With the exception of, “There’s an app for that!”, it seems like one of the most often suggested solutions to any of today’s most pressing problems is, “There’s a pill for that!” Hiking the John Muir Trial is no exception.
Keeping in mind that I am NOT a qualified medical professional, here are some common remedies, and some information you may want to consider.
1. Altitude Sickness Prevention. The most commonly prescribed drug to prevent altitude sickness is acetazolamide. Typically, your doctor will suggest you begin taking this medication a day or two before you start your hike and continue it for a few days into your hike. The effect of the treatment is to acidify your blood which causes an increase in respiration. My personal experience with acetazolamide (also known as Diamox) is that the tingling I get in my hands is significant and unpleasant. I vastly prefer a strategy of acclimating before my hike begins in order to avoid having to take it. You, on the other hand, may find that works great. (My wife, Kathleen, for example, has had excellent experiences with Diamox.) Alternatives, each of which should be taken only after consulting with a physician, include dexamethasone and nifedipine. More on this topic here.
2. Antihistamines. If you have allergy problems it’s best to talk to your doctor regarding what antihistamines you should carry with you. For some with serious sensitivities, an Epipen may be appropriate. Remember, on the trail you are a long way from the nearest clinic. One side-effect of many antihistamines is drowsiness, which can be an effective way to help you combat the insomnia which is common during the first few nights in the woods.
3. Caffeine. If you are in the habit of consuming caffeine each morning the last thing you want to do is to go cold turkey the first few days on the trail. I was talking to a surgeon a few years ago who told me that the drugs she gave patients after surgery were strong enough to deal with the pain of a sizable incision, but were insufficient to alleviate the headache from caffeine withdrawal. She said her “prescription” in those cases was to give the patient a diet Coke. Your best approach is to try to estimate how many milligrams of caffeine you normally consume and then replicate that on the trail. Pills are not your only alternative, although they are probably the lightest. There are a number of concentrates one can squirt into a water bottle.
4. Ibuprofen. I suspect that ibuprofen (or another NSAID) is the most consumed drug on the JMT. I have found it to be an extremely effective pain reliever and it’s also excellent as an anti-inflammatory. That said, care should be taken when taking this over-the-counter medication. I suggest a talk with your doctor about how much is too much, not just per day, but number of consecutive days. One problem with this drug is that it is so effective that it can mask symptoms of injuries, particularly those occurring in joints. No one is going to do a John Muir Trail thru-hike without some aches and pains, but the last thing you want to do is seriously injure yourself—without even noticing it—because you are masking the pain with ibuprofen. More on the dangers of overuse here.
Another drug one often sees on the John Muir Trail is alcohol. More about that in a later post.
Good hiking, Ray