The Chief wrote:Maybe one should just do it without any "Drugs", eh?

I think the best remedy is one that was posted earlier... weekend jaunts to altitude will definitely help your situ, Rob.

Just saying......

Not always possible to fix things without drugs. Thyroid problems and anemia are not going to be cured by "weekend jaunts".

fowweezer wrote:

rhyang wrote:Hmm .. anemia sounds like something I should look into.

Absolutely on the anemia thing (and maybe thyroid? Probably not though, since you're not lethargic generally, at home or whatever).....anemia kicked my ass pretty good until I got a handle on it 6 years ago or so. I'd be fine most of the time, but when I'd go for a run I could barely move my legs.

I seem to do fine at sea level. I went out for an evening hike yesterday in the Santa Cruz mountains near where I live - about 10 miles / 2400' gain, in about 2 hours 35 minutes. It's not uncommon for me to mountain bike in the evening 18-20 miles with two thousand feet of elevation gain.

Similarly, last Friday I drove up from San Jose to about 8600' (Lembert Dome in Tuolumne Meadows) and hiked up to ~10000' (within about a mile of Young Lakes), then back to the car .. probably 9-10 miles / 1500' gain, in something like 2 hours, 45 minutes. Above 9500-10000' is where altitude really starts to slow me down .. that hasn't changed much in the years I've been doing this.

I slept that night around 10000', and Saturday went from the meadows to Eichorn Pinnacle's NF and Cathedral Peak's west face (around 10900'). Drove down to Bishop (4000'), then up to North Lake (9400') and spent the night.

Sunday dayhiked from there up to Wahoo Peak (12488'), about 16 miles. I was pretty burnt after that, and above 12000' I was seriously dragging, as usual.

Google picked up a study that said anemia is not uncommon with spinal cord injuries, but usually it's because of some complication like pressure sores or urinary tract infection.. neither is an issue for me.

The Chief wrote: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.

+1

I usually insert around the 10 k level. A few days of training hikes. Go up slowly. It's not the days, but the nights. The trouble starts around 14k. Around 20k it's hard to breathe at night. Wake up after a few minutes and feel like I'm being strangled.

As far as technical, you're really looking to minimize this. Very, very slow. No lunges because they can set your heart/lung rate out of balance. Important to breathe through the nose as that relaxes your chakra. Probably won't be bouldering in the evening, to pass the time, above 6000 M (20 k feet).

Certainly, this will be an incentive to move fluidly. Minimize effort.

Trying something new now. Spilt trip. Spent some time in the Rockies, three day interval and head for the Himalaya. Will post on how that goes.

John Duffield wrote:I usually insert around the 10 k level. A few days of training hikes. Go up slowly. It's not the days, but the nights. The trouble starts around 14k. Around 20k it's hard to breathe at night. Wake up after a few minutes and feel like I'm being strangled.

As far as technical, you're really looking to minimize this. Very, very slow. No lunges because they can set your heart/lung rate out of balance. Important to breathe through the nose as that relaxes your chakra. Probably won't be bouldering in the evening, to pass the time, above 6000 M (20 k feet).

Certainly, this will be an incentive to move fluidly. Minimize effort.

Trying something new now. Spilt trip. Spent some time in the Rockies, three day interval and head for the Himalaya. Will post on how that goes.

Sorry, but aren't you the guy who hires guides to lead him up everything ?

fowweezer wrote:As an aside, anemia certainly requires iron supplements of some kind. There is a vitamin you need to take alongside it....maybe Vitamin C or D, I don't remember.

Rob, you'd be surprised what can lead to anemia, especially if your diet is relatively low in iron to begin with. When I moved from sea level to "altitude" (4,500 feet or so in Utah), I was training for college cross country at the time and running about 85-90 miles per week on average. I was in the best shape of my life in Maryland and within 3-4 weeks of being in Utah I could barely keep the same pace I had on my "easy runs" as a sophomore in high school. Since training/living at higher elevation spurs red blood cell production, which uses iron intensively, the move to altitude was the direct cause of my anemia. It was so bad that our team doctor forced me to take several weeks off without running at all until I got a handle on it. My diet was also not very good at the time, and certainly not high in iron.

In any event, I felt fine walking around (much like you do at "lower" elevations in the mountains or at sea level), but any sort of higher-end effort taxed me very quickly (just like you at higher elevations). It could have been caused by something as simple as hiking more in the mountains, spurring red blood cell production.....but it's worth checking, particularly since a ferritin blood test is cheap (~$30 I think).

edited to add: plus, if it IS an iron issue, it's a really easy fix relatively speaking. I'd hope for that, personally.

Very interesting, thanks ! My diet probably isn't exactly iron-rich .. in contrast my Sunday hiking companion had a nice-looking steak for dinner

rhyang wrote:
Sorry, but aren't you the guy who hires guides to lead him up everything ?

wow

I'm famous now! ha ha

Not everything. Sometimes, the guides take me up too fast. In China, with many outfitters, you have to arrive at a certain pass, on a certain day, already acclimatized. In any case, the guide can't acclimatize you. So if you start barfing your brains out on an ice shelf at 4500 M and a little wobbly on the pitches, you're stuck.

fowweezer wrote:As an aside, anemia certainly requires iron supplements of some kind. There is a vitamin you need to take alongside it....maybe Vitamin C or D, I don't remember.

I wouldn't suggest taking an iron supplement without talking to a dcotor. There is a reason that men's supplements usually do not have iron in them. With Rob's diet, it might be as simple as a change in diet or taking supplements. I would just say to check with a doctor first.

Anemia is not always easy to fix. My wife has anemia even though she is on iron supplements and we live at over 9,000'. She has been fighting it for several years but doctors still aren't sure what's causing it.

fowweezer wrote:As an aside, anemia certainly requires iron supplements of some kind. There is a vitamin you need to take alongside it....maybe Vitamin C or D, I don't remember.

I wouldn't suggest taking an iron supplement without talking to a dcotor. There is a reason that men's supplements usually do not have iron in them. With Rob's diet, it might be as simple as a change in diet or taking supplements. I would just say to check with a doctor first.

Anemia is not always easy to fix. My wife has anemia even though she is on iron supplements and we live at over 9,000'. She has been fighting it for several years but doctors still aren't sure what's causing it.

I spent the weekend trying out diamox. Maybe it helped a bit with acclimatization (since I was mainly sleeping in the car), but the effect was marginal at best. I was still pretty much out of breath above ~12000'.

Friday I went for a 12-13 mile warmup hike in Tuolumne, up to 10000' (visited Young Lake). Before bed I took 125mg acetazolamide and spent the night around 10000'.

Saturday in the morning I took another 125mg and then hiked up Mt. Dana (13057') from just below Tioga Pass. No major side effects that I could tell (other than slight increase in urination, but then I always pee a lot at altitude), so I traversed over to Mt. Gibbs (12774'). What a talus slog It was kind of a long day ..

Took 125mg Saturday evening and spent the night near Mosquito Flat (10000'-ish) then Sunday went up Bear Creek Spire (13713') via the NE Ridge (class 4 with short sections of easy fifth).

I did BCS NE Ridge about two years ago pre-injury. I felt a lot more out of breath this time, and weaker. In 2007 I was strong enough to jam my way up some 5.5 cracks on the ridge and did a 5.6 variation near the summit. This time I was spending minutes at a time catching my breath and pretty much stuck to fourth class or less whenever possible.

Maybe I should up with the dosage to 250mg, but I wonder if acclimatization is really the problem. In 2007 when I did BCS all I did was go climbing in Tuolumne the day before and then sleep at 10000' the night before.

I'm going to call my doctor and see about getting tested for anemia. Thanks again for the advice guys.

rhyang wrote:Maybe I should up with the dosage to 250mg, but I wonder if acclimatization is really the problem.

Taking acetazolamide has NOTHING to do with speeding acclimatization. Totally unrelated and shouldn't even be in the same conversation. Anemia is a possibility but unlikely unless you're a vegan whacko. Sounds like more of a case of getting old and losing fitness. [Insert mandatory crossfit cures everything drivel.]

It's called getting old brother. Your comeback is amazing, and you're performing at a level thats beyond most already. Stay away from that Diamox stuff.

Regarding technical climbing. Here's a breakdown of diminishing performance that makes sense to me. Scale as necessary.

5.12- on toprope
5.11 sport onsite
5.10+ trad onsite
hard 5.9 alpine
hard 5.8 alpine with an overnight pack

5.13 and 5.14 climbers in the big moutains are often giving total effort to OS hard 10 and easier 11 pitches. Likewise M12 climbers on M6 in the mtns.

I suppose anemia is a possibility if you have some remaining internal bleeding from the accident or something like that but with the anemia I felt it all the time, not just in particular situations. I also became lightheaded and dizzy really easily (e.g., standing up too quickly after picking up something on the ground) and my blood pressure was ridiculously low. You could try B supplements in the meantime if you don't want to start iron before seeing your doctor (good idea to wait.) If you end up on iron supplements, try the high dose ferrous gluconate (it wasn't on the shelf at my pharmacy but the pharmacist had it behind the counter) and take it with some citrus...otherwise it's rough on your stomach! Good luck! Hope you figure it out.

Alpynisto wrote:Taking acetazolamide has NOTHING to do with speeding acclimatization. Totally unrelated and shouldn't even be in the same conversation.

Anybody care to quote references for that? Until I see something that proves otherwise, I will tend to believe the doctors who have actually studied the issue (such as Peter Hackett and Thomas Dietz, both of who disagree with you.)

"It has been shown to accelerate acclimatization" - Dietz

"It speeds up the acclimatization process in the body" - Hackett

brandon wrote:It's called getting old brother. Your comeback is amazing, and you're performing at a level thats beyond most already. Stay away from that Diamox stuff.

Regarding technical climbing. Here's a breakdown of diminishing performance that makes sense to me. Scale as necessary.

5.12- on toprope
5.11 sport onsite
5.10+ trad onsite
hard 5.9 alpine
hard 5.8 alpine with an overnight pack

5.13 and 5.14 climbers in the big moutains are often giving total effort to OS hard 10 and easier 11 pitches. Likewise M12 climbers on M6 in the mtns.

Ah.... Source?

I am well over 16 years older than you Brendan and just finished some solid sustained .10+ alpine at 14K with clients. Spent over 6-10 weeks last summer climbing high 10's and low 11.s Trad, consistently, at 12k and above.

I believe that ones fitness level as well as the amount of time they actually spend acclimating is so very critical.

Also, we are working with Dr. Hackett on my recent client HAPE death scenario. My situ is a clear indication, according to his studies, that there are just some folks out there that are not physiologically adaptable to high altitudes.

Rob, you may just be one of these folks.

On a side note Rob, look into Cordyceps, Guarana and Taurine. Been taking them regularly for the past five years and really feel the difference in strength, endurance and 02 capacity at 10k and above.

There is no scientific evidence that Cordyceps, Guarana and Taurine help to acclimate, however there is plenty of evidence that Diamox does.
Why don't you try some coca tea. It might be somewhat difficult to come by in California but it worked great for me in Peru.