May 2, 2017

Preparation

Medical – 2010

In early February 2010 I went in to HealthPartners to again find out what vaccinations and medications were recommended for this upcoming African visit. This year I only had to have four shots and no prescriptions to fill – but I did receive 103 pages of printout – again giving me more information than I can or care to digest.

The four shots/immunizations were for seasonal influenza, rabies, hepatitis, and a Mantoux tuberculosis (TB) screening.  The influenza and rabies were prophylactic vaccinations.  I again received the Twinrix vaccine to counter the hepatitis A and hepatitis B viruses. Didn’t need to update vaccinations/inoculations against polio, typhoid, meningitis, yellow fervor, tetanus/diphtheria, and  MMR (measles, mumps, and rubella), as I was current on all of those.

I would have needed several prescriptions, but I received those medications last year and didn’t use them all.  The three prescriptions were Melfloquine, Cipro, and Acetazolamide. Melfloquine is a tablet taken weekly to prevent malaria.  Cipro, an antibiotic effective against a broad range of bacteria, is taken to help manage bad cases of diarrhea. Acetazolamide helps prevent altitude sickness (which I didn’t get last year at our highest point in Ethiopia).

Oh yeah, about that Melfloquine.  Take it once a week religiously!  I didn’t pay that close of attention to the exact day of the week I took it, and maybe was off by a day or two – and I paid a price.  Even though my ride in 2009 ended in Tanzania in late March, I was diagnosed with malaria in late July!  Surprised me, but now I know: take the Melfloquine religiously.  My treatment for malaria was 3 days with high doses of Malarone, which caused some intense but short lived side effects.  Hopefully the parasite is out of my system, and I have no reason to suspect it isn’t, because I have been healthy since the treatment.  There is a chance, however, that the type of malaria I had was a type resistant to Melfloquine.

In July, when I was getting a battery of tests prior to the diagnosis of malaria, they gave me a chest X-ray with the intent to verify no problems with the lungs.  The nurse called and told me the there was no problem with the lungs, then added ‘the fractures on the third and fifth right ribs look to be healing nicely’.  I must have fractured them in the fall.  Didn’t really notice it, in part because the arm captured most of my attention.

I suppose I should mention that the right arm which I broke last March is doing well.  I have virtually 100% motion with it.  The metal ‘plates and screws’ in the ulna don’t set off security alarms at airports.

Physical – 2010

How does one prepare for a long bike ride? Read the 2009 write-up below on how to establish a healthy and strong body.  After the fall in March 2009 it took a while for the arm to truly heal.  Foolishly, I did go on the Minnesota Ironman Bicycle Ride in late April with friends.  Had intended to ride the 100 mile route, but cold, rainy weather belted some sense into us, and instead we rode the 100 km route.  In early June I attempted to run in the FANS 24-hour run, but after 12 hours (and just over 60 miles) I quit because I was wet and cold and out of dry clothes to warm up with. (Plus I was tired.)  In early July I ran a 25 km trail run at hilly Afton State Park.  Buggered up my right knee (maybe aggravated and earlier problem from the TDA 2009 ride).  That forced me to take it easy during the summer months.  I had signed up for the Wisconsin Ironman in early September, but didn’t come into the event in all that good of shape (in part because the malaria in late July knocked me back some).  It was a beautiful day for the WI-IM, and I had a good time, but a slower time than the previous year.  In early October I ran the Twin Cities Marathon.  Again a beautiful day, and I had a respectable run.  Again buggered up the right knee shortly after that run and had to take it easy into the winter months.  Surprised myself with a good showing at the UofM indoor Tri-U-Mah triathlon in early February 2010.  Lately I have been primarily running, with some biking and some swimming – mostly all indoors because this was a good winter for snow and icy conditions in Minnesota.  Decided to be cautious and not cross-country ski much this winter, as I want to be healthy come March.  I am probably 6 to 8 pounds heavier than a year ago, but that extra weight will be gone by Malawi.

Bike – 2009 & 2010

In 2008 I purchased a ‘CrossCheck’ Surly bicycle from the Bicycle Chain in Roseville specifically for the TDA.  I was very happy with the bike in 2009 and plan to use it again in 2010.  The TDA2009 riders who had mountain-bike backgrounds really liked their bikes, but I liked the roll of this fixed-framed bike.  Well, at least on paved roads.  I paid a price on the corrugated, sandy, and rocky rough roads.  There were days when front fork suspension would have been very nice.

We put good component parts on the Surly:  not expensive light-weight stuff or cheap non-durable stuff, but solid components that would hold up and could be repaired if they failed.  In 2009 brought around 15 tubes and 8 tires (from 700 x 23c, x 28c, x 38 c to x 45c).  Went through all the tubes last year so I needed new tubes.  Really liked the Schwable tires.

This year prior to departing I had the Bicycle Chain guys put on ‘in-line’ breaks so that I wouldn’t have to ‘hang-out over the hoods’ for extended periods of time while trying to go slowly down mountainsides.  We’ll see if I like that addition…

I’ll try to add more bike specifics ‘soon’.

Medical – 2009

So in early December 2008 I went in to HealthPartners to find out what vaccinations and medications were recommended for this upcoming African visit. In less than an hour I had had five shots and three prescriptions to fill – plus a 107 page printout giving me more information than I can or care to digest.

The shots/immunizations were MMR, Twinrix, Polio, Typhoid and Menactra – meaning some new vocabulary for me. MMR is for Measles, Mumps, and Rubella – all viruses. Twinrix is a vaccine to counter the hepatitis A and hepatitis B viruses. Polio is also a virus. Typhoid on the other hand is caused by bacteria called Salmonella typhi. Menactra is a vaccine against meningococcal disease, a bacterial illness that includes meningitis (the inflammation of the protective layer surrounding the brain and spinal cord) and septicemia (blood poisoning). [Isn’t this great stuff to know?] Three shots went in the left arm, two in the right. Certain shots hurt worse than others. Yes, the pain inflictor said with a smile, some vaccines cause more pain than others when injected.

I felt fortunate to have recently had the flu shot (to counter influenza), and that my yellow fervor and tetanus/diphtheria records were up to date – otherwise it would have meant three more pokes. Oh yeah, they were sort of low on the rabies vaccine and it is not always effective, so I didn’t advocate for getting that poke. Note to Paul: avoid animals foaming at the mouth.

The three prescriptions were Melfloquine, Cipro, and Acetazolamide. Melfloquine is a tablet taken weekly to prevent malaria, a mosquito-borne infectious disease caused by protozoan parasites. Cipro, an antibiotic effective against a broad range of bacteria, is taken to help manage bad cases of diarrhea. Acetazolamide helps prevent altitude sickness (recommended as we will be biking at elevations greater than 10,000 feet above sea level in Ethiopia).

Oh yes, I was told not to swim in stagnant freshwater lakes for fear of getting Schistosomiasis. Yup, been there – done that. I spent several days at the National Institutes of Health in Bethesda, MD in the early 1980s getting treated for that after my Peace Corps experience in Zaire (now the DRC).

I still have lots of other medical stuff to accumulate (Band-Aids, ointments, sunblock, gauze, mosquito repellants, hand sanitizers, wet wipes, ……………)

So, I do all this stuff to assist in keeping me healthy. I suspect the vast majority of Africans that I will see will never have had more than one or two (if any) vaccinations in their lifetime.

Physical – 2009

How does one prepare for a 7000 mile bike ride? Don’t look to me for advice on that. All I can say is what I have done. Don’t look to that for how it should be done.

I am shortly into the second half of my first century in life. In my youth I was active in sports like football, basketball and track. To the chagrin of my high school football coach I gravitated toward running – distance running. I spent a couple of years on the Moorhead State University cross country and track teams, but was never a stand out. In my college years I did run a marathon – the North Dakota Marathon – but there were runners who finished miles ahead of me. Over the years I didn’t do much running until about 8 years ago, when at 210 pounds I was getting to the point where my 8 and 10 year old kids were beginning to outrun me. That was the impetus for me to get back into better shape. I started out with the intent of finishing a sprint triathlon (1/4 mile swim, 14 mile bike, and a 3 mile jog) in my hometown of Fergus Falls, MN. My intent turned into an obsession of sorts.

In the past 5 years (prior to 2009) I have run 8 marathons (Boston in 2006; Grandma’s in 2004-2006; and Twin Cities in 2004-2008), 2 ultramarathons (FANS12&24 in 2006 and 2007: <http://www.fans24hour.org/>), and competed in 4 Ironman triathlons (Wisconsin in 2006 and 2008; Louisville in 2007 and 2008: http://ironman.com/). This past year (2008) I also participated in 10 runs as part of the Minnesota Distance Runners Association (MDRA) Grand Prix (http://www.needtorace.com/MDRA/) and 6 du- or triathlons as part of the Midwest Multisport Series (http://www.midwestmultisport.com/). I am not the fastest participant, but I have been persistent.

But I am going on a bike ride – so what has been my biking experience? It started early – as a young teenager I went with a group of adolescences (‘deCycles’) for a 3000 mile ride in the eastern US and Canada. That experience gave me confidence that one can travel a long way on a bicycle without killing themselves. Shortly after that my parents and siblings went to Europe and rode bikes for about 1000 miles as slow moving tourists. Great experience! Other longer rides I have taken in my youth were from New York to Minnesota; Minnesota to Colorado and Minnesota to Kansas; and Illinois to New York and Illinois to Minnesota (with my wife, as graduate students). So it has been a long time since I have spent numerous days on a bike. I think I will remember how to do it. Running is one foot in front of the other, biking is simply round and round – and they say the faster the better.

To summarize my training this past year (in 2008) it has been mostly running with some swimming and biking thrown in as well. I train 6 plus days a week – usually alone because that is the way I like it and it leaves me to my own daily schedule. Typically I train in the early morning, while the city sleeps. There is a beauty then. That 6 plus days a week has been year around for the past 4 years or so. The Minnesota winters don’t bother me – I tell people it is easier to run at 20F than 80F (except when it gets too slippery). We have a treadmill in the basement which I run on, and there is a treadmill, stationary bike and pool at the University of Minnesota St. Paul Recreation Center which I frequent. That reminds me to put a plug in for the Rec Center’s indoor triathlon (Tri-U-Mah!) – a well run event typically held in February. See <http://www.recsports.umn.edu/triumah/index.html>

My advice for running on a treadmill in one’s basement is to have a system worked out where you can hand wash and hang your clothes daily. An air exchanger in the basement was also a good investment.