SummitPost.org

I'm slowly coming to terms with the possibility that technical routes above about 12000' are not realistic for me. Despite my best attempts at acclimatization, usually by 13000' I'm moving extremely slowly. Scrambling and snow-climbing seems to work out, if I schedule enough time .. but I can't imagine trying to lead, say, 5.7 feeling like that.

I've read that the autonomic nervous system is routed through the upper spinal cord, above T6 (my injury is somewhere below C4). I wonder if control of heart rate / breathing at altitude is somewhat compromised. I don't seem to have a problem at lower elevations, but am somewhat weaker than I used to be. Maybe altitude simply exaggerates this..

The first thought I had was diamox, but I wonder if that would really help .. AMS is not a problem, sluggishness is.

On a related note, do people find that they have to downgrade their lead level for altitude ? Let's say you lead 5.10a at the crags .. do you prefer to lead 1 or 2 levels down in the mountains ?

As I understand it, diamox helps prevent AMS by speeding up the acclimatization process, so I expect it would help with your sluggishness as well.

Have you tried taking your time with your acclimatization before the climbs? I'd expect to get my ass kicked if I tried to lead something at 12,000 without at least a couple nights' acclimatization.

By 'best attempts', I mean several nights .. generally above 7000' the first night, second night above 10000'.

Before my injury I wasn't that great at altitude either. Once I was persuaded to spend the night at 4000' near Bishop and then hike up to 12000' the next day (Gayley Camp in the Palisades) with a full pack. I got full-blown AMS with nausea, etc. by the end of the day.

I should probably see about trying Diamox .. maybe spending a week or two above 10000' in the Sierra would help (build up those red blood cells ) but for most trips that isn't realistic for me..

Yes, the rests issue is the main one that worries me, in addition to being generally weaker at altitude. On a third class ledge or leaning on my ice axe I can wheeze and catch my breath for however many minutes I need, but if I'm hanging onto some crack or doing some delicate stemming move, I can see that as being a lot more problematic .. the phrase "pump clock" also comes to mind.

Rob,

Acclimate, acclimate and acclimate!

Diamox IS NOT A SUBSTITUTE FOR PROPER ACCLIMATIZATION.

I do not care what anyone says. Especially if you are planning to climb at your hardest abilities for an extended amount of time.

I am finding that far too many are relying on DIAMOX these days and not properly acclimating all because "they do not have enough time to."

Well folks, DIAMOX will not prevent HAPE nor HACE!

And both can and have been fatal in the Sierra.

I know from a real very recent personal perspective.

You are probably right Rick. Anyway, I'm a little suspicious of most drugs, since they all have side effects.

I guess what it comes down to is logistics.. if it takes 3-4 days to just to acclimatize, then I will need to carry that much more food, in addition to gear, rope, etc. and allocate that out of my schedule. And who's gonna want to climb with some dude who's going to take 4-5 days to climb a route that has been done car-to-car ? It just makes no sense...

Life with disability is about adaptation .. I guess I'll stick to routes on lower-elevation peaks like Conness and see how that works out.

Normal aclimatization won't keep you from getting out of breath or becoming exhausted due to lack of oxygen, it will only prevent the ususal symptoms of altitude sickness (headache, nausea, Cheyne-Stokes respiration, etc.). It takes a month or so at altitude to increase the red blood cells enough to significantly reduce the exhaustion, etc. Even when I'm well acclimatized my ass is dragging when I'm going uphill at 15,000 ft.

Buz Groshong wrote:Normal aclimatization won't keep you from getting out of breath or becoming exhausted due to lack of oxygen, it will only prevent the ususal symptoms of altitude sickness (headache, nausea, Cheyne-Stokes respiration, etc.). It takes a month or so at altitude to increase the red blood cells enough to significantly reduce the exhaustion, etc. Even when I'm well acclimatized my ass is dragging when I'm going uphill at 15,000 ft.

And what kind of Aerobic PT resume do you have?

There has been a lot of debate about Diamox on this board and elsewhere. One thing about Diamox that seems to be universally accepted is that it only masks symptoms and it does not prevent AMS. Early symptoms of AMS are the signals that let people know they're ascending too fast. Ignoring those symptoms can get people into bigger trouble.

RickF wrote:One thing about Diamox that seems to be universally accepted is that it only masks symptoms and it does not prevent AMS. Early symptoms of AMS are the signals that let people know they're ascending too fast. Ignoring those symptoms can get people into bigger trouble.

YUP.. like HAPE & HACE!

And the two will not hesitate to KILL YOU in a time frame that you have no control over.

Like 3-6 hours if not immediately evac'd and given 100% 02 @ 2-3 litres per minute!

I read somewhere that the government of Argentina does not allow Diamox on Acongogua because too many people have become ill or died because they kept going up after taking Diamox.

In an effort to share more information, I checked the Acongogua page on SP and this is what I found:

"There are prescription drugs out there that you can take for severe symptoms. The most common is called Diamox; it works by stimulating your breathing. Diamox is a strong medication and has some slight side effects, such as an annoying tingling in the fingers and toes. You will urinate more frequently so getting out of the tent at night in a storm could be a problem (if you don’t use a pee bottle). This will also nessisitate you drinking more fluids to compensate. Do not take more than prescribed (some people get really sick), while I avoid taking it, many people find it helps them. My suggestion would be to try it out at home before you head to altitude so you will get to know the symptoms and side effects beforehand. Then when you take them up high you will have a better understanding what it is that is making you feel this way".

RickF wrote:There has been a lot of debate about Diamox on this board and elsewhere. One thing about Diamox that seems to be universally accepted is that it only masks symptoms and it does not prevent AMS. Early symptoms of AMS are the signals that let people know they're ascending too fast. Ignoring those symptoms can get people into bigger trouble.

Hey Rick, where did you get this from that diamox masks symptoms of AMS? I do not believe it is commonly accepted that it does. I read in a couple different references (brochures, articles) written by physicians that it does NOT mask the effects, which means that if you get AMS or even worse HAPE or HACE you will still have the symptoms. Diamox helps you to acclimated faster by acidifying your blood.

It is also a powerful diuretic...dehydration is a major side affect.

And if one reads the drugs prescribed instructions properly, it strictly instructs the individual taking the medication, that it is highly advisable and recommended that they still follow the prescribed proper acclimatization protocols. That this medication will only assist individuals to acclimate BETTER that have a history of having a slow physiological process in doing so.

In other words, DIAMOX is no substitute for proper altitude acclimatization.

Apologies if this is obvious but have you tried pressure breathing? I started doing this relatively recently and it does seem to help me get through harder tasks at altitude when I'm not fully acclimitized.

Another side affect directly from the Diamox Warning label:

"Use caution when driving, operating machinery, or performing other hazardous activities. Acetazolamide may cause dizziness or drowsiness."

Just what you want at altitude when you are making that runout 5.10 or WI6 move, right?

And how about this fact....

MYTH: acetazolamide (Diamox) will prevent AMS from worsening during ascent

Acetazolamide (Diamox) DOES NOT PROTECT AGAINST WORSENING AMS WITH CONTINUED ASCENT. It does not change Golden Rule II. Plenty of people have developed HAPE and HACE who believed this myth.

Unfortunately, this may be the most misused and misprescribed drug in the climbing community.

I've known about pressure breathing since I started mountaineering. btw I have no issues with hydration or appetite or sleeping at altitude.

And just so we're clear, I'm talking about rock and ice climbing at altitude, not slogging / hiking / snow-climbing or scrambling. I've done plenty of that and have no issues there. Yes, I know and use the rest-step too (a little pre-emptive strike )

Anyway, the impression I'm getting is that I'm just basically screwed. Above 12 or 13 thousand feet I should just stick to walk-ups and scrambles. Shit, I should be glad I can still do that .. a lot of quads can't even use their hands.