Frozen Flesh: Understanding Frostbite

Frostbite has long been one of the most feared cold-weather injuries for mountaineers, backcountry skiers, and winter adventurers—often leading to permanent tissue loss or even amputation. In this episode, we explore how frostbite happens, how to prevent it in the outdoors, and what to do when it strikes far from help. We also highlight a breakthrough in treatment: the FDA’s recent approval of iloprost, the first medication specifically designed to save tissue and improve outcomes in severe frostbite. From backcountry prevention tips to cutting-edge hospital care, this conversation brings together wilderness safety and modern science to help outdoor athletes and medical providers better understand and manage frostbite.

As climate and ecological conditions shift across the United States, the geographic boundaries of several tick species are expanding—and with them comes growing confusion about the diseases they carry. In this episode, we explore the spread of the Lone Star tick (Amblyomma americanum) and the blacklegged tick (Ixodes scapularis), and how their overlapping ranges are complicating the diagnosis of tick-borne illnesses.One of the biggest challenges is distinguishing between Lyme disease and STARI (Southern Tick–Associated Rash Illness). Both conditions can present with a similar bull’s-eye rash and early flu-like symptoms, yet they are caused by different organisms and may require different approaches to diagnosis and treatment.Join us as we examine how shifting tick habitats, changing ecosystems, and evolving patterns of human exposure are reshaping what we thought we knew about tick-borne disease risk. 

In the backcountry, decisions matter.  And sometimes the only difference between a good outcome and a bad one is knowing when to stop, when to descend, and when to listen to what the body is telling you. In this podcast we talk about a small device that’s making its way into more packs, first-aid kits, and expedition gear — the pulse oximeter.  You’ve probably seen one in a hospital or clinic. But what does it really tell you when you’re miles from a trailhead, at altitude, in the cold, and far from help? In this episode, we break down how pulse oximeters actually work, how reliable they are in the wild, and how they should, and should not be used in real backcountry and wilderness medicine settings. Because in remote environments, technology doesn’t keep you safe - judgment does.

When we head outdoors, we think about weather, wildlife, terrain, and terrain — but we rarely think about what’s floating in the air, living in the soil, or hiding in the dust. In this episode, we explore the invisible world of environmental fungi — where they live, how people are exposed, the illnesses they can cause, and how simple awareness can dramaticall

Bats are an essential—and often misunderstood—part of the Grand Canyon ecosystem. In this episode, we explore the role bats play in the canyon, why they are so abundant along the Colorado River, and what that means for people camping overnight in one of America’s most iconic landscapes. We’ll discuss the real but often low-probability dangers associated with bats, including rabies exposure and accidental nighttime contact, and explain why sleeping in tents is one of the simplest and most effective ways to reduce risk while protecting wildlife. The episode also takes a closer look at white-nose syndrome, a devastating fungal disease threatening bat populations across North America, and how human behavior—from campsite choices to gear hygiene—can help limit its spread. Designed for river runners, backcountry travelers, and anyone curious about canyon wildlife, this podcast blends safety, conservation, and practical guidance for sharing the Grand Canyon responsibly after dark.

Shock can develop quickly in the backcountry, and recognizing it early can save a life. In this episode, we focus on how to identify shock with limited tools and how to tell the difference between its major types in remote settings. We break down cardiogenic, vasogenic, and hypovolemic shock using real-world backcountry scenarios, emphasizing observable signs, mental status changes, skin findings, and simple assessments you can perform in the field. The discussion highlights how understanding the type of shock can guide priorities such as bleeding control, positioning, insulation, and evacuation decisions when definitive care is hours—or days—away.

Dr. Kathy Vidlock explores how the human body responds when sport and movement take place in the most demanding environments on Earth—and why proper fueling can mean the difference between performance, illness, and survival. From endurance athletics to long days hiking at altitude or in extreme heat and cold, the body undergoes profound physiological changes affecting oxygen delivery, hydration, metabolism, thermoregulation, and energy availability. In this podcast, Dr Vidlock breaks down how these stresses alter appetite, digestion, and nutrient needs, and why eating the right foods at the right time becomes essential when conditions are unforgiving. By connecting human physiology with practical nutrition strategies, we’ll highlight how thoughtful fueling supports adaptation, sustains performance, and reduces risk when pushing physical limits in extreme environments.

In this episode, Dr. Richard Ingebretsen explores women’s health challenges in the backcountry, focusing on common conditions that can arise far from definitive medical care. We discuss menstrual-related conditions—including dysmenorrhea (painful menstruation), mittelschmerz (ovulation pain), urinary track infections and premenstrual syndrome (PMS)—with an emphasis on recognition, prevention, and field-appropriate management.This podcast is designed for those who are not as familiar with these issues and help them understand how to keep others stay safe, comfortable, and resilient while traveling in the wilderness.

Dr. Keely Coxon discusses a critical but under-discussed topic in acute care: blood glucose management in the hypothermic patient. In this episode, Dr. Coxon examines how hypothermia affects glucose metabolism and challenges conventional treatment protocols. Are the guidelines we rely on truly appropriate for patients in the cold? Dr. Coxon breaks down current protocols, highlights where they may fall short, and offers evidence-based insights and practical strategies to improve patient outcomes. This episode will equip you with the knowledge to rethink and refine your approach when temperature and glucose regulation collide. 

High altitude changes the rules of the game for the human body. As oxygen levels drop, systems we usually take for granted—our heart, lungs, metabolism, and immune response—are suddenly asked to work harder. For some people, that challenge is barely noticeable. For others, especially those living with chronic medical conditions, altitude can quietly turn a manageable illness into a serious problem.In this episode, Dr. Kathy Vidlock explores how high altitude can exacerbate a wide range of medical conditions—from common issues like high blood pressure to more complex diseases such as autoimmune disorders, coronary heart disease, diabetes, and chronic obstructive pulmonary disease. We’ll break down what actually happens inside the body at elevation, why certain conditions are more vulnerable to hypoxia, dehydration, and cold stress, and how symptoms can present differently in the mountains than they do at sea level.Whether you’re traveling to altitude, working in the backcountry, or caring for someone with a chronic medical condition, this episode will help you understand the risks, recognize early warning signs, and make informed decisions before small problems become emergencies.