Safety redundancy, plans.

[49ereric]

As a healthcare provider who works in cardiology, I would not recommend a stress tests for anyone who is asymptomatic. It is a 10 to 15 minute conversation to comprehensively explain why, and I don't feel like writing it up currently and besides if someone is worried they should really have a conversation with their provider about it anyway.

The short answer is that we hurt more people than we help with asymptomatic testing and there is no way to know if you will be someone we hurt or help before hand as our crystal balls don't work any better than anyone else's.

As a side note, I have patients who continue to hunt and/or live in remote areas of Alaska, the surest way to die is to stop living and people who stay active do better.

Calcium scan first

 

[7mm-08]

Tracking always on is the safest bet, but the fastest at eating batteries. Having it on and not tracking, still lets them "ping" the device and saves battery life. Having the device off is the worse bet; that's the way I was using it for a couple of years

If you have buddies a field, they can ping your device (or vice versa0 to get a location- w/ the device(s) on. Can also be used to find a lost device (if on).

I am thankful to the knowledgeable folks on this forum every time I read something like this. I never knew this and will be leaving my inReach mini "on" but not in the tracking mode from now into the future. I, too, have historically left the device off until a prearranged time I contacted my wife every night. Thank you for this great (and potentially lifesaving) tip, mtwarden.

 

[Marbles]

Calcium scan first

Really depends. A coronary calcium score is good for guiding recommendations regarding a daily low dose aspirin and target LDL levels. It however only sees calcium and will miss non-calcified plaques and it is not a test for ischemia.

Generally higher calcium scores are associated with higher risk, though this breaks down in ultra endurance athletes. Insurance usually does not cover a calcium score, so someone must be willing to spend about $300.

 

[49ereric]

Really depends. A coronary calcium score is good for guiding recommendations regarding a daily low dose aspirin and target LDL levels. It however only sees calcium and will miss non-calcified plaques and it is not a test for ischemia.

Generally higher calcium scores are associated with higher risk, though this breaks down in ultra endurance athletes. Insurance usually does not cover a calcium score, so someone must be willing to spend about $300.

$100 here

 

[49ereric]

$100 here

Calcium scans can show you are possibly in need of a stress test.
most doctors can’t order a stress test without cause So a calcium scan can be used as cause.
even then doctors won’t do anything unless the blockage is 70% or more.
Carotid arterial ultrasound is another good test.

 

[Macintosh]

Some semi-incoherent rambling on the topic: Many of the tips in this thread are great and dont involve extra "stuff", which I appreciate. I do like to plan ahead and I do appreciate redundancy where it makes sense. Especially if multiple people are carrying stuff it makes perfect sense to coordinate enough to allow redundancy. Where it's easy, lightweight, etc there is no "cost" to redundancy. At the same time, I also see people who bring 2 of everything for redundancy's sake, and in my eyes redundancy to address extremely low-odds problems with a hypothetical situation that is a low-odds occurence in the first place (i.e. the backup for your backup for when something goes wrong or a backup item that could otherwise be improvised in the unlikely event the primary is broken, etc) causes as many problems as it addresses. Easy examples, if I'm traveling with one other person I generally dont bring 2 stoves (ie a stove and a spare) to cook on, but I will almost certainly want both of us to have a way to start a fire or the stove, and I can generally tear down and rebuild my stove if needed. Depending on forecast and what we're doing I may bring a spare pair of gloves and a second insulating hat, but I am not going to bring a second rain jacket. At the same time I'd never, ever head into the mountains for more than a few hundred yards without an insulating layer and rain gear, even in the desert, having been party to more than one unplanned bivy and more than one un-forecasted thunderstorm. These may be (?) obvious, yet I see people carrying multiples on some items that seem like "a bit much" to me, while not bringing things at all that I consider "must have's". That's for them to decide, I wont stop anyone, but after a lot of cumulative time in the backcountry all over the US and around the world over the past 50 years, I also see additional safety in the mobility that comes from being unencumbered with a carefully-dialed kit that addresses 99% of the situations I might run into that can realistically be addressed, while accepting some risk for the 1% of situations that, while it is possible it's so unlikely as to be considered a one-in-a-million fluke or an act of God. To me, paring down a kit in some places and beefing it up where you feel the need for redundancy is a balance that has to be learned and is also situational. If I had 50 miles of bushwacking in coastal alaska planned, that backup rain gear might make sense. Before LED headlamps we used to bring extra bulbs in addition to extra batteries--now I'm down to just extra batteries. The first trip I did in interior Alaska, GPS tech wasnt readily available for civilian use so we were navigating by map and compass using USGS quads from the 1950's that were horrendously out of date due to the river we were on having shifted considerably during that time. Cell phones didnt exist yet and sat phones were stupid expensive, so we had no way to contact anyone under any circumstances for several weeks and that wasnt an issue becasue that's just how it was; now, it's easy to stay located and in touch with a few ounces of tech so we freak out and make contingencies to avoid being out of touch, and I guess it's so easy now that it makes sense to do that. I've also now watched multiple helcopter rescues and been first on scene for a climbing fall that required a helicopter rescue. When I was traveling to Switzerland for work I maintained a REGA membership so I could get a rescue if needed, becasue it was such an easy option that more or less doesnt (or didnt) exist where I recreate outside here in the US. Times change, my tolerance for risk and what I worry about does too I guess, although I still worry more about managing my own shitshow than I do about contacting help. I guess I should probably get an inreach since it's so easy at this point.

Also, spare snacks. When TSHTF you want backup snacks, trust me. As an old pro at this I like to keep a bag of Dots pretzels in my truck at all times. When SWMBO (She Who Must Be Obeyed) gets hangry, you, the zip code you're in, mother nature and all of humanity will thank you for your forethought. Swedish fish work too in a pinch. (a snickers bar in your oh-shit-kit can be a happy-maker)

 

[7mm-08]

Some semi-incoherent rambling on the topic: Many of the tips in this thread are great and dont involve extra "stuff", which I appreciate. I do like to plan ahead and I do appreciate redundancy where it makes sense. Especially if multiple people are carrying stuff it makes perfect sense to coordinate enough to allow redundancy. Where it's easy, lightweight, etc there is no "cost" to redundancy. At the same time, I also see people who bring 2 of everything for redundancy's sake, and in my eyes redundancy to address extremely low-odds problems with a hypothetical situation that is a low-odds occurence in the first place (i.e. the backup for your backup for when something goes wrong or a backup item that could otherwise be improvised in the unlikely event the primary is broken, etc) causes as many problems as it addresses. Easy examples, if I'm traveling with one other person I generally dont bring 2 stoves (ie a stove and a spare) to cook on, but I will almost certainly want both of us to have a way to start a fire or the stove, and I can generally tear down and rebuild my stove if needed. Depending on forecast and what we're doing I may bring a spare pair of gloves and a second insulating hat, but I am not going to bring a second rain jacket. At the same time I'd never, ever head into the mountains for more than a few hundred yards without an insulating layer and rain gear, even in the desert, having been party to more than one unplanned bivy and more than one un-forecasted thunderstorm. These may be (?) obvious, yet I see people carrying multiples on some items that seem like "a bit much" to me, while not bringing things at all that I consider "must have's". That's for them to decide, I wont stop anyone, but after a lot of cumulative time in the backcountry all over the US and around the world over the past 50 years, I also see additional safety in the mobility that comes from being unencumbered with a carefully-dialed kit that addresses 99% of the situations I might run into that can realistically be addressed, while accepting some risk for the 1% of situations that, while it is possible it's so unlikely as to be considered a one-in-a-million fluke or an act of God. To me, paring down a kit in some places and beefing it up where you feel the need for redundancy is a balance that has to be learned and is also situational. If I had 50 miles of bushwacking in coastal alaska planned, that backup rain gear might make sense. Before LED headlamps we used to bring extra bulbs in addition to extra batteries--now I'm down to just extra batteries. The first trip I did in interior Alaska, GPS tech wasnt readily available for civilian use so we were navigating by map and compass using USGS quads from the 1950's that were horrendously out of date due to the river we were on having shifted considerably during that time. Cell phones didnt exist yet and sat phones were stupid expensive, so we had no way to contact anyone under any circumstances for several weeks and that wasnt an issue becasue that's just how it was; now, it's easy to stay located and in touch with a few ounces of tech so we freak out and make contingencies to avoid being out of touch, and I guess it's so easy now that it makes sense to do that. I've also now watched multiple helcopter rescues and been first on scene for a climbing fall that required a helicopter rescue. When I was traveling to Switzerland for work I maintained a REGA membership so I could get a rescue if needed, becasue it was such an easy option that more or less doesnt (or didnt) exist where I recreate outside here in the US. Times change, my tolerance for risk and what I worry about does too I guess, although I still worry more about managing my own shitshow than I do about contacting help. I guess I should probably get an inreach since it's so easy at this point.

Also, spare snacks. When TSHTF you want backup snacks, trust me. As an old pro at this I like to keep a bag of Dots pretzels in my truck at all times. When SWMBO (She Who Must Be Obeyed) gets hangry, you, the zip code you're in, mother nature and all of humanity will thank you for your forethought. Swedish fish work too in a pinch. (a snickers bar in your oh-shit-kit can be a happy-maker)

Love your writing style and your sage thoughts.

 

[Dos Perros]

A little tip on the InReach: if you leave it on, when you mistakenly drop it you can get to cell coverage and ping it from the website and get GPS coordinates of it's location and then go back and pick it up.