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Family Medicine and Dermatology

Family Doctors are well qualified to diagnose children, teens and adults and then, in most cases, treat them or direct them to the appropriate, definitive care. Often, when dealing with skin related issues, people think they need to go directly to a Dermatologist. However, your Primary Care Provider (PCP) such as your Family Doctor can diagnose and treat many of these concerns. You can be assured your PCP has received training to diagnose and treat acne, eczema, pre-cancerous lesions, cancerous lesions, rashes, moles and warts.

Our skin is our interface with the world and the barrier to infection.  A very important organ.

Patients, especially teens, do not like the pain and frustration that comes with acne breakouts, particularly on the face.  PCPs are trained to treat acne with conventional creams, including benzyl peroxide, Retin-A, antibiotics and keratolytics.  But their training doesn’t stop there.  If the acne doesn’t respond to conventional treatments, a PCP can also prescribe Accutane for the hard to treat and scarring type of Acne.  There is no need to leave the comfortable confines of your PCP’s office to receive this type of treatment.

The dry climate of our desert atmosphere makes eczema more severe.  If over the counter creams do not solve the problem, PCPs have the knowledge to prescribe steroid creams that will keep this irritating rash in check.  There is no need to see a dermatologist for this very common problem.

Sun damaged skin is also a concern that can lead to actinic keratosis, a pre-cancerous lesion that needs to be treated with liquid nitrogen or other skin creams.  A PCP has also received training in shaving off moles, doing a punch biopsy or excising lesions that need to be looked at by a pathologist to see if they are cancerous.

Now if a cancer is diagnosed from a biopsy, your PCP can either excise the cancer, thereby curing the disease, or refer to the proper surgeon to complete the treatment.  But, the diagnosis of cancer can always be made at your local office.

Many viruses or allergens will cause rashes.  Your PCP treats infection.  And will usually be able to identify the rash and provide treatment.  However, if the disease is an exotic disease of has unusual presentations, your doctor will know where to refer you for a consultation to establish the diagnosis.

The wart virus produces visible, irritating lesions that most people do not want to deal with for a long period.  PCPs have the equipment and materials to treat warts in the office, including liquid nitrogen, duct tape advice and DNCB treatment for hard to cure warts.  There is no need to travel to have your warts treated.

The skin is a vital organ.  It needs to treated with respect so it can continue to protect us from the environment and diseases.  Let your PCP help you keep your skin healthy.

Prep for Trek and other outdoor adventures…for leaders, parents & youth

Whether you are excited about your outdoor adventure or dreading it, preparation will help make this a more positive experience. Having the proper gear, knowing how to avoid health complications and a great attitude are vital to making this a memorable and enhancing experience.  Here are a few health highlights that will help as you plan your adventure!

1. SHOES:

Don’t count on your old comfy shoes to be good enough.  They may be too worn down, even if they don’t appear to “look old” from the outside.

Even though these shoes look “okay”, take a look at the tread on the bottom. 

You can see the wear on the soles. 

This means the cushions and support on the inside have also been well worn.

Good shoes for this type of excursion include:

a. A firm sole is more suitable for rocks and uneven surfaces. Avoid lightweight and flexible soles that bend easily.

Firm sole option best.

This is a great running shoe but not great for Trek.

b. A wide base of support creates less chance of twisting an ankle or getting rocks down in your shoes. Consider higher shoes/boots for weak ankles or rougher terrain.

c. Make sure there is adequate room in the toe box to lessen the chance of rubbing on the sides of your feet or jamming the toes into the end of the shoe, especially when going downhill.

d. Choose an appropriate upper covering. Engineered mesh uppers are great for running and water events but allow sand and dirt into the shoe, potentially causing irritation and skin problems on the feet.

The thin, porous upper on the shoe on the left allow too much dirt and sand to enter the shoe.

e. If new shoes were purchased, PLEASE WEAR THEM before going on TREK to break them in! It’s best to go on actual hikes (ideally 30 to 40 miles) or break in your shoes on uneven surfaces (rocks or slopes, rather than a smooth road or paved river trail) since this is more likely to simulate the TREK terrain.  (Most higher quality brands that sell running shoes, for example, offer a 30-day return or exchange because they recognize that it takes more than 3 to 5 miles to evaluate if the shoes are a good fit for your feet.)

f. Keen, Columbia and Merrell are good brands.

g. Bring 2 to 3 pairs of shoes and waterproof them!

2. SOCKS:

a. Avoid 100% cotton.

b. Two thin layers are acceptable (liner sock made of synthetic materials or knee-high nylon with a thin wool sock on top) or a polyblend sock will lessen the chance of friction and blisters.

c. “SmartWool” is a good brand. These socks will cost a little more but the comfort and protection are very beneficial.

d. Be aware of wet conditions. Wet socks and shoes increase the risk of friction and skin breakdown.  Consider bringing bread bags or small garbage bags along to wear over socks and under shoes to keep feet dry.

e. Be sure to have an adequate number of socks!

3. FEET:

a. Trim toenails two to three days before TREK. This way they can grow out a little if they are accidentally clipped too short.

b. Ideally, feet should be inspected a couple of months before going on TREK for any conditions that need to be addressed before hiking (ie. warts, tinea (infections), ingrown toenails, inflammatory conditions, etc.) Check feet again the weekend before TREK to be aware of any problematic spots.

4. CLOTHING:

a. Dress in moisture-wicking layers. It may be very cold at night so multiple layers, ie: T-shirt or Under Armour cold gear, a pullover, thicker flannel shirt, raincoat, and larger jacket, etc.

b. Avoid going to bed wearing the clothes that you wore in the day. They are likely to be wet and cold.

c. Be prepared for abrupt weather changes and potentially severe weather.

d. Try on clothing now, so adjustments that need to be made, can be made (taking in or out, hemming a seam up or letting it down, etc.) Try not to worry about like clothing.  Of course, it is going to be different from what we are accustomed to wearing!

e. Remember to bring some kind of leather gloves for pulling the handcart (to prevent slivers.)

f. CHAFFING

  • Consider wearing a sports bra or proper underwear to provide adequate support and prevent excess skin rubbing and irritation.
  • Use some kind of anti-chaffing product if needed where skin rubs together (examples are not limited to, but include: Body Glide, Gold Bond Powder, Monkey Butt, etc.)
  • Underclothing, such as yoga pants, compression shorts, Under Armour tights, athletic leggings, hiking pants, etc. may be helpful in preventing chaffing.

5. SLEEPING:

a. Cold-rated sleeping bag. (A six-pound fill is rated for zero degree weather while a three-pound fill is good for 60 degrees.) An additional thin liner or fleece blanket inside the sleeping bag will add extra warmth.  (A fleece liner is also easy to launder.)   A small pillow, adequate pad for cushion and tarp to layer on the bottom are important.  The general rule of thumb in keeping warm at night is to have twice as much bedding under you as compared to on top of you.  If you are concerned about being cold, a rip-stop nylon poncho thrown on top of these layers will retain more heat.  FYI, there are no government regulations to control manufacturer’s claims on sleeping bag warmth ratings.  Expect 10 to 20 degrees less than stated by the manufacturer. (If a bag is rated for 40 degrees, you may only be comfortable in it when the temperature is actually 50 degrees.) Some good sleeping cushion brands include (but are not limited to) Big Agnes and thinner Klymit pads.

b. Change underclothing at bedtime, when the temperature is warmer vs. in the morning.

c. Avoid sleeping with your nose and mouth under the sleeping bag. The breathing contains a great deal of moisture and that may cause dampness to collect in the bag.

d. A hat, liner and wool gloves, warm wool socks, Long Johns and instant hot packs may also be helpful.

Look for sales and coupons.  There are numerous products online and

local sporting goods stores that will carry these supplies.  

(ie:  REI, backcountry.com, North Face, Recreation Outlet in AF)

6. HYDRATION:

a. Adequate hydration is essential for a safe TREK experience. Hydration doesn’t mean drinking lots of water at the end of a long, hot day of walking, however.  Two to 3 days before TREK, all participants should be hydrating adequately.  Cross country runners have learned one of the keys to optimal performance is drinking water two to three days before a race. Without adequate fluid in the body, the body cannot cool down well or mobilize the necessary nutrients and electrolytes needed by the muscles.  Feeling thirsty or having a moderate to strong yellow color at any point during the days before TREK means that more fluids are needed.

b. Be aware of the early symptoms of dehydration. They include headache, dizziness, fatigue, muscle cramps, pale face, and cool, clammy skin, nausea, etc.  Address hydration issues NOW!  It is much better to take care of minor complaints and conditions before they become major ones!

c. Higher elevations require more water for several reasons.

  • Typically it is cooler in higher elevations and cooler air holds less moisture.
  • Higher altitude also means lower air pressure. This results in more rapid evaporation of moisture from the skin surface and from your lungs.
  • As the body acclimates to the higher altitude, urination is more frequent.
  • Because higher altitudes contain lower oxygen levels, the body compensates by breathing faster and increasing the heart rate. There is more water lost with rapid breathing.

At 6000 feet above sea level, you exhale and perspire twice as much moisture as you do at sea level.

Over the course of a day, that is a lot of water and can make a difference of a quart or more a day.

At higher altitudes, it gets even more pronounced.

d. The general guideline while trekking is 32 ounces of water every hour. To give an example… One red Solo cup holds about 16 ounces.  If you walk for about 8 hours in a day, this means about 16 Solo cups in 8 hours of walking or 2 gallons in a day (which doesn’t include the other 16 hours in a day!)  Even if participants are not pulling a handcart or don’t “feel thirsty”, drinking is a MUST!  If a person is severely dehydrated, the stomach cannot absorb fluid quickly enough to compensate, therefore PREVENTION is key!

7. HYGIENE:

a. On some TREKs or if backpacking in the outdoors, all the water available to each group must be hauled in, therefore, excess water for bathing may not be available. Wet wipes are a suitable option.  Some youth and women are prone to bladder infections if hygiene or hydration is not adequate.  Skin irritation may also be a problem. If these are repetitive problems, a visit to a health care provider before TREK can help give women the education or medication they need in order to avoid and treat these concerns.

b. If you are prone to razor burn, a rash or folliculitis with shaving, shave 3 days before TREK to avoid painful conditions or infection.

8. MEDICAL CONDITIONS:

a. Any chronic or high-risk condition should be addressed with a health care provider before going on TREK. It should be specifically brought up that the individual may be required to walk up to 10 miles per day in potentially hot or cooler conditions.  It will not be a paved pathway, like our beautiful River Trail!

b. Individuals should verify adequate amounts of medication for the TREK. Most health care providers will have same-day appointments or give a refill until an appointment can be made. If medication is taken on a regular basis, this is not the time to stop.

c. A health care team will be made aware of medications and conditions of all who are going on TREK but please talk to the person in charge of medical needs for any specific concerns.

d. The Medical Team on TREK will probably be trekking with the youth and touch bases with individuals and families throughout the event. The Medical Team is usually clearly identified.  They will be mindful of evaluating hydration and “hot spots” on feet, as well as other potential physical or health-related problems.

e. Usually, each Ma & Pa will have a simple first aid kit. They will help with youth who need to take medications daily and have the Medical Team support and backup available.  First Aid Kit suggestions to each family are….antiseptic wipes, moleskin, bandaids, antibiotic ointment, hand wipes, scissors, tweezers, baby powder/Gold Bond, feminine products, sunscreen, bug repellant (40% DEET), duct tape, safety pins, and sanitizer, lip balm, burn ointment, anti-chaffing stick, anti-itch cream, garbage bags, basic sewing kit.

The most common health conditions that occur are dependent on the location, climate, altitude, duration of the experience, preparation, etc.  Frequently, blisters, sunburn, excessive winds or temperature extremes and mosquitoes are problematic.

Preparation is the key! (physical & mental)

When trekking, you shouldn’t be “aware” of a specific spot on your foot.  If you notice a “hot spot” or a place that you are continually aware of, follow this treatment:

  • Clean foot with a wet wipe and allow to air out and dry.
  • Apply Nexcare Absolute Waterproof tape to the area affected.

If there is an actual fluid-filled blister, follow this treatment:

  • Clean foot with a wet wipe and allow to air out and dry.
  • Puncture the side of the blister with a sterile needle and gently milk the fluid out.
  • Apply 2 layers of NuSkin or liquid band-aid, allowing it to dry thoroughly after each application.
  • Apply Nexcare Absolute Waterproof tape to the area affected.

Attitude is Everything!

* This is meant to supplement the specific information you will be given from those who have organized your specific TREK.

Canyon-View_Provider-Haley-PLEDGER
providers
Haley Pledger, PA
801-465-2559
Women’s Care
page
Matthew Walton, DO
Canyon-View_Provider-Austin_BILLS
providers
Austin Bills, DO
801-798-7301
Family Medicine
Canyon-View_Provider-Aaron-FAUSETT
providers
Aaron Fausett, PA
801-465-9820
Family Medicine
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