March 29, 2011
This has nothing to do with altitude, but here’s some video of a male wild turkey I recorded from the living room of my house.
March 11, 2011
Disclaimer: I’m not a physician. You should discuss the recommendations below with your physician and make sure you understand the side effects and contraindications for these medications.
Expedition medical kits should contain drugs and equipment that people know how to use. So there’s no way to come up with a “standard” kit. In the book I discuss a number of different drugs that might be useful. I want to point out three drugs that might not be on your radar screen for your next trip.
Tinidazole is used to treat Giardia infections and amoebic dysentery, both of which are common visitors in an expedition. I recommend this drug because it replaces metronidazole (Flagyl), which has been the standard treatment in the US for many years. A single dose of Tinidazole is all that’s needed to treat Giardia. It will be much cheaper to buy it abroad. Buy enough to treat dysentery.
The Advair inhaler literally got me to the top of Mount Everest. The circular, purple plastic case contains powdered steroids that you inhale. The steroids then directly affect the respiratory system without having the nasty systemic effects of other steroids. It’s most effective against the dry, hacking high-altitude cough that often strikes on bigger peaks. It’s not for pulmonary edema or ‘wet’ coughs. It’s not needed on trips to the USA or Canada and one of these is enough for a small expedition. Take along an albuterol inhaler as well. You should buy these in the USA. The Advair is not cheap but you won’t care about the cost if you actually need it. Both require prescription and unfortunately you won’t find any scientific research to back up my recommendation.
I mention Viagra/Cialis in the book. You should carry some in case somebody develops high altitude pulmonary edema (HAPE) and you don’t feel comfortable administering Nifedipine. Nifedipine can cause a catastrophic decrease in blood pressure and the patient must be properly monitored as the drug is given. Viagra and Cialis don’t cause this systemic drop in blood pressure but still may reduce pulmonary pressures. Unfortunately at least 20% of the population won’t respond to Viagra/Cialis so it’s not a magical cure. Definitely buy these drugs in the USA/Canada.
There are other medications for high-altitude illness, gastrointestinal infections, respiratory infections, etc. etc. so this is not a complete listing.
For these and any other drugs you carry, keep them in the original containers with your name on it if your transporting it to another country. Package to drugs carefully as transport can turn pills to powder. And ask the pharmacist for the original instructions that came with the medication—not the printout that they normally give you these days. The original sheet will have all of the side effects, contraindications, interaction warnings, and so on.
February 13, 2011
I found out a few weeks ago that I had giardiasis, an intestinal parasite. I have no idea where I got it or how long I’ve had it. Maybe since this fall, or this summer, or since I’ve been back from Everest, or from K2—who knows? It certainly wasn’t a typical case; most cases of Giardia start ‘explosively’ but about 20% don’t follow the standard symptoms. One dose of drugs (Tinidazole 2 grams) took care of it and I feel like a new person. I’m thinking that I’ve had a subclinical case for quite some time. I blamed my constant fatigue on the frostbite injuries, but maybe the little critters deserve some credit as well.
My big project right now is the revision of my rock climbing guidebook. Once that’s done in June I’ll likely have some surgery to improve my fingertips. I have a bunch of topics in mind to talk about here so I’ll do my best to get started on those.
Here’s one little thing that I know I’ve touched on before. If you’re going to work on any stationary aerobic machine other than a recumbent bike, don’t read! I see people every day trying to read on an elliptical machine or treadmill and their biomechanics are completely screwed up. Put away the books and magazines, and while you’re at it, turn off your phone and quit fiddling with your music player. Keep your head up and look out at eye level. Your whole body will respond positively in your workout will be much more effective.
November 1, 2010
It’s almost time for the Midwest Mountaineering Winterfest, and they have a lot of fun stuff for climbers and trekkers this year. I’ll be giving two presentations:
Trekking to Everest Base Camp. Saturday, Nov. 20, 9:15 AM, Humphery Center, Cowles Auditorium
Adjusting to High Altitude: A Primer for Flatlanders. Saturday, Nov. 20, 11:45 AM, Hansen Hall room 102.
November 1, 2010
I write about what I use, and I buy what I use. No freebies or sponsorship. Other gear might work as well or better for you.
In 2005 I was climbing unroped with a 40 lb. load, heading for Camp 1 on Broad Peak. After climbing a couple of 40 degree sections of water ice, I was glad to set foot on snow again. At that precise moment, I felt something rattle on my one foot. I looked down and saw that one crampon had fallen apart, the two pieces dangling from the straps. A nearby climber gave me a hand and it was soon fixed. The problem? The quick release mechanism (which adjusted the length) popped open when used on my very big high altitude boots. If this had happened 20 feet lower on the water ice… That’s when I got serious about building a boot/crampon system that was bombproof yet light and precise.
On both K2 and Everest I used a two boot/ two crampon system. At lower altitudes, the Trango boot and Petzl Sarken crampons were a nice combination of warmth, durability, and technical agility. I must admit that on Everest I actually used M10 crampons as my previous Sarkens had been recalled. Petzl anti-balling plates are far superior to the Charlet plates on the M10s. The vertical front points on the Sarkens climb ice as well as a technical crampons, at least when using both the heel bail and toe bail binding. I would have used the Sarkens up to Camp 3 on K2 with warmer boots.
Once above 6700m the Trango boots simply aren’t warm enough and I switch into my La Sportiva Olympus Mons boots. I’ve used both these boots and the Millet Everest boots and prefer the Olympus Mons. They fit my feet better (the most important consideration), they are not nearly as bulky, and they allow me to do more technical climbing. Both crampons mentioned above fit these boots though you may have to whittle the heels down a little bit if you use a lever style heel bail. The lacing system on the Olympus Mons is unique but functions quite well as long as you don’t try to figure it out at 7500m. The outsole is quite fragile (in an effort to save weight). If you travel on rocks you’ll chew it up quite quickly.
The Camp XLC Nanotech crampons are aluminum with steel reinforcement under the front points. They are amazingly light and about as durable as you would expect for such a soft metal. They worked well on the Olympus Mons and I wore them from Camp 2 to the summit and back on Mount Everest, and from ABC to C2 and back on K2. They wear down very quickly if you have to expose them to rock; they would probably make one round-trip on K2. Of course weight is the primary issue and saving a pound on your feet is worth the price in this case. But you couldn’t use them as your everyday crampons in an expedition situation. For a single ascent without much technical climbing they will do just fine.
Retailers are quite happy to sell you way too much boot, pricewise. Know the worst condition you can reasonably expect to encounter and buy appropriately. If you’re stomping up Aconcagua or an easy trekking peak, a pair of plastic double boots are generally sufficient (and half the price of the specialized high altitude boots).
Make sure your crampons fit your boots! This may seem a no-brainer, but there are a lot of folks who don’t discover this problem until it’s too late. You may have to trim the boot heel a bit. The type of strap/bail system use use will depend on the boots and crampons you have, as well as personal preference.
Finally, make sure you have the tools needed to adjust your crampons, as well as replacement bolts etc. On Broad Peak I removed the quick-release clamps and bolted the suckers together. No more crampon disintegration.
September 27, 2010
With apologies to those who are not midwestern rock climbers…
I’m pleased to announce I will be doing an update to Rock Climbing: Minnesota and Wisconsin. This update was planned, delayed, and then canceled for various reasons. Those issues have been resolved and the publisher has given a firm commitment to the revision. The new edition will be in color and not much more expensive than the current edition.
Go here to get further information. The main source of news concerning the progress of the revision will be my other blog. You can subscribe to get notified of any posts by clicking above. I also have a Facebook Page that you can follow. I won’t post more often than every couple of weeks.
I look forward to your help on this project. Please pass the word to MN/WI rock climbers.
September 17, 2010
The workout facility that I use has magazines lying around for those using bicycles etc. the beauty/fitness magazines plaster their covers with the same things every month–promises of great results quickly with little effort. I picked to cover at random to show you what I mean: Get it now! Do it fast! Guilt free! Not boring! Easy! These are the messages that people want to hear, so of course the magazines will oblige. And I’m not just picking on the women’s magazines, but they are probably the most extreme.
Guess what? It takes time and effort to truly improve. Most people will take several years to reach their potential in endurance activities such as marathon running and alpine climbing. Showing improvement in simpler activities (losing weight, gaining strength) will still take months of dedicated effort.
As I watch the many overweight people doing their aerobic workouts and reading these magazines, I wonder what sorts of psychological damage these messages cause: ” If it’s really so easy, fast, and not boring, then why am I bored, why is it so hard, and why aren’t I losing weight? I must be a failure!”
In The Altitude Experience I spend a lot of time talking about how we are all different from each other. No matter how much you want to, you may not be able to go faster/get stronger/be more confident/lose more weight. And this is where the dark side beckons; steroids, weight-loss drugs, and human growth hormone have trapped many with the promise of results without effort.
So you need to set realistic goals, research the best ways to accomplish them, and be willing to put the time and energy into reaching those goals. At some point you need to readjust your goals up or down, depending on your progress.
And ignore the siren’s song from the six pac abs, airbrushed hips, and silicone chests of the magazine covers when they whisper “it’s easy, it’s fast.”
August 10, 2010
Most folks who travel high are rightly concerned about altitude illness. Here are some new resources for you. You can download the Wilderness Medical Society Consensus Guidelines for the Prevention and Treatment of Acute Altitude Illness for free. This contains the latest medical recommendations (though in real life one might vary from some of these recommended approaches, but I’m not a doctor and can’t give medical advice). Anyway, lots of good info here.
So you’re at altitude and you feel lousy–do you have altitude illness? To help diagnose acute mountain sickness (AMS), physicians and researchers have developed numerical scoring systems which use your symptoms and the observations of others. These are known as the Lake Louise Consensus Scoring Systems (the name will help you to search for more info). I included a version for both adults and children in the book, and have finally formatted them for easier use in real life. You can download the adult version and the child version from my home page.
Keep in mind that there are two other important types of altitude illness: high altitude pulmonary edema (HAPE) and high altitude cerebral edema (HACE). These scoring systems don’t diagnose these serious illnesses, so make sure you read Chapter 5 to become familiar with them.
July 28, 2010
I was recently asked for any tips, tricks, or suggestions that would help this person successfully climb Everest in 2011. The facile answer is “read my book.” But most of us (including me) will look for the shortest and easiest way to get the information we want, and there is a lot of information in the book that doesn’t apply to this person’s question. So with the caveat that this post is incomplete and certainly doesn’t contain everything you need to know to climb Everest, here are a few tips for the climber going to extreme altitude.
Physical conditioning. You should be in decent shape, able to keep moving for eight hours at a stretch, uphill and downhill, carrying a 30 pound pack. In Chapter 12 I lay out the general rules of the training program. If you are traveling with a guided party you will likely get some specific training advice from your guide. The most highly stressed muscles in your body at extreme altitude may be your breathing muscles–not your heart, not your legs. Train those breathing muscles! And being in good shape doesn’t mean you’ll necessarily do well at altitude.
Technical skills. Practice ascending fixed ropes and rappelling prior to the trip. Practice with mittens on, in the dark, in the howling wind. Technical skills must be ingrained into your brain so that this ‘muscle memory’ is available when you’re hypoxic, cold, and half asleep.
Psychological skills. While the previous two skills may seem to be the most important, failures on Everest and other big peaks are more likely to be caused by other factors. In my discussion of physical performance in Chapter 3, I list a whole series of factors that affect performance, and in many cases performance (= climbing Everest in this case) will be strongly affected by psychological factors. Figure 21 summarizes these factors and how they affect performance and judgment. Examples: are you a control freak? Prepare to be stressed, because a guided expedition means you relinquish control of almost every decision once the airplane lands. Get bored easily? Can’t stand sitting around for days on end? Then you’re going to have trouble on expeditions unless you are prepared to cope with it.
Social skills. Your relationships with fellow climbers, guides, and staff will have a major effect on your emotional and psychological well-being, which affect performance. When I wrote the book, chapter 9 (Interpersonal Relations) took on a life of its own as I realized how critical it was, especially on expeditions. On a guided trip you will be insulated from most of the backroom politics among expeditions, but you’ll still have to deal with people on your team. Zen-like detachment is the only way to go.
Even if you’ve been to Denali and Cho Oyu, don’t assume that you have the expedition game all figured out. You can expect things to happen a certain way, but don’t get frustrated if they don’t! On the other hand, if something seems screwy, speak to your guide or Sherpa privately and reach an understanding. Of course any life-threatening situation needs to be dealt with openly and immediately.
Even if you are surrounded by guides and Sherpas, things happen. Know what can go wrong and think about how to deal with it if suddenly you are in charge. Chapter 11 discusses decision making and accidents and will acquaint you with the major types of problems you may face.
Know the primary symptoms of altitude illness and thoroughly understand any drugs that you might use (Chapter 5). Along with that, know the major changes that take place during acclimatization (Chapter 4). If you wake up gasping for air, at least you’ll know why.
You might be surprised that I’ve left out the vast majority of the biology of altitude (Chapter 2). If you’re interested, go for it, but frankly you can climb any peak without understanding the basic science. Okay, maybe you should read the summary statements in the page margins of Chapter 2. It’ll take you about two minutes.
Finally remember that you haven’t paid to climb Everest. You’ve paid for the opportunity to climb Everest. And return safely. If you do so, you’ll return home and still be essentially the same person that you were, with the same problems, the same opportunities, and the same family and friends. Don’t expect Everest (or any mountain) to change your life.
July 28, 2010
After a long hiatus, I’m back. I’ve intended to start posting regularly for almost 6 months now but something always seems to get in the way. I plan to be providing useful information about once every week or so. I’ll try to keep the drivel to a minimum so you can spend more time on Facebook. If you subscribe you can pick which categories you want to be notified about. Or if it’s too much just unsubscribe. Any problems with this should be reported via the e-mail address in the header above.
I have reformatted and added to the photo galleries and will be posting videos on YouTube starting this week. I’ll post info on how to find the video when it’s available.
On a personal note, I’m mostly healed up. I’ve been running, biking, and climbing since the beginning of the year and things continue to improve. I did a double crossing of the Grand Canyon in May (check out the photos) and climbed South Teton a week ago. Frankly, my typing has suffered more than anything else, which is the main reason I haven’t been posting.
Feel free to e-mail me with your questions; I’ll try to answer as long as the volume of questions remains manageable.