The All Important Cardiovascular Drift

What happens when you spend days, weeks, or even months walking through some of the most demanding landscapes on earth?In this first conversation with Titus Humphreys, we explore the remarkable treks that have taken him far beyond the ordinary trail experience. Titus shares what draws him to long-distance journeys, what he has learned about endurance and the human body, and what it is really like to spend extended periods of time far from the comforts—and medical resources—of civilization.We also explore some of the medical experiences he has encountered along the way. What happens when your body begins to break down? How do you recognize when a problem is simply part of the challenge of a long trek and when it becomes a genuine medical emergency?Join us as Titus Humphreys takes us onto the trail—and shares the medical lessons he has learned along the way.

Why does your heart rate keep climbing during a long hike even though you’re walking at the same pace—or even slowing down?This phenomenon is called cardiovascular drift, and it is an important physiologic response to prolonged exercise. In this podcast, we explore what happens to the heart during a long hike as dehydration, heat, altitude, and fatigue begin to affect the cardiovascular system.The heart is a pump—but the pump has to fill before it can pump. Understanding venous return will help you become a safer and more knowledgeable wilderness traveler.

Most of us think of tick bites as a risk for Lyme disease. But ticks can transmit a surprising number of other infections—including a rare and potentially deadly virus known as Bourbon virus.First identified in Bourbon County, Kansas, in the United States in 2014, Bourbon virus is believed to be transmitted by ticks, particularly the lone star tick. It can cause fever, severe fatigue, headache, muscle and joint pain, rash, and abnormalities in the blood—including low white blood cells and low platelets.In this episode, we’ll explore where Bourbon virus is found, how the lone star tick may spread it, what the illness looks like, why diagnosis can be difficult, and what wilderness travelers can do to prevent infection.

At just 16 years old, Brock Holloway set out into the mountains expecting an adventure. Instead, he found himself in a life-threatening battle with two of the most dangerous forms of altitude illness: high-altitude cerebral edema (HACE) and high-altitude pulmonary edema (HAPE).In this gripping episode, Brock shares his experience of becoming seriously ill at altitude and the frightening progression of symptoms that nearly cost him his life. His story provides a firsthand look at how quickly altitude illness can escalate—and why recognizing the warning signs and acting decisively can make the difference between life and death.We explore what happens to the brain and lungs at high altitude, why young and otherwise healthy people can develop severe altitude illness, and the critical decisions that must be made when someone begins to deteriorate in the backcountry.Brock’s story is more than a story of survival. It is a powerful lesson in altitude awareness, early recognition, prevention, rapid descent, and wilderness medical decision-making.

Sunscreen technology is evolving rapidly, offering better protection, improved cosmetic feel, and a growing focus on environmental sustainability. In this episode, we explore the latest advances in sun protection, including next-generation UV filters such as Bemotrizinol (Tinosorb S), innovations in engineered zinc oxide, antioxidant-rich plant extracts, and ingredients that enhance water resistance and photostability. We’ll separate fact from marketing, discuss what “reef-safe” really means, and explain how these new technologies are helping outdoor enthusiasts stay better protected during long days in the sun. Whether you’re a hiker, climber, trail runner, or simply enjoy spending time outside, this episode will help you make informed choices about the next generation of sunscreens.

In this episode, our hosts Sophie Emery, Kaylee Stark, Noelle Lordahl, and Kate Persak explore how a nonprofit organization is transforming the lives of girls ages 11–17 through backpacking and other outdoor adventures. More than just learning outdoor skills, these experiences build confidence, leadership, responsibility, resilience, and lifelong friendships. We’ll discuss how spending time in nature supports mental health, encourages personal growth, and helps break down financial and social barriers so more young women can experience the outdoors. Join us as we discover how adventure in the wilderness inspires the next generation of confident, capable leaders.

Rabies remains one of the deadliest infections known to medicine, yet it is almost entirely preventable with prompt treatment. In this episode, Alastair Milne from the medical school in the University of Nicosia in Cyprus, explores how the virus is transmitted, and describes a practical scenario to understand how fatalities from this disease can be avoided.

Cuts and lacerations are among the most common injuries encountered in the backcountry, but in wilderness medicine the greatest threat often isn’t the wound itself—it’s infection. In this episode of the AWLS Wilderness Medicine Podcast, we explore why nearly every wilderness wound should be considered contaminated and why thorough irrigation and cleaning are often far more important than closing the skin. Through real-world wilderness cases, listeners will learn when wounds should be left open, why premature suturing can trap bacteria and lead to serious infections, and how proper wound care can make the difference between an uncomplicated recovery and a medical evacuation. Whether you’re a backpacker, climber, guide, first responder, or wilderness medicine provider, this episode offers practical, evidence-based principles for managing wounds safely when definitive medical care may be hours or days away.

Join mountain medicine expert Dr. Sebastián Donato for a fascinating discussion on the realities of altitude illness on Aconcagua, the highest mountain in Western and Southern Hemispheres.  Drawing from recent rescue operations and real patient cases, Dr. Donato explores the recognition, prevention, and treatment of acute mountain sickness (AMS), high-altitude pulmonary edema (HAPE), and high-altitude cerebral edema (HACE). Through dramatic stories of climbers who required emergency evacuations, listeners will gain valuable insights into the challenges faced by rescuers and medical teams operating in one of the world’s most demanding high-altitude environments. Recent data from Aconcagua show that altitude illness accounts for the majority of mountain evacuations, with HAPE being the single most common reason climbers require rescue. This podcast is ideal for climbers, wilderness medicine practitioners, guides, and anyone interested in the medical and human challenges of high-altitude mountaineering.

In Part 2 of this fascinating podcast series, Dr. Matt Gunderson explores more about Hantavirus, a rare but potentially deadly infectious disease carried primarily by rodents.  Dr. Gunderson also breaks down the biology of Hantavirus, This episode provides more details and cases of one of the world’s most intriguing zoonotic diseases.