TRTER 2019: Letter from Dr. Pasternak

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Dear Runners,

We’re excited to have you back out on the course for the 2019 Tahoe Rim Trail Endurance Races.  Once again we’ve put together an incredible medical team and will have full medical aid stations at the start/finish area, Tunnel Creek and Diamond Peak aid stations.  We will also have very limited over the counter medications at the aid stations without full medical support. We hope that we don’t have to see you in the medical tent.  If something should arise, our goal will be to do what we can to help you finish the race safely.

1.  We will not being doing any mandatory weight checks for any of the runners.   For 100 mile runners, we will check your baseline weight prior to the race. The medical aid stations will have scales, but we won’t use them unless medical issues arise.   THE KEY IS TO LISTEN TO YOUR BODY AND DRINK WHEN YOU ARE THIRSTY! As you may be aware, we are more concerned with over-hydration, weight gain and low sodium (hyponatremia) as this can be a life-threatening concern in ultra runners.   For a great review on this topic, please read Dr. Marty Hoffman’s article in Ultrarunner magazine.

2.  Speaking of helicopters, while it’s unlikely you will need a medical evacuation, things can and do happen during an endurance running race. With all of the health care changes, many people are on high-deductible plans that have fairly limited coverage.   You may want to check with your insurance on the cost of a medical rescue during a race. If you live in the area, you may want to consider Calstar’s policy for less than the cost of a new pair of shoes.

3.  While we have reviewed all of your medical history forms from when you registered, please contact us with medical issues or questions you want to discuss.  (e-mail, phone number 775.219.6535)  Again, our goal is to help you out and if you have specific concerns, we’d love to try and answer your questions.  

4. If you have had any new medical issues arise in the last few months since registration that you think we should know about, again, please let us know.

5. Our aid stations are pretty well stocked.  Remember, however, there can be long stretches of time and distance between aid stations.   If you have medical conditions that could be life threatening, remember to bring rescue medications with you (e.g. an epi-pen if you have a severe bee-sting allergy).  

6.  As a reminder, we don’t have any non-steroidal anti-inflammatory medications at the aid stations (ibuprofen, naproxen, etc.) due to worries about kidney damage and hyponatremia.  We will have Tylenol and some topical creams for aches and pains.

7.   More and more, we’re seeing companies that offer athletes IV hydration either before or after races.  DON’T WASTE YOUR MONEY ON THESE PLACES!!! These services are at best unnecessary and could potentially be harmful.   All of the current recommendations concur that if athletes can drink fluids, that is a much safer way to get fluids and that there is NO benefit to “elective” IV fluids.   As a result, we are VERY conservative about giving IVs. If you do get an IV during the race, you will be disqualified. Again, we don’t routinely give IV fluids at the finish as the current medical literature shows that oral rehydration is much safer than IV rehydration.   There are instances where IV rehydration may be necessary and if you feel like you might need an IV, please talk to one of the medical staff in the tent and they will evaluate you to see if you might benefit.

8. Take care of your feet.   The decomposed granite is good at getting in your shoes  I you want to read the best book on foot care for ultra runners, check out Jon Vonhof’s fixing your feet.

9. Remember, the medical staff are here to help you meet your goals, but we also want to make sure you do things safely.   Be honest and upfront if you are having issues and we’ll do what we can to help you.

Run Long and Healthy,

Andy Pasternak, MD, MS