Travel Reference
In-Depth Information
ministration of enough fluids to significantly increase urinary output helps prevent this
complication.
Occasionally, strenuous exercise alone results in hemoglobinuria or myoglobinuria.
(Myoglobin is a protein similar to hemoglobin that originates in muscle and also can be
released by crushing injuries.) Such disorders can also cause acute renal failure but usually
disappearwithrest.Generousfluidintakemustbemaintainedtoreducethechancesofren-
al failure.
Thepigmentfromsomefoodsordyes,particularlybeets,occasionallyimpartsareddish
color to urine. However, the individual can usually remember the ingestion of these sub-
stances, and the pigment disappears from the urine within a few hours or days. Hemo-
globinuria that is not associated with renal failure requires no therapy other than a high
fluid intake.
FEMALE GENITAL PROBLEMS
Although gynecologic problems are common and widely variable, few appear so rapidly
thattheycreateproblemsonawildernessouting.(Ectopicpregnancy,whichwouldusually
cause serious problems, is discussed in
Chapter 20: Acute Abdominal Pain
.) An examin-
ation by a physician before departure should disclose any potential disorders and permit
their correction before the outing is underway.
Two problems that could occur are dysmenorrhea and abnormal bleeding.
Dysmenorrhea
Dysmenorrhea means “painful menstruation.” The pain is caused by many different ab-
normalities, including a wrongly positioned uterus and passage of blood clots. Most wo-
menwithdysmenorrheahavehaditmostoftheirpostpubertallives,andencounteringitfor
the first time on a wilderness outing would be most unusual. Exercise often relieves dys-
menorrhea.
The pain typically is cramping, may be disabling, although it usually is less severe, and
usuallyisworsethefirstdayortwoofmenstrualperiods.Mildormoderateanalgesicsusu-
ally mask the pain. Prostaglandin antagonists such as ibuprofen are most effective.
Diminished physical activity may be of some benefit. Women bothered with this prob-
lem—they are numerous—have usually learned to deal with it long before it could create
problems in a wilderness situation.
Abnormal Uterine Bleeding
Abnormaluterinebleedingcantaketheformofexcessive bleedingwithmenstrual peri-
ods, bleeding between periods, or both. Although numerous disorders can produce such
bleeding, commonly no cause can be identified, particularly in perimenopausal women.
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