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Traveler’s Diarrhea: The Basics

This is a guest post by Dr. Erik McLaughlin.

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Traveler’s Diarrhea: The Basics

Known around the world by many names including “Montezuma’s revenge,” “Delhi belly” and “mummy tummy,” traveler’s diarrhea (TD) is the most common illness faced by travelers. Nothing can slow down a fun trip as easily as TD — and it can also have serious health implications. TD typically lasts four to six days, and 90 percent of cases occur within the first two weeks of travel.

Anatomy You Need to Know

The gastrointestinal tract starts at the mouth and ends at the anus. After food enters the mouth, it passes through the esophagus to the stomach, where it sits for approximately 45 minutes. After being broken down by gastric secretions, food matter enters the small intestine (duodenum, jejunum, and ileum in order). The small intestine is the site where most nutrients are absorbed by the body. From the small intestine, food matter begins to look more like feces as it progresses to the large intestine or colon. The colon absorbs water from the food material before the material passes through the anus and exits the body as feces.

Symptoms

Recognizing the warning signs of TD, such as blood in the stool, fever, or abdominal cramping, can help a savvy traveler know when to seek medical help.

TD has many definitions; the presence of three or more loose-formed stools in one day is a good one. Abdominal cramping, nausea, vomiting and fever may also occur. The presence of blood in the stool can indicate that infection has directly damaged the intestinal wall and should be taken seriously. Read more »

This post, Traveler’s Diarrhea: The Basics, was originally published on Healthine.com by Paul Auerbach, M.D..

Book Review: Heading Outdoors Eventually Leads Within

Heading Outdoors Eventually Leads Within” is a small book written by Kathy and Craig Copeland and published through their company, HikingCamping.com. Here’s a summary from the website:

Everyone walks. What distinguishes hikers is that walking does more than transport us, it transforms us. But nowhere is the thoughtful undercurrent of hiking celebrated. The wisdom we glean from the wilds is a match lit in the rain. That’s why we created this book: to cup our hands around the flame. These journal entries are the mental waypoints we recorded while hiking 30,000 miles / 48,280 km (more than the circumference of the Earth) through wildlands worldwide. Accompanying them are photos of the places (primarily the Canadian Rockies, Utah canyon country, and New Zealand) where we conceived and noted the initial ideas. We hope our words and images compel you to recognize, voice, own and honour the thoughts arising from within while heading outdoors. Doing so will deepen your fulfillment. A truly adventurous life is contemplative as well as vigourous.

It is important for me to state at the outset that my opinions, like those expressed in most book reviews, are highly personal. What I write about “Heading Outdoors Eventually Leads Within” are my impressions, and you may not agree with them. I am beginning with this comment because I truly had mixed feelings about the book. There were parts that seemed right on target, for me personally, and parts that seemed to miss the mark. I am certain that the authors have great pride in their work, and they are to be congratulated for their efforts. Read more »

This post, Book Review: Heading Outdoors Eventually Leads Within, was originally published on Healthine.com by Paul Auerbach, M.D..

Leaving Haiti: Small Child – A Triple Amputee – Offers MD A Cracker With His Remaining Hand

We found out today that we are going to ship out tomorrow. My feelings are certainly mixed. There is an incredible amount of work to be done here – we have only contributed to the first wave of what is necessary. This may sound strange, but I cannot remember the details of much of what we did the first three days, when we were functioning on hyperdrive in a battlefield setting. My recollections become detailed after the third day, when we were able to see only four or five patients at a time, and we stopped triaging amputees to the operating room.

Now the hospital has been substantially augmented. Teams of foreign (to Haiti) surgeons have left to go home, because the operations to be performed now are largely orthopedic and plastic surgery, as well as specialty cases. Sadly, there are scores of patients with spinal fractures who are paralyzed, and little can be done for them this far out from the initial injury. Children continue to break our hearts. I had a small child who is a triple amputee offer me his cracker with his remaining hand. One can only pray that the memories he carries of this tragedy are erased swiftly, that he is assisted in his rehabilitation, and that his life improves. All of these will, of course, be hard to achieve. Read more »

This post, Leaving Haiti: Small Child – A Triple Amputee – Offers MD A Cracker With His Remaining Hand, was originally published on Healthine.com by Paul Auerbach, M.D..

Audio: What Is Needed Most In Haiti Now? Live Report From Hospital In Port Au Prince

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Dr. Paul Auerbach And Injured Haitian Boy

Dr. Paul Auerbach is the author of the definitive textbook on Wilderness Medicine. Though he’s spent his entire emergency medicine career teaching others how to survive in the wild, even that didn’t fully prepare him for the extraordinary devastation in Haiti. He’d never seen anything like it. He hopes he never does again.

In an exclusive Skype interview with Better Health, Paul describes what it was like “on the ground” during the first week of the disaster. He goes on to explain (in part 2 below) what the current critical needs are, and which organizations and websites volunteers should go to in order to contribute in a coordinated fashion.

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Dr. Val: Do you need supplies?

Dr. Auerbach: We have lots of medications, vaccines, and small supplies. What we need most is a large autoclave to sterilize used OR equipment. Read more »

Live Reporting From Haiti: Dr. Paul Auerbach Calls Dr. Val Via Skype

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Paul Auerbach, MD (far right)

In this extraordinary first-hand account, Dr. Paul Auerbach (he is now the head administrator for NGOs at Port Au Prince’s largest hospital) describes what he has seen on the ground since his arrival one week ago.

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“The floor was covered with bodies. Some were dead, some were alive, some were screaming… There were rows of children with missing limbs… The smell of dead bodies was coming out of the old nursing quarters where the peers of the women helping us lay dead… The Haitian people are the strongest people I’ve ever seen.”

Read more »

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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