Introduction to Wilderness Medicine

Introduction to Wilderness Medicine

Reading Time: 16 minutes

In the wilderness you will have limited resources, and limited capabilities for major medical intervention. So it is important to have a basic understanding of wilderness medicine and first aid, as it could save a life. So with my medical background in trauma surgery, and the emergency room – here is an introduction to Wilderness Medicine.

Disclaimer: Please keep in mind this is a guide and you should receive additional training in order to feel confidant and comfortable in each scenario.

Initial Assessment:

The best thing to do is approach the patient using the Acronym: ABCDE, which stands for Airway, Breathing, Circulation, Disability, Exposure. The initial question before all else, is “Am I putting myself at risk by trying to save this person?”. Make sure there won’t be two injured people on the ground before you commit to completing the ABCDE steps. Please make sure that the scene is safe for you approach – don’t approach a bleeding person with a Grizzly Bear standing over them.

Make sure to wear gloves, put on your sunglasses because you may not know them- and don’t know your friends as well as you do.

For those with minimal medical knowledge, here are some questions you should ask after taking a big breath, and introducing yourself in a calm way to the injured person or suspected injured person.

Airway in Wilderness Medicine

  • Remove dirt or objects that you can see. Do not do blind sweeps with your fingers as this can lodge things further down the throat. They can have dirt, teeth, severed tounge etc… it might be bloody so be prepared (thus the gloves and sunglasses).
  • Jaw thrust – go to the head of the patient, grab their jaw (right at the angled portion) and lift it slightly forward. Do not move the neck, or tilt the head back significantly when you are doing this because they may have a major neck injury.
    • In the Emergency Room they often use an nasopharyngeal tube to keep an airway open in an emergency. You can use a camel back to cut this down measuring from ear to mouth.
    • If you don’t have a nasopharyngeal tube, then you can take your knife – cut the tube on a camel back and insert that into the nose down to the airway. Be sure to measure it properly. Using the ear to jaw measurement method.
    • If the camel back doesn’t work, you can also use TWO safety pins pinned on either side of the tongue with a shoelace threaded through them tied to the belt loop, their finger etc… I like to have four safety pins so that the paracord/string/shoelace remains in place.
      • If this wakes the patient up, then you have solved the issue of their airway, because an awake patient, can control their tongue muscles. Also, keep in mind it will feel weird grabbing a limp tounge, it might be weird and gross but it is better than that person being dead because you couldn’t leave their airway while trying to treat the bleeding broken leg that may also kill them.
  • Chin lift – you only want to do this if you are absolutely SURE that the patient has had NO head trauma.
Wilderness Medicine
Jaw Thrust with no Chin Tilt – Photo Credit Rrapid
  • Have they choked on something? Is there something blocking the airway?
  • Cricothyrotomy (The Emergency Airway): You can slit the skin right below the Adams apple and stick the knife in. You will pop (it will literally be a pop) through a couple of layers and will hear a rush of air. If you don’t feel a rush of air, then you aren’t in the right space. Don’t dig around, in a normal weight and build individual, it should only be about a 1/2 inch below the layer of skin/fat. In larger individuals you may have to go a little deeper. You can measure a stick a straw, a camel back tube or ball point pens to the side of the neck and it will give you a good idea of how deep the tube needs to go in order to get into the airway.
    • I like to keep a 14G IV Catheter with me so that I can use that to puncture into the airway. It will be large enough to help air escape, and guide you for making a larger incision in the event that you need to ventilate.
    • Keep in mind that once you put an incision in this position, medical personell will not be able to insert a viable airway tube through the mouth. So only resort to this option if the upper airway is completely blocked and the patient is deteriorating.

Breathing

Do you lay them on their back or on their side? Are you sure they are breathing? What do the breaths sound like and feel like? Breathing is really important obviously, it is generally associated with death if someone isn’t breathing and/or isn’t breathing well. There are entire campaigns in the States to help the public become more aware about how to save a life through CPR and First Aid classes. I highly recommend going if you have the chance.

So when assessing breathing, I would review the list below before each activity or vacation. Have someone be in charge and a backup person to support them. Having someone assigned to each task, and someone assigned to be the team leader in the event of an accident will help prevent confusion.

Wilderness Medicine
  • Look for the breathing, is their chest moving?
    • Is the chest moving equally? Is one rising above the other?
    • Are they using nose, neck or other muscles to help them breathe?
  • Listen for their breath by putting your ear right next to their chest.
  • Feel the breaths by placing your hands lightly on the chest. Does it feel like broken bones grinding together or does it feel like rice krispies under their skin?
    • The feeling of Rice Krispies on the chest can indicate a tension pneumothorax. This is something that cannot wait and the patient will be dead by the time someone arrives.
      • Keeping a 14G IV catheter for this situation. You go very high on the chest, right below the collar bone, pick a rib high up, and stick the needle on the TOP part of the rib. (Hold onto it because the trapped air will push the needle out- if there is no rush of air, try the other side. If the rush of air is not on the other side, then take it out).
      • Most of the time, people don’t put the needle deep enough.
    • Open Pneumothorax – this is when someone has something penetrating through their skin into their lung. This destroys the physics of the lung and how we breathe. So if there is a hole in the chest, with abnormal breathing – take a plastic baggie, take your duct tape and tape ONLY THREE Sides flat onto the chest (so that air can get OUT of one side).
      • Do not EVER remove an impaled object into the chest area, or into the leg area.
  • Basic Life Support would suggest giving breath’s (use a glove as a barrier for rescue breathing- tear off the middle finger and put your mouth in the opening to give breaths) to the patient and doing chest compressions. Contact your local hospital to get education on how to do this. In the USA the Red Cross does BLS courses in the community.

Circulation in Wilderness Medicine

First things first, if they aren’t already laying down – ask them to lie down. If you know how to take a pulse (near the thumb, or on the neck on either side of the neck right near their windpipe) see what their heart rate is. A normal adult should have a heart beat from 70-80 beats per minute.

Wilderness Medicine

Check their skin color, are they pale, cool, moist? If you answered yes, they may have an issue with their circulation or are in shock.

If you press down on their fingernails does the blood come back into the fingernail within <2 seconds? If it doesn’t, they may be losing a lot of blood, or being going into severe shock. This method is called checking capillary refill time.

If it looks like they have a lot of the symptoms described above, or you can’t feel the pulse on the wrist – you may not be able to see the bleeding that the patient is experiencing. Some of this bleeding can be internal, so raising the legs (only raise the legs that are uninjured) it can be a way to increase the blood pressure and keep blood pressure up to the brain.

If there are any areas on the surface of the body make sure to hold direct pressure for 10-15 minutes. Don’t let the pressure go and check to see if it is still bleeding until that 10-15 minutes is up. If you have quick clot, pour that on and hold pressure.

  • For Wounds/lacerations you can use crazy glue, duct tape, staples (even the small stationary staples), or the hair closure technique.
  • Hair Closure technique: If the hair is more than 1-2 inches long, you can take small pieces on either side of the wound, and twist them around each other tightly. Lay them down flat against the scalp, and put crazy glue on the knot on the top of the head.
  • If there is a lot of debri in the wound, you can use the sterile saline rinse kits they have over the counter that people use for sinus irrigation, or they also come in small disposable packs. You can also use water (with chlorine tablets dropped in) inside a bag with small holes poked in it to irrigate it out. You can use garbage bags, condoms, sandwich bags etc.. to bring enough water to clean out the wound.
    • In the Operating Room we had a saying, “The Solution to Pollution is Dilution” – and oh how true that is.
    • Just keep in mind, you don’t want to close a wound unless it is life threatening. Just clean the wound as well as you can, and then put pressure on it. If you close it completely then they have to keep the wound open for irrigation and it closes on its own leaving a massive scar. If it is a life threatening opening that won’t stop bleeding even with pressure, then there isn’t a choice but to close the wound.
Wilderness Medicine

If the bleeding is coming from the legs or arms, putting a tourniquet on the limb using a stick slid just underneath the knot (turning it slowly until the bleeding stops). Make some kind of mark on the patient to make sure that someone knows a tourniquet has been placed.

If a tourniquet is left on for more than 6 hours they are at risk of losing their limb. You are ok to release the tourniquet after 6 hours, as long as the bleeding from the limb is not life threatening. Leave it off for at least 20 minutes to 1 hour (as bleeding allows) then replace it.

If you don’t have quick clot, you can use duct tape, crazy glue (but not for lots of bleeding as it won’t stick), hair ties, staples. If someone has an epi pen for allergies- you can use that injected into the body. There are certain places they say NOT to use any kind of Epi (Fingers, Toes, Penis, Nose) – but again, if it is life threatening….then just do it).

Many medical personell don’t know how to use Epi pens if you ask them, they will likely go into their office or look up how on their phones. So it is really simple…take off the caps and THE ORANGE PART GOES INTO THE PATIENT. Don’t stick it in quickly and pull it out once you push the button on the top, as it takes 10 FULL seconds to get the epi (the medicine) into the patient.

Disability

Are they talking normally, confused (name, date, location, what they were doing), responding with a loud voice, do they respond to pain (pinch them on the wrists and behind the ear)? Are their pupils equal? Do the pupils respond to light (use your phone light)? Are they able to move both arms and both legs?

Wilderness Medicine

The reason you want to do this as the initial portion for ‘D’ is to see what type of transportation you need for this person. If their pupils aren’t reacting like they should, if they do not respond to pain stimuli, or they are confused – then there is likely something going on with their brain and they need immediate attention via a helicopter transport that would get them the medical attention necessary to save as much of their brain as possible.

Neck Injury

Always assume they have a neck injury if they have had a head injury, major injuries or broken bones, they are intoxicated, or were hit by a moving vehicle or boat. Do not believe them when they say their neck is fine, there are plenty of times in the moment of the Adrenalin rush that they won’t feel the trauma that is there.

  • In this case you want to imagine the patient as a log. everything should remain in line, and no turning, pulling pushing on the spine or neck.
  • Improvising to protect their neck – you want to prevent them from flexing their neck and turning it side to side:
    • Preventing Forward Neck Flexion
      • Aluminum Splints area a great way to splint not just a fracture, but you can thread these behind the neck, and then cut it down so it encircles it once.
      • A really bulky sweater wrapped around the neck and duct taped on also works
    • Prevent them from looking side to side with Side Rolls
      • Improvise with: Water bottles duct taped to the side of the neck to keep it in place. paddles on both sides crossed over the chest, taping sticks together and wrapping a shirt around the ends to prevent punctures, putting their shoes on either side of their neck, stuff sacks or a back pack (filled with sand, clothes) put on both sides and duct tape it together.

Exposure

What are the weather conditions like? Do you, or can you move them to a better location without causing pain or further damage?

  • For cold environments you want to try and keep them warm. Use something to block the wind.
    • You can also use a garbage bag wrapped around and underneath them (as a improvised shirt or pants) with DRY leaves or other clothing stuffed inside of it to keep the heat in.
      • Make sure whatever you stuff into the bag is DRY, no exceptions.
    • Using a sleeping bag is also a great idea (only if not wet).
    • The ground is very cold, even the dirt – so don’t forget to wrap their entire body.
      • It can be 85 degrees outside, and someone in shock will still be shivering relentlessly.
Wilderness Medicine

Were they impaled with any objects?

  • If there is an object that impaled the patient and is stuck in them — DO NOT REMOVE THIS AS IT CAN CAUSE FURTHER DAMAGE!
    • A good example of this, is when Steve Irwin was stung by stingray rebarbs, he quickly removed them and one was in his heart. When he removed it, it created an outlet for bleeding to happen around and from his heart causing his death.
  • You can wrap something around the impaled object to stabilize it until the patient can get to the operating room to have it taken out. Even doctors in the Emergency Room don’t typically mess with these things until you know for CERTAIN that an object has not severed an artery.

Invest in a Good First Aid Kit (not just ones with bandaids)

There are thousands of First Aid Kits out there, but how do you know which one if the best? Think of your situation, how much you are willing to put in the suitcase?

I was looking into getting an updated First Aid Kit, and ran across the company MyMedic. This company sells tourniquets, first aid kits that fit into your pocket, all the way up to a First Aid Kit that field Medics use in the war zone. The MyMedic First Aid Kit I chose, was one that specifically has quik clot in it.

This First Aid Kit has so many good things in it! I’m sincerely impressed with everything in here. It is so compact too, it is smaller than my makeup bag (and I don’t wear a lot) yet has everything I would want in an emergency other than an AED and a back board. They have built the outside of the bag so you won’t lose any space on your backpack with loops to hang carabiners off of.

On the back there are two button straps you could also use to hang onto your bag. You can unclip the strap that goes around the bag and use that as a neck brace with the rolled clothing or water bottles and cinch it down.

Inside it is very well organized with straps holding everything in place, just like you would find in a paramedic bag. There is benedryl, tylenol, advil, sunscreen, electrolytes, 2 pairs of gloves. Sterile bandage, triangle bandage, emergency blanket, suture kit, scissors, tweezers, sterile saline, ace wrap, tourniquet (the fancy kind), paracord, QuikClot, snap light, whistle, medical tape, bandaids, Nasopharyngeal tube, hydrogel (used for severe burns – to help slow damage to lower levels), CPR shield (so you don’t have to use a glove).

This is just to name a few of the things tightly compacted into this bag. The bag also is easy to close once you are done exploring it.

Wilderness Medicine

Another thing I do when I go camping, hiking, climbing, or any other adventuring – I always make sure everyone knows where the first aid kit is. You put it in the same spot every time you go out adventuring. If it is on your backpack, or in your backpack, you make sure that people know how to access it. If it is in your car, make sure they know where the keys are to open the car.

If I were to add a few more things to this MyMedic Pack, I would add an Epi Pen, 14G IV Catheter, strap my swiss army knife to the outside. I would also put 4 safety pins, chlorine tablets, and crazy glue.

Just like Duct Tape, Safety Pins have so many uses, so I would highly recommend always keeping a few handy:

  • Tongue Extension, making eyeglasses, removing foreign bodies from skin, cornea, abscess drainage, removing a fishhook, T-shirt arm splint, sewing needle, wound closure, unclogging camping stove jet, tick removal, fix zippers/bindings, and last but not least for all my ladies out there – they work great for separating eyelashes after putting mascara on 😉

When Do You Evacuate Someone?

If the patient is having any of the following, you will likely need to ask for a helicopter or rescue team evacuation:

Wilderness Medicine
Photo Credit: Canada West Mountain School
  • Breathing difficulties
  • Dizzy/weak/weak pulse
  • Unconscious/Confused
  • Trouble Breathing
  • Neck or Torso Pain
  • Unable to Walk
  • Visible Bone or Clear Dislocation
  • Unsure of Severity of Injury

Animal Bites and Stings in Wilderness Medicine

Know the area, animals that frequently attack – an easy way to know this is to ask a local. If you ask the concierge, the taxi driver, the ticket counter, or even your guide should know.

When I was hiking in Jamaica through the Jungle, we emerged and I felt a pinch on the skin of my foot. In the States, ticks are known to hold Lyme Disease- but my guide was able to dislodge the tick, and said that Jamaica didn’t have Lyme Disease like the States did. She was from New York, and one of the toughest ladies I have ever met. So even common pests like this, may not be dangerous in the places that you visit – they may be…just pests.

This is why it is important to just ask questions about dangers when hiking in certain areas, or animals. The animal world is always changing, and animals can be quite territorial, or hide in places you may not think of.

For example, where I live, we have to keep our dogs out of the weeds in certain places we go hiking as Rattlesnakes are quite common here. You likely wouldn’t find Rattlesnakes while hiking in Zermatt Switzerland. So get educated and be prepared.

  • Snake Bites: Move away from the snake, take off any tight clothing, do not use a tourniquet. Take a photo of the snake if possible. Call 911 to minimize having to move and increase the circulation of the poison.

Hypothermia in Wilderness Medicine

The first time I personally experienced Hypothermia was when I went camping and hiking on Mount Whitney in November. You don’t really know that you are getting cold until things start to turn blue (especially if you are exercising). Make sure to read about my whole experience there.

If you encounter someone who has Hypothermia, or if you yourself start to experience it – there are some things you can take with you. Hand warmers (the 12 hour ones are best) I would bring at least 6 for each person, or more if you are car camping. An emergency blanket, if I am backpacking or camping I will typically bring a compact Mylar blanket, and then a cloth emergency blanket over that that you can find at REI and are easy to put on your backpack.

Hyperthermia in Wilderness Medicine

Wilderness Medicinejg5409

The first time I experienced Heat exhaustion was hiking in Zion National Park in the sun when it was 112 F (44C). Ever since that time I have been easily prone to heat exhaustion (another reason I sweat like a whore in church in any kind of humidity).

It starts with a dry mouth, then you get hot and start sweating so much you can hardly keep it off your body. Then it feels like your heart is going to beat out of your chest. It feels like it takes monumental effort to take even a few steps or keep your eyes open. Then your stomach starts to cramp, and you can get nauseated. When I got to the nausea and dizzy stage, that is when I knew I had heat exhaustion for sure. Be sure to read that first hand account, and keep yourself safe in warmer climates.

Getting Travel Insurance

Sometimes the first aid kit isn’t enough, it can save a life in order to get to medical care though. When you are traveling abroad, you won’t know what hospital is a good one, or what the cost will be. This is why I highly encourage Travel Insurance.

World Nomad Travel Insurance

Not only do they help with repatriation (arrange for your body to be transported back home), they also can help with delayed or canceled flights, long term hospitalizations abroad etc..

I recommend World Nomad Insurance, because it is highly customizable. Even for coverage for my diving trip in Cabo San Lucas, for my age it was only around $69 for repatriation coverage, hospitalization, cancelled flights, delayed flights and more. For everything that they cover, I was stunned….especially since I work in the medical field and know how much headache it is to cover sports like these.

Stay Aware, and Stay Safe

There is only so much that you can prepare for on a trip. There will always be the unexpected in this life, so just prepare as much as you can – get familiar with some of these Wilderness Medicine Hacks. Some people never get hurt while they are traveling, some people are so accident prone they can regail you with stories for hours. You personally may not feel you need any of this information, but you may just possibly save someone else’s life should you prepare yourself with the right information and your own first aid kit. Be safe, don’t be sorry you didn’t prepare. The worst thing in the world to live with is the ‘What If I Would Have?’

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How to Recover from Your Vacation

How to Recover from Your Vacation

Reading Time: 8 minutes

Have you ever heard someone say, “I need a vacation from my vacation”. I hear this more and more from people who ask me how I have so much energy after traveling so much. There really isn’t a secret to it, I just know how to pace myself while traveling, listen to what my body needs, and follow a certain set of rules for when I get back no matter how tired I feel – or how heavy the post-vacation blues feels.

Leave the House Clean

There is nothing worse than coming home to a pile of laundry that you know you are just going to make worse by all your travel clothes. While it seems stressful to try and add another thing to your ‘to-do’ list before you leave – at the bare minimum do your laundry before you leave. For those of us who love watching Marie Kondo, or Mrs Hinch; I suggest making the bed, chopping those pillows, doing the dishes, and vaccuming and mopping the floors.

How to Recover from a Vacation

You will find just how refreshing it is to come home to a clean house. Trying to readjust to normal life after a vacation is almost like trying to screw your head back on straight. It is easier for me to do get my life in order and back into a routine inside a clean house.

Arrange For A Ride Before Leaving

If you don’t need a car to take you, at least make sure you know if you will need to take a Taxi, train, or bus on the way home. Think about the luggage you will have, the time of night, if the transportation methods run that late; or if you should just take that Uber home and save yourself some headache.

How to Recover from a Vacation

There are always ways to get home, just be sure to keep in mind what time you arrive back home so you don’t have to stress about it when your jet lagged and shuffling your way out to your chosen transport method in a post vacation hangover.

Good Night’s Rest

The blessed bed! There is no bed, in the whole world, that is as comfortable as my own bed, my own incredibly soft Crown Goose Bedding, my 1000 count sheets, and Zoey snuggling up next to me. This is bliss to me!

Do not under-estimate investing in your bed, it is the thing that will help you the most with the inevitable Jet-Lag. It will help you recover your scrambled brain to help you function at work, so you can save for your next trip.

I am a very light sleeper, so I have made every effort to make sure that every part, portion and piece of my bed feels like heaven. I got my tufted headboard off of Amazon, and my favorite color being blue – for it’s soft and relaxing shade contributes to a relaxed environment.

The bedding, from Crown Goose, with some of the softest material I have felt in a long time. This bedding holds up in the wash really well, so no worries when you have your puppy snuggles. I also really like how elegant it looks, almost as if I have my own hotel room at home. The fabric holds up really well when I go and chop my pillows like Mrs Hinch in the morning, with crisp clean lines, and a white that reflects the sunlight from my window. They have several colors, all which are in the comforting and relaxing shades – so be sure to check them out – I promise you won’t regret it.

The 500 thread count sheets are a must for me. I know it sounds like a bit of a Princess and the Pea at this point, but I rub my feet on the sheets to help me sleep. I also toss and turn so much I needed some sheets that would hold up. I like that they come in all shades, and really can make or break my whole bed.

The last things I would add to this section is make sure you have a darkened room at appropriate times of the day. I personally use black-out curtains, and have to have the bedroom a little cooler. Fun fact, studies show that humans sleep better when the temperature is cooler at night because our body temperature drops slightly.

Be sure to check out my tips on How To Combat Jet Lag.

Unpack Immediately

I must try and ride the wave coming off the plane on auto mode, and promptly unpack. I typically will unpack immediately and at least throw all the clothes either in the wash or the hamper. That way at least it is in its proper place ready for the madness of dealing with the laundry on your day off.

How to Recover from a Vacation

I also tend to pick out an outfit for work the next day. I typically go with some dark colors, to help my inevitable dark circles look a little brighter. I will either wear a flowy dress or skirt as well, so I don’t have to suck in the gut I tend to get from eating so much while on vacation.

Exercise vs Resting

Each body is different, and so I would say – listen to what your body needs. I typical traveler can walk anywhere from six to ten miles per day. When you add that up over the course of your trip, you pretty much walk two marathons over a week long trip!

How to Recover from a Vacation

For those coming from a desk job, to suddenly walking more than you do in a month combined – give your body the rest it needs. Give yourself plenty of water, and when your ready, keep walking at least three miles a day to keep up the stamina for your next trip. Even 20 minutes per day at least four days a week is great.

For those who run five or six miles a day, well… you just pat yourself on the back and get straight back to that gym! No pain, no gain – work off those carbs you indulged in while on vacation.

Nutrition vs easy Fast Food

I know how easy it is to drive home jet lagged and just stop by the nearest fast-food joint to do ‘one less thing’. RESIST THE URGE TO DO IT! This is part of the reason I try to meal prep something the week before I leave. Then freeze part of it so I have something healthy and nutritious to come home to.

How to Recover from a Vacation

If nothing else, grab your InstaPot throw in BBQ and some Frozen chicken and you can have a hot meal in 20 minutes. Get creative! There are plenty of recipes on Pinterest that are still good after being frozen.

Self Care

Now this is the step that is an absolute must! It is hard for me to remember to take care of myself after going on a trip, feeling jet lagged, and needing my precious self care time. A time where I can soak the sore muscles from the flight in the tub, take a hot shower with a bath bomb thrown onto the floor for an infusion of wonderful smells. I also need cuddle time with my dog and to let the silence reset me while I rock in my recliner.

How to Recover from a Vacation

I feel like a part of me gets extremely fatigued by all the camera work, video work, and general mass amounts of ‘new input’ it receives while on vacation. Don’t get me wrong, I really love to travel the way I do, but after doing it every other week for two months – this step became increasingly important to me and the health of my friendships at home.

Take an Extra Day Off Work

The older I get the more I’m allowing myself to be ok with at least an extra day off of work. My paid time off of work is EXTREMELY precious to me, but I try and schedule my flights to give me at least one full day (or nearly full day) at home on my regularly scheduled day off, or I come home early on a Saturday instead of midnight on a Sunday. The extra cost is worth it to me, to come home earlier in the day.

How to Recover from a Vacation

Arrange for Grocery Pickup/Delivery

With Walmart, Amazon, Costco, Smiths and many other large grocery chains now offering ordering your groceries online – take advantage of this! For one thing, it helps you stay on budget which will help you save for your next trip. The second part, is that you can jump in the car, drive 5-10 minutes and just pick up the few things you will need to complete the work week and still get the rest you need.

How to Recover from a Vacation

I started doing this on my last trip, and was amazed at just how incredibly put together I felt the next morning – knowing all I had to do was go to work and come home to rest.

Purge All Your Thoughts

Writing down all the impact memories that either agitated you, or inspired you along your trip will do two things. One- It will help you release some of the emotions you may have collected along the way, and also ease the worry of not remembering your incredible journey. Two- Allows your mind to take a rest of trying to input so much information, learning, and experiences.

How to Recover from a Vacation

I also keep a small journal with me, or notepad where I take notes of buildings I visit, places to remember – costs of tickets etc…. See the things I do for my Culture Trekkers? 😉

Print Out The Photos

We live in a Digital world, and sometimes having the photos on the wall when you get that post-vacation blues can be a way to remind you of the amazing journeys you have been on.

How to Recover from a Vacation

You can make an arrangement of photos in frames, use string/cord to clip them to your wall with fairy lights. Take it a step further and make a travel book for your coffee table, or fireplace mantel that you can show friends when they come over. I think that creating something like this, along with inserting feelings/phrases like before would be

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How To Avoid Motion Sickness, and Treat It While Traveling

How To Avoid Motion Sickness, and Treat It While Traveling

Reading Time: 7 minutes

Motion sickness is something everyone gets in their lifetime. From all my travels with friends, family and treating patients- you either get the car sickness, or you get sea sickness, or you have a crazy gag reflex and get both.

I used to be one of those people who would laugh at someone when they were sea sick. After getting motion sickness myself, in the back of a bus winding down the mountain in Jordan…..well….Karma doesn’t let me laugh anymore.

So how do you prevent motion sickness from happening? What if it starts in an obscure location, or in the middle of a cruise and you have no way to escape it for the next 14 days? Here are a few tips and tricks I have learned over the years, that have helped even the weakest of stomachs still be able to enjoy their vacation.

How Do you Know If You Are Prone to Motions Sickness?

All you need to do is a watch a YouTube video with really shaky footage, and if you start to get a lump in your throat just from watching it – well you are likely prone to motion sickness. It is the small rapid movements of the eye, or the tiny hairs in the inner most part of your ear that are responsible for helping you keep your balance that seems to be the biggest contributor to motion sickness.

A big distinction is if you just feel ill to your stomach, or if it is truly motion sickness. If you continue spinning even despite stepping away from the activity, and the if the room is spinning vs you are spinning – this may require you to see your Primary Care Physician for further examination and evaluation. Also if you get dizzy when standing up from a seated position, this can also indicate a medical issue and should not be confused with motion sickness.

Motion Sickness Treatments and Home Remedies

Sea Sickness Patches

I give these patches, called Scopolamine patches, to my patients who are prone to sea sickness. These tiny little tan patches are often worn, by patients going on a cruise and seem to help quite a bit.

You put the patch behind your ear, on the skin, about four hours before getting on a boat, or doing any other sort of activity that can cause motion sickness. Make sure the patch is directly touching skin, or the medication will not absorb. For those with beards or excessive hair, you may need to shave a small area to put the patch for best results.

This option is not appropriate for children.

Side effects:

Common: dry eyes, dry mouth, sensitivity to bright light

Less common: blurred vision, dizziness, headache, sedation

Sea Sickness Tablets

These are also called anti-histamines (First generation anti-histamines), while these can work well with kids, and adults alike – they often cause drowsiness. For those who are able, try the sea sickness patches first.

This option can be used with children, but you should check with your Pediatrician or Pharmacist on proper dosing.

For males with Prostate issues, or Females with Urinary retention issues – proceed with caution as some of the medications in this class often cause urinary retention.

Examples of First Generation Anti-Histamines:

Diphenhydramine (Benedryl or equivilant)
Hydroxyzine (Atarax)
Chlorpheniramine (Aller-Chlor)

While not widely used, this is one a Specialty Pharmacy Technician recommended to me and worked really well for both motion sickness and allergies without too much sedation. Everyone reacts differently to medications though, so be cautious and maybe try the first dose at home so you know how you react to it.

Side Effects:

Very common: sedation

Common: dry eyes, dry mouth

Less common: Urinary Retention

Woman suffering from motion sickness in a car and holding sick bag

Non-Medical Remedies:

Look To The Horizon:

Look forward at a fixed point on the horizon and avoid close visual tasks as this can de-synchronize your visual and vestibular (inner ear) movements.

Pick The Right Position On The Boat

Having a Balcony Room for the Horizon, being in the middle, top, front half of the ship also helps. The best thing to do is call the cruise company and tell them you are prone to motion sickness. Their staff doesn’t always like to clean up the mess you make, so they are more than happy to let you know what would be the best option for your budget.

Head Movements and Stabilization

Actively move, steer, tilt your head into turns, recline and stabilize your head and body. Think of this as if you are playing a video game, where you subconsciously turn with the game during a race, or when your watching a football game you subtly mimic what your favorite team is doing.

Go To Sleep

Closing your eyes, and taking a little snooze while on the road can really help with quelling the motion sickness until you get to your destination. If you are on a ship, this can be difficult.

Ginger Root:

While many medical professional say this does not work; I always tell my patients to do what works. Even if it turns out it is a placebo affect, if it works for you then continue to use it. You can use it in a tea, and the warm drink can also have a calming effect on your stomach.

Pressure Point Wrist Bands:

I’m sure you have seen the stylish grey wrist bands that people wear on cruise ships, that appear to have a white dot near on their wrist.

These are pressure point wrist bands, I know many people who have used these and swear by them. While there aren’t a whole lot of studies out there on if these are effective, it is an alternative you can try if you adverse to taking medication or are unable to take medication due to other health issues you may have.

Isopropyl Alcohol – or Rubbing Alcohol

While I have mainly seen this used in Post-operative nausea and vomiting release, I feel this does help temporarily quell an upset stomach. There are several studies out there on the utility of this for nausea, but if you are out of options than it may be worth a try.

All you have to do is take a couple of whiffs of the pungent smell. It tends to trigger a swallowing reflex and heightening of senses towards the smell instead of your nausea.

Other Transportation and How to Avoid Motion Sickness:

  • Airplanes
    • Try and sit over the wing so you are in the center of the axis point.
  • Buses
    • Sit near the front at the lowest level facing forward.
  • Trains
    • Sit on the lowest level facing forward, and don’t look directly out the window, but further in the distance and don’t try to follow objects as they pass by the window.
  • Wear Sunglasses
    • This can blunt visual input slightly which may help
  • Synchronize Movements
    • Actively synchronize the movement of the body with the movement of the motion of travel.
  • Food and Drink
    • Avoid Alcohol, eat before traveling, eat soft/bland foods, avoid dehydration, avoid noxious fumes, listen to music

The Last Resort:

I might get shot down by other medical providers for mentioning this one, but it has always helped me in the past. The problem with these is that they are prescription medications, that may require more workup before giving them to you.

The major symptom that people complain about when getting motion sickness is nausea. So there are several medications that can help with nausea itself, Phenegren or Zofran.

I am not a huge fan of Phenegran myself, as it is really sedating, and most people have a hard time being able to stay awake when they take it. It is quite effective for nausea symptoms, and if you are on a cruise ship – it might be a good option for it.

Zofran is one of my favorite Anti-nausea medications, as it is not very sedating. The only type of motion sickness symptom I get is nausea, and cannot stand the dry mouth or dizziness that comes with the other anti-motion sickness medications – so this is the best option for me personally.

There can be some drug interactions with Zofran from Amniodarone or other heart rhythm medications, Haldol or other medications used for mental health. For those who have some knowledge of how the heart functions it has a known affect on the QTc interval – so be careful when combining medications with this same side affect.

A Blissful Ending To A Bad Beginning:

Although motion sickness can destroy vacations with its terrible symptoms, it can be prevented and treated. If I had to recommend my top three ‘go to’ remedies I would say Scopolamine Patches, Pressure Point Wrist Bands, and Zofran. Make sure you are conscious of where you position yourself on each transportation mechanism for your travels, and bring a little alcohol wipe or ginger tea to help soothe the stomach. This way you can both start, enjoy, and finish your vacation just the way you imagined.

Like it? Pin it! Sharing is Caring 😉

All resources from this article were from my own experience, as well as information found on UpToDate.
How to Cope With Loneliness While Solo Traveling

How to Cope With Loneliness While Solo Traveling

Reading Time: 7 minutes

Anyone who says they have never been lonely while solo traveling is lying or they just don’t need that type of human connection. It can be hard to push those internal boundaries and make those connection with people in other countries, because somehow we still have that Highschool feeling of ‘needing to fit in’. So here are a few ways that I have found help me connect with others while I’m traveling and avoid that looming loneliness that seems to haunt me personally.

How to cope with loneliness while solo traveling
Making friends with Omar in Cascades de Akchour in Morocco

Have a Plan

When you are traveling, have a plan in mind of where you would like to go – things you would like to see. While some people like to just let the wind direct their travels, having a plan gives you foresight so that you can invite other people to join you.

This hasn’t always worked for me, but it has allowed me to start a conversation with people that may not know anything about the location or activity you plan on seeing/doing.

The other part of this step, is that if you have a plan laid out – even if you can’t find a temporary travel buddy; your schedule will be full and you won’t have time to worry about being lonely.

How to cope with loneliness while solo traveling
Young man passing out doughnuts to tourists in Austin – just to have a conversation

Connect through Tours or Viz Eats

I have grown to love Airbnb experiences! The activities they have are typically done by locals, who are a lot more affordable. They know all the back alleys and shortcuts to the best places in town, and are far more relaxed about timing and sharing their knowledge. They will also know where the locals’ hangout, where the best bars or places to meet people are which is another way to get an authentic experience while at your travel destination.

How to cope with loneliness while solo traveling
This girl tied my headscarf for me, I talked to her for awhile about her life, bought one of her necklaces and she followed me around all day giving me ideas on pictures I could take. Even dusted me off. Making friends abroad isn’t hard, you just have to be open to it.

VizEats is another one I am going to be trying soon. I thought this idea was so spectacular! This app lets you pick a time and date to have a traditional dinner with a local! Some of the hosts will teach you how to cook, and have other travelers willing and wanting to connect in the same group. The only downside is, the host has to approve your attendence. The first time I tried, I mentioned I had a camera and wanted to film the experience and I don’t think it was appreciated. So keep that in mind, but what an amazing experience to be able to ask how life is like, where the best places to go are, and where to get produce for the meal (and all subsequent meals). Really excited to see if I can try this for my next trip.

How to cope with loneliness while solo traveling
Started taking photos of the guy taking photos of me, and even though we didn’t speak the language – it was the small human interaction of being able to put a smile on his face that put a smile on mine.

Sit down and Observe –

It makes others feel uncomfortable when someone is sitting at a table alone in a crowded place. Observe the space around you, imagine the lives of those you observe. Eventually someone will make eye contact and give you a empathetic smile, and that will be your ‘in’ for a conversation with them. I have made so many friends by just being confident enough to sit alone.

Sometimes we feel lonely, or sad, and want to have or feel that human connection but don’t really feel like carrying on a conversation. Just going and doing some people watching in a public space is a great way to do this. You might even have a kindred spirit sit next to you and have a leisurely conversation. The possibilities are endless if you just take the time, to take your time while traveling.

Be prepared to put your plan aside

This is something I struggle with, but have started to set aside one day of my travel to do what the locals recommend – to go to that place my tour guide recommended. When I was in Amsterdam in November for my Birthday, I was so bummed out because the weather was so terrible it was going to be difficult to walk around the city and not destroy my camera gear from the rain.

How to cope with loneliness while solo traveling
Walking through a labyrinth of sand in at Face-rock wayside beach in Oregon – called Circles in the Sand is an activity dedicated to bringing people together to have a meditative experience. One of the best happy accidents I have come across in my travels.

I Googled ‘things to see in the Netherlands’ and Castle De Haar popped up on my feed in one of those small picture boxes. It was about a 45 minute bus ride through the country, and walking onto the castle grounds made me feel like I was walking into a Fairytale. If I had not left enough time to explore options in Amsterdam while there, I would have never seen this fascinating place. So my tip to you, is to take your time, and be prepared to set aside your intricate plans to take one day where you can be a spontaneous explorer to the unique destinations suggested to you by Google or the locals. Trust me, you won’t be bored, and won’t regret it.

How to cope with loneliness while solo traveling
Friends I made while sailing in Seattle for the first time

Try a new activity

I was told I was too fat to go Scuba Diving, but I have the type of personality that if someone tells me what my limitations are- I have to blow that blockade to smitherines. So I got my certification for Scuba diving, and made some wonderful friends along the way. I also found a tremendous amount of healing when I realized that diving helps people with PTSD.

When I lived in Las Vegas, I had a thought of ‘it would be fun to go rock climbing’. So I bought a harness, and some rock climbing shoes and put the sticker from my climbing shoes on my bumper. A week later, I had a note left on my car from a girl (Bree) that was looking for a chill climbing partner and we became fast friends. I ended up going to Joshua Tree with her and Sheri Keller, who I will be visiting in Guatemala in a few months to do a video about how she has created a business there that helps children be able to go to school and not have to work. Bree also arranged for me to stay with her parents in Dallas when I moved there, and set me up with another dear friend Faryn (from Get Fit with Faryn).

How to cope with loneliness while solo traveling
My first ocean dive with my buddy James, I became fast friends with him and his wife Denise – lovely people, whom I would have never met had I not taken up diving.

By just trying one activity, I have made countless friends, found personal healing, and created this beautiful network of people from across the world. So when I tell you to go out and try something new, even if it is entirely uncomfortable – the rewards of having that type of courage to do so will come back ten-fold!

No Pity Party of One Here!

I hope these examples and suggestions give you a little peace when trying to go out into the world and not be afraid of traveling solo. Yes you will feel sad when you see beautiful things and don’t have friends from home to share those things with. Yet, when you truly see that there are people all over the world who might be just as lonely as you; it opens the door of being able to reach them and create friendships that will last a lifetime. Don’t have a pity part of one, have a party with anyone you meet! When you have self-confidence, a big smile, and mischevious eyes — the language of enthusiasm and joy can bridge any gap of awkwardness or cultural barriers.

If you have any suggestions on how to combat lonliness while solo traveling please leave them in the comments below.

Happy Travels, Happy Tales and see YOU on the flip side 😉

Top 15 ways of combatting Jet Lag

Reading Time: 7 minutes

Jet Lag is the bane of any travelers existence, with the affects stretching on for days sometimes weeks after a trip. There are a few proven (scientifically) ways to help with combating jet lag I will share with you. If you follow these suggestions, I guarantee that you will still be able to enjoy your vacation. Anytime I don’t follow my own rules with this, I end up regretting it for weeks on end.

What To Bring

Check out my packing tips post on what to bring with you on the plane. But for sleeping get a stuff sack, here is what to include in it: put your contacts/glasses, sleep aid, water bottle (filled inside the airport), eye mask, earplugs, pillow, and blanket. I like this J-pillow because my head always falls forward or to the side & when I bring the head wings (what I call them) out then it holds my head in place perfectly. Also, place a small bag at your feet so you can use it as a footrest, or if you have the room you can buy one of these footrests – but I found them to be hard to get into and out of.

Top 15 Ways of Combatting Jet Lag.

1- Avoid or Minimize Caffeine As Much As Possible

few days before your trip. If you need the energy to be able to make it through the workday prior to your trip; try Natural Energy Supplements from an Organic store or health foods store. This method alone will significantly help with combatting jet lag.

2- Choose An Overnight Flight

Overnight flights typically turn all the lights off on the plane at night which makes it easier to fall asleep. I wear my eye mask even if the lights are off because there is always one or two people that turn their reading lights on & wakes me up (#lightsleeper).

3- Choose a seat away from the bathrooms

Even with earplugs, the carts and bathroom visitors will wake you up. I also choose a window seat so I don’t inadvertently get hit by an elbow, a cart, or woken up by the person next to me to visit the restroom.

4- Bring a Treat for the Restless Children

Make sure to bring some candy, suckers, or freeze-dried fruit to give to children who wake up and start screaming. It saves the mom from embarrassment, the flight attendants stress (because of grouchy passengers) and helps everyone get back to sleep. I’m not a mom, but the few times I have done this, it works like a charm. One mom friend of mine actually suggested dried fruit, or crackers so it doesn’t give them a sugar high and make it worse. You can also have little packets of crayons or paper in your bag as well. As a passenger, you also have to remember that Benedryl for kids doesn’t always work….sometimes it has the opposite effect on the kid and then you have a crazy person.

Traveler Tip: Tips on Flying with Children and Family Friendly Airlines

5- Exercise Before Your Flight

Doing this before your flight gives you the natural relaxation of the muscles, keeps the blood pumping and staves off blood clots as well. The rule of thumb for my patients is I advise them to get up every hour to stretch their legs and do some calf raises for about 5-10 minutes. 

6- Wear compression stockings

These stockings can be found at any Walgreens, but the really good ones are the ones that you measure from your ankle to the knee and around the calf. I prefer the open toes because they seem cooler & don’t squish my toes if my legs start to swell slightly. When you sit down the blood vessels in your groin and behind your knees get cut off resulting in fluid retention in your feet and calves. It can set you up for a blood clot as well (no matter your age), unless you plan on walking every 30 minutes — which isn’t always possible because of the risk of running into turbulence. When I sit for long periods of time even at work the compression stockings save my life. You will be amazed at how much this helps your energy level by the time you reach your destination.                                                              

7- Utilize Jet Lag Rooster

This is an App to properly plan your sleeping times make sure you start this at least 2 days prior to your departure. This was developed by a psychologist in Florida.

8- Sleep When You Are Tired

Some flight attendants do suggest that you just sleep when you are tired, and try to stay awake when the sun is up. I find that this method works for me as well as just sleeping as much as possible when I’m on the plane.

9- Set Your Clock To The Destination

By setting your clock to the time of the destination it will help you keep doing your daily routine by the destination time zone. Thus circumventing hungry, tired, or other cycles.

10- Don’t Overeat or Drink Alcohol

Let’s be honest….unless you are flying some fancy airline in first class….airplane food is no better for you than hospital food. Try to stick with water and the healthier options when your flying as this will help fight off fatigue when you land. The body releases cortisol when it is stressed and can cause fatigue feelings when traveling. Eating healthy will boost your natural defenses, provide ample water to flush out the Cortisol and nutrients to help keep the energy needed to explore up as well. 

11- Don’t Go Straight To Bed On Arrival

Decide on a tourist-y site with lots of people. Preferably interactive sites, this will force yourself to stimulate your mind and your legs and blood flow. I typically pick the most popular museum, then get an audio guide so I don’t have to concentrate on reading & wander through all the spaces.

12- Keep Your Routine You Have At Home

Once you have toured a little, have dinner at the typical time for your destination, go take a shower/check-in at the hotel. Watch a movie, and then fall to sleep a little bit early — or lay there until its time to sleep (whichever works). I typically don’t do much the first day I’m at my international destination. It really helps to keep the first day easy, it allows my mind to accept that I’m on vacation and that it is ok to relax and not constantly look at my to-do list. 

13- Over The Counter Sleep Aids

When I am traveling back home, that’s when the JetLag is really bad. I will typically take an over the counter sleep aid (Melatonin, 5-HTP, or if you aren’t on any blood thinners then consider St John’s Wort or Valerian Root) — Don’t combine all of these sleep aids, just take the recommended dose for ONE these herbal supplements. I typically will buy my supplements from an Organic Food store and look for one that has some sort of certification on it. Typically supplements and herbs are not FDA regulated, so that means you typically don’t know what you’re going to be putting in your body. I take the sleep aid the minute I get on my longest flight (so if I have a transfer or something, I’m not too groggy).

  • I would not suggest getting any of these with Magnesium if you take more magnesium than your body requires it can actually cause some pretty gnarly diarrhea (a known side effect of oral Magnesium).

14- When You Get Home

Immediately unpack your suitcase, I typically will take a 30-minute nap to tide me over until my usual pre-vacation bedtime. The key here is, to sleep when you’re tired, but if it is during normal wakeful hours– limit it to 20-30min naps.

15 – What To Do When You Wake Up In The Middle of the Night

If you wake up in the middle of the night when you get home, I will look at a few social media sites, watch a YouTube Video on Classical Music or Yo-yo Ma & let that help me fall back asleep. Please realize if you do use your phone it can stimulate your frontal cortex and make you feel more awake, but for me, reading always puts me to sleep no matter what it is. So whatever typically makes you feel sleepy, do that and then try going back to bed….warm milk and Turkey also works if I’m desperate.

Happy Travels — Happy Tales — and good luck sleeping 😉


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