iluka

Trip: Mt. Deception 6/14-6/15, 2008 - Date: 6/16/2008 Trip Report: Cebe, Susan, Grace, Ken and I headed out to the Olympics this weekend to climb Mt. Deception, a trip we'd had to cancel three times in the past two years due to weather. Saturday was spent hiking into the group camp at Royal Lake. The skies cleared on the drive to the trailhead but by the time we were halfway up to Royal Lake the clouds had settled in and we had pea-soup the entire rest of the day. Spotty snow is encountered for about a half-mile below the lower meadows. Continuous snows starts past the lower meadows on the climb to Royal Lake. We managed to find a few dry spots right near the big rock at the Group Camp; otherwise it's pretty much still snow covered all around there. Sunday morning, we awoke to bluebird skies and headed up to upper Royal Basin. The snow had frozen overnight so we put on crampons for the trip up and found the travel to be pretty fast, reaching the base of the climb to the ridge within about 1-1.25 hours. From there, we climbed the steep slope to the ridge to the right of the summit (the low point of the saddle in the photo below). We initially followed the broad gulley going up to the left (above the right-most trees in the photo) but then cut back right about one-third to half-way up and moved between the rock bands up to the saddle, largely following some existing tracks. The snow was pretty firm, requiring crampons. A bit steeper than we expected but it was easy to get good purchase and maintain good footing. Once on the ridge, we took a break and spied the continuation of the route. The guide book says to drop off the ridge, then traverse over to and climb a steep slope to the left of Gilhooley Spire. The sun had just gotten onto that slope and given the firm conditions we had just encountered, it did not look very appealing, particularly with how steep it looked up top. We did see steps from a group that had been up there in the previous day or two and wondered if they had hit it later in the day when it might have been softer. Instead of going up that slope, we found a nice, easy approach that went around to the right of the spire (shown in the first photo below; the spire is cut off a bit but the right side of it is seen in the left-most part of the photo) and eventually brought us out onto the slopes on the southwest face of the peak. From there, it was easy to beat around on the rock and scree until gaining the ridge up to the summit. Just below the summit, we encountered some more steep, firm snow that had not seen the sun yet. The photo below is as we came off that steep section. Once above that, it was an easy last stretch to the summit where we had great views of the entire range including some nice ones of Constance (the "Bitch Goddess" as Cebe calls it), Anderson and Olympus, which is still loaded with tons of snow. Time from camp to the summit was about 5.25 hours For the trip down, we downclimbed a short section of steep, firm snow just to the side of the slope we had ascended and, after that had an easy trip back down the ridge, around the spire and off to the col on the ridge above Royal Basin. Fortunately, by the time, we got back to the ridge, the sun had really softened up the slope back down to Royal Basin. This was fortunate as we had not anticipated the steep snow we got on the trip and did not have pickets with us. We downclimbed the top 50 feet or so and then managed to turn and safely plunge step down to the basin. A slip up high would have been pretty bad as it's steep and there are lots of rock bands below. It's a bit easier to understand now what Smoot was referring to in Climing Washington's Mountains when he described the hazards on this peak. Once in the basin, it was an easy trip back to the group camp to pick up our gear and head out. The maps and guidebooks say this is a 6 miles walk out from the lake, but I'd felt more like 8+ given the time it took to get back to the trailhead. Approach: Trail to Royal Lake. Easy snow travel up to upper Royal Basin Trailhead to Group Camp: 4.5 hours Group Camp to Summit: 5.25 hours Summit to Group Camp: 2.75-3 hours Group Camp to Car: 3.5 hours Gear: Helmet, axe. Pickets might have come in handy had the snow conditions been different

The term is actually "aphasia." It refers to a loss of language function. There are two types: 1) Expressive -- the person knows what they want to say, understand what you are telling them but cannot get the words out; 2) Receptive -- the person doesn't even understand what is being said to them and just respond with fluent, but non-sensical speech. Apraxia is an inability to perform learned motor tasks despite having the sensory and language skills/function to understand the commands.

Just because there are good physiologic reasons for something to work doesn't 'mean it is actually effective in practice or that there are research data proving clinical effectiveness. Anti-tussive medications are notoriously ineffective for cough, whether it be here at sea-level or at high altitude. Also, the cough often derives from irritation down in the lower airways, well lower than anything a throat lozenge will access or a little bacitracin in the nostrils will affect. The dry, hacking cough at high altitude typically does not respond well to any of these standard approaches and often just resolves once someone gets down to lower elevations. No harm in trying any of the things you mention... just don't be surprised when they don't work.

None of which have ever been shown to work for dealing with the dry hacking cough that is common at high altitude.

While low grade fevers, fast heart rate and fast respiratory rate are features of HAPE, mental status changes and ataxia (clumsiness) are not... Altered mental status and ataxia are feature of high altitude CEREBRAL edema (HACE). Some people get both HAPE and HACE together but many get HAPE alone and would not have altered mental status etc. It's an important distinction because if you see altered mental status and ataxia going on as well, your choice of medications to treat the problem would change a bit... you'd add Dexamethasone for the HACE symptoms. Descent remains the best treatment for both but if that isn't feasible... meds are necessary.

The fact that it last several days after coming down argues against this being due to HAPE. Improvement occurs with descent and, while the symptoms can last days in very severe cases, it should resolve faster, particularly if you go down to sea-level. Someone else in the thread mentioned that in HAPE people cough up pink sputum. That is typically a very late finding in severe HAPE. Early on, before it gets really severe, many people have a dry cough. Exposure to the H2S could create the symptoms you describe. A useful bit of info to helping figure out what this is would be how high in altitude you've been on other volcanoes. If you've been to similar elevations as Hood on other peaks but no symptoms, that would argue against HAPE

If this has been going on for more than just a few days, it is definitely worth getting checked out by a physician. For something present for just a day or two, a viral syndrome is always a possibility but if this has been persistent there are other things that should be checked out.

AMR and Medic-One are fundamentally different organizations. AMR is a privately owned company whose ambulances are driven largely by EMTs, with occasional critical care nurse support based on the type of patient they are transporting. Medic-One is run out of the Seattle fire department. They only use paramedics and do not use EMTs. The parmaedics have a much higher level of training than EMTs who drive for AMR. Almost all paramedics who work for Medic-One come to the organization after having been fire fighters in the SFD for several years before hand and it is extremely rare for them to hire someone who was not trained in the Medic-One paramedic training program. The rules differ slightly for the Medic-One systems in outlying areas such as Shoreline Medic One, Bellevue Medic-One etc. although for the most part they also only hire people who went through training with the Seattle paramedic training program.

I read in an article elsewhere about this that the Nepalese agreed to close down access from the Khumbu side for a 10-day period and not the entire season. This will be certainly be a disruption to the climbing on that side but it seems surmountable in some respects. In the past few years, many groups have been putting large numbers on the summit well past the 10th and into the second half of the month. This will just require getting the acclimatization work prior to the period when they'll be closing down the route. Many groups also come off the mountain in this early May period, particularly if the weather isn't great, and head to lower elevations to let their groups recharge a bit. The big problem, however, will be the big number of groups moving up the mountain once the 10th passes. I suspect this season will set a record for the most Tibet flags and Free Tibet signs displayed on the summit.

Without knowing what the pain feels like, where it is located, what aggravates it or makes it feel better, it's hard to comment on the precise cause of the pain and, therefore, hard to comment on what is best for dealing with it. Some thoughts: - PT should not be written off because you are in good shape. Good PT work can be of benefit to very fit people for the purpose of rehabbing specific injuries or training up other muscle groups whose weakness or instability may be contributing to a particular problem. It helps, though, if the PT has a specific diagnosis to work with in developing a rehab program. - The source of the problem could be in the knee but Layton is correct in pointing out that in some situations it is a problem elsewhere that manifests as pain in the knee. For example, sometimes people develop knee pain due to hip problems. This is only something that can be sorted out with a thorough history and musculoskeletal exam. - I would not look at a cortisone injection until you know have a reasonably firm diagnosis as the utility of such a shot will depend on what the problem is. Similarly, whether or not you need surgery depends on what this is. If you don't like the opinion you get from the knee specialist, you could consider going to a dedicated sports medicine clinic. There is a good one at the UW ((206) 543-1552). They have some quality docs over there.

Sent you a PM...

Three words to ease this pain: Sierra Nevada granite. Plus... the road access up to the eastern Sierra Nevada and the Owens Gorge from SoCal is great all year round.

While the Republicans will clearly be happier if Hillary is the nominee, I'm not so sure it's a slam dunk they win the election in that situation. The big issue will be the economy and the tremendous economic insecurity that people from wide swaths of the country are feeling. She's got ideas/plans that speak to that insecurity while McCain not only has openly admitted to knowing little about economics but also continues to spout off about his plans to cut taxes, cut spending and let the free market reign, which I think, after the past 8 years, sounds to many people like not much of a plan at all. That and enough replays of his line that we could be in Iraq for 100 or more years and I'd say he's not such a slam dunk.

My precinct went for Obama as well. I have to admit to being fairly disappointed in the way the process worked at my precinct. It was so disorganized that by the time they did the initial tally and delegate count they only had time for a few comments from supporters of each candidate before moving on to other business like fundraising and choosing the representatives to later parts of the caucus process. A friend said it similar at her place. If there's not going to be ample time to allow discussion and opportunities to sway people's minds, let's just go with a primary and scrap the caucus.

Here's a link to the Inyo National Forest website with information about Mt. Whitney Permits: Whitney Permit Link Looks like permits are needed year round to go into the Whitney Zone, which includes the north fork of Lone Pine Creek. Quotas in place May 1 to November 1.

A friend of mine who works with S&R told me they've had some situations this season when they've noticed that GPS units are interfering with avalanche beacons in the receive mode. Has anyone else noticed this?

I can't speak much to whether there is data about one particular breathing technique being better than another but there is not much physiologic merit to the idea of doing one thing or another to fully clear out the carbon dioxide or maximize the oxygen you take in. If you have healthy lungs, they will do an efficient job of eliminating carbon dioxide and taking in oxygen independent of whether or not you pressure breathe, do a forced exhalation every 4th breath or do other things. In the end, with healthy people (i.e. no emphysema, pulmonary hypertension, severe asthma, heart failure) maximum exercise capacity is limited by the ability of the heart to deliver oxygen to the exercising muscles. Healthy people are not limited by the ability to take oxygen in or get rid of carbon dioxide through the lungs so the exact pattern of breathing will not have much of an impact.

Learn how to avoid having your next big trip to some high altitude region ruined by a bad case of altitude illness and get the latest on ginkgo, viagra and other idea being tossed around for dealing with these issues. (Some eye candy will be thrown in to prevent boredom). "Safe Travel at High Altitudes" Speaker: Andrew Luks, MD University of Washington. Division of Pulmonary and Critical Care Medicine When: Wednesday February 6, 7PM Where: Seattle REI Free to the public Questions: aluks@u.washington.edu Link

There is a guide who does tons of work in ANWR in the eastern Brooks Range who I have travelled with and is great. Macgill Adams. His company is Wilderness Alaska. Website is wildernessalaska.com. While you obviously don't want a guide, he offers a service whereby for a fee he can help you plan a route, help set up bush flights, get you maps etc. He calls it No Guides & No Gear. The webpage where he discusses what this is: http://wildernessalaska.com/No%20Guides%20No%20Gear.html Even if you didn't use this service, he has been guiding up there for a long time and knows ANWR better than most. You could always try to contact him through the email on his website for some beta. It is a sweet place to visit... hopefully you can pull it off.

R.J. Secor The High Sierra: Peaks, passes and Trails devote 5 pages to Whitney. You might also get some beta here: http://www.mt-whitney.info/index.php If you go down there... don't forget to get permits. Even if you're going in as a day trip you need a permit to go up the Whitney Portal trailhead or be in the Whitney zone if you enter from another trailhead and move into that area.

I second exactly what mneagle said. A rib fracture due to coughing is certainly possible but some of what you describe is consistent with having a pleural effusion (fluid buildup in the chest cavity around the lungs) and you need to get this possiblity evaluated. If it is, in fact, what's going on antibiotics alone will likely not make it go away. mneagle mentioned seeing you can get the clinic/hospital who did your chest-xray to give you a digital version of it that you can forward to him. Most hospitals in the US now handle their x-rays electronically but a small clinic in a remote area where you are probably doesn't. If the clinic can't get you a digital version, try to take a digital photo of the x-ray yourself and then forward that on.

Thanks to those who have helped out with the survey. We're still looking for participants so if you or any of your climbing partners has Raynaud's and would be interested in participating in the anonymous survey, please send an email to aluks@u.washington.edu and you will be provided with more information about the study. Thanks again!

I think that as impressive as his first ascent was, an equally impressive set of accomplishments is all the work he did for the people of Nepal in the years that followed. You cannot go anywhere in the Khumbu Valley without seeing something with his name or the Himalayan Trust on it. Schools, clinics, reforestation efforts... he did a lot with his time and money.

Very little information is known about how high altitude affects people with Raynaud’s phenomenon and whether they experience more frequent and/or more severe attacks when traveling at high elevations. We are conducting a research study on the effects of high altitude on people with Raynaud’s phenomenon. If you have Raynaud’s Phenomenon and would be interested in participating in a short, anonymous on-line survey about this issue please contact Andrew Luks at aluks@u.washington.edu or by phone at 206-221-2814. You will then receive further information about the study and a link to the on-line survey. Please be aware that the confidentiality of emails cannot be guaranteed. This is a University of Washington research project and the forum administrators have granted permission to put this post on this website.

Perhaps more warnings via the local media outlets would be useful when avalanche conditions are high. Weather forecasts on the local TV stations always include plenty of information about anticipated snowfall and the stations devote attention to road conditions at the passes but how often do they announce that avalanche conditions are high and skiers, snowmobilers and the like should use extreme caution. I don't recall hearing them say such things that much.