Race doctors speak: Dr Suvash Dawadi & Dr Beth McElroy

In green, Dr Pranav. In blue, Seth Wolpin. This short tale is set at the stunning location of Hinang Monastery. Seth was getting a fast start to be ahead getting on to the narrow trail through the forest. The start happened in the monastery grounds – such a beautiful place – and everybody was super excited. He followed leader Phudorjee Lamasherpa sprinting away through the monastery gate. The gates are built so that the locals – on average of shorter height – have to bend to get through them. Seth is nearly 180cm/5’10” tall, and was wearing a peaked cap. In the rush of the starting pack, he hit his head on the frame of the door, hard, at running pace. Wow.

It’s at time’s like this that you’re glad you’ve an excellent doctor and $400 first aid kit with you. Seth was stitched up within the hour and after the wooziness had settled down, walked on to complete the day. And he was very brave, and didn’t cry at all. Swore like crazy as the stitches went in, but no tears.

Manaslu accident

Stemming the bleeding

Manaslu accident

Temporary surgery in the monastery dining hall

Manaslu accident

Preparation for stiching

Manaslu accident

Excellent kneebend.

This year we have two doctors. Dr Pranav last year was on his toes most of the time treating minor matters and checking on wellbeing. He suggested two people might be better.

This year we have Dr Beth McElroy and Dr Suvash Dawadi with us. You can call him DAWA he says. Dr Beth McElroy has enormous experience of expedition medicine, and Dr Suvash is still studying, one day training to be a GP in a remote place in Nepal in order to help his country. He’s very excited to come along and learn as much as he can from the experience.

We met last week to check through the first aid rucksack and I asked him a few questions written out below.

dr-suvash-dawadi-nepal-expedition-doctor

Dr Suvash, aka Dawa, checking through the medicines in the extensive first aid kit.

  1. Where are you from? Where do you work, and what is your specialisation?

    I am Suvash Dawadi, from the terai (plains) of Nepal. My friends call me DAWA. I work in Tribhuwan University Teaching Hospital and currently am training to be a General Practitioner. I also have successfully completed the Diploma in Mountain Medicine and a one day Basic Life Support/ Advance Cardiac Life Support training here in Nepal.
  2. Why are you looking forward to the Manaslu Trail Race this year?

    I have a great interest in trekking and travelling in the Himalayas. I plan on pursuing an expedition medicine fellowship later on in my career. The Manaslu region itself is one that I have dreamed about visiting ever since my late father told me about his travels to the base camp and over the Larkya La.He told me the culture and nature both are unparalleled. I am looking forward to being part of this race and am very happy to put what I have learnt in the Diploma in Mountain Medicine to good use.
  3. For you as medical experts, what is going to be the biggest challenge?

    There are plenty of challenges regarding the practice of medicine in a remote environment, let alone a race. The sheer number of people to take care of, the wilderness environment, the altitude and the multitude of problems that can arise within a limited resource setting are some challenges. Keeping up with the race so that medical assistance is as early as possible is another challenge. Also dealing with participants and teams from various walks of life, and various countries and culture will be a welcome challenge.
  4. What advice do you have for participants to keep healthy and strong?

    I think the biggest advice to the participants is simply to train properly before the race! During the race do not hesitate to point out even trivial symptoms rather than persisting despite them. Any problem if caught early is always easily manageable. Keep hydrated and nourished. And please avoid the use of medications without informing the medical team – this just keeps everything in order. Keep a very basic first aid kit, for small cuts, blisters, water purification and any medications you might be using regularly.
  5. Do you have anything else you’d like to share?

    Most important, enjoy the race!

Dr Beth McElroy is the second part of the team. She answers the same questions below!

1. Where are you from? Where do you work, and what is your specialisation?

My name is Beth McElroy I am a UK based Doctor currently working in
the Emergency Department in Cumbria. Part of my role is within the
Mountain Rescue Team where I continue to gain experience in
pre-hospital and emergency care. I completed my Diploma in Mountain
Medicine in Nepal in Spring 2014. This year I have worked as medic on
the London to Paris bike ride, on an expedition to the Calakmul
Jungle, Mexico and on a sucessful summit fo Mount Kilimanjaro.

 2. Why are you looking forward to the Manaslu Trail Race this year?

The Manaslu circuit is a beautiful part of Nepal and a road less
trodden by tourists. To be able to work in this environment is indeed
spectacular and to be able to support the elite-athletes involved is
very exciting.

3. For you as medical experts, what is going to be the biggest challenge?

As a Doctor trained in high altitude medicine I am prepared to deal
with a lot of altitude and cold related problems. Exertion at altitude
makes people particularly susceptible to altitude sickness and may
affect many people’s races if they are not adequately acclimatised.
Given the terrain I am also expecting to manage a number of
musculo-skeletal problems particularly with knees and ankles. Trips
and falls are therefore a worry but with the good medical kit we are
well equipt to deal with these problems in the remote setting of the
Manalsu range.

4. What advice do you have for participants to keep healthy and strong?

Hydration and nutrition is essential for a good race. Being dehydrated
can ruin an event for a participant so it is important to drink, drink
and drink. It is crucial to let the medical team know at the first
incidence of any diarrhoea and vomiting or signs of altitude sickness:
Headache, nausea, shortness of breath, tingling fingers or
difficulties sleeping.

Participants can help themselves by changing out of their wet clothes
and keeping warm at the end of each day, drinking as much as they can,
being sensible with footwear, clothing and eye protection throughout
the race. Essential items inculde personal medications, knee and ankle
supports of the appropriate size, supply of pain killers, plasters,
medicated talcum powder, rehydration sachets and Diamox
(acetazolamide).

 5. Do you have anything else you’d like to share?

For those choosing to use Diamox –  the tablet which helps with
acclimatisation without masking symtpoms of altitude sickness there is
an information sheet which can address your questions. Diamox information sheet 2014

Any questions you might have, please post below!