RE: [pct-l] Backcountry Medicine

["Mayer, Jim" <JMayer@crt.xerox.com>]

There seems to be a bit of "all or nothing" thinking around carrying
medications in the backcountry.  The polarization is along the lines of
either "never treat yourself with antibiotics" vs. "self diagnosis and
treatment is just fine."

I carry antibiotics and codine with me.  They were prescribed by my MD, and
we discussed ahead of time why I wanted them and how I would use them.  I
don't carry a full course of treatment... why?  because if I am ever sick or
injured enough to need to take them, my first order plan is to get to a
doctor.  I carry the medications so that if I am really, really sick I have
a better chance of getting to professional help.

Here are some examples where I might take the stuff (I never have, by the
way):

(1) If I got a big, deep, dirty cut and couldn't hike out that day I might
start taking the antibiotics.

(2) If a cut became hot, tender, and red or I started seeing red streaks
moving out from an infected cut, I would probably start antibiotics and get
out as fast as I could.

(3) The codine might well make the difference between being able to get to
help and having to sit tight.  Since hiking with an injury can cause
additional damage this has to be a judgement call.  In many cases, it may be
better to sit and wait for help.

Anyway, in my opinion there is a big difference between starting a treatment
in an emergency when prompt medical care isn't available and "self diagnosis
and treatment" with no intention of seeking professional medical help.
Basically, if one is hiking in places where medical care could be a day or
more away, then I think carrying a couple of days supply of a broad spectrum
antibiotic is a reasonable thing to do.  On the other hand, everything I've
read suggests to me that if you are sick enough to want to take an
antibiotic, you really ought to see a doctor.  Not only might the antibiotic
you have be ineffective, but the drugs do have side effects and can
(personal experience here) make you quite sick.  I was acutely ill, and then
had lactose intolerance for months, after a round of antibiotics killed off
the helpful bacteria in my stomach.

-- Jim
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