Thanks for posting this review. Everybody here on this board should be aware of these issues (and I am sure most of us are). As you pointed out, the basic underlying cause of every major form of altitude sickness (lung and cerebral edema) is hypoxemia (low oxygen levels in your blood) caused by lower atmospheric pressure at higher altitudes. As a consequence less oxygen gets absorbed in your lungs. As a matter of fact, blood oxygen levels have been measured in climbers on top of Mount Everest. The results demonstrated that the levels were so low that any patient with those values would be immediately transferred to an intensive care unit in any hospital. If not corrected immediately almost every patient with these low oxygen levels would die.
Thanks for the kind words! I intentionally left out Diamox & Dex since I'm no doctor, and can't even play one on TV. ;-) I'd have to completely plagiarize someone else in order to add something on those.
Thanks, that's some serious information... very relevant stuff. I've suffered some serious frostnip and it has left me very vulnerable to cold of late. Have you read or heard of any effective drugs (for use in emergencies only, and not for long term treatment) in common use that improve circulation to the extremities to help ward off frostbite? It might be a good thing to have in one's winter pack.
Re; Frostbite-I had a car accident several years ago that caused nerve damage so that I, generally, have no feeling in my thumb and 2 fingers in my right hand. However, when it is very cold, they start to feel numb and tingly. My doc can't explain it. It causes me to worry about frostbite so I found that helpful.
There was a good article in the American Alpine Club annual journal on various biochemical markers which would be interesting to include. Some of these include NO, which is excreted by endothelial cells, and is responsible for vascular tone and has shown to have beneficial affects in decreasing HAPE. If this is true then an area of research that may be productive is addition of arginine to the diet. In a double blinded study at Stanford, arginine has been shown to increase NO production, but in this case it was for MI patients....
I plan to spread your great article around to participants on our ecuador volcano climbs. Thanks for the clear info. One question - on 8000m ascents, what approximate elevation does the use of oxygen simulate?
Just remember that I'm not a medical professional and can't even play one on TV... ;-)
A good rule of thumb is that bottled oxygen will effectively drop your elevation by 3000-4000' (1000m). Since the masks don't always seal that well against the face, there's a wide variance in how much one can actually get out of the bottle
in my opinion- drugs to help with altitude even if only used in case of emergency will not help save lives, it will downgrade the dangers of high altitude and more people will venture up where they shouldnt, in effect it will kill more people then it helps. Bottled Oxygen is in the same boat. I would like to climb 8000m peaks but if I cant I wont.
Great article, I didn't know that amino acids acted as neurotransmitters. It is amazing all of the things I don't know that I don't know. I won't comment on dexamethasone, but acetazolamide is a carbonic anhydrase inhibitor (it blocks the interconversion between CO2 and bicarbonate). Consequently, it acts as a diuretic. How this helps with acclimatization is unknown, but there are lots of hand waving explanations for it. Thanks for the well researched article!
I just wanted to give my 2 cents on frostbite. I grew up in a cold climate, and winter is my favorite time of year. Any excuse to get out and have fun in the snow I take. All these years, up until last week, I had only had frostbite once, and that was on my wrist where my gloves ended and my coat sleeve began. So I was very surprised last week when after a day of skiing at Brighton, Utah (not exactly a cold place -- the temperature was around -8C [17 F]) I ended up with frostbitten cheeks. It's weird cause I was dressed the same as usual and I would occasionally warm my face with my hand while on the lift. It was really windy so maybe the wind chill was the factor, and also I put on sun block thinking it might form a protective layer, but in retrospect the sun block might have contributed to the problem by keep moisture in which ended up freezing, or maybe the sun block itself froze leaving a thin ice layer on my cheeks. The point is Jack Frost is out there ready to nip you, so don't take any chances and cover up!
For me full face masks don't work well with goggles, and so I went on a quest to figure how to protect exposed skin, such as cheeks and nose, from frostbite. In so doing I came across a study conducted in Finland in which they tested whether skin moisturizers or ointments provide protection. The study concluded that emollients actually increase the risk of frostbite. The only reasonable protection I have been able to come up with is to tape exposed skin. I've learned that ski racers in Canada, dog sled races in Alaska and ice fisherman in Minnesota use duct tape to cover exposed skin. ThePoles.com suggests covering exposed facial skin with medical paper tape.
There are plenty of medicines to prepare for higher altitude you cant cover all your bases without lower air-pressure but you can definately increase your vascular system and its efficiency. Oxygen deficit workout, that can even be targeted to a specific muscle group will increase the vascular pathway high rep little rest. A bunch of medicines increase RBC and hemoglobin (EPO, most AAS, HGH or GHRP) sometimes to dangerous levels so it def can compensate for adjust to high altitude before-hand. There are many things that will dialate the oxygen carrying vessels in the lungs one off-hand I can think of would be clenbuterol, an its long lasting so no constant inhaler use.
SoCalHiker - Jan 7, 2008 9:06 pm - Voted 10/10
Great expose!Thanks for posting this review. Everybody here on this board should be aware of these issues (and I am sure most of us are). As you pointed out, the basic underlying cause of every major form of altitude sickness (lung and cerebral edema) is hypoxemia (low oxygen levels in your blood) caused by lower atmospheric pressure at higher altitudes. As a consequence less oxygen gets absorbed in your lungs. As a matter of fact, blood oxygen levels have been measured in climbers on top of Mount Everest. The results demonstrated that the levels were so low that any patient with those values would be immediately transferred to an intensive care unit in any hospital. If not corrected immediately almost every patient with these low oxygen levels would die.
txmountaineer - Jan 7, 2008 10:21 pm - Hasn't voted
Re: Great expose!Thanks for the kind words!
schmid_th - Jan 8, 2008 9:30 am - Voted 10/10
Good!Good and interesting article!
Thanks for adding!
Cheers, Thomas
txmountaineer - Jan 8, 2008 10:24 am - Hasn't voted
Re: Good!Thanks for voting!! ;-)
tanya - Jan 8, 2008 10:39 am - Voted 10/10
Scary to read....but interesting :)
Nice job!
txmountaineer - Jan 14, 2008 3:19 pm - Hasn't voted
Re: Good articlePuma,
Thanks for the kind words! I intentionally left out Diamox & Dex since I'm no doctor, and can't even play one on TV. ;-) I'd have to completely plagiarize someone else in order to add something on those.
Best Regards!
Daniel
maverick - Jan 15, 2008 10:49 am - Hasn't voted
Wow!Thanks, that's some serious information... very relevant stuff. I've suffered some serious frostnip and it has left me very vulnerable to cold of late. Have you read or heard of any effective drugs (for use in emergencies only, and not for long term treatment) in common use that improve circulation to the extremities to help ward off frostbite? It might be a good thing to have in one's winter pack.
bajaandy - Jan 15, 2008 4:19 pm - Voted 10/10
Great read...Hope you got an "A" in your Phy/Psy course!
Grampahawk - Jan 15, 2008 5:46 pm - Hasn't voted
Great infoRe; Frostbite-I had a car accident several years ago that caused nerve damage so that I, generally, have no feeling in my thumb and 2 fingers in my right hand. However, when it is very cold, they start to feel numb and tingly. My doc can't explain it. It causes me to worry about frostbite so I found that helpful.
CClaude - Jan 16, 2008 2:39 pm - Hasn't voted
interesting....There was a good article in the American Alpine Club annual journal on various biochemical markers which would be interesting to include. Some of these include NO, which is excreted by endothelial cells, and is responsible for vascular tone and has shown to have beneficial affects in decreasing HAPE. If this is true then an area of research that may be productive is addition of arginine to the diet. In a double blinded study at Stanford, arginine has been shown to increase NO production, but in this case it was for MI patients....
txmountaineer - Jan 17, 2008 2:27 pm - Hasn't voted
Re: interesting....Thanks for adding this great piece of information!
dsmucker - Jan 16, 2008 2:51 pm - Hasn't voted
QuestionI plan to spread your great article around to participants on our ecuador volcano climbs. Thanks for the clear info. One question - on 8000m ascents, what approximate elevation does the use of oxygen simulate?
txmountaineer - Jan 17, 2008 2:24 pm - Hasn't voted
Re: QuestionJust remember that I'm not a medical professional and can't even play one on TV... ;-)
A good rule of thumb is that bottled oxygen will effectively drop your elevation by 3000-4000' (1000m). Since the masks don't always seal that well against the face, there's a wide variance in how much one can actually get out of the bottle
ClimberMan420 - Jan 25, 2008 12:01 am - Voted 10/10
Thanks for articlein my opinion- drugs to help with altitude even if only used in case of emergency will not help save lives, it will downgrade the dangers of high altitude and more people will venture up where they shouldnt, in effect it will kill more people then it helps. Bottled Oxygen is in the same boat. I would like to climb 8000m peaks but if I cant I wont.
Ivona - Jan 27, 2008 3:21 pm - Voted 10/10
Thanksfor useful informations.Very interesting article.
Cheers
Iwona
Ialewis - Feb 1, 2008 5:51 am - Voted 10/10
Great articleGreat article, I didn't know that amino acids acted as neurotransmitters. It is amazing all of the things I don't know that I don't know. I won't comment on dexamethasone, but acetazolamide is a carbonic anhydrase inhibitor (it blocks the interconversion between CO2 and bicarbonate). Consequently, it acts as a diuretic. How this helps with acclimatization is unknown, but there are lots of hand waving explanations for it. Thanks for the well researched article!
vanman798 - Dec 23, 2008 12:04 pm - Hasn't voted
FrostbiteFor me full face masks don't work well with goggles, and so I went on a quest to figure how to protect exposed skin, such as cheeks and nose, from frostbite. In so doing I came across a study conducted in Finland in which they tested whether skin moisturizers or ointments provide protection. The study concluded that emollients actually increase the risk of frostbite. The only reasonable protection I have been able to come up with is to tape exposed skin. I've learned that ski racers in Canada, dog sled races in Alaska and ice fisherman in Minnesota use duct tape to cover exposed skin. ThePoles.com suggests covering exposed facial skin with medical paper tape.
learn2farm - Nov 26, 2018 8:50 pm - Hasn't voted
PrepareThere are plenty of medicines to prepare for higher altitude you cant cover all your bases without lower air-pressure but you can definately increase your vascular system and its efficiency. Oxygen deficit workout, that can even be targeted to a specific muscle group will increase the vascular pathway high rep little rest. A bunch of medicines increase RBC and hemoglobin (EPO, most AAS, HGH or GHRP) sometimes to dangerous levels so it def can compensate for adjust to high altitude before-hand. There are many things that will dialate the oxygen carrying vessels in the lungs one off-hand I can think of would be clenbuterol, an its long lasting so no constant inhaler use.