-Limits runs some of the worlds most amazing, staged ultra-marathons in locations such as Albania, Sri Lanka, Bhutan and Cambodia and I was privileged to work with this organization to keep the runners healthy during this race. 

We prepared with race medicine topics in mind. Dehydration, hyperthermia and hyponatremia were the major initial considerations for which we were well prepared and continually vigilant. However, blisters, sprains, strains and over-use injuries were the most common. Yet, when race medicine collides with tropical and travel medicine, then you have some fun. 

pastedgraphic-3Nausea, vomiting and diarrhea? Is it due to the hyperosmolar race supplements, bad water/food or some virus being spread thru the close living quarters of the camp. When the runners and staff share tents, toilets and hot water containers – for the dehydrated meals – and no-one has showered in 6 days, aside from beautiful jungle rivers and waterfalls; sanitation is a challenge. The logistics abound. 

Fever, chills and myalgias? Is it a bite, sting, vector borne disease, hyperthermia, dehydrations, flu or a UTI? All while carrying all of your medical equipment on your back or in the support vehicle and hours away from definitive medical care. This is the grand intersection of my training in Wilderness, Tropical/Travel, Expedition and Emergency Medicine and the perfect spot for me to practice my kind of medicine!