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Thursday, October 8, 2015

Tankwa Camino done and dusted!

Tankwa Camino done and dusted! It was quite a challenge -  being compared by some to Kamp Staaldraad, a notorious bootcamp for the Springboks before the 2003 Rugby World Cup and said to be worse than being in the army. A challenge worthy of any wannabee endurance athlete! 

However, do not be fooled by many of the participants' grey hair and/or lack of a sixpack into thinking that it will be a walk-over! They all have wills of steel - or is it just plain stubbornness?
It is one tough mother of a hike! Ignore those cosy fireside camp scenes on Facebook and in the magazines! The camps (often by the roadside) are generally dusty, cold at night, the ground hard and the creepy crawlies many! As for the toilets - very, very basic, usually backlit by the setting sun and embarrassingly close to the tents - except for the nights one had to cross the R355 gravel road to get to them. Washing is done with only 5 liters of warm water in the late afternoon.
In the daytime a variable number of toilets were set up along the route. I could never work out their spacing. At any rate they were never there when I needed one, which seemed to be very often, as I was making sure that I was staying hydrated - especially after one participant had to withdraw on day two due to anuria (an inability to urinate).  There is also a good chance that you will suffer from diarrhoea a few days into the race as blood is diverted from your digestive system to your muscles. On that note, if after reading this, you still insist on going, take lots of toilet paper along! Leave your sense of shame behind. The Tankwa has kilometers of nothing but small rocks and occasional very low bushes. Squatting amongst the bushes not only offers scant privacy, but also exposes you to tick infestation. You either have to be very fast, or build a shelter out of rocks - but then you risk disturbing a snake or scorpion!

Also look out for rodent (gerbil?) holes in the ground when you sit down to rest. Cover the openings with flat stones so snakes do not crawl out while you are resting quietly. Remember to remove the stones before you leave, just in case the holes are inhabited by gerbils. Remember to leave some of your food to apologize for shutting their door. Examine yourself thoroughly for ticks after sitting down and again in the late afternoon after pitching your tent and washing in your allotted 5 liters of warm water. Remember that when you hide your bum in a bush when "going to the toilet" you are giving ticks direct access. By day three you will be thoroughly bored by the snacks and lightweight packaged foods you brought along and you won't be very hungry anyway. The evening meals at camp are quite tasty and you will make up for not eating during the day. Bedtime is just after supper - giving the large  meal you just ate no time to digest and leading to heartburn. Do not forget the antacids. Also take anti-inflammatory drugs (Dr's prescription) and paracetamol or similar. You will need them. If you take them, you will need to drink even more water to protect your kidneys and liver. (Do not overdose on drugs, tempting as it may be!) Some form of sleeping tablet will also be useful, as aching feet and muscles as well as fluttering tents and snoring participants will keep you awake all night otherwise. You will use meters of elastoplast. Take several rolls and then pack 3 more. The only person I know of who came off blister free, did everything they advise against. She did not walk much beforehand, bought brand new hiking shoes the week before, as well as new socks. She did not wash her socks beforehand. You, however, SHALL get blisters, even if you never had a single one before!

How to prepare? Marathon athletes and speed walkers as well as veterans of many, many long distance hikes suffered from blisters and in general. I averaged about 3 blisters a day, until I covered my  feet entirely in elastoplast by the end of day 3! I still managed to get a couple after that. I am losing a toenail and a second one looks like it may be on the way out! I think the repetive motion on the endless relatively level terrain leads to blister formation. The heat and swollen feet aggravate matters. I stopped every two hours and examined my feet and would find new blisters which had developed since the previous stop.

Weather in the daytime will vary from hot and sunny and dusty, to cold and windy and dusty, to cold and wet and muddy. Nights are very cold. Make sure you have enough warm clothing and bedding. Air mattresses are good until they spring a leak. The last three nights I had to get up every two to three hours to blow up my mattress which had deflated.

The R355 traversing theTankwa is notorious for causing flat tyres. Perhaps that is why most people in their big SUV's try and drive through it as fast as possible, throwing dust and stones at you as they roar past at breakneck speeds. In the afternoons, the cooled air rolling off the high peaks of the Cederberg in the west causes strong winds as it rushes to fill the void created as the hot air rises off the baking Karoo earth. Only after the earth has cooled in the evenings, does the wind  and the dust settle.

You will be bored often. Everyone will always walk faster or slower than you. Unless you have a dedicated companion who will stay by your side no matter what, you will be alone a lot. The road is endless and the scenery often monotonous. On day 4 I woke up tired. My blisters were many and my muscles were sore and stiff and progress was slow. Eventually all the other hikers had passed me and had moved on out of sight. For a while I enjoyed the solitude.Then I realized that I had not seen another human being or a support vehicle for over two and a half hours!

When I finally reached camp, I objected to being left for the predators. For the rest of the walk, the support vehicle would accompany the last walker (usually me) all the way in. This was a mixed blessing as I now felt guilty about needing a rest and found it impossible to use a low bush when nature called.

Why did I complete every step of the way when I had the option to ride with the support vehicle when necessary? There were a several reasons. My grandson sent me a recorded whatsapp message saying "Ouma, I hope you win." I replied that it was not a race but that finishing was winning. For a while this kept me going. Ego and sheer stubbornness played a role, for sure. There was a stage when I thought that teaching the grandchildren that sometimes it is OK to realise that something you started was a really bad idea and that bailing out is a sensible option, is also a valuable lesson. Then I thought of how my finishing would empower my children. Every time a grandchild whines about not wanting to walk somewhere close by, they could say to them: "but your grandmother walked 260 km through blazing sun and freezing rain across the Tankwa at the age of 66!"

The last few days I kept walking through my pain because I wanted to leave no stone unturned or business unfinished, lest I decided to come back again and finish what I had started another time!

Now that it is all over, and bumping my toes against my down duvet at night still hurts, I do feel a great sense of achievement. I made terrific friends. I enjoyed the social evenings and chats along the road. The Tankwa has a certain fascination, magnificent sunsets, lovely flowers and fascinating rocks. I feel fitter than I have done for a long time. The organizers and support team are lovely, real people.
And I really appreciate my bed, my shower, the roof over my head, my good health, and most of all, my grandchildren. May this act of madness be an inspiration to them!

Long live the Tankwa Endurance Camino!
Is this what happens to hikers who do not make it?

Starting point at the giant post box in Calvinia.
At the start  of the R355
Shade! 

Road side toilet
The hikers are still enthusiastic!
Some need their first break


"Murder Most Foul" by Paul Kihn

Years ago my old friend Paul Kihn, gave me his manuscripts shortly before he passed away. He was a great poet. His poems are relevant to the times he lived in.

Murder Most Foul. 20/9/1948

High on Golgota's hill,
Crowned with thorns,
The Prince of Peace
Pierced with nails to a cross,
Was lifted high,
And the heavens were riven,
And darkness fell.

Now,
This other son of peace,
Bernadotte, to whom death came
Dastardly and with shame
Lies dead
In the city of peace.

But unleash no sword
Nor let any banners of battle
Be unfurled.
For the guilt and the blame
Lie heavily on the world.From Wikipedia, the free encyclopedia
Folke Bernadotte
Folke-Bernadotte.jpg
Born2 January 1895
StockholmSweden
Died17 September 1948 (aged 53)
West Jerusalem, de facto Israel
Resting placeNorthern CemeterySolna
TitleCount of Wisborg
Spouse(s)Estelle Romaine Manville
(1928–1948) (his death)
ChildrenGustaf Eduard Bernadotte of Wisborg
Count Folke Bernadotte of Wisborg
Fredrik Oscar Bernadotte of Wisborg
Count Bertil Oscar Bernadotte of Wisborg
Parent(s)Prince Oscar Bernadotte, Count of Wisborg
Ebba Munck af Fulkila
Folke BernadotteCount of Wisborg (SwedishGreve af Wisborg; 2 January 1895 – 17 September 1948) was a Swedish diplomat and nobleman. During World War II he negotiated the release of about 31,000 prisoners from German concentration camps including 450 Danish Jews from the Theresienstadt camp. They were released on 14 April 1945.[1][2][3] In 1945, he received a German surrender offer from Heinrich Himmler, though the offer was ultimately rejected.
After the war, Bernadotte was unanimously chosen to be the United Nations Security Council mediator in theArab–Israeli conflict of 1947–1948. He was assassinated in Jerusalem in 1948 by the militant Zionist group Lehiwhile pursuing his official duties. The decision to assassinate him had been made by Natan Yellin-MorYisrael Eldad, and Yitzhak Shamir, who later became Prime Minister of Israel. Upon his death, Ralph Bunche took up his work at the UN, but was removed from the post around six months after Bernadotte was assassinated, at the critical period of recognition of the fledgling state.





Tuesday, September 1, 2015

Protocol for DKA

This is not my own work. It was written down by a vet at an emergency centre where I did a locum.
I always struggle to get my head around the correct approach to stabilise a newly diagnosed diabetic with (or without) DKA, so will find this most useful. This protocol is used for a symptomatic DKA dog.

Maintain hydration
Keep on top of changes in electrolytes
Aim to get BG between 10 to 15 mmol/L and keep it there

INSULIN admin:
Aim to drop BG approx 3 mmol/L per hour to prevent cerebral oedema.
Insulin type = regular rapid acting insulin - usually 100 IU/ml. NB use correct insulin syringe!
Initial dose = 0.2 IU/kg IM
Then every hour: take BG and inject 0.1 IU/kg IM ongoing until BG is between 10 and 15.

Once this happens - change fluids to
0.45% saline with 5% dextrose
Change IM injections to every 4-6 hours
alter depending on what you need.

Ensure well hydrated at all times
Continue until eating and drinking with no vomiting
Only then change to twice daily dosing with intermediate acting insulin. 

Other option is CRI

Piggy back insulin fluids into the maintenance fluids using a separate infusion pump and allow 50 ml to run through the tube before attaching as insulin binds to plastic.

Dose is 2.2 IU/kg/day or regular insulin for dogs and 1.1 IU/kg/day for cats.

Add to 0.9% saline.
Rate @ 10ml/hr
BG monitoring every 1 - 2 hours.
Need other fluid as well to maintain hydration.

Once BG is between 10 to 15: change main fluid to 0.45% saline with glucose 2.5% and run insulin drip at 7ml/hr,
Once BG drops below 10, drop rate to 5ml/hr.
If BG drops below 5, change to 5% glucose and stop insulin infusion.



Saturday, August 29, 2015

Tankwa Camino

In only 25 days, I start the Tankwa Camino. It is a 256 km hike through the Tankwa Karoo. It takes place over 10 days, starting at Calvinia and ending at Ceres. I fear that I am not nearly fit enough. I "wasted" 10 days of walking time while doing a locum in Ceres recently. I belong to an informal walking group that does a fairly tough hike with lots of hill climbs three times a week. We usually do about 3 to 5 km per walk at a fairly fast pace. I have been walking regularly for several months, but have only done one full day hike. The Camino takes place over mostly flat terrain on a rough gravel road and one does it at one's own pace, so I am hoping that I can do it. The organisers require a letter from a doctor if one is over 65. My doctor issued one. I also had a rabies and tetanus vaccine this week - not for the walk, but because I was bitten by a Pit Bull while doing the locum! It reminded me that I had not had any boosters for a very long time.

I am sure I am cardiovascularly fit enough. What concerns me is whether my joints - especially my knees - will stand up to the long distances day after day. I have stocked up on anti-inflammatories and glucosamine. Now to remember to take the latter regularly!

Tomorrow I am doing a locum in Cape Town, so no hiking. However, from Monday onwards I have to start increasing my daily distances. It is difficult to walk alone because the environment is not safe for a single woman. I walk round and round my neighbourhood, but it does get very boring! I considered joining a gym about 20 km from here, but they insist that I join for a year, and I really do not enjoy working out in a gym, so am not likely to use it once the walk is over. The September issue of Getaway magazine has an article about the walk - written by a young lady who did the walk with minimal preparation. She did however use state of the art everything which will cost a fortune to buy! I trust my old clothes which do not wick, vent or UV protect, will get me through. I did splurge on a Oztrail Eco swift pitch tent. Struggling with fiddly poles on my own after a long day does not appeal. I watched a few videos on folding it up again. That does look a bit tricky, but I am sure once one has the hang of it, it should be easy.

My shoes are well used, though I did buy one pair of light walking shoes a size bigger than normal as advised. Apparently one's feet swell on such a long walk. The other problem many people strugggle with, is blister formation. I will go prepared, but in my younger days when I hiked long distances in the mountians, I rarely had blisters, so I am hoping that this will once again be the case. I am taking a pair of sandals along too, just in case.

One advantage of the regular walking, and not eating any sugar, is that I have lost a few kg. I am hoping to lose a little more before the start of the walk. I am unsure what food and snacks to take with me. The organizers provide supper and some fruit daily, but walkers must provide all other meals and snacks.

I will update this blog post as the time goes on. Hopefully I will be able to report that I completed it successfully.

Sunday, August 2, 2015

Ten-Ten se eerste vlug.

Ten Ten se eerste vlug.
Ongeveer 1998
So bykans twee dekades gelede, toe ek die ouderdom van 40 nader, het ek begin voel my lewe is verby. Daar was ‘n gewaarwording van ongedane sake en onverwesentlike drome en ‘n leeftyd wat sommerso iewers tussen babadoeke en finansiele oorlewing verbygesnel het.
Toe word ek veertig en kom agter dit voel nie veel anders as 35 nie, solank ek net nie te stip in die spieel kyk nie. My lewe was jou waarlik nie verby nie! Daar was egter ‘n besef van dringendheid. As ek van die onverwesentlike drome wou verwesentlik sou ek moes begin werk maak daarvan.
Toe leer ek vlieg! Wat ‘n bevryding! Nie net van die aarde nie. Ook van die ouderdom. Dit laat mens besef hoe relatief alles is as mens ‘n nuwe vaardigheid aanleer en boonop jou eie vrees herhaaldelik moet oorwin. As gevolg  van al die adrenalien het ek glad 3 kg verloor in die eerste paar weke.
Nou kon ek vlieg!  So kom dit eendag dat ek besluit om van Gaborone na Jwaneng te vlieg om ‘n kliniek daar te gaan doen en ook ‘n halfmak siek volstruis op ‘n wildplaas te gaan vang en behandel. Vroeg die oggend ontmoet ek my helper Ten-Ten Ikwathaeng, agterkleinseun van Koning Khama se toordokter, by die praktyk. Hy staan slaggereed – medisyne klaar gepak, pylgeweer vir die volstruis gereed vir in geval,  maar wat onmiddelik opval is sy kleredrag! Sy blink gepoleerde skoene weerkaats die oggendson en sy hempkraag se punte staan wyd soos die das styf om sy nek geknoop is. Hy het tot ‘n baadjie aan en op sy bors pryk vir die eerste keer sedert ek hom ken ‘n ZCC wapen.  Ek wonder nou nog of hy bloot gedink het hy moet goed lyk vir sy eerste vlug en of hy gereed gemaak het om sy maker te ontmoet.
Toe ek by ons terugkeer na ‘n suksesvolle dag van honde dokter en volstruis vang vir hom vra “hoe was die vlug?”, was sy enigste kommentaar “Interessant”.


Saturday, July 25, 2015

Peestersiekte

Tuesday, June 9, 2015