alpine style and the edema(s)...

whats the deal? I was thinking, does the alpine approach (quick and fast; gaining altitude quickly, ie 16,000 to 20,000 in a day) lend itself to a quicker build up of fluid in the lungs/brain?

any websites or general advice would be great. seems like it would, right?

here's a quick site I googled which has an overview of various problems:

climbing-high.com/altitude.…

I would say, if you're going into that, it'd be good to have that option where you can bail/retreat. It probably wouldn't hurt to talk with a mtn doc about all these issues & what you would like to do, also.

What you're probably asking is by going light & fast you aren't stressing your body as much, can you just power through and outclimb the symptoms before they seriously beset your ability?

And, there is also your genetic predisposition.

Either condition offers unique problems; HACE is like a sledgehammer that can onset & shut you down pretty quickly; HAPE can allow for you to mouse-trap yourself as you continue to stress your body. They both can develop into pretty serious medical emergencies. You could dose yourself; then I guess figure if your situation is dramatically worsened by continuing, or is it just best to bag it. (Provided your position on the mountain, I assume it's already a given that descent is the only real treatment)

Here's a snippet from Beach describing the onset of HACE down in Peru:

...
About now, 20,000ft or so, I note that my right eye is blurry. With the headache I've got I ask Kent to watch me for HACE, though I think it's just the wind.

Back on route and waaay up there, I'm tired. Hit by truck, mauled by badgers, beat up by ninja's, and given GHB tired. I go up to the final technical section. The climbing is easy, a lot easier than what we just experienced but I'm crawling. I simply cannot summon the energy to climb well up this 45 degree slope. After a few hundred feet, the snow gets soft and untrod again, I'm clearly on top of a giant crevass too. I find a safe spot and bring Kent up, but not before dropping my headlamp. No worries though, I can't even see out of one eye and the other is blurry. It's not like it was helping me.

After some exploration, Kent goes ahead and finds something promising. As he sets up, my seat half crumbles and I half fall into a crevass. Not bad though, I crawl out. The trouble is that my axe fell in too, and is in a much worse part, where we can't climb down and get it. With delicate rope trickery, we retrieve it. Good thing, it's borrowed. Kent's route doesn't pan out, he's about to try something else when it hits me. I'm mostly blind, exhausted, hypothermic, and even if he finds the way, I don't have what it takes to get down. About 15 more meters of technical climbing and probably less that 1000 feet below the summit, I had to bail. Kent knew it too, but had to wait until I said it.

stredna wrote:whats the deal? I was thinking, does the alpine approach (quick and fast; gaining altitude quickly, ie 16,000 to 20,000 in a day) lend itself to a quicker build up of fluid in the lungs/brain?

I'm no expert but I think you're overestimating the actual altitude gain by a lot. Don't think people can really do that much in a day. Most huge climbs don't gain 20,000 feet in total because base camp is high. House and Anderson's climb of the Rupal Face, which is a modern benchmark for light and fast I guess, gained 4100 meters (13,450 feet) elevation, and they took six days to climb and two to descend. On an easier route perhaps they could gain more feet per day, but still not nearly as extreme as 16k - 20k/day.

The main cure for HAPE/HACE is to descend to lower altitude. So part of preparing against it is to have an option for retreat.

Check out Dr. Charles Houston. He's the authority on high altitude medicine and has written a lot of user-friendly material on the subject.

In addition to what has already said, when going alpine style no one simply gets off the plane and climbs to the summit. There is a lot of acclimitization that takes place first, either up smaller peaks or on different routes. You go high and then back to basecamp a couple of times, or even just hike around for a few days or weeks. Then you blast up the route. It is still adjusting to the altitude, just not in the "traditional" camp to camp yo yo done in expedition style climbing.

I've gotten HAPE on two attempts to climb a 20,000 foot mountain, once while solo. I was careful to check for it on the second time to turn back before it got too bad, but the first time it really hit debilitated me.

Hydration and altitude gained per day factor into the equation but I believe the main factor is physiology. Some people acclimatize very easily and others do not. I am one of those that do not.

The factor you as a climber have the most control over is the rate at which you gain altitude. Climbing high and sleeping low can help you acclimatize. The rest of these comments are right on, alpine style climber often acclimatize by climbing other mountains. To me alpine style refers more to not setting fixed lines and taking multiple trips to advance your gear up the mountain. Alpine style climbs still spend multiple nights at "high" altitude and those are what can cripple you if you are vulnerable to HAPE.

It doesn't take very long for HAPE to develop and if you continue going up and sleeping high it will get worse fast. Unless you can avoid spending a night at your "HAPE" zone you won't be able to outclimb the symptoms.

We are looking for people who have ever had high altitude pulmonary edema (HAPE) to participate in a research project at Harvard Medical School in Boston. Study will involve new non-invasive MRI techniques to functionally image the lungs. If interested please contact me at - michael_patz@hms.harvard.edu.
Thanks!

stredna wrote:whats the deal? I was thinking, does the alpine approach (quick and fast; gaining altitude quickly, ie 16,000 to 20,000 in a day) lend itself to a quicker build up of fluid in the lungs/brain?

Yes.

I think most climbers planning to do a big route in a light and fast style usually do another high altitude route beforehand to acclimate themselves before they do their intended route. So for example if I wanted to do the Cassin Ridge on Denali in a light and fast style then I might climb the West Buttress on Denali in a slow expedition style to acclimate. If you don't do that then it's the quickest way to having a real bad day.

I don't know that there is an actual graph showing it but yes. A rapid increase in altitude increases risk of developing HAPE/HACE. There are other factors and I've seen research even hinting at a link to biorhythms although I can't seem to find it. Perhaps one of the leading research organizations is here at coloradoem.org/Altitude_Res… and you may find some more interesting info on the subject.

jmeizis wrote:So for example if I wanted to do the Cassin Ridge on Denali in a light and fast style then I might climb the West Buttress on Denali in a slow expedition style to acclimate.

This is exactly how my partner and I climbed the Cassin in 2008. Proper acclimatization takes at least one of the variables of alpine style climbing out of the equation.