mneagle

I checked these out at the Grivel booth at the outdoor trade show in SLC. Getting the handle to rotate out seemed a little tricky and I worried that with anything but very thin gloves it could be very difficult. I suppose with practice it may be easier. The handle seemed a little flimsy too. They sure would rack better than the 360 screw. A piece of equipment that I liked was a rip off of the Black Diamond Ice Clipper by Charlet Moser. The body of the device is slung around the harness which looked to be much more secure than the rubber bungy-cord-like attachement of the Ice Clipper. Everyone had outragiously light and funky looking new leashless tools. Expect good deals on old inventory leashless tools soon.

I just got back from a day at the SLC outdoor trade show. The new BD camalots were the item that grabbed my attention most. With improved engineering and better materials, the new camalots are incredibly light. Even the number 5 felt like it was made out of styrofoam. Now if they could only get the price down. The new titanium Leathermen are pretty cool too. No truly ground breaking finds, though. It was fun to be there at slocing time when the beer and sushi came out. Marmot was giving out pints of quality micro brew.

Colin Grissom would be a great person to contact. He worked for the National Park Service on Denali for 10 years or so while going through college, medical school and his residency at the University of Washington. He did a fellowship in pulmonary and critical care medicine and has been doing research in avalanche victim physiology for the last several years. I know several people he has buried with an Avalung (I declined after hearing the stories of uncontrolled shivering and claustrophobia). He's also done research into HAPE. He works at LDS Hospital in Salt Lake City where he works as a critical care doctor and does his research. He was also one of the major organizers for the medical facilities during the Salt Lake City Winter Olympics. On top of that he is also on the academic staff and frequently teaches house staff, medical students and pulmonary fellows. If you are interested in pursuing any of these endeavors, he's the one to talk with. Call LDS Hospital at 801-408-1100 to get in touch with him.

Check for trail closures due to past fires. When we did it in 2001 we ended up hiking 44 miles roud trip because the more direct 10 mile approach was closed. We summitted on Sept 11 with blue skies in all directions and not a plane in the sky. I remember thinking how peaceful it was. When we hiked out the next day we were probably the last people in America to learn the Twin Towers had collapsed. Just follow the cairnes for the walk off. Make sure to stay left of the ridge on the way down. The walk off involves one or two airy steps over big drop offs but is overall non-technical. The 5.9 off-width was a big surprise and we didn't bring anything large enough to protect it. There is a sweet 10a finger crack 8-10 feet to the right of the hanging belay below the off-width that for some reason isn't in the Becky guide. It protected well with a yellow TCU and 2 red Aliens. About 20 feet up there is a hand crack and a short traverse left to rejoin the std route just above the off-width. I think the SE Buttress is one of my favorite climbs I've ever done. Enjoy.

I think the Borderline to Angel's Crest link-up is my favorite climb so far in Squamish. I made a TR awile ago: link The route got short-changed in the select guide. There was some conflict between the FA's and the guidebook writer (something to do with the writer stealing biners and leaving them with a dangerous anchor). Note: he was from BC and the FA's were from Seattle. Spray away...

It's my favorite climb since I moved to Utah. I too thought I could have done it in better style as I hung once at the crux to shake it out before climbing through it. I think there is a psychological factor to overcome when coming out of the sister squeeze suffering from claustrophobia onto that exposed ledge and shear face looming above. The whipping wind didn't help either. Now that I've climbed it, I realize it's all there and hopefully if I go back I'll get it clean. With regards to the last pitch, I think it's 5.9 face, not 10c. The crappy bolts add a little spice though. http://www.climbingmoab.com/rock/db/castle_valley/sister_superior_group/ Note: Lower climber at belay atop sister squeeze pitch and higher climber about to complete 3rdpitch. Forgot to mention that there is a new bolted line along the right side of the face with anchors at the far right end of belay atop the sister squeeze pitch. It looks pretty hard but welll protected. Anyone know anything about this route? We used it to rappel as it was in better shape than some of the Jah Man anchors.

I would bet it's some type of synovial cyst. The most common place for these is on the back of the hand and wrist, but they're possible anywhere there is a synovium (fluid filled compartment preventing friction between bones and tendons). When the connective tissue surrounding the synovium is compromised (e.g. by trauma) the fluid filled sac pooches out (medical term) and can sometimes feel fairly solid. The common name for this is a "Bible cyst" because the old fashioned treatment was to slam a Bible down on it to rupture it. The best diagnostic test would be to stick a needle in it and aspirate. If a thick gummy liquid comes out and it disappears, then it's a synovial cyst. It may come back and sometimes require additional aspiration. Injecting steroids rarely helps. For large and recurrent cysts, surgery is sometimes done. The best person to examine it is an orthopedic hand specialist if your M.D. doesn't have the competency to put a needle in it.

One reason not to cancel credit cards too fast is the paper trail they leave by using it. When our house was broken into, they got my wallet and my wife's engagement ring (my great-grandmothers diamond). They used 2 credit cards all day and were recorded on 3 seperate video tapes (2 clothing stores and a Kmart). They also bought some rims for their Suburban at a tire store and the guy who sold them recognized one of the guys with them and gave us his number. However, despite all this evidense the pathetic excuse for a police dept we have here in SLC couldn't be bothered to raise a finger and nothing has come out of it. I guess it's not surprising as theirs months of head scratching in the Elizabeth Smart kidnapping was upstaged by a little girl and her father. Also, this is a great example why renters insurance is a good idea. I had a policy in Seattle that covered me for $30k in my apartment and $3K anywhere else in the world with a $250 deductible for about $120 / year. It gave me piece of mind when leaving a wad of gear in basecamp down in Bolivia or in the car in Canada (I wish my license plate could indicate that my wife is a Canadian citizen). By the way, anyone know what happened with the exit 38 bandits after someone got their license number and descriptions and all that?

I didn't have any trouble finding cannisters for my pocket rocket when I was there last in 2002. Inside a little indoor "mall" on Sagarnaga there is an outdoor store named Condoriri. I bought my cannisters there and got a cool chalk bag. Buy 2 and keep one in your coat for when the other begins to sputter and then switch them. I recommend sleeping with them at the bottom of your bag to have them ready for morning. Of course if you are not planning on any multiday alpine stuff, then just bring an XGK and leave it in base camp. Those things will burn anything.

I am investigating a job opportunity in Bellingham. The only experience I have with the place is stopping for gas on the way to Squamish. Anyone have any opinions about the place? Besides being close to Baker, Squamish and the North Cascades, what else does it have going for it? Thanks.

I recently bought an old wooden ice ax but I can't find out much about it's origin/age online. An ingraving on the adze says it was made by Sporthaus Schuster in Munich, Germany. There is also an engraving on the pick that says "ASMU Pickel Garantie". Anyone know anything about the company or the engraving?

As of 2-3 years ago when I last certified, Vermont was the only state that had an obligation to perform CPR law. Nearly every other state has a Good Samaritan law which protects those from performing CPR from lawsuits. I should add that BLS (basic life support) is what most people are taught. MD's, EMT's, RN's are mostly taught ACLS (advanced cardiac life support). ATLS (advanced trauma life support) is usually only taught to medics, ER doctors and surgeons. It is quite a bit more complicated and requires loads of medical gear to do right. If medics can arrive soon to a trauma, then start BLS but with one change. Step 1 (airway) is different in ATLS than BLS as traumatic C-spine injuries are common. To do it right without a C-collar, have a second person lay on the ground and place their hands on either side of the head. Whatever happens, that person cannot allow the head to move. Under no circumstances should you thrust the forehead down to put a victim in the sniffing position like often instructed in BLS.

This is a recent position statement on the cessation of CPR in trauma patients intended for rescue workers. Journal of the American College of Surgeons Volume 196 • Number 1 • January 2003 Copyright © 2003 American College of Surgeons Guidelines for withholding or termination of resuscitation in prehospital traumatic cardiopulmonary arrest: joint position statement of the national association of EMS physicians and the american college of surgeons committee on trauma Position statement The National Association of EMS Physicians (NAEMSP) and the American College of Surgeons Committee on Trauma (COT) support out-of-hospital withholding or termination of resuscitation for adult traumatic cardiopulmonary arrest (TCPA) patients who meet specific criteria. 1. Resuscitation efforts may be withheld in any blunt trauma patient who, based on out-of-hospital personnel’s thorough primary patient assessment, is found apneic, pulseless, and without organized ECG activity upon the arrival of EMS at the scene. 2. Victims of penetrating trauma found apneic and pulseless by EMS, based on their patient assessment, should be rapidly assessed for the presence of other signs of life, such as pupillary reflexes, spontaneous movement, or organized ECG activity. If any of these signs are present, the patient should have resuscitation performed and be transported to the nearest emergency department or trauma center. If these signs of life are absent, resuscitation efforts may be withheld. 3. Resuscitation efforts should be withheld in victims of penetrating or blunt trauma with injuries obviously incompatible with life, such as decapitation or hemicorporectomy. 4. Resuscitation efforts should be withheld in victims of penetrating or blunt trauma with evidence of a significance time lapse since pulselessness, including dependent lividity, rigor mortis, and decomposition. 5. Cardiopulmonary arrest patients in whom the mechanism of injury does not correlate with clinical condition, suggesting a nontraumatic cause of the arrest, should have standard resuscitation initiated 6. Termination of resuscitation efforts should be considered in trauma patients with EMS-witnessed cardiopulmonary arrest and 15 minutes of unsuccessful resuscitation and cardiopulmonary resuscitation (CPR). 7. Traumatic cardiopulmonary arrest patients with a transport time to an emergency department or trauma center of more than 15 minutes after the arrest is identified may be considered nonsalvageable, and termination of resuscitation should be considered. 8. Guidelines and protocols for TCPA patients who should be transported must be individualized for each EMS system. Consideration should be given to factors such as the average transport time within the system, the scope of practice of the various EMS providers within the system, and the definitive care capabilities (that is, trauma centers) within the system. Airway management and intravenous (IV) line placement should be accomplished during transport when possible. 9. Special consideration must be given to victims of drowning and lightning strike and in situations where significant hypothermia may alter the prognosis. 10. EMS providers should be thoroughly familiar with the guidelines and protocols affecting the decision to withhold or terminate resuscitative efforts. 11. All termination protocols should be developed and implemented under the guidance of the system EMS medical director. On-line medical control may be necessary to determine the appropriateness of termination of resuscitation. 12. Policies and protocols for termination of resuscitation efforts must include notification of the appropriate law enforcement agencies and notification of the medical examiner or coroner for final disposition of the body. 13. Families of the deceased should have access to resources, including clergy, social workers, and other counseling personnel, as needed. EMS providers should have access to resources for debriefing and counseling as needed. 14. Adherence to policies and protocols governing termination of resuscitation should be monitored through a quality review system. It is very important to understand the difference between trauma patients and cardiac arrests. A cardiac arrest patient has otherwise functioning organs and intact anatomy (namely intact vascular system). A trauma patient may have internal injuries or obvious injuries that result in blood loss and no matter how hard you compress, there will not be effective circulation. Hence the saying, "Fill the pump before you flog the horse". I have done a lot of CPR on cardiac and trauma patients. I have also been sprayed in the face with Hepatitis C positive blood and been stuck with large hallow gauge needles during codes on patients with an unknown status. To anyone out there who says they would do CPR on someone without barrier protection, I guarantee they have never had to go through the hell of blood testing every few months to see if you have contracted a potentially fatal disease. (Fortunately, I'm clean.) I wouldn't even consider doing CPR on a stranger without gloves and airway barrier. Assuming the right equipment is present, I'd try to revive an avalanche or drowning victim but a full on major head injury in the wilderness just isn't going to get better.

Don't just go to an orthopedic surgeon, make sure it's a specialist in sports medicine. Contacting the University's gymnastics team trainer and asking who they recommend may be a good idea. Of all the mainstream sports, gymnastics seem to be the most like climbing to me.

What happened Jeff, I thought you were all set up to work as a guide for him?

I have been to Bolivia 3 times and have learned quite a bit about the guiding companies in La Paz. I was a newbie my first time down there and got guided up Huayna Potosi by the agency run out of the Continental Hotel. The company is run by a retired doctor and his wife who speak good English. They own the refugio at the base of Huayna Potosi and really only specialize in trips to that mountain. On my last few trips I didn't get very good beta about other areas and the transportation prices they offered for jeep service were higher than others. I'd say if you want to be guided up HP, then go with them but otherwise go somewhere else. My favorite agency is Adolfo Andino, near the top of the hill on Sagarnaga (you will undoubtably find your way onto this road at some point). It's run by Adolfo who is a super and very honest guy. He's open to negotiations on transport options and prices (he even offered to rent me his car). When we came asking about jeep transport to Sajama, he told us it was way too expensive and gave us directions on how to get there by public transport for a few dollars apiece. He has a fair amount of gear for rent as well. If you know where you want to go and what you want to do, he can make it happen for less than everyone else. His guides are pretty cool and gave us some good beta that led us to climb an awesome mixed route on the South Face of Ala Izquierda. He also speaks excellent English as a bonus. Across the street from Adolfo's is Bolivian Journeys. It is owned by Adolfo's brother (I think his name is Marco) who is much more serious and less flexible with independent climbers (e.g. with us), but seems to run a pretty tight guiding service. He has a 3-ring binder full of itineraries for various mountains with prices and schedules. If you're not interested in going along on one of his all-inclusive trips then I would not expect great service. He does however rent climbing shoes you can take to La Florida in the south end of town for some sport climbing if you have some time to kill, although you have to get the guide book from Adolfo. I think these are the 3 best climbing oriented set-ups in town. I checked out many others in the area and found them either way too expensive or more focused on tours of the sight-seeing variety. My advice is not to arrange anything until you get there. Stay at one of the hotels around Sagarnaga and check out the agencies and try to get condition reports from them and other climbers. You can find all the provisions you'll need in the streets higher up. As a bonus, you'll already be acclimatizing as this area of La Paz is at around 10,000 feet. Be sure and visit the Deadstroke for some beer and pool. Have a great trip!

The symptoms you describe have a medical term: coccygodynia. Some have ideopathic pain while others have it associated with injury. Birthing trauma is associated with the pain but has not been specifically studied that I could find. Unfortunately many people have chronic pain that is refractory to conservative management (i.e. keeping weight off/preventing additional trauma, anti-inflammatories and steroid/anesthetic injections). However I found a recent article that seems to give a fairly optimistic outlook regarding patients with chronic pain. Orthopedics. 2003 Apr; 26(4): 403-5; discussion 405. Related Articles, Links Coccygodynia: treatment. Ramsey ML, Toohey JS, Neidre A, Stromberg LJ, Roberts DA. South Texas Orthopaedic & Spinal Surgery Associates, PA., San Antonio, Tex, USA. This article presents a retrospective review of the treatment of coccygodynia. The past 5 years of conservative treatment for coccygodynia were reviewed, including local injection. The results were evaluated. Retrospectively, the past 20 years of surgical treatment for coccygodynia were reviewed and the clinical results were evaluated. Twenty-four patients were treated with local injection and 15 patients were treated with coccygectomy. Local injection was successful in 78% of patients. Coccygectomy was successful in 87% of patients. The results of conservative treatment with local injection for coccygodynia appear to be successful. However, no other historical literature exists to compare these results. The results of coccygectomy for coccygodynia were also highly successful, and the success rate compares favorably to previous historical data in the literature.

There is data to support that 125mg twice daily is equally effective as 250mg or more. Diamox is both a prophylactic as well as a treatment for AMS and cerebral edema. Diamox speeds acclimatization and can be stopped without worry for rebound. Dexamethazone (Decadron) however does not and therefore if started for AMS/cerebral edema at altitude you should not stop it until you are back at lower altitude. The only treatments for pulmonary edema are descent, supplemental oxygen, or nifedipine. Why they chose to treat edema with "dex" in Vertical Limit I cannot explain, but it is completely wrong just the same. If you don't know what you are doing with nifedipine you could easily kill yourself. Your best bet is to take it slow. Spend 3-4 days in La Paz at ~11,000 feet. Then go to Condoriri base camp at ~15,000 for another 3-4 days. Ilusioncita at a little over 16,000 feet is a good first climb to test your acclimatization. The weather in Bolivia is very good and stable, so don't let your Washington instincts to not let good weather pass by. If you push it you may be very sorry.

I've put in two trip reports in the past: http://www.cascadeclimbers.com/threadz/showflat.php?Cat=0&Board=UBB1&Number=5918&Forum=f1&Words=bolivia&Searchpage=0&Limit=25&Main=5918&Search=true&where=sub&Name=310&daterange=0&newerval=4&newertype=y&olderval=&oldertype=&bodyprev=#Post5918 http://www.cascadeclimbers.com/threadz/showflat.php?Cat=0&Board=UBB1&Number=30557&Forum=f1&Words=bolivia&Searchpage=0&Limit=25&Main=30557&Search=true&where=bodysub&Name=310&daterange=0&newerval=5&newertype=y&olderval=&oldertype=&bodyprev=#Post30557 I posted some pics of the Ala Izquierda climb in the alpine gallery. The best routes down there really depend on the conditions. I would advise avoiding the Quimsa Cruz area due to glacial retreat. The Condoriri area is a great place to bag multiple moderate peaks and if conditions are right, a few major alpine routes. Yossi Brain's book is pretty good, although many routes may be up a bit in difficulty due to glacial retreat. Have a great trip.

Crazy vs. purist? http://www.crystalcanyons.net/Pages/TechNotes/RemovableBolts.shtm

Alta has had 72 inches so far with a 34-43 inch base and 22 fresh in the last 2 days! We did some snowshoeing up Big Cottonwood Canyon Sunday and the powder was deep, dry and amazingly untouched in the back country. This is only the 8th time since opening that Park City is opening before Thanksgiving. We have all the makings for a banner year.

UBB23-ML-275860-ML- went to Spray, coz it was.

I agree that this is a great route and getting up it is a major achievement. Check your watch before making the traverse. Once you're across it you are fairly committed. My partner also carried the pack suspended from a few girth-hitched runners. The belay above the squeeze chimney is a memorable one, perched atop a jutting block. It's a very physical climb and a bit of a sandbag but I don't remember it being very runout. Definitely rack gear on the left side. Enjoy.

http://www.omegapac.com/omegaman_adventures.html

Extremely constructive comment. Thank you. Here is some info from micromedex (probably the most used online resource for doctors and pharmacists): Ciprofloxacin-induced tendonitis, an unusual adverse drug effect, can be unilateral or bilateral appearing between 3 and 30 days after initiating therapy. Prognosis is usually favorable and symptoms resolve within the first week after antibiotic discontinuation with persistent symptoms occurring for several weeks in some patients. The mechanism for tendon damage is unknown. Tendon necrosis related to ischemic processes in areas of deficient blood supply has been suggested (Carrasco, et al, 1997). As of October 1994, the FDA's Postmarketing Spontaneous Reporting System has received 25 case reports of TENDON RUPTURE thought to be associated with fluoriquinolone therapy (Szarfman et al, 1995). A majority of the cases occurred outside the United States. The patients were 33 to 85 years of age with most of the ruptures (n=17) occurring bilaterally or unilaterally in the Achilles tendon. Tendon rupture was reported to occur 2 to 42 days after the start of fluoroquinolone therapy. Most patients allegedly received therapeutic doses; however, in 7 patients the dosage may have been higher than recommended. Of the 25 cases, 16 had risk factors for tendon rupture (eg, concomitant corticosteroids, advanced age, long-term dialysis). Other sources have stated that more than 40 cases of Achilles tendonitis and rupture have been associated with the fluoroquinolone antibiotics (Huston, 1994). A retrospective review of outpatient prescriptions for ciprofloxacin (n=2,122) within a naval medical center over a one year period was conducted. International Classification of Diseases (ICD9) codes for admission for ACHILLES TENDON RUPTURE were identified among the ciprofloxacin prescriptions. None of the 24 admissions for Achilles tendon rupture received ciprofloxacin. The result was not statistically significant and clinic visits (non-admission visits) were not apparently analyzed. The authors concluded that prospective studies are needed to quantify relative risk of Achilles tendon rupture in patients treated with ciprofloxacin and other quinolones (Shinohara et al, 1997). Cipro is one of the most frequently prescribed medications in the world. It is one of the safest antibiotics with a very low rate of cross reaction with other drugs and adverse drug reactions, but as with all medications there is some finite risk.