Philmont requires that this information be shared with the parent(s) or guardian(s) and examining physician of every participant. Philmont does not have facilities for extended care or treatment; therefore, participants who cannot meet these requirements will be sent home at their expense.
Cardiac or Cardiovascular Disease
Adults who have had any of the following should undergo a thorough evaluation by a physician before considering participation at Philmont.
- Angina (chest pain caused by blocked blood vessels or coming from the heart)
- Myocardial infarction (heart attack)
- Heart surgery or heart catheterization (including angioplasty to treat blocked blood vessels, balloon dilation, or stents)
- Stroke or transient ischemic attacks (TIAs)
- Claudication (leg pain with exercise caused by hardening of the arteries)
- Family history of heart disease or a family member who died unexpectedly before age 50
- Smoking and/or excessive weight
Youth who have congenital heart disease or acquired heart disease such as rheumatic fever, Kawasaki's disease, or mitral valve prolapse should undergo thorough evaluation by a physician before considering participating at Philmont.
The altitude at Philmont and the physical exertion involved may precipitate either a heart attack or stroke in susceptible persons. Participants with a history of any of the first seven conditions listed above should have a physician-supervised stress test. More extensive testing (e.g., nuclear stress test) is recommended for participants who have coronary heart disease. Even if the stress test is normal, the results of testing done at lower elevations and without the backpacks carried at Philmont do not guarantee safety. If the test results are abnormal, the individual is advised not to participate.
Hypertension (High Blood Pressure)
The combination of stress and altitude appears to cause a significant increase in blood pressure in some individuals attending Philmont. Occasionally hypertension reaches such a level that it is no longer safe to engage in strenuous activity. Hypertension can increase the risk of having a stroke, developing altitude sickness, or angina. Persons coming to Philmont should have a normal blood pressure (less than 135/85). Persons with significant hypertension (greater than 150/95) should be treated before coming to Philmont, and should continue on medications while at Philmont. The goal of treatment should be to lower the blood pressure to normal.
Persons with mild hypertension (greater than 135/85 but less than 150/95) probably require treatment as well. It is the experience of the Philmont medical staff that such individuals often develop significant hypertension when they arrive at Philmont. Participants already on antihypertensive therapy with normal blood pressures should continue on medications. Diuretic therapy to control hypertension is not recommended because of the risks of dehydration that exist with strenuous activity at high altitude and low humidity. Each participant who is 18 years of age or older will have his or her blood pressure checked at Philmont. Those individuals with a blood pressure consistently greater than 150/95 may be kept off the trail until the blood pressure decreases.
Insulin-Dependent Diabetes Mellitus
Exercise and the type of food eaten affect insulin requirements. Any individual with insulin-dependent diabetes mellitus should be able to monitor personal blood glucose and know how to adjust insulin doses based on these factors. The diabetic person also should know how to give a self-injection. Both the diabetic person and one other person in the group should be able to recognize indications of excessively high blood sugar (hyperglycemia or diabetic ketoacidosis) and to recognize indications of excessively low blood sugar (hypoglycemia). The diabetic person and one other individual should know the appropriate initial responses for these conditions. It is recommended that the diabetic person and one other individual carry insulin on the trek (in case of accident) and that a third vial be kept at the Health Lodge for backup. Insulin can be carried in a small thermos, which can be resupplied with ice or cold water at most staffed camps.
An insulin-dependent diabetic who has been newly diagnosed (within the past six months) or who has undergone a change in delivery system (e.g., insulin pump) in the past six months should not attempt to participate in the strenuous activities encountered at Philmont. A diabetic person who has had frequent hospitalizations for diabetic ketoacidosis or who has had frequent problems with hypoglycemia should not participate in a trek at Philmont until better control of the diabetes has been achieved. Call Philmont at 575-376-2281 to obtain permission from the chief medical officer for individuals hospitalized within the past year.
Excessive Body Weight
Any youth or adviser who exceeds the maximum weight limits on the Philmont weight chart is at extreme risk for health problems.
A seizure disorder or epilepsy does not exclude an individual from participating at Philmont. However, the seizure disorder should be well controlled by medications. A minimum one-year seizure-free period is considered to be adequate control. Philmont's chief medical officer may consider exceptions to this guideline. Any exceptions will be based on the specific type of seizure and the likely risks to the individual and to other members of the crew. The medical staff at the Health Lodge may place some restrictions on activities (rock-climbing, horse riding, etc.) for those individuals who are approved for participation but whose seizures are incompletely controlled.
Asthma, Allergy, or Anaphylaxis
Asthma should be well controlled before coming to Philmont. Well-controlled asthma means (1) the use of short-acting bronchodilator MDI (albuterol, Ventolin, Proventil) zero or one time per day, and (2) no need for nighttime treatment with a short-acting bronchodilator. Well-controlled asthma may include the use of long-acting bronchodilators, inhaled steroids, or oral medications such as Singulair. You must meet these guidelines in order to participate. You will not be allowed to participate if (1) you have exercise asthma not prevented by medications, or (2) you have been hospitalized or have gone to the emergency room to treat asthma in the past six months, or (3) you have needed treatment with oral steroids (predisone) in the past six months.
You must bring a 15-day supply of your medications and a spare short-acting bronchodilator. At least one other member of the crew should know how to recognize signs of worsening asthma or an asthma attack, and should know how to use the bronchodilator. Any person who has needed treatment for asthma in the past three years must carry an inhaler on the trek. If you do not bring an inhaler, you must buy an inhaler at Philmont before you will be allowed to participate.
Allergy shots may be given to persons on a maintenance dose and who have not had an anaphylactic reaction. You must bring your own medications. Philmont staff may not be able to give allergy shots while persons are on their trek.
Persons who have had an anaphylactic reaction for any cause must contact Philmont before coming. If you are allowed to participate, you will be required to have appropriate treatment with you. You and at least one other member of your crew must know how to give the treatment. If you do not bring appropriate treatment with you, you will be required to buy it at Philmont before you will be allowed to participate.
Recent Musculoskeletal Injuries and Orthopedic Surgery
Every Philmont participant will put a great deal of strain on feet, ankles, and knees. Participants who have had orthopedic surgery—including arthroscopic surgery—or significant musculoskeletal injuries within the past six months find it difficult or impossible to negotiate Philmont's steep rocky trails. To be cleared to backpack by the Philmont medical staff, individuals with significant musculoskeletal problems (including back problems) or recent orthopedic surgery must have a letter of clearance from their orthopedic surgeon or treating physician. A person with a cast on any extremity may participate only if approved by a Philmont physician. Ingrown toenails are a common problem and must be treated 30 days prior to arrival. All such problems will be reviewed by a Philmont physician to determine if participation in a trek will be permitted.
Psychological and Emotional Difficulties
A psychological disorder does not necessarily exclude an individual from participation. Parents and advisers should be aware that a Philmont trek is not designed to assist participants to overcome psychological or emotional problems. Experience demonstrates that these problems frequently become magnified, not lessened, when a participant is subjected to the physical and mental challenges of a trek at high elevation, carrying a heavy backpack over steep, rocky trails. Any condition should be well controlled without the services of a mental health practitioner. Under no circumstances should medication be stopped immediately prior to a Philmont trek, and medication should be continued while at Philmont. Participants requiring medication must bring an appropriate supply.
Each participant at Philmont who has a condition requiring medication should bring an appropriate supply. The pharmacy at the Health Lodge is limited and the identical medications may not be available. In certain circumstances, duplicate or even triplicate supplies of vital medications are appropriate. People with an allergy to bee, wasp, or hornet stings must bring an EpiPen or equivalent with them to Philmont.
An individual with congenital or chronic medical conditions should always contact the family physician first and call Philmont at 575-376-2281 if there is a question about the advisability of participation. Philmont's chief medical officer and other medical staff of the Health Lodge reserve the right to make medical decisions regarding the participation of individuals at Philmont.