High Altitude Climbing and Acute Mountain Sickness

everest-top

 I have been researching the impact that high altitude climbing will have on my body, what I can expect, what I can do to assist my body’s ability to cope.

And importantly, to be able to recognise the onset of Acute Mountain Sickness in its more serious forms.

Acute Mountain Sickness, AMS as it is often referred to, is the effect the declining number of molecules of oxygen in the atmosphere has on our body as we ascend in altitude. It can range from a mild illness, to the more severe life-threatening forms of the illness, such as High Altitude Pulmonary Edema (HAPE), and High Altitude Cerebral Edema (HACE).

The latter two conditions require immediate attention and descent from altitude otherwise death is the most likely outcome.

I’m not intending to go into a great discussion on either, nor am I qualified to do so, but as part of my journey “To Climb a Mountain” I want to gain a better understanding of both conditions.

High altitude is defined as 5,000 to 11,500 feet, very high altitude 11,500 to 18,000, and extreme altitude as 18,000 feet and above.  At extreme altitudes physiologic function will outstrip  acclimatisation eventually.

My reading has taken me across a wide variety of topics, but the one that caught my attention was the connection between muscle and the requirement to fuel our muscles with oxygen when under exertion.

Over the years I have trained as a power-lifter for strength purposes and I have achieved results I am happy with.  As a consequence I have grown muscularly and currently weigh-in around the 95 kilogram mark.  This has given me a good power-for-weight ratio and has enhanced my speed on the kayak over the short to mid sprint distances.

Power-lifting has helped me develop strong legs, especially my quads through squatting, and dead-lifting.

Will this muscle help, or hinder me on the mountain as I trudge up the side of an 8,000 metre peak?

When exercising, the body, or more specifically the contracting muscles have an increased need for oxygen and this is usually achieved by a higher blood flow to these muscles.

And therein lies the dilemma as I see it.

Due to the less dense air at altitude the number of oxygen molecules for any given mass of air will drop. Consequently, mental and physical performance will decline, and the larger the muscles, the larger the requirement for oxygen to prevent muscular fatigue…

So what can I do?

There is not a lot that you can do to prepare for the effect of AMS, some people will adapt and perform better at altitude than others and this is hard to predict from one individual to another.

What I can do is decrease my muscle mass, and whilst that will mean a decrease in overall strength I can try and maintain the power for weight ratio balance.

The upshot of all this is that ahead of my expedition to Nepal in April I will deliberately take around 10-12 kilograms out of my frame…

The climbs in Nepal will be done without the aid of supplemental oxygen.

I won’t be changing my training routine greatly, I will maintain some weight training, rowing and kayaking, and importantly, a daily walk of around 10-kilometres with a 25-kilogram backpack at silly o’clock in the morning (that is 4:00am).

The best way to control weight change, either gaining, or losing, is via your diet and that starts in the  kitchen.

Baz – The Landy (In my home gym in the “Shed”)

 

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It’s a bit of a lottery (Crikey – Deep Vein Thrombosis)

Recovering

With my recovery coming along and after a fortnight off work I decided to return to the cut and thrust of foreign exchange dealing this week. 

 And don’t let on to my colleagues, but I’ve been missing them and the fun times we have, after all we’ve been doing it together for a long time!

I had a practice driving Janet’s car on the weekend, in preparation for the week ahead, as it is an automatic, enabling me to drive myself to work, and yes, I know, it isn’t quite Red Rover

But it was Monday morning and I was pleased to be heading across the Harbour Bridge and looking forward to the day ahead; after all doing nothing is hard work!

Crossing Sydney Harbour Bridge in Red Rover
Crossing Sydney Harbour Bridge in Red Rover

Well, it was short-lived!

I began to notice some pain in my calf muscle around mid-morning and was thinking it was maybe just my sitting position. I was almost inclined to the old adage “suck it up princess” but after becoming more uncomfortable I thought it best to speak with my surgeon.

It had been impressed on me that after any surgery blood clotting in your veins is possible. Deep Vein Thrombosis or DVT is the technical term they use, and it presents just like an aching muscle in the initial stages.

Naturally, he sent me for an immediate ultra-sound test, and yes, there is clotting; DVT evident…

So I’m now on a heavy dose of blood thinner, something I’m not too enthusiastic about, and back on the couch for another day or two to give it a chance to settle down and the medication to do its work!

Oddly enough, I suspect that if everyone who had surgery was scanned for DVT there would be a far greater number of people detected, so clearly many instances perhaps just resolve themselves or go unchecked.

However, once identified and with the risk of it becoming a more serious condition like Pulmonary embolism, it needs to be treated appropriately!

My journey to the mountains is taking a path I didn’t foresee, but I guess it is all part of the journey!

Baz - Climbing in New Zealand
Baz – Climbing in New Zealand

 

 

The Road to Recovery (Back at home)

Baz - Recovering
Baz – Recovering in the backyard

The miracle of modern medicine and surgery has me at home already, recovering from the surgery I had on both of my ankles late last week…

My doctor is very happy with the procedures and results.

I had an endoscopy on my right ankle to clear some bone debris from a skydiving accident in 2008, and a couple of spurs that had formed.

The left heel was opened completely and the Achilles tendon detached to repair a split which apparently was mostly due to degeneration and to clean the heel of a couple of spurs and a boney protrusion, commonly known as a Haglund’s Bump.  Because it was detached I have had to have two anchor screws placed to enable the Achilles to be sewn back on.

My sport’s doctor had tried some conventional and non-conventional non-surgical therapy on my left foot, including Platelet Rich Plasma (PRP) injections that provided only moderate results.

I’m now recuperating at home and the doctor has suggested two to three weeks of complete rest to hopefully assist in a quicker recovery. Mobility is a problem as my left foot cannot take any weight at all, although my right foot can take weight, which is useful for getting around.

The plan is to progressively introduce some weight and physiotherapy to both feet over the coming month and we are hoping for a full recovery within three months.

Of course, that is the plan, and whilst it is unlikely to be earlier, it may take longer.

Baz - Grey's Peak, New Zealand
Baz – New Zealand

I have until mid-August to confirm my place on the expedition to Nepal in November, so plenty of time to recover and train, hopefully.

And to all, thanks very much for your kind words of support and I’m confident I’ll be back to doing what I love very soon…just being Out and About having fun!

Baz - Southern Alps, New Zealand
Baz – The Landy, Out and About having fun

Strewth, Crikey, Fair dinkum (Stone the ‘flamin crows even)

Baz - Climbing in New Zealand
Baz – Climbing in New Zealand

Now I know some of you might just be wondering when is Baz going to get Out and About in those mountains again and take us on that journey to the really big mountains.

Don’t worry, I’m with you on this one, I’ve been wondering the same thing!

I am missing the mountains.

Anyway, as I was telling you recently, I have had an Achilles Tendon problem that has not responded to conventional treatment, so tomorrow, Thursday, I will be going “under the knife” so to speak to have the problem surgically corrected!

Baz - Southern Alps, New Zealand
Baz Southern Alps, New Zealand

I’m quite positive about the outcome and can’t wait, in fact, I’m quite looking forward to it as it signals the road to recovery, another step forward on the journey to the top of the world’s highest mountains, heaven forbid, the aspiration I have to climb Mt Everest…

There is so much to learn, to absorb, and I guess I’ll have plenty of “free reading time” over the next couple of weeks while I rehabilitate from the initial surgery, which by the way is on both ankles!

Two for the price of one (Yeah, okay Doc, I know you never said that).

Baz - Climbing in the Blue Mountains
Baz – Climbing in the Blue Mountains

 But crikey, bring it on I say

My lovely sister-in-law, that would be Janet’s sister, Leah, has suggested it is best I take a rest from my blog, Baz – The Landy (Out and About having fun) for a day or two. She reckons all you’ll be getting is a morphine induced rambling of strewth’s and crikey’s from the hospital bed. 😉

Good advice, perhaps!

Double Trouble - The Fawthrop Girls...
Double Trouble – The Fawthrop Girls…Janet and Leah

Fair dinkum, she can read me like a book…

So see you mob in a few days, hey!

And hey, I’ll accept all “likes” as a hang in there and get better quickly, Baz!

High Altitude Climbing and Acute Mountain Sickness

I have been researching the impact that high altitude climbing will have on my body, what I can expect, what I can do to assist my body’s ability to cope.

And importantly, to be able to recognise the onset of Acute Mountain Sickness in its more serious forms.

Acute Mountain Sickness, AMS as it is often referred to, is the effect the declining number of molecules of oxygen in the atmosphere has on our body as we ascend in altitude. It can range from a mild illness, to the more severe life-threatening forms of the illness, such as High Altitude Pulmonary Edema (HAPE), and High Altitude Cerebral Edema (HACE).

The latter two conditions require immediate attention and descent from altitude otherwise death is the most likely outcome.

I’m not intending to go into a great discussion on either, nor am I qualified to do so, but as part of my “journey to the mountains” and extreme  altitude climbing I want to gain a better understanding of both conditions.

High altitude is defined as 5,000 to 11,500 feet, very high altitude 11,500 to 18,000, and extreme altitude as 18,000 feet and above.  At extreme altitudes physiologic function will outstrip  acclimatisation eventually.

My reading has taken me across a wide variety of topics, but the one that caught my attention was the connection between muscle and the requirement to fuel our muscles with oxygen when under exertion.

Over the years I have trained as a power-lifter for strength purposes and I have achieved results I am happy with.  As a consequence I have grown muscularly and currently weigh-in around the 95 kilogram mark.  This has given me a good power-for-weight ratio and has enhanced my speed on the kayak over the short to mid sprint distances.

Power-lifting has helped me develop strong legs, especially my quads through squatting, and dead-lifting.

Will this muscle help, or hinder me on the mountain as I trudge up the side of an 8,000 metre peak??

When exercising, the body, or more specifically the contracting muscles, have an increased need for oxygen and this is usually achieved by a higher blood flow to these muscles.

And therein lies the dilemma as I see it.

Due to the less dense air at altitude the number of oxygen molecules for any given mass of air will drop. Consequently, mental and physical performance will decline. The larger the muscles, the larger the requirement for oxygen to prevent muscular fatigue…

So what can I do?

There is not a lot that you can do to prepare for the effect of AMS, some people will adapt and perform better at altitude than others and this is hard to predict from one individual to another.

What I can do is decrease my muscle mass. Whilst that will mean a decrease in overall strength I can try and maintain the power for weight ratio balance.

The upshot of all this is that ahead of my expedition Nepal where I will be climbing three 6,000 metre peaks, including Lobuche East, I will deliberately take around 12-15 kilograms out of my frame…

The climbs in Nepal will be done without the aid of supplemental oxygen.

Essentially, I will not change my training routine at all, I will maintain my same level of weight training, kayaking, rowing and other activities. I have found the best way to control weight change, either gaining, or losing, is via the kitchen and diet.

In fact I won’t even modify my diet to any great extent, simply quantity control.

Baz - Meteor Peak
Baz – Meteor Peak

You’re suffering from what? (Retrocalcaneal Bursitis)

Baz - Mountain Run, Coast to Coast Race, New Zealand
Baz – Mountain Run, Coast to Coast Race, New Zealand

For those of us who run, walk, jog, exercise on a regular basis the term achillies tendonitis is probably equally as familiar as the dog that always chases you half-way through your usual running route.

I suspect the achillies is blamed for most of the pain occurring in that region, but it can also be from other sources.

Over a period of time I have been suffering from Retrocalcaneal Bursitis.

Retro what, I hear you ask.

And just to be clear and to avoid any confusion, the condition and associated pain is in my heel, well below, um, my rear-end.

So what is this ailment, what causes it, and more importantly, what makes it go away?

My sports physician and I have been working on the last part of that answer for some time now.  Bursitis is an inflammation of a little fluid sac found around most of the major joints in our body and it is designed to provide lubrication against friction where muscle and tendons are sliding over bones.

Retrocalcaneal Bursa(photo A.D.A.M Inc)
Retrocalcaneal Bursa
(photo credit  A.D.A.M Inc)

Retrocalcaneal bursitis is the area specifically located around the ankle and heel area of the foot.

Causes for the condition can be varied, but for the most part it is an overuse type of injury that can be induced by walking, running, jogging, and can be accentuated by walking uphill.

For me, that is a tick on all counts. Jogging, tick, running, tick…

Women People wearing high heel shoes can often suffer from the condition.

Last year when I was training for the Coast to Coast Adventure race, a race from the West to East coast of New Zealand ,the condition came and went and was usually treated with plenty of stretching and some anti-inflammatory medication.  However, the condition has worsened over the past few months, corresponding to an increase in my mountaineering endeavours, which involves plenty of uphill walking on steep inclines.

Baz - The Landy
Baz – The Landy

A recent x-ray confirmed that a small bone spur is triggering my condition.

Preparing blood for PRP Treatment
Preparing blood for PRP Treatment

And now that we know precisely what we are dealing with remedial treatment has commenced.  My sports physician has elected to use Platelet Rich Plasma injections, or PRP as it is referred to as.  This is a relatively new technology that involves taking a sample of your own blood, in the same way you would normally do so if having a blood test, and this is placed in a centrifuge to extract the plasma which is then injected into the injured area.

The science behind the treatment is that the platelets contain growth factors which stimulate an inflammatory and healing process.

Okay, I’m sure it is far more technical than that, but crikey, the last time I played doctors and nurses it was with the Kelly girls when I was 10 years old, and it was nothing as complex as PRP treatments.

But I’m digressing…

I had one PRP treatment about two weeks ago, along with a cortisone injection and I will be having a follow up injection in a week’s time to assist the healing process.

And whilst the treatment does not correct the bone spur at this time, it will help strengthen and thicken the achillies tendon and help protect against the aggravation, well that is what we are hoping for as surgery usually takes quite some time to recover from, but may be necessary eventually.

A boy who dreamed of big mountains
A boy who dreamed of big mountains

So another couple of weeks of rest away from the normal exercise routine, but I’m chomping at the bit and need to get extremely fit for the climbing expedition to Nepal later this year.

Strewth, can’t wait for that…

And remember, if all else fails, just remain out of control and take a big leap of faith!

Baz and TomO (two peas in a pod?)
Baz and TomO (two peas in a pod?)

Crikey – Wire me up and check if I have a heart (beat)

Recently I wrote about Acute Mountain Sickness and the effects it can have on the body as you gain altitude when climbing. As we all know the human body was never designed to function at extremely high altitudes and supplemental oxygen is usually required.

And although Mt Everest and other 8,000 metre peaks have been climbed many times without the assistance of supplemental oxygen, the occurrence is rare.

I am taking a number of steps to help prepare for the climbing I am doing over the coming year. I’m training intensely to ensure I am in a peak physical condition, eating a well-balanced diet, and another consideration is to ensure that I do not have any medical conditions that might create issues for myself or others.

Monitoring the latter is an important process.

Grey's Peak New Zealand
Grey’s Peak, New Zealand

I routinely see a Specialist Sports Doctor for ailments and issues associated with exercising. I just saw him a week ago to discuss my high altitude climbing and to obtain a referral to a cardiologist so I can undergo a full coronary check-up, which is something we discussed a few months back.

I don’t expect the tests to reveal anything adverse as all indications are I am in good shape and have no family history of coronary disease. Mind you, if they do produce a negative result at least I can deal with it now!

Friday this week is my appointment day.

Well, as it would turn out I have been suffering a low level cold for the past couple of weeks, you know the type, nothing too serious to cause concern, just enough to be irritating. Janet, my partner has been suffering a full-blown cold for the past few days, although she is recovering now, and TomO, our son has also had one.

On Tuesday this week I woke up feeling a little tight in the chest, wheezing, runny nose, and feeling a little short of breathe. I’m making it sound worse than it was, but I’m a mere male and you know what we are like when it comes to being sick!

And with some rock climbing coming up this weekend in the Blue Mountains, just to the west of Sydney, I wanted to ensure I nipped this in the bud before it got any worse. Later in the day I visited my local General Medical Practitioner in the hope he had some instant cure…

mountaineering
Rock-climbing, Blue Mountains

Crikey, didn’t I open a can of worms!

After describing my symptoms he immediately sent me for an ECG, chest x-ray, and a plethora of other tests, including cholesterol, blood sugar, prostate (phew, at least I got the pathological test) and a couple of others for good measure.

I did suggest that I would be having most of these tests this Friday, but he wouldn’t be swayed. Just as well as I didn’t hear any sirens at the time otherwise I would have been in a mild big panic thinking it was an ambulance coming to collect me!

And don’t get me wrong, better to be safe than sorry, after all he has my health at forefront of mind for sure.

So there I was, lying on the bed, I had more wires on me than you could poke a stick at, and everyone asking did I have any chest pains.

It was just a common cold surely and I just wanted something to make me feel better!

As an aside, when I arrived at the reception of the pathology company the nurse reviewed my requirements, but asked would I mind waiting while she finished ordering her stores for the week. I wasn’t sure whether she meant her groceries or something for the medical practice.

Either way I didn’t mind, it was just a common cold after all I reassured myself. Geez, my heart was starting to beat a little faster by now…

About 10 minutes later when we entered the ECG room she immediately asked whether I had any chest pains.

I just chuckled to myself and said,  “no”. Really I was glad she got her stores done!

Must be an insurance thingy, maybe the waiting room is still on my watch, not theirs? Cark it in the waiting room, well bad luck, but just don’t do it in the consultation room, that’s far too much paper work…

I’m pleased to say all the tests were normal and I still have my specialist appointment tomorrow which will include a stress-test. In fact, for the most part, the results are above average for my age…

But as I was having my ECG I got to thinking that many of us exercise for fitness, health, and general well-being and we assume that it goes a long way towards that goal.

I’m sure it does.

Rowing in the Shed
Baz on the C2 Rower

But equally, there is most likely a point where you can push the body too far, a point at which the exercise undertaken may become detrimental to your health…

I can’t imagine changing anything I do, despite that possibility as I enjoy pushing to the limits, but it is always something to be mindful of!

So how much is too much, what do you reckon?