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CSUMarmot - Oct 31, 2010 6:12 pm - Voted 10/10


they should print this out and put in every FA kit...great stuff
Thanks for posting this


markhallam - Nov 1, 2010 12:37 am - Hasn't voted

Re: Wow

Thanks Chris
I have enjoyed putting this together & glad you feel it could be useful. Just still struggling with the formatting - can't get the tables & photos to go where I want them!
Cheers, Mark


Deltaoperator17 - Nov 1, 2010 12:15 am - Voted 10/10

Thank you

Very detailed and informative!


markhallam - Nov 1, 2010 12:40 am - Hasn't voted

Re: Thank you

Thanks for for that - just wish I could get the formatting right!


markhallam - Nov 1, 2010 2:22 am - Hasn't voted


Yay! Dunnit!
Have to say this HTML business is not easy for an old git. For those who struggle like me then the SP article 'setting tables using HTML' by 'the photo hiker' is an absolute must. And I now know why you have to use noformat before and /noformat after a table!

Liba Kopeckova

Liba Kopeckova - Nov 1, 2010 10:23 am - Voted 10/10

Great article..

I was planning to write something similar being a physicican myself, but wow - you did a great job. HOw about Cialis and Viagra? Gingo? Coca leaves?


markhallam - Nov 1, 2010 11:02 am - Hasn't voted

Re: Great article..

Thanks a lot Liba - great to have some feed back from another medic!
What kind of physician are you?
Yes - Cialis & Viagra. I am not sure - but without more information I probably would be wary of giving, not least since if I treated somebody for HAPE I would give Nifedipine 1st line. I don't know if it could precipitate serious hypotension to then follow with a PDP inhibitor - as can happen with Nitrates. Do you have any thoughts? I had it in mind to put this question to a medical forum.
On Ginco - latest I have heard is that there is no evidence of benefit - pity!
On Coca leaves - not seen any evidence (other than generations of Andean inhabitants chewing the stuff to alleviate altitude symptoms)- but from my perspective as a substance misuse doc, have to say, bad idea!
Thanks again, Mark

Liba Kopeckova

Liba Kopeckova - Nov 1, 2010 12:26 pm - Voted 10/10

Re: Great article..

Hi Mark,
I attended several lectures by Dr. Peter Hackett - he does believe in Cialis and Viagra, and Codeine - great for the cry hacking cough! Yes, Ginco and coca are more herbal supplements with questionable benefits. I did prescribe Viagra in the past for guys racing at high altitudes. I think that there is quiet a lot of evidence for its effects.
I am a pediatrician - so this is totally outside my specialty, but I love mountaineering. How about you?


markhallam - Nov 1, 2010 3:22 pm - Hasn't voted

Re: Viagra etc..

Hi Liba, Yes I have heard of Peter Hackett - and if he is recommending Cialis/Viagra, must look into this some more. What little I know I thought use was treatment of HAPE - but with you mentioning racing at altitude, sounds like you prescribed it to aid altitude performance?
Yes, I have loved mountains for over 30 years. Climbed a lot in the European Alps and a little in the Himalayas in the 1980's - then paragliding for a few years - and then returned to climbing in 2000's. In February I'm making a solo attempt to climb Aconcagua (fundraising for a Hepatitis C charity)- hence a reactivation of my interest in high altitude etc.
Had a quick glance at some of your photos - lovely dog & very game to go up to over 4000m! (Ours is fairly game, but 1100m is his best so far!) And Elbrus looked great - that's next on my list!

Liba Kopeckova

Liba Kopeckova - Nov 1, 2010 3:28 pm - Voted 10/10

Re: Viagra etc..

it was for a cyclist - and they are all on drugs...haha No, he asked me to.
I climbed in Europe too, I am actually from there...


radson - Nov 3, 2010 12:26 pm - Voted 10/10

Re: Great article..

I agree great article. On the subject of Nifedipine ( and I am very aware this is 1 person anecdotal evidence) I took several dosages when I got HAPE at 6,400 to no avail. On my next trip to HA, I was lucky enough to have some chats with Dr Freer and Dr Hackett of the HRE. I was left with the impression that Cialis was considered a more effective prevention and treatment nowadays for HAPE.


markhallam - Nov 9, 2010 1:21 am - Hasn't voted

Re: Great article..

Hello Radson of Oz - sorry, missed your comment until now. Great to hear from someone from your neck of the woods - this is a great site for net-working all over the world!
Thanks for your comment regarding Nifedipine & Cialis. Hmmm - I can see my article may need an update sooner than I thought. I shall be off to Aconcagua end of January and there will be a medic at Base Camp. I shall be interested to find out if they also are now giving Cialis to the number of HAPE cases they would be treating per season. Must also have another burrow in the UIAA site - perhaps sign up & go on the medical forum.
Anyway, sorry to hear you went down with HAPE - assume it must have wrecked a trip for you.
All the best, Mark

Liba Kopeckova

Liba Kopeckova - Nov 9, 2010 11:36 am - Voted 10/10

Re: Great article..

Mark, I have a few articles on Cialis and dosage etc. It is the standard now. I will try to e-mail you some links. Anyway, great job.
P.S. Peter Hackett will be in Mendoza in January educating guides on HAPE etc.


markhallam - Nov 11, 2010 1:02 am - Hasn't voted

Cialis etc

Thanks indeed for the update on Cialis. I'd be keen to see those links if you can e-mail them - and then I'll put an update on this article, acknowledging you of course. I have already got another update to put on: one of my work colleagues was expedition medic on a large Himalayan trek recently - or rather co-medic with a very experienced doctor - and she has told me about single dose Ciprofloxacin (4 x 250mg) for the treatment of 'explosive' diarrhoea.
I shall look out for Peter Hackett in Mendoza - if he is still around at the end of January.
Best wishes,

vancouver islander

vancouver islander - Nov 1, 2010 7:01 pm - Voted 10/10

Wonderful article

Obligatory reading for anyone heading for the big hills. I'm sending the link to many of my non SP pals.

This must have been a tremendous amount of work. I, for one, am very grateful that you've made so much effort and for sharing it with us.

One tiny point under "Haemorrhoid cream" to use "As above or as directed". As above reads "2 drops then tape closed until sensation returns". Ouch !! I'm sure you didn't mean it to read that way. Or did you :-)

All the best, Martin


markhallam - Nov 2, 2010 1:42 am - Hasn't voted

Re: Wonderful article

Thanks very much Martin. Yes, it was quite a lot of work - but in the process I learned a good deal - things that have changed over the years and not least the beginnings of this wierd language HTML (hmm - think I'll take up Chinese next!).
Oh dear, see what you mean about the Haemorrhoid cream. No, I didn't mean it to read that way :-( But mebbe that'd work? Anyway, just in case of litigation, I have made a small alteration :-) Ciao, Mark


asmrz - Nov 2, 2010 10:21 am - Voted 10/10


Hi Mark, very relevant info, very useful, very true. Very good article. Thank you. Alois.


markhallam - Nov 2, 2010 1:05 pm - Hasn't voted

Re: Informative

Thanks for the kind comments Alois,
Cheers, Mark

Brad Marshall

Brad Marshall - Nov 2, 2010 8:53 pm - Voted 10/10

Great Article

Nice work Mark and a great resource for your fellow climbers. Thanks for taking the time to put it all together.


markhallam - Nov 3, 2010 1:52 am - Hasn't voted

Re: Great Article

Thanks very much Brad, appreciate your remarks. And thanks again for your recent article on Aconcagua, which I shall be re-reading a few times before I go out there end of January. I took the liberty of adding this article as a 'child' of yours.
Best wishes, Mark

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