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Scot: All right. Welcome to the "Who Cares About Men's Health? Sideshow" today. We've got our mountain medicine expert on the show. Going to talk to him about the first aid winter kit that you should have in your car. Especially if you live in Utah or areas like Utah, where you might go on a car drive across the state of Wyoming in the wintertime, and if something happens it might be hours before somebody is able to help you. So what should you carry with you to stay safe? This is "Who Cares About Men's Health?" My name is Scot. I bring the BS and the MD to my BS, Dr. Troy Madsen.

Troy: That's me, Scot.

Scot: And producer Mitch is in the mix.

Mitch: Hey there.

Scot: And we've got Graham BZ, who practices mountain medicine here at University of Utah Health. Welcome, Graham.

Dr. BZ: Thank you so much. Thanks for having me.

Scot: On the podcast, I want to get a story from you if we could. So on the podcast, we talk about something called the core four, and that's to be healthy now and in the future, that if you concentrate on your nutrition, your activity, your emotional health, your sleep, and then the plus one more is you've got to know what your genetics are, that that'll go a long way to keep you healthy, prevent disease, and just, you know, make life a little bit nicer.

Any of those things are things that you struggle with, Graham? We like to talk about that on the show to just kind of normalize it a little bit. I, you know, sometimes struggle with my activity and my nutrition. I know Mitch does as well. I don't know about Troy. Troy is a super . . . I mean, he runs marathons and stuff, so he's fine. But Mitch and I are listening, if you have any stories you'd like to share. I mean, how's your health in terms of those things?

Dr. BZ: I always say, first of all, for my mental health, I never compare myself to Troy because it's always so depressing.

Troy: Oh, right. Yeah. You're doing much better than I am, I know that.

Dr. BZ: But I struggle with all of those things as well. I think I could use . . . using, you know, shift work as an excuse for making it hard to motivate, to get up in the morning and be active before I do anything. Or, you know, getting home at 2:00 in the morning and forcing myself . . . trying to prevent myself from just eating an entire pint of ice cream when I get home when I want to prevent stress.

I think I definitely struggle with that. The biggest thing for me is having some sort of routine, whether it's, you know, whatever time of the day it is I've . . . When I build my schedule, I'm a big to-do list person. I'm a big calendar person. And I actually put whatever I need to do on my calendar. And so whether it's my workout or activity for the day, it's got its own designated time slot.

When I was better at focusing on my diet and my nutrition, I would actually plan my meal out the next day. I would kind of think about, "All right, this is what I have in the fridge. This is what I'm eating for each lunch, of each meal." When I had that kind of planned ahead of time, it was much easier to follow that routine and stick to it rather than just trying to do it in the moment, where I'm like, "Oh, I'm pretty hungry, maybe I'll just grab a handful of chips or have that candy bar instead of getting a meal."

And so, for me, I definitely struggle with it. It's something I wish I was better at, but when I do succeed, it's when I'm really intentional and really plan it out.

Scot: I think that's a great point. I think, you know, for some people that does work really, really well. And I think we tend to believe that stuff like exercise or what you're going to eat, when you're going to eat, it just kind of happens, right? But it really in our busy lives doesn't. And if you want to avoid eating that pint of ice cream, you've got to be full on something. So if you've planned out, "Hey, this is what I'm going to have for my meal. I know if I bring a meal to work that makes all the difference when I get home. I'm not, you know, in the sweets and stuff." So good lesson there.

Dr. BZ: Well, I wish I could practice what I preach all the time, but.

Scot: Yeah. Well, it's all a work in progress, right?

Dr. BZ: Yeah, yeah.

Scot: I think that's the thing we're all learning on this podcast.

Troy: Yeah, it is. Yeah. And it's so refreshing to hear that from you to, Graham, because I struggle with the exact same thing. And obviously, we both do shift work, we get home late or early, depending how you look at it, you know, 3:00 in the morning or whatever. And yeah, I agree. I'm the same way. I've got my calendar. I have to plan things out. I have to think ahead and be like, "Okay, this is what I'm doing then." I think for anyone who's doing shift work, that's a big challenge. So it's great to hear you're doing that and making it happen.

Scot: All right. What is in your survival kit in your car? Now we're talking about a winter survival kit. If you're going to do any traveling over the, you know, the wintertime and you live in kind of a remote area, like here in Utah, you can drive a lot of places where you might not be near a town. Or if you have to travel like I do to another state and you have to drive across a state like Wyoming, if a storm hit and you had to spend the night in your car or a couple of nights, what kind of survival kit would you have? Graham, do you have one in your car, and what do you recommend?

Dr. BZ: I do. And I'm so glad you're asking me this because my wife makes so much fun of me for my kit that I keep in my car.

Scot: Maybe this is something just guys like, I don't know.

Troy: Yes, exactly.

Dr. BZ: There's probably something to that. You know, I've actually . . . So I also commute out to a hospital in Wyoming for work as well. And I've had one particular close call where being stuck would have been awful. And so my kit, I keep kind of continuously adding to that kit over time. But I think with any medical kit, you want to think about, you know, what you're using it for, the environment you're going to be in, and how far you are from definitive care or rescue. So, you know, how long are you planning to use these materials to survive?

Thankfully, in a car, you know, 24 hours is probably pushing it in terms of how long you need to be. If you're on a highway, I should say commuting to Wyoming, something like that and you're stuck in a storm. So your kit can be sized down for that. If you're going further out into the wilderness, then plan for more time.

I have a couple of things. So one, I have something for just kind of self-rescue, like you should do with any activity because the best way to get yourself out of something is to be able to get yourself out and not rely on someone else for help. So now in my car, I've got some traction devices that I can use to place under the wheels if I were to get stuck in deep snow or sand or mud. I have a -- I'm trying to think of the term for it -- a tow rope, basically, that's a very heavy-duty, synthetic rope that I can attach to a point in my vehicle and hook it up to somebody else's if I needed to pull someone else out or vice versa. And I also have my own jack, a spare tire, all those things.

So whatever you can do to help yourself, I think is super important.

Troy: And what do you mean by traction devices? Are you talking like tire chains or like cables or something like that? Or what exactly do you have there?

Dr. BZ: So no. So you should always have those things, especially if you don't have four-wheel drive. So I have four-wheel drive and winter tires. I actually hate putting chains on and cables, but I think those are great things to have, especially on a road like that.

There's a bunch of different commercial devices you can get that are kind of deployable tracks that you can put down onto loose snow or something. I think Trax, T-R-A-X is one company, and just as an example. Not that I'm endorsing them over another. But they're basically these traction pads you can put down to help your wheels get traction and get out of a rut, especially, you know, I think a lot of people, myself included in the past, when you get in deeper snow, you try to get yourself out and you end up spinning your tires and digging yourself down. And then the more you do that, the harder it is to get those tires out. So these traction devices, you can place down and give your tires some grip to help you get out of those ruts.

Troy: Oh, nice. And you can get those down far enough where your tire can actually get a little traction on it. Once it's on there, then it's going to start moving forward on that traction?

Dr. BZ: Exactly. And that brings up another thing I have, which is a snow shovel. Not the one you . . . I mean, if you wanted to, you could carry the one you bring in your house, but that's going to be pretty cumbersome in your car. So I actually have an avalanche snow shovel that you put in an avalanche pack for back-country skiing or snowboarding. Because sometimes you dig your car so deep that you're actually kind of high pointing it and the chassis of the car is actually in the snow. And so you have to have a shovel to help dig around those tires so you can dig that, you know, spot for that tracking device or at least dig a trough out for your car to drive out of.

Troy: And have you ever used this stuff? Have you ever had to use it?

Dr. BZ: I have actually. I'm embarrassed to say how many times.

Scot: What? Really? Because I'm sitting here this whole time thinking . . . I'm the one that wanted to do the topic and I'm thinking the whole time, "Oh, I'd never use any of that stuff." And you're like you've used it multiple times.

Dr. BZ: Well, I should say again . . . So getting yourself out of things is the best thing to do. The very best thing to do is make good choices, and I have definitely not made good choices.

Troy: Prevention.

Dr. BZ: Yeah, prevention is key in all these situations. When you miscalculate, that's where these devices can be very helpful.

Troy: See I can definitely think of times I wish I had these things. Like, especially the traction devices, I never even thought about that. I guess I should have known they're out there. But that seems like an incredibly useful thing, because I've definitely been stuck in the snow and just been like, "How am I going to get out of this?" So that's good to know.

Scot: Yeah, they're useful for sand too. If you ever decide you want to go out into the desert or whatever with your four-wheel drive vehicles, a lot of people use them for sand as well. There must-haves.

Dr. BZ: There's some really big, burly ones that people love to put on the side of their adventure vans that are not, you know, practical to put in the back of most cars, but they also make some much smaller ones that fold up or roll that are still very effective that I just . . . I basically have all the stuff just stuffed around my spare tire. They kind of divide up my spare tire in the back of my car, and it fits very well.

Scot: It's cool. So you've got your tools to get you out of the situation. What other kit do you have and what's in it?

Dr. BZ: Yeah, so I've got . . . I always carry . . . I have probably too much water. I have like 10 gallons of water, but I always carry spare water.

Troy: You've 10 gallons of water in your car?

Dr. BZ: Well, that's just the . . . Yeah, I do.

Troy: That's awesome. I'm impressed.

Dr. BZ: And that, you know, moves out of my car sometimes. And whenever I'm going to Wyoming, that's in there. It's just one of those big, kind of blue squares.

I actually have a sleeping bag that I keep in my car. I've got some extra pair of gloves. And so I basically have a bin that I move in and out of my car when I'm going, you know, anywhere, like going to work or going on a bigger trip. And so it's got an extra sleeping bag, an extra beanie, extra pair of gloves, an extra jacket. I think I've got like six or seven like meal bars in there as well. I've got waterproof matches and kind of one of those match kits. And always have duct tape. Wherever you go you need duct tape.

I've got a headlamp and a flashlight because you always want to make yourself visible as well. They make some really great kind of emergency lights as well, the triple one that's like a flashlight and a flasher. And you can kind of put that on the back of your car if you are going to sleep in your car so you stay visible for plows and things like that. So I've got one of those. I've got a knife as well. I feel like pretty much every vehicle I have or backpack I have has two headlamps and two knives just because I go a little overboard on that.

Troy: I was going to say you never know when you need two knives.

Dr. BZ: See, if you've got two knives, you've only got one knife, it's the same with headlamps.

Scot: What? I don't understand that saying.

Troy: The second knife breaks or what?

Dr. BZ: Yeah, it breaks or you lose it, or yeah, I like to have some redundancy in the safety stuff.

Troy: See, I'm just thinking of the movie, "The Grey" with Liam Neeson, when he was fighting wolves and he had two knives. It made perfect sense. He had a knife in each hand, so I guess . . .

Dr. BZ: Well, exactly. Yeah, you never know when the pack of wolves are going to come out.

Troy: Yeah, you never know. But yeah. See, I am feeling so inadequate right now. In my car I have a roll of duct tape.

Dr. BZ: That's good.

Troy: I have a blanket. I do have a spare tire and a jack.

Scot: Maybe a couple of French fries down the side of one of the seats.

Troy: Yeah, I think there's some Cheetos under the driver's seat, maybe some peanuts or something. I might have a screwdriver and some zip ties, like if I could do something, you know, to fix my car, if I actually knew how to fix it. So I am feeling very inadequate. But this is like incredibly helpful to hear this because, yeah, I like the idea, like you said, Graham, you've just got your kind of your bin, it has everything in it. Obviously, you're not dragging this stuff around town all the time, but if you're going on a long drive, you just grab it and you throw it in and you've got everything you need.

Dr. BZ: Yeah. And again, you can see . . . My wife makes fun of me because mine's a little overkill. I will say, so zip ties are great. The other thing that works really well for any sort of securing or kind of jury rigging some together are Voile ski straps, if you're familiar with those. They're very heavy duty, kind of stretchable straps that have saved me in a lot of different environments. And so I've got a couple of those in the bin as well, and a multi-tool like you said.

Scot: Mitch, how's your survival kit shaping up in your car? How are you doing?

Mitch: It's pretty miserable. I'm the opposite of Graham in my relationship. Jonathan has maybe seven different first aid kits and survival kits in each of our vehicles and everything. I just have some tools. Like, I drove junk cars for so long in my life, I have a mobile thing to fill up my tires. I have a full tool kit. I have spare spark plugs, spare battery jumpers, etc. But nothing if my car were to break down into like the wilderness. I think I maybe have a Red Bull in a glove box, but.

Troy: Well, since we're talking about Wyoming, I have to tell you my favorite, not favorite, but just, yeah, a survival experience in Wyoming. I pulled off an exit. I was driving through Wyoming. I was super tired. So I took a nap, but I left my lights on. And it was just an exit out in the middle of nowhere in Wyoming. And so my car died and there's no one there. And so I just I had jumper cables. So I do have jumper cables in my car. So I got out and I'm just walking along the highway just thumbing and holding up jumper cables, thinking like some nice person will just see I need my car jumped. Like, no, they're going to think like some creep is out here walking along, getting ready you to strangle me if I pull over. So fortunately, I found like this old, rundown gas station like a couple of miles down the road, middle of nowhere. So I found the guy there and the guy's like, "Yeah, if you give me 40 bucks, I'll go jump your car." So.

Scot: Oh, that's real neighborly.

Troy: Yeah. It was super nice. I'm sure it's not the first time it's happened there, but anyway, yeah, I can't imagine. And do you carry like . . . Speaking of your car dying, since then I've thought, on long trips, you can get those kind of small things to jump your car battery that are rechargeable. Do you carry one of those as well?

Dr. BZ: I do. Again, out of experience. So I had a similar experience, and actually, Troy, you're familiar with this. So I was driving back from a shift at about 4:00 a.m. on Highway 80. And I got a flat tire between the two exits between my house and Troy's house. And so I was probably about four miles from home. So I pull over, I fix my tire, and I get into the car to drive, and I had left my headlights on and my battery was dead and I did not have one of those devices.

Troy: Oh, no.

Dr. BZ: Yeah. So I ended up . . . Thank God, I had my headlamps. And at the University of Utah, we wear black scrubs, so I'm running down Highway 80 trying to get home. And so I have my headlamp over my head, and I'm flashing it so someone can see me. And I have to run the four miles home to wake my wife up, who wasn't answering her phone, to have her take me to my car. So since then I use one of those devices. The one I use is called Jump-N-Carry, and I take it on all my van trips. We have a VW van that it definitely lives in the back of that. And I also have one, like a smaller version in my car as well, just so I don't get stuck in that situation also.

Scot: So if I'm hearing this right, it sounds like that in my car if I'm going to be driving out, you know, maybe this might be actually a trip out in the back country, I'm driving to go somewhere, I'm doing a little expeditioning or whatever, or just a, you know, across the lonely state of Wyoming on a highway in the wintertime, it sounds like there's a few categories of things I want to have. Thing number one is things to get me out of the situation I might be in, which you talked about. Thing number two is if you can't get out of that situation, warm clothes, sleeping bag, gloves, hats, boots, that sort of thing. I suppose that's also helpful if you have to walk and get help, because, I mean, how many of us would have adequate clothes to go on a prolonged walk in Wyoming, in the wintertime? And then it sounds like number three is food and water. Does that cover kind of the major things?

Dr. BZ: That's definitely how you want to think about it. Again, you don't have to have all the stuff in your car at all times. You should just think about the trip you're doing and how much time, you know, worst-case scenario you think you'd need to be self-sufficient or what you need to get yourself to a safe spot or to a place where you can contact folks.

Troy: And I'm going to ask this real quick here, Graham. I remember there was this horrible story like a couple of years ago. A guy was going out to interview somewhere out in like the west desert and took a wrong turn and his car got stuck and he went to try and find help and died out there somewhere. So I guess that brings up the question, and I've thought about it a lot since then. Are you better off if that does happen and you are in a situation where you get stuck, do you just stay in your car, or do you go out trying to find help?

Dr. BZ: So most of the time we advise, if you're lost like that, you stay with your vehicle, you stay where you are, because people are going to have a better sense of the general area where you're going to be. If you leave that space, if you leave that area, you know, vehicle, that's much easier to spot from, you know, a search helicopter, a search plane, it's going to be much harder to find you. So the best advice is to stay with your vehicle in that case. Unless you know exactly where you're going and you have a very good sense that you can . . . you know, if you passed a gas station four miles ago and you know you can get there, that's one thing. But if you're just completely lost and, you know, more than a reasonable distance from any infrastructure like that, just stay with your car.

Troy: And it sounds like with the kit you've got, you know, 10 gallons of water, you've got protein bars, you've got sleeping bags, you can just set up camp there and live there for a week and you're good.

Dr. BZ: Yeah. Honestly, it'd be a great break. Yeah, [inaudible 00:17:54].

Scot: Oh, my God.

Troy: So if you don't show up for a shift next week, I'll know what happened.

Dr. BZ: Yeah, exactly.

Troy: Graham goy lost? I guess he's okay.

Scot: I was going to say Graham's living better in the event of an emergency in his car than I live in my house. What do you bring to read to kill time? Since, I mean, you're going to be so cozy and well-fed and well watered.

Dr. BZ: Yeah. You have a spare book. You're listening to all your podcasts on your phone. You have an extra battery for that.

Troy: Just listen to 90 episodes of "Who Cares About Men's Health?" You know? What more could you need?

Dr. BZ: Exactly.

Scot: If the exposure doesn't kill you, the podcast will.

Troy: That will be the end.

Scot: All right, Graham, thank you so much for geeking out a little bit about what's in your first aid survival kit or your in-car survival kit. That's been a lot of fun. And thanks for sharing your health story as well. And thanks for caring about men's health. It's been great having you on the show.

Dr. BZ: It's been a ton of fun. Thanks for having me.