mneagle

Curious Cat

After 5 years in Seattle I moved to Salt Lake City in 2002. Although afternoon cragging in LCC and a 25 minute commute from our doorstep to the lift line at Alta were pretty nice, I really missed the North Cascades. Lone peak was pretty nice, but that wasa about it for good alpine climbing. After moving to Fort Collins last year I finally escaped the new house projects to get in some climbing in RMNP and see how the Rockies compare to the Cascades. We headed up Tyndall Gorge for Hallet Peak, a huge monolithic face with many 7-8 pitch climbs. Our route was to the right of the central gully up through the dark overhang near the top. Hallett Peak: Pitch 1 was up some easy blocks stuff with the ever present yellow lichens: Jim turning the roof on the 5.8 second pitch. It was a continuous corner crack with sweet stemming and good gear: I can't remember whether this is pitch 3 or 5. There was a lot of wide open mid-5th class face climbing with solid holds and spaced out protection. It felt great to run it out with pretty large exposure. Jime heading up more of the same terrain. Note the blue sky overhead on the last shot. We were enjying ourselves and not making too much effort to hurry. This turned out to be a mistake as within the next 45 minutes RMNP lived up to its reputation for rapid weather changes. I found myself panting and fighting massive rope drag as I ran 2 pitches togetther to get through the last 5.8 roof section before the sprinkles started. Jim followed and finished the last short pitch before we both bolted for the repel route as thunder roared overhead. Pretty scary. We did have time for 1 photo before repelling. A few days later my wife and I did some more hiking and spotted a few more future objectives. The Shark's Tooth - from Northeast: There are sure a lot of spires around the park. These are Zowie (left) and Wham (right) on the way to Andrews "Glacier". This is what they call a "glacier" in Colorado (note guy to the left of the photo who just took a run through the sun-bowls): Nice scenery on the way to check out the Cathedral Spires. Glass Lake: The Cathedral Spires have some must do spires including the Petit Grepon (center), the Saber (right) and the Shark's Tooth (left).

I take care of people all the time with DVT's. You're lucky, in a way. Clots below the knee tend to break free and travel to the lungs less often and the long term damage to the valves in the veins is usually less so long term problems with swelling are not a big deal most of the time. Major bleeding is more likely to occur while on coumadin and bleeding into your head is the biggest concern. I strongly advise patients to avoid any activities that can result in head trauma. Here is Colorado that involves telling people they should not ski, climb or mountain bike while being treated. I get a lot of groans but after I tell them that I have also taken care of a lot of severely brain injured patients in the ICU who had head bleeds on coumadin, they usually comply. My advice would be to take some time off from climbing and instead pursue those activities that you've been meaning to do (read more books, take guitar lessons, etc) but climbing has always gotten in the way of. As for the pain, it's variable. Many people have no symptoms at all. In people who have pain, in my experience, it usually subsides in day to weeks. Heating pads can help. Stay away from aspirin and NSAIDS. It concerns me a little that the doctors who put you on blood thinners haven't already talked to you about these things and you have to ask for advice on a climbing web site. I hope they have filled you in a little on how coumadin works. If not, it is a vitamin K antagonist. This means it impairs your liver's ability to make certain clotting factors that vitamin K is used in making. It is a competitive inhibitor, meaning that you need to balance the coumadin with the amount of vitamin K you are taking in. This doesn't mean you need to avoid vitamin K, just that you need to eat a fairly steady diet. For example, if you eat a pound of broccoli one day despite eating a diet usually devoid of green vegetables your blood will get too thick for the next several days, increasing your risk of more clots or the clot breaking loose and going to your lungs. If your blood levels are difficult to control, a nutritionist may help you sort out your diet. On the other hand, some drugs can accentuate the effects of coumadin and can cause you blood to get too thin, increasing your risks of bleeding. Antibiotics are frequent causes of this situation. Make sure whoever is giving you any new medications knows you are on coumadin and discuss the possibility of drug interactions with your pharmacist.

When I lead the second pitch of Bishop's Terrace I was told by a Valley savy fellow that it is considered "The 5.8 of the Valley" that others should be compared to. It was strenuous but I still think The Lizard at Index is way harder.

The rep from Merck was trying to convince me to use Singulaire for allergic rhitis a few months ago and gave me some literature to prove it. It used some screwy statistical method that I have never heard of and the rep couln't explain. I got the numbers out of the paper and there was only a 3% absolute difference between placebo and drug and (with the help of my palmpilot) I calculated the number needed to treat was 65 to prevent 1 event. so, 64 pissed off patients that wasted money on the drug compared to the 1 who got better? The rep blushed and had no reply. I thanked him for lunch.

I forgot to mention the Monastery, which is up the Big Thompson Canyon just past Glen Haven. This is probably a 20 minute drive from Estes Park and is said to have a ton of good routes of all grades, although I haven't been there. The Monastery:

Estes Park would be the place for some nice hiking with the family. Lumpy Ridge has a fair number of routes where you could TR the first pitch. There is also a sport cilmbing area in Poudre Canyon called the Palace that not a lot of people know about. It is about an hour drive from Estes Park. It's got a lot of moderate stuff and is well bolted. It does require a steam crossing which can be up to your thighs and pretty cold. Eldo has quite a bit of single pitch stuff that would probably fit your bill. Photo of the Palace (not mine):

It's not that hard for 5.9 but if you fell you would most likely be badly injured. Sliding a #5 Camalot or #6 WC up is best. Bigger and smaller stuff is only available at the beginning and the end of the pitch. Here it is:

When we did it in late season we had some problems on the descent from EMS. The snowfield below dorado was all melted out and we had to climb down and through a lot of crevasses and got cliffed out to the left so we had to descend a long ways to get around a huge slab before making our way back up to the col. Still totally doable that time of year but with the melt out and short daylight we ended up making a 24 hr round trip from the base of Eldorado East Ridge. After a few hrs of sleep we bagged Eldo and then headed home for a total 2 day trip with not very much sleep. Also, we got confused on the descent in the dark and instead of going all the way down to the col behind EMS we just rapped the face down to the glacier. It cost me a cordelette to make the anchors. Enjoy.

The mosquitos were the worst I have ever seem. They followed us all the way to the summit, harrassing us whenever we stopped. Bring lots of DEET. We did it with a bivy and it was fine, but 1 day would work pretty well too.

Try looking here if you've got the cash: Valley Cams

Here's a great day: take crescent crack (classic 5.7) then the 5.9 slab variation to the top; rap off back side practically at the belay spot for the coffin. Climb the coffin 5.9 and up the second pitch 5.9 on the right side. Then rap back to base with 2 rapells while looking at the bolted 10a on the right side of the coffin. If you don't mind the tenuous fist 20 feet then lead it, otherwise TR it from the bolts at the top of the first pitch. These are all great pitches and close together. I alson agree that the Thumb is a classic route. If you want to sample the best climbing in Utah, consider a hike up to Lone Peak and take the Vertical Overhangs 10a variation on the summit wall or Out of the Question 10b on Question Mark Wall. Not sure if snow will be gone however. A 2 hour drive gets you to Maple Canyon if you want to climb cobbles.

Huayna Potosi high camp. Via de los Franceses is the slope at the top left of the photo. The standard route goes off the picture to the right and circles around. I was a sexy beast 10 years ago with those sweet gators. Expect lots of gapers like this on the standard route. And yes, I really did need 2 sleeping pads. [/img] Huayna Potosi West Face. Dalius, I'm jealous you got to climb it. A big storm came in 2 days before we were going in and conditions were too sketch. This is the piste on Chacaltaya complete with painfully difficult to use surface lift. Here she is, Condoriri. Ala Derecha is to the right (duh) and Ala Izquierda is a bit hidden to the left. Summit ridge of Condoriri from just above the ice gully. Now Dalius, you are the actual photographer...let's see some shots.

Please don't be offended by a little advice... Chacaltaya isn't a climb, it's just a place to get a few ski runs on the highest lift serviced ski area in the world. It's a nice day trip from La Paz, though. (I'll look for a picture when I get home.) It seems like kind of a waste to go into the Cabeza de Condor basecamp and only climb Pequeno Alpamamyo. From that camp you can tag several other summits of varying difficulty from walk ups to the more difficult stuff on Ala Derecha and Huallomen. We tagged an excellent line on the South Face of Ala Izquierda, which I would highly suggest provided conditions are good. Ala Izquierda (We climbed the left side of the serac at the bottom of the face and then traversed to the right to the mixed face. Descended the east ridge at right skyline.) Ala Izquierda (climbing the lower serac.) Ala Izquierda (Upper mixed pitches...don't forget the stubbies and screamers.) View from Condoriri (Illampu and Ancohuma in the distance): The ridge on Pequeno Alpamayo is pretty beautiful though: Illimani actually is a pretty cool climb that can be done in 3-4 days round trip from La Paz. The "trade route" turned out to be pretty challenging with hard/icy conditions with 1000's of feet of fall potential. Bring a few screws and pickets for the steeper wind-blown sections. Two French guides from Chamonix died there 2 weeks after we climbed it. They left their ice axes in camp and tried to climb it with ski poles...ooops. I've never been higher or colder than I was on Sajama. Not too thrilling otherwise but the local hotsprings are pretty cool if you can find them. Avoid the "commercial springs" and go a little further down the road looking for the rock stacks used to dam up the hot water. Sajama: If you are doing tourist stuff, don't miss the road to Coroico. Best to take mountain bikes down the road and spend a few days hiking back to La Cumbra. Unless you would rather ride in the back of a truck like this: Don't miss Lake Titicaca either: You can rent climbing shoes from Bolivian Journeys and go sport climbing in La Zona Sur in La Paz for an afternoon as well. La Florida, La Zona Sur: Have a great time.

Hmmm... web page

My wife and I climbed Cathedral Peak on Sept 11, 2001. We climbed the southest buttress and it was one of the best lines I've ever done. On the summit it was a blue-bird day, without a plane in the sky . We spent another night and hiked out on the 12th. I think we were the last people in America to know about the Twin Towers. Despite the association with terrorism, the Pasaytan Wilderness is still one of the most beautiful places on Earth. The Southeast Buttress is an amazing route. Every pitch was fun and challenging. We didn't bring any big cams, so we climbed a 10a finger crack just to the right of the 5.9 off-width. The walk off is a no brainer as long as you stay to the left.

I looked into hypoxia tents thinking I would use them for some research into the effects of altitude on sleep during my pulmonary fellowship. They are designed to work based on the alveolar gas equation: PA O2 = FIO2 (PB - PH2O) - PCO2/.8 PA is alveolar partial pressure of oxygen FIO2 is the fraction of oxygen in air PB is the barometric pressure PH2O is the pressure of water vapor PCO2 is the partial pressure of carbon dioxide At any altitude the fraction of oxygen is always .21 (or 21%) and the parital pressure of water vapor is basically fixed in the alveoli where air is basically fully humidified. Your PCO2 is also stable unless you are hypo or hyper ventilating. As the barometric pressure drops as you go higher the partial pressure of oxygen drops in the alveoli (and consequently the partial pressure in your blood will fall). Based on these priciples, the tents are designed not to affect barometric pressure but to deliver an FIO2 lower than the typical .21 of room air. Using a chart to correlate PAO2 with altitude you can calculate the FIO2 you need to simulate that altitude while staying at the same barometric pressure. Bottom line is that provided they are able to deliver the specified FIO2 they should be able to accurately simulate altitude. But why would you want to do this rather than just spending a few extra days in a beautiful place in the mountains? As for VO2max, I agree with others that it shouldn't be your focus. By definition your VO2max is past your anaerobic threshold so it really only matters in sports like sprinting. Although the anaerobic threshold can be modified, once you are in shape it is very difficult to get much more improvement with additional training. The real number to work on for endurance sports is the amount of time you can maintain exercise at a level just below your anaerobic threshold. Yeah, it's impressive that Lance has a VO2 max in the 80's and an unreasonably high anaerobic threshold but what is really sets him apart is that he can keep going at 90% of his anaerobic threshold for hours. This is a factor that really can change with training. I hope that was helpful.

Was this the route you did? I did it several years ago in cold but thin conditions and submitted it as a new ascent to the new Olympics Guide. I remember a short rock section midway up with a bulge that was a little scary to get over. I also remember thinking that I really didn't want to downclimb it. I went up after work and did most of the route by headlamp (hence the name). I bivied on the ridge and continued on to the summit the next day. Great climb. For reference, from the diamond shaped snowfield at the base of the route you just make a right turn and enter the standard couloir route for the South Brothers.

Pursed lip breathing improves breathlessness in patients with COPD not by holding aleoli open but rather by preventing early airway collapse and allowing for longer expiratory times and larger expiratory volumes, thus increasing efficiency of ventilation and carbon dioxide elimination. It works in COPD patients because of the loss of airway tethering, increased mucous production and other factors that comtribute to airway obstruction. "Pressure breathing" as the RMI folks describe it, is meant to increase the pressure of the intrained air in hopes of forcing it into your blood (or some such nonesense). What they fail to appreciate is that force applied to the thoracic cavity (by contracting your chest wall muscles) does not just change the airway/alveolar pressure but is instead applied to all tissues. The transmural pressure of the alveoli is therefore not changed and oxygen will therefore not be "forced into your blood". If anything, you may have a drop in venous return which may decrease your cardiac output. Of course if they are dragging a bunch of smokers with COPD up the dog route then it may be of some benefit. So does true pressure breathing exist? It sure does, just ask this guy: Since World War II we have known that tightly fitting masks delivering highly pressured air and/or oxygen can increase blood oxygen levels at altitude. The reason RMI "pressure breathing" won't work is that the pressure is created by contraction of the chest wall muscles against a partially closed airway as opposed to having a high pressure mask and breathing normally. Of course, pilot masks are aid.

I talked to Sam and he gave me a sickening first hand account of the ordeal. He may want to post the story himself, so I won't steal his thunder but one thing I can say is that I hope to never feel myself going into spinal shock the way he did (imagine being paralyzed with your whole body on fire while sporting a big boner). He's out of traction but has to wear a brace for 12 weeks or so. He's looking at 6-12 months of rehab but if all goes well he should be back to normal with only a 10-20% decrease in neck mobility. He admits to a huge amount of luck in not being paralyzed but completely credits Dave and Pax with saving his life. Come out and climb with me in RMNP and I'll buy you guys some 's. Hang in there dude.

I just found out today that the "Sam" involved in the accident is a buddy of mine that I used to climb with a lot when I lived in Washington. This is terribly upsetting to learn. He is an excellent guy and a great partner. I sure hope he gets through this soon and gets back on his feet and back in the mountains. Here are a few shots of him in better condition: Total Soul - Three O'Clock Rock Summit of Black Peak Smoking a sausage atop Prussik Peak Crux-offwidth on Backbone Ridge - Dragontail Peak Bivy before Liberty Crack - Liberty Bell Best wishes dude.

A puffy morning below Liberty Crack with reconstituted eggs as a reward for sleeping head downhill on an incline.

Here are some abstracts from peer-reviewed medical journals to consider. Efficacy and safety of ephedra and ephedrine for weight loss and athletic performance: a meta-analysis. Shekelle PG - JAMA - 26-MAR-2003; 289(12): 1537-45 From NIH/NLM MEDLINE Abstract: CONTEXT: Ephedra and ephedrine sometimes are used for weight loss or enhanced athletic performance, but the efficacy and safety of these compounds are uncertain. OBJECTIVE: To assess the efficacy and safety of ephedra and ephedrine used for weight loss and enhanced athletic performance. DATA SOURCES: We searched 9 databases using the terms ephedra, ephedrine, adverse effect, side effect, efficacy, effective, and toxic. We included unpublished trials and non-English-language documents. Adverse events reported to the US Food and Drug Administration MedWatch program were assessed. STUDY SELECTION: Eligible studies were controlled trials of ephedra or ephedrine used for weight loss or athletic performance and case reports of adverse events associated with such use. Eligible studies for weight loss were human studies with at least 8 weeks of follow-up; and for athletic performance, those having no minimum follow-up. Eligible case reports documented that ephedra or ephedrine was consumed within 24 hours prior to an adverse event or that ephedrine or an associated product was found in blood or urine, and that other potential causes had been excluded. Of the 530 articles screened, 52 controlled trials and 65 case reports were included in the adverse events analysis. Of more than 18 000 other case reports screened, 284 underwent detailed review. DATA EXTRACTION: Two reviewers independently identified trials of efficacy and safety of ephedra and ephedrine on weight loss or athletic performance; disagreements were resolved by consensus. Case reports were reviewed with explicit and implicit methods. DATA SYNTHESIS: No weight loss trials assessed duration of treatment greater than 6 months. Pooled results for trials comparing placebo with ephedrine (n = 5), ephedrine and caffeine (n = 12), ephedra (n = 1), and ephedra and herbs containing caffeine (n = 4) yielded estimates of weight loss (more than placebo) of 0.6 (95% confidence interval, 0.2-1.0), 1.0 (0.7-1.3), 0.8 (0.4-1.2), and 1.0 (0.6-1.3) kg/mo, respectively. Sensitivity analyses did not substantially alter the latter 3 results. No trials of ephedra and athletic performance were found; 7 trials of ephedrine were too heterogeneous to synthesize. Safety data from 50 trials yielded estimates of 2.2- to 3.6-fold increases in odds of psychiatric, autonomic, or gastrointestinal symptoms, and heart palpitations. Data are insufficient to draw conclusions about adverse events occurring at a rate less than 1.0 per thousand. The majority of case reports are insufficiently documented to allow meaningful assessment. CONCLUSIONS: Ephedrine and ephedra promote modest short-term weight loss (approximately 0.9 kg/mo more than placebo) in clinical trials. There are no data regarding long-term weight loss, and evidence to support use of ephedra for athletic performance is insufficient. Use of ephedra or ephedrine and caffeine is associated with increased risk of psychiatric, autonomic, or gastrointestinal symptoms, and heart palpitations. Adverse cardiovascular events temporally associated with ma huang, an herbal source of ephedrine. Samenuk D - Mayo Clin Proc - 01-JAN-2002; 77(1): 12-6 From NIH/NLM MEDLINE Abstract: OBJECTIVE: To evaluate possible cardiovascular toxic effects associated with use of dietary supplements containing ma huang, an herbal source of ephedrine. METHODS: We reviewed the comprehensive database Adverse Reaction Monitoring System of the Food and Drug Administration, which included clinical records, investigative reports, and autopsy reports related to ma huang use. The main outcome measurements were stroke, myocardial infarction, and sudden death. RESULTS: From 1995 to 1997, 926 cases of possible ma huang toxicity were reported to the Food and Drug Administration. In 37 patients (23 women and 14 men with a mean +/- SD age of 43 +/- 13 years), use of ma huang was temporally related to stroke (in 16), myocardial infarction (in 10), or sudden death (in 11). Autopsies performed in 7 of the 11 patients who experienced sudden death showed a normal heart in 1, coronary atherosclerosis in 3, and cardiomyopathies in 3. In 36 of the 37 patients, use of ma huang was reported to be within the manufacturers' dosing guidelines. CONCLUSIONS: Analysis of the 37 patients indicates the following findings: (1) ma huang use is temporally related to stroke, myocardial infarction, and sudden death; (2) underlying heart or vascular disease is not a prerequisite for ma huang-related adverse events; and (3) the cardiovascular toxic effects associated with ma huang were not limited to massive doses. Although the pathogenesis of the cardiac toxic effects of ma huang remains incompletely defined, available observational and circumstantial evidence indicates that use of the substance may be associated with serious medical complications. Adverse cardiovascular and central nervous system events associated with dietary supplements containing ephedra alkaloids. Haller CA - N Engl J Med - 21-DEC-2000; 343(25): 1833-8 From NIH/NLM MEDLINE Abstract: BACKGROUND: Dietary supplements that contain ephedra alkaloids (sometimes called ma huang) are widely promoted and used in the United States as a means of losing weight and increasing energy. In the light of recently reported adverse events related to use of these products, the Food and Drug Administration (FDA) has proposed limits on the dose and duration of use of such supplements. The FDA requested an independent review of reports of adverse events related to the use of supplements that contained ephedra alkaloids to assess causation and to estimate the level of risk the use of these supplements poses to consumers. METHODS: We reviewed 140 reports of adverse events related to the use of dietary supplements containing ephedra alkaloids that were submitted to the FDA between June 1, 1997, and March 31, 1999. A standardized rating system for assessing causation was applied to each adverse event. RESULTS: Thirty-one percent of cases were considered to be definitely or probably related to the use of supplements containing ephedra alkaloids, and 31 percent were deemed to be possibly related. Among the adverse events that were deemed definitely, probably, or possibly related to the use of supplements containing ephedra alkaloids, 47 percent involved cardiovascular symptoms and 18 percent involved the central nervous system. Hypertension was the single most frequent adverse effect (17 reports), followed by palpitations, tachycardia, or both (13); stroke (10); and seizures (7). Ten events resulted in death, and 13 events produced permanent disability, representing 26 percent of the definite, probable, and possible cases. CONCLUSIONS: The use of dietary supplements that contain ephedra alkaloids may pose a health risk to some persons. These findings indicate the need for a better understanding of individual susceptibility to the adverse effects of such dietary supplements.

You are thinking of deQuervain’s tenosynovitis. (It's Dupuytren's that had the contracture named after him). The physical exam test is my favorite in all of medicine, the "Finkelstein Test". Wrap your fingers around your thumb as above and flex the wrist down like you are milking a cow. If the tendon is inflammed pain will radiate up your forearm from the thumb. A steroid injection can fix it fast but has the increased risk of tendon rupture. Rest, ice, etc is probably safer.

I saw Iggy Pop on a double bill with the Ramones in the 80's. Freakin' incredible.