Rider Health Risks in the Tevis Cup Ride
"There's a rider throwing up on the side of the trail about halfway up. Says he's terribly dizzy. He's not looking too good," the sweaty rider reported as his horse drank at the trough at the top of the hill. The infamous climb to Devil's Thumb had taken its toll on another rider. Deb and I started down to see if we could help.
He was staggering broad-based up the trail, leading a tired horse. His face was gray, his mouth drawn. He'd been sick since he left Dusty Corners, couldn't keep anything down. He was dizzy and light headed. And, oh, by the way, he was diabetic. With the complicated electrolyte shifts that can occur with diabetes, I shuddered at the stress he was putting on his heart and nervous system. When I finally got him to lie down, he refused to sip Gatorade because it would elevate his blood sugar. No amount of explaining that he needed the fluid and the electrolytes and the body would burn the sugar with the work he was doing could convince him he needed to rehydrate. He didn't die but he could have, from a heart arrhythmia or hyponatremia (low sodium). Or from stupidity and stubbornness.
Several years before, at the finish line, word came through on the radio that a rider had passed out and fallen off her horse at White Oak Flat. She was complaining that she couldn't see. She didn't volunteer that she was taking a new antihistamine for allergies. If I hadn't known her and asked the right questions, she might have taken a very expensive ambulance trip to Auburn.
Both of these stories are true and are good examples of how the extremes of the Tevis Cup Ride can create serious health problems for the the rider as well as the horse. It's a testimony to the ruggedness of Tevis riders and our unbelievably good luck that no one has ever killed himself riding the Tevis. Heaven knows, it's not because they haven't tried. Before someone does, it might be wise to implement some rider safety measures that could go a long way toward preventing such a disaster.
Here's how you can help:
First, show up at the starting line in the best physical shape possible. If your horse goes lame a quarter mile out of the Lyon Ridge trot-by, can you walk the 10 miles (at 7000 feet elevation) to Red Star Ridge where he can be trailered out? You may not notice the altitude of the high country when you are riding: You certainly will if you have to get off and lead a lame horse.
Second, do as much heat training as you can. We haven't had a really hot Tevis in five or six years, so we're due. If the temperatures go into the triple digits in the canyons, will you be prepared? The only way to prepare for heat is to ride in the heat. Remember, you can lose 4 quarts an hour sweating in that kind of heat. Will you have enough water bottles, camel packs, canteens to keep yourself hydrated? Dehydration can make you weak, dizzy, nauseated, and it can impair your judgment. Be sure you drink a sports drink that has some electrolytes. If you drink straight water, your sodium will plummet and you may risk fatal hyponatremia. How well I remember a veteran ultrarunner in front of me at the 1988 Western States Run who collapsed at Dusty Corners and had a grand mal seizure. A helicopter ride later, his sodium at Auburn Faith Hospital was 106 (normal is 130), barely compatible with life. Practice drinking often in the heat.
Be very careful to check with your family doctor to see if any of your routine medications might affect your heat tolerance. Some medications decrease your ability to sweat, especially some antihistamines that might be taken for allergies, or motion sickness medications that might be taken to prevent the motion sickness that some riders encounter riding at night. I vividly remember an outstanding high school runner who suffered heat stroke in a hometown 10 K run because he was taking an antihistamine for a cold. Get the patient information leaflet that comes with every prescription medication you take and read it. If it's unclear, consult your pharmacist.
Make certain that you eat early and often as you ride the Tevis. Practice that as well on long, hard, hot training rides. Find foods that give you sustained energy and that won't be terminally boring or barfy in the middle of a hot afternoon in the canyons. Remember to keep eating after dark: The weakness and confusion that some riders experience in the long night ride into Auburn is from hypoglycemia (low blood sugar).
Make certain that your clothing will not chafe you raw and miserable in the 24 hours it may take you to complete the Tevis. Buy a stick of Body Glide from Longriders Gear and butter your butt with it. And maybe butter your inner thighs, knees, and nipples while you're at it. After seventy thousand rises to the trot you may be glad you did.
Take a three-by-five card and write on it your emergency medical information: Name, address, emergency contact during the ride, blood type, major medical problems, drug allergies, and all medications. Keep that card in the same baggie where you have your vet card in case SOS Riders or emergency medical personnel need information on you in a hurry.
And because you are so well prepared, you will have none of the potential problems that could sideline you during the ride. You won't be among the poor unfortunate riders who get lifted off their horse at Michigan Bluff because they can't go on. What a tragic irony: Plenty of horse but no rider. And you won't need that emergency medical information. You can trade that three-by-five card in for a buckle on Sunday afternoon.
Be prepared. Be smart. Be safe.
Jeff Herten, MD