altitude acclimatization - IHE etc
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Looking for new approaches to acclimatization.
but ...
by the U.S. Dept of Defense. Pre-Exposure during one week in advance, to reduced O2 pressure with total pressure normal sea-level, did not help with short-term acclimatization. (That finding at first surprised me, but then made sense -- for the samed reason acetazolamide does help me acclimatize even though it has no effect on red blood cell count or oxygen utilization). The summary of the DoD suggests that what really does work is pre-exposure to reduced Total pressure atmosphere - (but a simulated environment for that is very very expensive). Or is there some other new trick? Ken |
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Buff Johnson wrote: Any chance you could take more time off?Thinking about the total cost involved I was wondering this very thing. Take a few more days off and just hang out doing casual touristy stuff wherever you're planning on playing. |
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If you really wanted to do something like that, find a friend that is a technical diver or make friends with a local dive shop operator. A common fill of trimix is 18/45 or 18% oxygen, 45% helium. You could get the training in order to get the fill, get yourself a few tanks and a full face mask and a treadmill and go to town. Not sure if it'd be really worth it to you though. My trimix training and gear cost me nearly $5,000 and filling the tanks are about $130 a pop because of the cost of helium. |
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I haven't heard of this being done by mountaineers, but I know that athletes sometimes blood dope. They draw a unit or two of blood a couple of weeks prior, spin off the red blood cells, and reinject them prior to need to increase O2 transport capacity. Side effects could be increased risk of embolism and the other symptoms of polycythemia. Staying hydrated as well as possible would be important. Any thoughts on this? |
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I don't mean this to sound sarcastic, but move to a higher altitude and work out more. IHE sounds tempting, and probably does work for a number of people (long-distance bike racers), but regular endurance training is the way to go. Climb whenever you can. |
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Mike Washburn wrote:I haven't heard of this being done by mountaineers, but I know that athletes sometimes blood dope. They draw a unit or two of blood a couple of weeks prior, spin off the red blood cells, and reinject them prior to need to increase O2 transport capacity. Side effects could be increased risk of embolism and the other symptoms of polycythemia. Staying hydrated as well as possible would be important. Any thoughts on this?I think blood doping is just not worth it. Blood becomes much more viscous doing this and can be a risky and dangerous practice. |
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Nick Mardi wrote:find a friend that is a technical diver or make friends with a local dive shop operator. A common fill of trimix is 18/45 or 18% oxygen, 45% helium . . . My trimix training and gear cost me nearly $5,000Thanks a lot for such a creative suggestion ... but for that money I could almost buy two "molecular sieve" / membrane separator machines. (I'll guessing that the need to handle helium for divers boosts the price. Non-divers are happy with extra nitrogen) Ken |
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Mike Washburn wrote:I haven't heard of this being done by mountaineers, but I know that athletes sometimes blood dope. They draw a unit or two of blood a couple of weeks prior, spin off the red blood cells, and reinject them prior to need to increase O2 transport capacity. Side effects could be increased risk of embolism and the other symptoms of polycythemia. Staying hydrated as well as possible would be important. Any thoughts on this?My unexpert thoughts about blood doping ... This is a more direct form of what people are trying to achieve by using altitude tents or IHE with masks: increase red blood cell count. I think there's abundant evidence that it improves aerobic muscular performance at altitude (or at sea-level just as well). Fundamental shortfall of all the different methods for increasing red blood cell count is that I don't see how that addresses my problem of AMS symptoms - (that's the point of that DoD study). My goal is not to go uphill 5% faster so I can place 6th instead of 19th in some alpine speed-climbing race. Rather I just want to avoid feeling nauseous and lethargic so I barely feel like climbing at all. My theory (also in some books) is that the cause of some of the AMS symptoms is reduced partial pressure of carbon dioxide CO2 -- not an oxygen problem. Thus for example the drug acetazolamide addresses that by modifying the buffering of carbonic acid in my blood. Otherwise the concentration of carbonic acid drops thru exhange of CO2 with thinner air, and my blood pH rises. So the obvious theory is that many symptoms of AMS are a result of alkalosis. Therefore, one idea is that I could try filtering sea-level-pressure normal (non-rebreathed) air thru one of those CO2-soaking "silos" (e.g. from AltoLab) into a breathing mask, and try intermittent sessions of exposure to reduced-CO2 air during the week or so before I go on my trip -- and see if that induced some early adaptation of my carbonic acid buffering - (instead of waiting for my body to make the same adaptation three days after I arrive). But it's just a theory and I've never tried anything like that before and I don't know the risks (other than feeling nauseous and lethargic before I've even left home). Ken |
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I'm preparing for a trip to thinner air in 4 months, and have been adding a few supplements to the mix in addition to training - chlorophyll drops (closest thing in nature to hemoglobin) and blood builder pills, totally food-based. |
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chris_vultaggio wrote:... diamox etc should not be used prophylacticallyWell you haven't said how high you're climbing or how high you're sleeping or what the group social dynamics are. I've been taking acetazolamide / Diamox prophylactically for multiple trips per year for over 20 years -- gotten reliable results with no problems other than well-known side effects that I could easily manage. I believe it's been studied lots for prophylactic use since decades ago. My prescribing doctor is fully aware of me starting to take it two days before leaving on a trip -- indeed those were his instructions. My context is that I never climb higher than 15000 ft and never sleep higher than 10000 ft. And I'm responsible for my own use only, not a whole group of climbers. What I've heard is that normally the best treatment for unexpected serious altitude-related problems is retreat to lower altitude. Well for me "retreat" is my normal climbing plan after I've reached the summit. I love hanging out down in the valley -- not much interested in sticking around in huts or tents that lack convenient Web access or boot dryers. On the other hand, if I were leading a larger group, at higher altitudes, with high camps in possibly bad weather where retreat might be dangerous, perhaps I'd have a policy against prophylactic use. Ken |
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kenr wrote: Well you haven't said how high you're climbing or how high you're sleeping or what the group social dynamics are. Ken+6000m Sounds like what you're doing is working for you - just go in healthy and give yourself plenty of time to adjust to the lower O2 pressure. |
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Last year i was using ginko biloba before high altitude runs. 120mg 2x a day with food (that was just the size i got, they come in different doses, but ive read at lease 100mg 2x a day is whats required for the effects). Its also supposed to help focus and whatnot. I beleive it works by thinning the blood slightly. Start at least 5-7 days before altitude exposure. It also may have help me sleep better (not sure about confounding variables here). |
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chris_vultaggio wrote:...have been adding a few supplements to the mix in addition to training - chlorophyll drops (closest thing in nature to hemoglobin) and blood builder pills, totally food-based.I don't really want to rain on the supplement parade, whatever works for you, but just because chlorophyll looks like hemoglobin in chemical structure, does not mean the two molecules work the same way. Closest thing in nature = close, but no cigar. Both have a porphyrin ring, which is kind of a structure built to hold a metal ion at the center, iron for Heme and magnesium for chlorophyll. The iron in heme binds oxygen, the magnesium in chlorophyll helps shuttle electrons to other plant proteins. Chlorophyll contains no iron. Sorry, it just drives me crazy when people say chlorophyll is the plant's blood. That other stuff "blood builder" seems a bit more worthwhile. It looks like it is processed Hydrilla plant which has a ridiculous amount of B12, which is used to make DNA, which is needed by your bone marrow to make lots of red blood cells, cause you turn them over quickly. You can get B12 from liver, shellfish or dairy, but - Hydrilla is an invasive weed in Florida, so why not rip it out of lakes and ponds, grind it up and sell it to people. Hopefully they check it for heavy metals like mercury and lead, which it can hyperaccumulate. Or you could always eat some liver for B12 (apparently you can store several years worth in your own liver) and some green leafy vegetables like spinach or swiss chard for iron. Plus then you get chlorophyll straight from the source. :) |
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Ben B. wrote:Have any local 10,000'+ peaks you can hike sometime in the week before your next Alps adventure?No - the highest are about 4000 ft. And those are not very interesting from a skiing or climbing perspective. So the idea of driving several hours to one of them -- then sleeping out on top for a very cold night to get maximum stimulation -- and driving back again -- doesn't seem like a very effective use of my time and money. Acetazolamide would seem to have a way better cost/benefit ratio for my situation. Ken |
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It will take a few days to adjust. No matter how you try to decipher the acid/base buffering, it's hypoxia and pulmonary hypertension relationship. |
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I'm not any sort of medical professional, so I'm doing my best to try to understand all these terms + ideas. Buff Johnson wrote:it's hypoxia leading to pulmonary hypertension. If the symptoms always led to edema, then I would be more aggressive, but it's not.I looked up the symptoms of "pulmonary hypertension" in the Wikipedia -- it seems like when I go up to my selected ranges of altutude, I only experience one out of the five symptoms. I'll take your word for it that likely I'm experiencing some level of pulmonary hypertension -- but to me it seems like my symptoms and context are a much closer match for Acute Mountain Sickness. Buff Johnson wrote:talk to your doc with would be ed medsI'm guessing that "ed" means drugs for erectile dysfuntion, such as sildenafil. I have done some reading about that, and it seems likely that I could climb uphill say like 2% faster if I took it -- another way to improve oxygen utilization - (tempting if I were some kind of alpine racer) - but I'm not seeing how it addresses my AMS symptoms. I guess I could ask my doctor to let me carry some sildenafil just in case symptoms of pulmonary hypertension ever became a problem for me -- but so far in about a hundred trips like this, it hasn't. Buff Johnson wrote:A good sleep aid is ambien ...But I've never had any problem sleeping at 10000 ft (my typical plan in the rare cases where I sleep up high at all) -- as long as I've started taking acetazolamide a couple of days ahead. Buff Johnson wrote:It will take a few days to adjust.Not with regard to AMS symptoms at my chosen altitude range -- Not when I take acetazolamide. Now I believe it does take a few days or longer for other significant adaptations, but at my target altitude range those other factors don't bother me and have not gotten in the way of achieving my (admittedly limited) goals. Buff Johnson wrote:I would think about stopping diamox. It's not ... doing anything more than your body wouldn't naturally do in a few of days of rest ...But that effect is exactly the only result I ever wanted from taking Diamox / acetazolamide. I guess some people do not think that's a purpose worthy of taking acetazolamide. But it's my purpose, and my doctor understands it, and fortunately he thinks it's worthy. And lots of other doctors in the past have thought that quicker avoidance of AMS symptoms was worthy enough for them to take the time and effort to perform scientific studies to support that off-label use. I'm guessing that your point is that my purpose is not worth the risks and potential bigger side-effects of starting to take any new drug. Which might be useful as public service announcement to other people reading this thread. But myself, I'm way past that. I've been taking acetazolamide now for like a hundred trips over twenty years. Ken |
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You are trying to hard. Either listen to the other people and go 5 days early and get aclimated or go talk to your Doctor. Looking shit up on wikipedia is not the same as talking to a physician, if you are that worried about your AMS go talk to someone that knows what they are talking about.... Or just do the easy way and go 4 days early. |
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I tried an IHE procedure with breathing Low CO2 / normal O2 at sea-level pressure. Hit me much stronger than I expected. Next time (if there is a next time) I'll try either less time or less intensity of exposure.
Afterward - up to 3 hours ...
Thoughts:
Whether this really helped for acclimatization I'll get a clue in a few days when I try climbing up on skis at 7500-13000ft. For now I can say this was definitely the least fun way to get acclimatized in advance that I've tried. Ken |