Archive for the ‘The Altitude Experience’ Category
Updates on altitude illness
August 10th, 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.
Posted in Altitude science, The Altitude Experience, Uncategorized | Comments (0)
Question: going really high
July 28th, 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.
Posted in Exercise and Performance, The Altitude Experience | Comments (0)
Decision making link
December 31st, 2009
Best wishes to all in 2010! Be happy, be safe.
Here’s an interesting article from Wired Magazine on the science of screwing up. Since proper decision making is critical at any altitude, I thought you might enjoy it.
Tags: The Altitude Experience
Posted in Exercise and Performance | Comments (0)
Farewell Charlie
October 13th, 2009
Dr. Charles Houston died recently at the age of 96. I first started learning about high-altitude physiology from his book Going Higher. He was the godfather of high-altitude medicine and climbed in Alaska and Asia. My book wouldn’t have been possible without the research he conducted and inspired over the years.
Read a fitting tribute by journalist Bill Moyers. Watch the 1953 K2 film there too!
Tags: The Altitude Experience
Posted in Altitude science, Opinion | Comments (0)
Does Ginkgo biloba prevent altitude illness?
September 11th, 2009
There have been a number of studies that examine the effectiveness of Gingko biloba extracts in preventing acute mountain sickness (AMS). A nice paper by van Patot and others in the spring 2009 issue of High Altitude Medicine and Biology summarizes the results of these studies. They suggest that the main problem is the lack of standardization of extracts, leading to different amounts of the various chemicals being present in the pills. Until the various individual compounds are tested, we won’t really know what benefit gingko might have.
So I continue to suggest that taking gingko is ok, but acetazolamide (Diamox) is still the go-to drug for AMS as long as you’re not allergic.
Citation: Martha C. Tissot van Patot, Linda E. Keyes, Guy Leadbetter, Peter H. Hackett. High Altitude Medicine & Biology. Spring 2009, 10(1): 33-43. doi:10.1089/ham.2008.1085.
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Nothing happening/book recommendation
July 21st, 2009
I haven’t posted in a while because nothing new has happened recently. Still healing, still shriveling, still sitting around a lot. I won’t be posting any more about my condition until after my surgery August 11. I do hope to post a preliminary report on what happened in the next few days, so stay tuned.
I do want to steer the blog back to its intended use, which is to talk about altitude-related issues. An important book that I failed to cite in my book is Paul Auerbach’s Wilderness Medicine, fifth edition. This 2300 page monster covers just about every subject you can think about plus a few more. It not only covers altitude issues, it also covers marine issues, deserts, volcanoes, etc. etc. it’s way too heavy to carry on a trip but it should be on the bookshelf of any serious wilderness traveler.
Posted in Everest 2009, The Altitude Experience | Comments (0)
Expedition primer added
March 12th, 2009
I’ve posted a short illustrated explanation of how a modern expedition generally works; click the Expedition Primer link to the left. If you don’t know the difference between low-altitude and high-altitude porters, or how we arrange to get all of the stuff to Base Camp, this is for you. I’ll tinker with it a bit more before I leave for Everest.
Posted in Everest 2009, The Altitude Experience | Comments (0)
You are unique: more interesting research
February 8th, 2009
If you’ve read my book, you know that I talk a lot about your uniqueness, and how that affects your response to altitude, training, etc. Here’s another study which confirms this.
Researchers at Tufts University published a study that examined differences among people’s glycemic index (GI) for white bread. Recall that the GI measures the degree to which a food changes blood sugar levels. Low GI foods (most fruits, pasta) have little effect on your blood sugar, while high GI foods (potatoes, carrots) cause a spike in blood sugar.
While white bread has a published GI of 72, the fourteen test subjects had average GI values that ranged between 44 and 132! And, the measured GI of white bread varied a lot within some individuals (they measured GI three times in each person).
So your response to a food might be quite different than you would expect, based on the published values. Knowing how your body responds to food, dehydration, altitude, etc. will allow you to tune your approach for better performance.
Citation: Vega-Lopez, S., L. M. Ausman, et al. (2007). Interindividual variability and intra-individual reproducibility of glycemic index values for commercial white bread. Diabetes Care 30(6): 1412-7
Tags: The Altitude Experience
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New Year’s Resolutions
January 22nd, 2009
As we start the new year, I have a few suggestions for resolutions that you might want to adopt this year:
- Strive for quality in your activities. It does no good to lift big weights if you’re out of control, or climb ice by thrashing and dangling. Strive for excellence and control.
- Train your smaller muscles. Work the shoulder stabilizers, ankle stabilizers, and your pushing muscles (if you’re a climber).
- Don’t look for shortcuts. There is no simple way to succeed at altitude (or elsewhere). Understanding your mind and body is the key, and nobody (including me) can do that for you.
- In your training, emphasize things you’re not good at, especially if it has to do with your mind. If you get bored after 15 minutes on the elliptical trainer, you need to train your mind. Can’t go for a run/ski/walk without your iPod? You need to train your mind.
- Re-evaluate your training approach regularly. If you’re doing the same old routine, maybe it’s time to change. What works for a novice isn’t necessarily appropriate for a veteran, and vice versa.
In Chapter 12 of The Altitude Experience, I have a bunch of suggestions for training that apply even to low altitude activities.
Tags: The Altitude Experience
Posted in Exercise and Performance, The Altitude Experience | Comments (0)
Out of the country until Dec. 3
November 25th, 2008
I will be out of the country until December 3. Any book orders that come in will be shipped on December 4. I get to lay on the beach a few days!
Tags: The Altitude Experience
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