Days in the desert have an Alice in Wonderland quality, they stretch into one another and one quickly loses track of the length of stay out here. Day 1 of desert racing was hot and high altitude did a number on most competitors - with the relative lack of ambient oxygen per breath doing a number on most competitors on the high pass (see blog on dealing with high altitude). Amazing that the fast runners did it so fast and in such style.
 
What really caused the *#%* to hit the fan, was an old-testament styled plague of gastroenteritis that swept through camp in the first 24 hours Rumors and speculations persisted as to the cause - from a suspect empanada to San Pedro drinking water. Regardless the cause, the majority of competitors responded well to supportive care with our "desert cocktail" of antinausea meds, antacids, and antibiotics as indicated. The most threatening side affect of bad diarrhea and vomiting is keeping up with hydration...people were doing a great job. The often heard query at checkpoints of "have you peed?" was greeted with thumbs up and smiles.
 
Day 2 of competition was notable for amazing water crossings, big sand dune descents, the media team recovering from their own illnesses (in the Atacama crossing - no one is spared), and some hurting feet. Dr. Marla single handedly ran the med tent with a smile and her usual calm demeanor. When I arrived more than 4 hours later, she had not moved from her blister-curing lotus position - she gave a Buddha like smile and kept cranking away. The competitors were great about putting names on waiting lists, getting dinner, then when their reservation was called - coming on over for care. Dr. Jay arrived later, having swept in the end of the course- chaperoning another competitor who had gotten a bit lost, before finding himself right where he needed to be.
 
Today, day 3, to bring any readers patient enough to get down to the 4th paragraph - finds us high up on the dunes,nestled in the skirts of the Andes. Always amazing to look up and see the skyline speared by 6000m volcanoes. The med team has 3 of 4 doctors gearing up for the waves of soon to be competitors coming our way. We eat and rest early, then will work for the next 7 hours. There are sure to be some nasty feet. There are several athlete's whose gastrobug got the better of them, and are being brought in for IV hydration and recuperation. Another fierce athlete made a poor decision to drain a blood blister, has concerning symptoms of aggressive cellulitis - so Dr. Jay made a wise medical decision and we pulled him for the course for IV antibiotics. NEVER DRAIN A BLOOD BLISTER. It represents a deep injury to the dermal plexus of vessels - and can lead to serious infections.
 
Otherwise, oh gentle readers, everyone is well. Miss Ashlie is looking stunning as always, and running checkpoint one with her usual aplomb. Fantastic to have her out here. Tomorrow we hit the salt flats, and the fun really begins for another day, not sure which day, as I have lost track.

Dr. Grant

Arrived all in one piece.  The competitors are an impressive, healthy bunch.  Many people have completed previous races and many endurance events in the past.  Nothing to report from a medical standpoint, but the team of docs are hopeful that the competitors will eat and drink enough to stay in good shape.  We are sure their feet will suffer.  The scenery is breathtaking and the locals have been great.  More to follow.

As the athletes roll into San Pedro de Atacama, the medical team is all geared up getting amped to get some action. Dr. Marla, Dr .Jay, and Dr. Alice are looking forward to what is sure to be a memorable and beautiful RTP event. One thing we are hoping to avoid is the bane of desert living - diarrhea.

For the desert racer, hygeine is an often overlooked necessity. While concentration and concern regarding electrolytes, pack weight, quality of gaiters, and the best tasting dehydrated food may take center stage. Nothing will quench  the athlete's fire like a case of copious infectious diarrhea. 

To avoid issues, 1) always use hand wipes or hand gel (ie. purell) before putting hands to food to mouth. 2) Always clean your hands after using the bathroom (especially the solid form) 3) Feel free to ask the medical team or check poiint team for a squirt of their  hand wash when passing by. 4) Go at least 50m away from camp or checkpoint or trail to relieve yourself. It is too easy to track through something, which gets on your hands when you remove your shoes, which gets on your food when you eat, which gets in your GI track when you swallow your food , and can lead to nasty diarrhea which can lead to best case scenario - chafing, and worst case scenario - dehydration, collapse,  and metabolic issues.

So please. keep it clean!

Dr. Grant

It seems that almost everywhere in the world takes 2 days to get to. 1 day of international travel to get to the foreign country in question, with the prerequisite recycled air, unhealthy food, poor sleep, and if you're really lucky - crying babies  to ignore and burgeoning deep vein thromboses to stretch out.
Day 2 involves inter-country travel. Luckily, Chile has fantastic roads and on-time national airlinesystem. I thank the ex-fascist regime, nothing brings infrastructure and order like dictators.
Now the old me would have spent the 8 hour airport layover ensconsed on a comfy chair, feet up on the duffel bag, ear phones in, sleeping the one-eye-open sleep of international travelers everywhere. But the new me (travelingwith my lovely fiance Ashlie) has come to appreciate a day hotel, with showers and soft beds. I do have to say, the former is a much more relaxing style!
So 2 days in, and we're in San Pedro de Atacama. THe athletes are trickling in, the sky is the blue blue blue of the high desert, and old friends are meeting new friends.

Each day, the excitement and tensions increase, and looking forward to the rest of the medical team arriving tomorrow. Dr. Marla just arrived, her 2 daysof travel unfortunately turned into 3...so are the issues of staffing a Racing the Planet event. 

Time to go sort through the stored medical supplies, to prep our medical tent that will hopefully remain empty - and since it likely will not, we will be prepared for hopefully anything. As one of my mentors likes to say, If you're prepared, it is not an emergency.

peace. 

Dr. Grant

There is a lot of concern re: running at high altitude. San Pedro de Atacama is at a lofty 2400m (or about 8000 feet) above sea level. Arriving in town you may feel a bit more winded than usual carrying your bags into the hotel... no you have not lost your hard fought endurance and stamina - rather you are feeling the effects of high altitude. While few people get serious altitude illness at this altitude, there are a few simple measures you can do to prevent feeling unwell. While air at all altitudes has 21% oxygen, the higher you go in elevation, the lower the barometric pressure, the more dispersed the oxygen gets in a low pressure environment - and you will be taking more breaths to get the same amount of "O's." At 19,000' - there is 50% of the inspired oxygen per breath than at sea level, while on the summit of Mt Everest (29,029') - it is 23% of sea level! Preventive measures: drink lot's of fluids, Hydrate Hydrate Hydrate. (If it is said 3 times, it must be important). Avoid alcohol, eat 70% carbohydrates, do not take any respiratory depressants (alcohol, sleeping pills, etc). Take ibuprofen for a headache (and a recent study about to be published shows Ibuprofen 4x doses prior to ascent may prevent onset and severity of high altitude headache). Avoid excess exertion the first couple days, warm up slowly and let your body be acclimatized. Racing the Planet does not endorse prophylactic acetazolamide (diamox) for this race - the instances of requiring diamox at this elevation in race history is minimal, and also the diuretic affect of the medicine may lead to dehydration. If you have a history of altitude sickness, or are feeling bad (headache, nausea, fatigue, winded... like a hangover, but without the preceding inebriation), please find one of the medical team or RTP staff immediately. Dr. Grant

I have 7 huge boxes of medical supplies filling up my extra room... more are arriving every day. A harbringer of the excitement and adventures to come. 3/4 of the medical team are stopping by this afternoon to divvy up the goods - the easier to get by the OCD eyes of international customs and Airline shipping regulations. Starting to get excited for San Pedro de Atacama and all the fun to be had! Dr. Grant