Yesterday's Long March day was epic. 74+km of relentless foot-punishing terrain, with most competitors finishing in the wee hours of the night, following green glowsticks laid out on the ground like an airplane landing strip. A really, convoluted, long airplane landing strip like the kind that you end up on with sweaty palms when you have a really tight connection for your next flight.
 
Today's rest day was needed by all, including the medical staff. Our afternoon was spent doing inventory, counting rolls of tape, needles, pills, and organizing/documenting the supplies for next year's race. We closed down the medical tent, distributed our last Powerflex anti-inflammatory cream, and joined the competitors in eating the surprise cake that showed up at camp tonight.
 
Imagine 80+ grown, ravenous, circling vultures descending upon a kill and you can kind of picture what it was like when the cake was unveiled after 6 days of eating only dehydrated food and electrolyte tablets. Competitors dug at the cake with their swiss army knives and camping sporks, were videotaped licking their plates clean, all with huge smiles on their faces. Job well done guys.
 
I'll close with my favorite quotes overheard from camp.
 
"It's OK to spoon in your tents but not spork." - Dr. Grant
"I have acute tendonitis. Do you think it's cute?" - competitor
"I don't think I've ever seen spandex go baggy like this." - competitor
"Drink more, Run less." - Medical tent announcement board
"Loose nuts." - staff
"Doctor, can you give me a massage?" - large male competitor to Dr. Grant
"I'm doing just fine from the ankles up." - competitor at 43rd km on Long Day
"I think I'm going to have lunch by the dead burro over there." - staff
"It's not easy to be the hardest race in the world." - course setter Carlos
 
 

Hey there loyal readers,
 
Thanks for your emails! Especially to my husband David who is apparently _sympathy running_ for the competitors out here (he could not make it to Atacama due to work commitments) and did 30 miles up and down Mt Diablo last weekend. He then proceeded to vomit 3 times in his BMW on his way home, but was well prepared with some plastic bags. He does this all the time. That's my boy.
 
I've been seeing and treating lots of nausea and vomiting in the field. Mostly probably due to the gastro bug that swept our bowels clean, but also a lot from dehydration, exertion, the heat, and some secondary to electrolytes upsetting the stomach. Antiemetics like phenergan and zofran have been mainstays, and TUMS and ranitidine work wonders as well.
 
It's been a long exhausting day. But at night we are rewarded with clear skies, a brilliant moon, and more stars than you could ever imagine.
 
Nitey nite,
Dr Alice

Let's talk about the runs- a quite different type of run with a quite different mode of suffering. I would say by now about 40-50% of the group (competitors, staff, volunteers, myself included) has suffered some form of acute diarrheal illness. The potential causes are numerous but at about 3am in my tent on the first night, the only though that came to mind was, "it must have been the empanadas."  Empanadas are scrumptious, delicious veggie and sometimes meat filled baked products reminiscent of a calzone. I had wolfed one down at dinner, as did most of us. Now it could have been anything- a virus, something in the water back in San Pedro, the heat, my own sensitive GI system, but I'm putting money on the empanada.
 
Regardless, the treatment of diarrhea remains pretty much unchanged. Hydration to replete lost fluids, including electrolytes lost to the latrine. Persistent diarrhea may require a dose or two of imodium, as well as an oral antibiotic (usually cipro or azithromycin) if symptoms should suggest traveler's diarrhea. Severe cases, including bloody diarrhea or severe abdominal pain or severe dehydration should seek prompt medical attention.
 
Wash your hands. We have alcohol gel and use it liberally. . .
Here's hoping you don't have a run-in with the Runs, and that Hershey squirts remain a desired ice cream topping instead of a symptom.
 
Gel'ing Out,
Dr Alice

Hello from the Atacama Desert! I've taken my last shower for a week and am officially a desert denizen.
Today we checked in 80+ racers at the medical tent in San Pedro. Each passed through registration, pack weigh-in, medical screening, and equipment check dressed in all colors of the rainbow and flags from all over the world. After meeting many of these amazing competitors, I've come to one conclusion: this is a different breed of people. People who work normal jobs and are probably quite normal in everyday life, but are willingly signing up for a week in the desert, pushing their bodies to their extreme limits, while carrying the bare minimum required to survive. It takes a special breed. And I look forward to helping these competitors reach the finish line.
After a 1.5 hour off road drive to Camp 1, competitors are getting ready for the start tomorrow. The desert is gorgeous and camp is buzzing. Medical is ready with bandages, tape, and medicines to help everyone along. I have everything I need (well except for the beef jerky that was confiscated at Chile customs- careful they are STRICT!) and am super excited!
RTP has created a wonderful media tent for competitors and staff to blog, email, and receive messages from family and friends. Amazing what you can do in modern times. Message your competitors, they need and will receive your support!
  
Signing off. Stay hydrated and drink your electrolytes.
Dr Alice