iluka

It does not look good... http://sports.espn.go.com/sports/boxing/news/story?id=5530216

It appears people all over the world manage to run into serious problems with their BASE jumping: http://www.splatula.com/bfl/

Retinal hemorrhages actually happen in a lot of people and often have not relation to cerebral edema. They happen in way more people than actually realize it but are often asymptomatic because they are either small or happen in an area of the retina that isn't critical for vision. Symptomatic retinal hemorrhages typically present as simply painless blank spots in one's vision. Sunglasses or not, you cannot actually see them yourself without the aid of an opthalmoscope to look in the back of the eye.

Looks like he at least made it to the top... http://www.usatoday.com/news/world/2010-05-21-13-year-old-mount-everest_N.htm What's next in the pantheon of first/oldest/youngest-to-do-something-on-Everest?

I think you need to be careful with your friend and the sources you consult for information. There is actually some information in the medical literature about what happens to CF patients at altitude. For example, some studies show that at moderate altitudes (~ 8,000 ft; eg. the cabin "altitude" that might be experienced on an airplane at cruising altitude) they become quite hypoxemic (much more so than normal individuals at altitude) and experience further drops in their oxygen levels with even mild-moderate exertion. Most of the studies, however, only involve short duration exposure to hypoxic environments on the order of hours... much shorter than what they would experience on a climb of Rainier. Many CF patients struggle with periodic exacerbations of their disease. There are no systematic studies about whether these occur more frequently at high altitude and no studies looking at what happens to their airway secretions in the cold dry air at high altitude, but there are case reports of CF patients with severe disease at baseline who developed right heart failure during a ski holiday at high altitude. In the end, the risks faced by your friend, and any CF patient going to high altitude for that matter, will to some extent be a function of how severe their underlying disease is. The hypoxemia noted above, for example, was more pronounced in those people with lower baseline lung function. As a result, you can expect that the worse their underlying disease, the greater the risk they likely face of severe hypoxemia on the mountain and the potential for severe respiratory difficulties. Most CF patients are cared for in specialized CF centers and they should consult with their CF specialist prior to such a trip and, if possible, someone who knows something about the issues involved in high altitude travel.

If you've got an upcoming trip to high altitude planned for some point in the future and want to learn a bit more about how to recognize, prevent and treat altitude illness and ensure a safe trip for you and your partners, come out to this free lecture Lecture: Safe Travel at High Altitude Speaker: Andrew Luks MD University of Washington Where: Seattle REI When: Wednesday February 17, 7:00PM Link: http://www.rei.com/event/287/session/168

A great piece on Bill Moyer's journal about Charlie Houston including an interview and some old footage Houston shot himself on his expeditions... http://www.pbs.org/moyers/journal/10092009/profile2.html

The weather was pretty bad in that area late Tuesday afternoon and evening with low cloud ceilings, precipitation and a lot of wind. It rolled in pretty fast too after a really nice morning into mid-afternoon. Let's hope for a good outcome.

We completed this route yesterday. We opted to do the Gerdine and Cool Glacier route rather than go over Disappointment Peak. Here's an update on conditions following the snowfall last weekend... - Little Wenatchee River Trail is completely snow-free - Trace amount of snow in small patches on PCT on way to White Pass and then onto Foam Basin. Snow-free campsites at White Pass - A few inches of snow mixed in with rocks on north side of pass you cross getting out of Foam Basin to unnamed basin west of the White Chuck Glacier. We camped on dry ground in that basin. - Ascent from that basin up to the White Chuck Glacier Basin is snow free. The route through that basin all the way up to Glacier Gap between the White Chuck and Suiattle Glaciers has small amounts of snow in spots but travel is very easy. Plenty of bare spots for camping if needed. - There is new snow on the Gerdine and Cool Glaciers. Still some bare ice in spots, new snow in others. Anywhere from 2 to 6 inches. We generally punched through a crust in most places but the depth was pretty minimal so travel was reasonably fast. The ridge running on the west edge of the Gerdine has only trace amounts of snow and made for fast travel to the upper Gerdine - A few easily passed crevasses on the upper Gerdine below Disappointment Peak - The transition from the Gerdine to the Cool Glacier is really broken up but we were able to find a straightforward route through - Several large crevasses on the Cool Glacier but solid bridges allowed us to cross each one - The final ridge to the summit is largely snow free until the last 400 or so feet and travel is easy up the remaining part of the ascent with snow to 4-6 inches or so in spots, exposed scree in others. Things look really pretty up there right now.

We found a water filter this past week on the way to Glacier Peak. It was found in the unnamed basin north of the pass you take to get out of Foam Basin and west of the White Chuck Glacier Basin at around the 6,500 foot level. If you think this may be yours, send me a PM with a description of the filter.

A life well-lived...

Based on your description you may need an orthopod who specializes in hands rather than a "soft-tissue specialist." They deal with tendon and ligament injuries as well as bone problems.

I think you're looking at the south facing aspects of Black Peak. The north ridge is likely not visible. I did Black a week before we did Dumbell-Greenwood and remember being able to look south towards Bonanza quite easily from the summit This would have put Greenwood a little off to the east from that vantage point, which, would correspond to what you're seeing in the photo from the Greenwood summit.

Sorry if this seems a silly question but are you saying it's THIS Black Peak? That is, in fact, the Black Peak to which he was referring.

Trip: Dumbell and Greenwood Mountains - Southwest Scramble Route Date: 8/30/2009 Trip Report: ScottK and I headed off to scramble Dumbell and Greenwood mountains over the weekend. This trip is actually doable in a long day but we opted to make an overnighter of it. We got a late start on Saturday, heading up from the Phelps Creek TH to Upper Phelps Basin. There's one campsite at the bottom of the Phelps Basin at present. There may have been others but a slide from last winter has left a lot of debris which might have taken them out. With a group already camped in the one site, we headed up to about 5,900 ft in the upper basin and set up camp on a heather bench, about 3 hours after leaving our car. We got an early start the next morning, getting moving around 6:15AM. The route from the upper basin towards the peak is straightforward, as you follow the obvious drainage that leads all the way to a basin below the summit. If you stick to the north side of the drainage, there's a climbers trail that leads up through the heather, granite benches and talus. Earlier in the season, this may be a bit wetand slippery in spots. From the basin, you do not want to head straight up to the prominence seen in the first photo above... that is not the true summit. You need to follow the drainage as it moves to the southeast of that prominence all the way up to the talus or snow-filled basin where you will see the true summit at the east end of the ridge line. We read many reports of people who climbed or attempted the wrong summit. The views in the early morning were really nice including this view of Red, Chiwawa and Fortress: Up high in the basin, we found minimal snow and mostly talus. Approaching the top, the rest of the route becomes apparent. Looking at the summit above the head of the basin, there are two sets of cliff bands on the left that need to be surmounted. The lower one is easily passed on one of several shelves. For the upper cliff band, there are several options. There is a steep, loose gully, described elsewhere as Class 2-3, off to the left. We opted instead to follow a gully on the right side of the cliff band that was less loose. It's mostly class 2-3 with one or two Class 4 moves and maybe some exposure depending how you opt to do those moves. It looks steep from down in the basin but that was due to foreshortening and is not bad once on the route. Lots of solid hand and foot holds for the harder spots. We followed this to an obvious notch on the ridgeline where we turned right and climbed the Class 2-3 ridge up to the summit. Phenomenal views looking toward the Dakobed Range, Glacier, Dome and Bonanza (which is just staring you in the face). From camp in the upper basin to the summit took about 2 hours We then retraced our ascent route back to the upper talus basin to head over to Greenwood. To get there, we ascended from the talus basin to an obvious notch in the ridge south of the Dumbell summit. From there, you cross over the notch onto a series of ledges (photo below) that lead around Dumbell towards the Dumbell-Greenwood saddle. They're a bit narrow with some loose rock but plenty of space to move except in one spot where you need to get around a rock prominence. A fall in here would not be pleasant and this might be tricky with lingering snow or ice. From the ledges, we crossed a snowfield that took us to the saddle. It was pretty firm with ice in spots and we found our crampons useful. Once at the saddle, it was easy Class 2 scrambling up the southwest ridge of Greenwood to the summit: Looking towards the northeast from the summit, there's another prominence on the ridgeline that we spent a lot of time looking at to decide if it was higher and, therefore, the true summit. (beyond Scott in the photo below) We couldn't find any reasonable way over there even if it was the true summit so we decided to declare victory where we were and took in more great views. Dumbell summit to Greenwood summit took about 1.5 hours. From there, we retraced our steps to camp, arriving back just under 6 hours after leaving in the morning. Less than 3 hours later we were back at the cars heading for some burgers with a few interruptions on the way down the road to earn kharma by giving lifts to several groups of backpackers needing to get back to their cars or to the trailhead.

The toxic chemical big pharma industry is amazing in some respects... they convince people to spend $Trillions on their products in spite of the fact prescription drugs are one of the biggest killers in the health care industry. And with their greedy corrupt multi $million dollar CEO's and poor outcomes of drug "therapies" they're one of the major reasons the USA pays many times more $$$$ than the next nearest country for piss poor health care ranked 36th in the world. Certainly not trying to defend big Pharma. We could go on ad nauseum about their issues. My basic point is that the supplement/herbal remedy industry is not nearly as benign or well-meaning an industry as many would like to believe.

There are actually several great trailheads at pretty high altitudes you can access on the east side coming down 395 besides Tioga Pass. Out of Bishop, you can get up to Lake Sabrina, South Lake and North Lake and do nice hikes up higher out of either one. Out of Independence, you can also head up towards Kearsarge Pass which has some nice views. A key part of any acclimatization plan regardless of what you do is to make sure you stop at the Whoa Nellie Deli in the Mobil Station at the junction of Tioga Pass Road and 395. A must stop on any trip down there. Great grub for pre- and post-trip.

Both mine and theirs. And it costs about 15 cents a dose. Cuz their not spending $Billions on Advertising and Lobbying. I'm not saying Diamox doesn't work, just that I prefer a natural method. Both dexamethasone and diamox are actually both very cheap.... as they have been generic for a long time with prices down near the range you get for Gingko depending where you get it. The studies that looked at their role in altitude illness prevention and treatment were not big pharma-sponsored studies either. Cheap drugs + small market = not much interest from the likes of Pfizer, Glaxo etc. in studying or promoting them. These are not heavily advertised medications by any stretch. The problem with Gingko and most of the other herbal/supplement market is that because the production of the supplement is not regulated by the FDA, people really have no idea if the product their grabbing off the shelf contains 10% active drug or 90% active drug. No one is looking at what these supplement companies are doing and one of the reasons is that they have been very successful at preventing any real oversight is a significant amount of lobbying to prevent more stringent regulations of their practices. The supplement industry is amazing in some respects... they convince people to spend billions on their products in the near absence of any evidence that any of it works.

It depends on what you mean by "natural AMS remedies." If you're referring to Gingko Biloba... the data just isn't there to support its use to prevent AMS. There are some studies showing a benefit in this regard but there were also several negative research studies in which it was no better than a sugar pill. The discrepancies between the various studies probably relates to the fact that the gingko products used in the various studies are not the same (no FDA regulation of production or uniform manufacturing standards etc.). I've seen people refer to the wonderful effects of Vitamin E. No evidence whatsoever to suggest this has any effect besides draining your cash supply. Lots of travelers to the Andes will have guides and the like recommend the use of coca leaves or coca tea. Despite its widespread use down there, no one has ever systematically studied whether it really works. Any other "natural" remedies you've heard about? If someone was going to use something aside from controlling the ascent rate, I would go with either acetazolamide or dexmamethasone as there is plenty of data and clinical experience to support a benefit from either one.

The rules of acclimatization that keep getting referred to in this discussion generally refer to not increasing your sleeping elevation (not the highest elevation reached during the day) by more than a certain amount each day and as a result can be applied to climbing peaks like Rainier or Whitney. The reason many people do fine with fast ascent rates on Rainier is that they start coming down soon after ascending and end up at a very low elevation, if not all the way down, by the end of the day. (Still... a lot of people do get sick on Rainier, Whitney and other high peaks in that range when they try to blast up in a day) Were you to ascend rapidly to the summit of Rainier and stay there overnight the risk of illness would be different than the person who did the same rapid ascent and then turned around and descended immediately.

A headache from dehydration is not the same as a headache from AMS. A headache from AMS can progress to HACE (a potentially fatal problem) if someone continues to ascend when they have AMS whereas that wouldn't be expected with dehydration. Your personal experience at high altitude is not a sound basis for providing advice to others. The same would apply to anyone else, not just you, in particular. The problem is that the response to high altitude varies dramatically between individuals. Some adjust great and can get up to high altitudes very quickly without problems while others have a lot of trouble with similar ascent profiles. Just because one person does well doesn't mean that others should follow their lead. Everyone has their own tolerance for altitude and they need to plan based on that. Unfortunately, unless someone has been to altitude in the past, there's no real way to predict beforehand how well they will do. And... even if they did fine on a previous trip, if they go higher and/or faster on a subsequent trip, it's possible they could get sick. A night at the portal before starting the hike slows the pace of ascent and gives the body time to acclimatize. A hike to higher elevation than the portal then coming down to sleep at the portal elevation would also be of benefit... consistent with the fairly well-accepted "climb high, sleep low" philosophy many adhere to. Either option is far superior to sleeping down in Lone Pine and then coming up, starting the hike to the Whitney summit immediately. That trail is often littered with people doubled-over feeling ill because they insisted on doing it in a single day.

You should check at the Forest Service ranger station that does the permitting before you head up to the trailhead because they often hold permit spots for the day of the trip and you may be able to get a longer permit once you're down.

Hydration doesn't prevent AMS. That is a bit of a myth. What is does is prevent dehydration (easy to develop that at altitude particularly down in the dry Sierra) which feels a lot like AMS. An acclimatization trip would do more for getting ready for altitude issues on Whitney than hanging out drinking and eating.

It would be in your best interest to do an acclimatization hike up to high elevation rather than just hanging out and saving energy. You might consider visiting the South Lake, Lake Sabrina or Kearsarge Pass trailheads as you can get pretty high from the parking areas in relatively short distances. A better option for avoiding altitude illness, however, would be to change your ascent plans and spread the trip out over several days rather than banging it all out in one push. Even with an acclimatization hike the previous day, there is a reasonable chance of getting sick with your current plan. There are many people who do Whitney in a day and don't get ill just like there are many up in this area... many of whom frequent this site... who can do Rainier in a day and not get ill. The problem is that the tolerance for that type of ascent varies a lot from person to person and some do not do well with that type of fast climb. If you know you have good altitude tolerance based on prior experiences, you'll do fine, particularly with an acclimatization hike the day before. If you or your partners don't know your tolerance or have a prior history of altitude illness, you could be asking for problems.

Most text books will quote the 8,000 foot figure as the lowest altitude at which you will see AMS but very susceptible people can get sick at lower elevations that this. There are also studies in the literature documenting its occurrence at elevations much lower than this, such as this one looking at the incidence of AMS in a general tourist population in Colorado: http://www.ncbi.nlm.nih.gov/pubmed/8452324?ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum That being said, the symptoms of AMS are, as noted above, very non-specific. If someone was dehydrated from carrying too much gear on a hot day at altitude, they could have a bad headache. The fact that the headache persisted after rehydration in camp, however, would argue against his problems being solely due to dehydration.