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I'm new to the region (in central Phoenix) and have made a couple of brief forays around the edges of the western Superstitions. Looking for someone to lead/second a more extensive day hike. Considering 10-14 miles. Perhaps Hieroglyphic Canyon up to FlatIron or something equivalent. The trails and parking seem underutilized this time of year.

Cheers,
Bill

formertexan wrote: But I stand by the point on exercise associated hyponatremia (EAH) and your Bright Angel case.

This presupposes an awful lot for someone who wasn’t tending to the patient first-hand. It may turn out that you’re correct, but I would give the caregiver who actually did the assessment the benefit of the doubt instead of superimposing my own judgments and calculations on a situation where variables might well have escaped me. It can be difficult to impossible to differentiate the symptoms of hyponatremia in the field from a whole range of other medical problems like dehydration, heat illness, hypothermia, or even hypoglycemia; all of which present in much the same way. It’s not as if he could have run labs right there.

Now, here’s the real problem with your reply: You didn’t even read what had been posted previously. Nick’s original point was that the patient requires saline (or other intervention), not just water. He made the call that the patient was hyponatremic. In your most recent reply you’re making his point for him and simultaneously arguing with him. Who are you actually trying to disagree with?

Rumors to the contrary, before my previous replies I did read and reread prior posts about hyponatremia and found them ambiguous. Addressing on a point by point basis seemed argumentative and somewhat off topic, hence the non-specific reply. That said, my reading comprehension skills can certainly be fair game for criticism.

Back to the ambiguities, I am having difficulty in figuring out in these prior posts when hyponatremia is being referred to, whether in a chronic or acute form, symptomatic or asymptomatic, if references are to the Bright Angel case or something more generalized, whether sports drinks/saline/salt are being suggested as a prophylactic or for treatment and if so, whether oral or IV, hypotonic fluids or salt tablets, etc.

the whole treatment rationale is based on your volume status, and i'm assuming the scenario of volume depletion as the inciting event (as it typically is here). eventually you treat by restricting everything (salt and water) because you become volume-overexpanded, but in the volume-depleted patient saline is the answer

To me the above sentence is ambiguous though I agree that fluid restriction is appropriate for exercise associated hyponatremia. Initially I scratched my head and thought it implied exercise associated hyponatremia is typically a hypovolemic phenomena and so take exception to that. Now writing this I am thinking perhaps it was meant that volume depletion precipitates SIADH which in turn leads to volume expansion. But I'm still guessing here.

when a life threatening situation arises, gatorade, powerade, or any-ade is what you need.

This is rather vague as to what sort of life threatening situation is being referred to. And I couldn’t reconcile it to the earlier “Gatorade is bad” statement or the fluid restriction advice. If I'm stuck in the bush and severely dehydrated from cholera induced diarrhea, then I'm likely to say "another any-ade, bartender". But if I have severe hyponatremia, that same any-ade might be my last. It struck me that some rather remarkable powers were being attributed to any-ade and its commercial variations that aren’t supported in the scientific literature..

Regarding the Bright Angel case, I was not second guessing or criticizing Nick’s working diagnosis, I accepted it. And no treatment details in this case were provided to comment on. I interpreted the statement that the patient needed salt/gatorade as implying that ingesting these things would have corrected or prevented the apparent hyponatremia. If it was meant otherwise and I misinterpreted, then I apologize.

Thanks Nick. Calling me partner made me feel like I was back in Texas. And I did take the cholera/gatorade comment a bit over seriously. But there is a published study (out of India?) that found Gatorade equally effective compared to one of the stock ORT formulations. This study seemingly evolved in response to clinical use of Gatorade . As to my "opinions", they aren't dogmatic, and will be cheerfully reconsidered in the light if any data that surfaces. Considering your experience, if there was anything I have said here in regards to hydration/hyponatremia that you specifically disagree with, I will be interested in hearing of it. Live and learn.

Cheers, FormerTexan

My point was more to why there was a specific need to disagree with Nick when you seemed to be making the same call.

:bdh:

Jeff MacE wrote:Multiple studies back this and they are the basis for the military physical fitness grading systems, which test 35 yo males hardest (thereabouts).

Since this topic won't die, that statement is also incorrect. Now I can only speak for the Air Force but <25 is the hardest fitness bracket then it adjust slightly from there every 5 years. Each set the numbers adjust getting a little easier the older you get. I'm not disagreeing with you %'s by each year, just not the military aspect of it.

Under Age 25
Ages 25 - 29
Ages 30 - 34
Ages 35 - 39
Ages 40 - 44
Ages 45 - 49
Ages 50 - 54
Ages 55 plus

azpride wrote::bdh:

hehe Joel

nothing wrong with bringin back the topic tho, as July 4th comes every year...

my only critisizm is that Gatorade (read the ingredients list) is nothing more than sugar water with a bit of salt and potassium (3% of daily value, per quart.) Its not a wonder drink and barely qualifies (imo) as a thirst quencher. *
My reference to the homemade stuff was to show that it is recommended by several medical sites online and has been shown to be very popular in situations of cholera outbreaks. Plus, its around $0.06 per quart if you do it at home. Compare that to Gatorade, $1.90

*but then, beer companies want you to think alcohol re-hydrates you too! how many times have you heard the misleading catch phrase "thirsty?? grab a bud light"

Wait... Beer doesn't rehydrate you???? Come on, even if it's really really cold? ;)

Only if the mountains turn blue!

davis2001r6 wrote:

Jeff MacE wrote:Multiple studies back this and they are the basis for the military physical fitness grading systems, which test 35 yo males hardest (thereabouts).

Since this topic won't die, that statement is also incorrect. Now I can only speak for the Air Force but <25 is the hardest fitness bracket then it adjust slightly from there every 5 years. Each set the numbers adjust getting a little easier the older you get. I'm not disagreeing with you %'s by each year, just not the military aspect of it.

Under Age 25
Ages 25 - 29
Ages 30 - 34
Ages 35 - 39
Ages 40 - 44
Ages 45 - 49
Ages 50 - 54
Ages 55 plus

I was referring to the Army and Marine standards, I should have been more specific. 27-31 is graded toughest. Doesn't the Air Force ride a bike, or something, anyway??!

Hey, we got rid of the bike few years ago. Now it's a waist measurement (max 30pts) 1.5mile run (max 50pts) 1 minute of pushups (max 10pts) 1 minute of crunches (max 10pts).

If your skinny and can walk fast you can pass. If your overweight but can do the rest it's harder to pass, good thing I can run.

That bike test was horrible though, I saw overweight smokers who would have a cigarette just before pass with flying colors. But then I would see in shape athletes fail the thing. It was stupid.

Jeff MacE wrote:I was referring to the Army and Marine standards, I should have been more specific. 27-31 is graded toughest. Doesn't the Air Force ride a bike, or something, anyway??!

According to marine standards your still wrong. These are the minimums to pass.
Age Pull-Ups Crunches 3-Mile Run
17-26 3 50 28:00
27-39 3 45 29:00
40-45 3 45 30:00
46+ 3 40 33:00

Good, fine; I was in the Army, after all.

Once, in Korea, the Marines on CP Henry asked if they could join the PT test we were doing (since the mats were out and route was marked) and just add a mile to the run, because...their other standards were the same. That came from the Marine E-5 that was running the test alongside my Joes and I. Apparently he must have been an ASVAB waiver, or something. I guess I put bad info out there. Go look the non-military studies up, if you so choose.

As for the rest of this thread, what difference does any of this make? All I wanted to know was why someone felt the need to get on an anonymous forum and argue with a very educated and skilled person about a point to which his argument was congruous? What was the ultimate aim? That fifteen seconds of sad pleasure that one might get when the other finally capitulates because your argument and ramblings have left the realm of reality and can no longer be parsed? "Hey honey - I argued with a doctor about heatstroke and he ran away like a scared dog, let's go to Olive Garden and celebrate!!"

Good Friday afternoon to everyone - go out an hike this weekend. ut:

what an extremely painful thread this is

ut:

Some people just don't play well on the internet I guess.

If this thread lasts long enough, the weather will cool off, and then we'll have to find something else to discuss..... ;)

Hmmm, to answer the OP, I like to hike in the Supes during the summer months. I have the trails pretty much to myself, just the occasional mad dog or Englishman. Typically I like to hit the trailhead at or before sunrise. Then I make it a point to get off the trail by noon. My favorite hike is Peralta TH, Bluff Springs trail to Terrapin Trail, to Dutchman to Peralta trail and back to the TH. It's 12.5 miles with some modest elevation gains/losses.