Post on 17-Oct-2020
MT. EVEREST: THE BODY AT ALTITUDE
Case Studies into the Death Zone
Jon Kedrowski, Ph.D
N.O.D. Enterprises
January 22, 2020
DISCUSSION TOPICS
The beauty and culture of the
Everest Himalayan region
What happens to our bodies on the way up to the top of the world's highest summit,
Everest
How people prepare themselves for the rigors of a
high altitude expedition
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• Ph.D in Environmental Geography, Weather, and Climate
• Professor at Colorado Mountain College
• Professional Mountaineer
• 4 Expeditions to Mt. Everest (2012, 2015, 2018, and 2019)
• Summited Everest in 2012 and 2019
• Climbed 6 of the 7 continental summits
• 1000’s of summits of Colorado 14ers
• Ski Mountaineer
• Keynote Speaker
ABOUT JON
• Author of 3 Books
• Sleeping on the Summits: CO 14er High Bivys
• Skiing and Sleeping on the Summits: Cascade
Volcanoes
• Classic Colorado Ski Descents
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ABOUT JON – PUBLISHED RESEARCH
2011: “Dirty Snow”; NWA Journal of
Meteorology
2009: “Assessing Human Environmental Impacts on Colorado’s 14,000ft Mountains”; Mountain Research and Development
(from 2006 MA thesis)
2005 2009
2010: “Climber Perception and
Environmental Interaction on Mt.
Rainier, WA” (2010 Ph.D. thesis)
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TOPIC #1: THE EFFECT OF HIGH ALTITUDE ON OUR
BODIES
THE EFFECT OF HIGH ALTITUDE ON OUR BODIES
What happens to our bodies on the way up to
the top of the world's highest summit, Everest
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THE EFFECT OF HIGH ALTITUDE ON OUR BODIES
Staying healthy on high altitude expeditions is
always a concern
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THE EFFECT OF HIGH ALTITUDE ON OUR BODIES
Air pollution in Kathmandu, Nepal
– early April
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THE EFFECT OF HIGH ALTITUDE ON OUR BODIESUnderstanding the body at
altitude:
• Increasing altitude changes the way
our bodies function
• O2 absorption decreases
• O2 needed for metabolism by body
tissues
RESULT = Hypoxia (CO2 in blood)
This causes:
• Increased breathing rate
• Increased diuresis
(dehydration/diarrhea)
• Insomnia
Recall normal lapse rates? Pressure, temp,
and O2 decrease.
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THE EFFECT OF HIGH ALTITUDE ON OUR BODIES
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THE EFFECT OF HIGH ALTITUDE ON OUR BODIES
Acute Mountain Sickness (AMS)
Signs and symptoms to recognize:
• ½ of all climbers will experience AMS initially
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Headache
Insomnia
Listlessness
Loss of coordination
Puffiness around eyes
Cough
Shortness of breath
Fullness/tightness in chest
Irregular breathing
Cough
Shortness of breath
Fullness/tightness in chest
THE EFFECT OF HIGH ALTITUDE ON OUR BODIES
Diamox
• 250mg per day while acclimatizing (trekking in)
• Build up levels in the blood, helps with O2 intake
• Some side effects though.
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Controversial Use of Acetozolamide (Diamox) 48 hours before ascension
THE EFFECT OF HIGH ALTITUDE ON OUR BODIES
Acclimzatization:
• Time = Best Practice
• Above 10,000ft: Climb high /
sleep low
• Limit increases in sleeping
altitude to 1,000 to 2,000ft per
day
• It takes time for the body to
adjust
• Each person’s physiology is
different
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THE EFFECT OF HIGH ALTITUDE ON OUR BODIES
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THE EFFECT OF HIGH ALTITUDE ON OUR BODIES
30% of O2
• At the summit of Everest, each
breath contains about 30% of
the oxygen saturation as a
breath at sea level
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THE EFFECT OF HIGH ALTITUDE ON OUR BODIES
Acclimatization
• Gradually trekking to higher elevations over the
course of days or weeks.
• Example – trekking to EBC over 7-10 days
• Start at 2700m
• End at 5400m
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THE EFFECT OF HIGH ALTITUDE ON OUR BODIES
• One village at a time, no more than 6 hours and
1,500’ per day vertical once you approach 14,000’.
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THE EFFECT OF HIGH ALTITUDE ON OUR BODIES
Acclimatization Problems
• Abnormal shifts in body fluids
related to stress of high altitude
and an individual’s inability to adapt
to the conditions
• AMS (Acute Mountain Sickness)
• HAPE (High Altitude Pulmonary
Edema)
• HACE (High Altitude Cerebral
Edema)18
THE EFFECT OF HIGH ALTITUDE ON OUR BODIES
HACE
• A Polish climber became very lethargic.
• Disorientation, vomiting, no strength, loss of muscular control with inability to walk a straight line, headache, swelling if head and eyes (coma can even occur)
• Dexamethasone attempted, retreat to lower altitude was critical!
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THE EFFECT OF HIGH ALTITUDE ON OUR BODIES
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HACE and
Hypothermia
• Hallucinations for a
South Korean climber
THE EFFECT OF HIGH ALTITUDE ON OUR BODIES
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HAPE
• Bubbling noises while breathing, fluid cough (blood), bluish finger nail beds due to barriers in O2 transfer
• Treatments:
• Immediate descent
• Nifefipine
• Gamow bag
• One week hospital stay to stabilize lungs, flui,d and breathing
Gamow Bag
THE EFFECT OF HIGH ALTITUDE ON OUR BODIES
2019 Everest Stats
• 1136 Total Climbers
(including Sherpa)
• 876 Total Summits
(77% Success Rate)
• 11 Deaths (2006
Deadliest – 15 deaths)
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THE EFFECT OF HIGH ALTITUDE ON OUR BODIES
Everest ER
Video – 17 mins
Video – 2 mins
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THE EFFECT OF HIGH ALTITUDE ON OUR BODIES
Nutritional Physiology
Appetite Suppression = Induced
Cachexia
If adequate food and fluid are
neglected:
• Rapid dehydration / glycogen
depletion / weight loss
occurs due to
• Inappropriate thirst and
appetite responses
• Increased insensible water
loss, transient diuresis and
increased energy expenditures
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THE EFFECT OF HIGH ALTITUDE ON OUR BODIES
To Lower the Probability of Experiencing AMS
• Consume a minimum of 3 to 4 liters of fluid per day containing 200 to
300g of carbohydrate in addition to that contained in the diet.
• This should:
• Prevent dehydration
• Improve energy balance
• Improve the oxygen delivery capability of the circulatory system
• Replenish muscle glycogen
• Conserve body protein levels.
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THE EFFECT OF HIGH ALTITUDE ON OUR BODIES
Acclimatization / Everest South Side Route26
THE EFFECT OF HIGH ALTITUDE ON OUR BODIESAcclimatization – 3 Rounds
1. Pumori ABC - 20,000ft
(1 night)
2. Camp I and II - 20,000-22,000ft
(2 nights)
3. Camps II and III - 22,000-
24,000ft (6 nights)
4. Descend to Pheriche (14000ft)
and rest
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THE EFFECT OF HIGH ALTITUDE ON OUR BODIES
Acclimatization Graph 28
THE EFFECT OF HIGH ALTITUDE ON OUR BODIES
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THE EFFECT OF HIGH ALTITUDE ON OUR BODIES
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Full body coverage to protect against the sun
THE EFFECT OF HIGH ALTITUDE ON OUR BODIES
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Sunburn & Snow Blindness
• High SPF Sunscreen
• Full body coverage critical
• Protective Sunglasses w/ Side
Shields for daytime
• Clear glasses for night-time
• Goggles
• Glacier travel makes climbers
especially vulnerable.
THE EFFECT OF HIGH ALTITUDE ON OUR BODIES
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Hypothermia & Hyperthermia
• Balancing the extremes
• Travel early in the day
THE EFFECT OF HIGH ALTITUDE ON OUR BODIES
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Effects of using bottled oxygen
THE EFFECT OF HIGH ALTITUDE ON OUR BODIES
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Helicopter rescues up to Camp II
Rescues in the death zone
THE EFFECT OF HIGH ALTITUDE ON OUR BODIES
352019 Case Study
2012 – Canadian Climber
CASE STUDY 2019 – AUSTRALIAN CLIMBER
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THE EFFECT OF HIGH ALTITUDE ON OUR BODIES
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2012 Summit of Everest
• Turned around 800 feet
from summit due to
weather / tragedy
• Descended to base camp
• Rested for 3 days
• Acclimatization allowed
me to go for the top in a
speed ascent…….left May
24, summited May 26th
THE EFFECT OF HIGH ALTITUDE ON OUR BODIES
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Achieving your goals is not going to be easy……if doing
something great was easy, then everybody could do it, and
there would be no reward.
TOPIC #2: PREPARING FOR HIGH ALTITUDE EXPEDITIONS
Sleeping on the summits of
CO 14ers
PREPARING FOR HIGH ALTITUDE EXPEDITIONS
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PREPARING FOR HIGH ALTITUDE EXPEDITIONS
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PREPARING FOR HIGH ALTITUDE EXPEDITIONS
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My Everest 2020 No O’s Project
• Lessons learned from previous summits
• Lessons learned from Manaslu project
Lessons from Famous Mountaineers:
• Tom Hornbein
• Reinhold Messner
• Peter Habeler
PREPARING FOR HIGH ALTITUDE EXPEDITIONS
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Summit or suffer? A training program with specific,
consistent training is why I was able to go back up in 2012.
PREPARING FOR HIGH ALTITUDE EXPEDITIONS
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No substitution for
mountaineering:
• Train for mountains in the mountains
• Additional strength training in gym:
• Core strengthening
• Leg strengthening
• Balance exercises
• Brain patterning
PREPARING FOR HIGH ALTITUDE EXPEDITIONS
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Train for altitude with….altitude:
• I live in CO and climb 14,000ft mountains weekly, and live
at 8000ft
• Some are now using hypoxia tents
• Modify nutrition / add iron to maximize hemoglobin
• Metabolic Efficiency benefits
MT. ELBERT SUMMIT - 14,400’
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Jan 3, 2020
PREPARING FOR HIGH ALTITUDE EXPEDITIONS
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Example of training for mountaineering
• Monday: 60 min endurance hike with weighted backpack
• Tuesday: 30 min rock climbing + strength training
• Planks / 1 Leg Squats / Bosu ball balance exercises / pull ups / ball chop
• Wednesday: Short, steep hill intervals
• Thursday: 1-2 hours skiing + strength training
• Friday: 60 min endurance hike with weighted backpack
• Saturday: Climb Mt. Elbert, highest peak in CO. Simulate big goal climb by using same gear
• Sunday: rest / yoga
TOPIC #3: THE BEAUTY AND CULTURE OF THE HIMALAYAS
BEAUTY AND CULTURE OF THE HIMALAYAS
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BEAUTY AND CULTURE OF THE HIMALAYAS
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The world’s most dangerous airport?
Lukla, Nepal
BEAUTY AND CULTURE OF THE HIMALAYAS
58Trekking to Everest Base Camp
BEAUTY AND CULTURE OF THE HIMALAYAS
59Trekking to Everest Base Camp
BEAUTY AND CULTURE OF THE HIMALAYAS
60Trekking to Everest Base Camp
BEAUTY AND CULTURE OF THE HIMALAYAS
61Trekking to Everest Base Camp
BEAUTY AND CULTURE OF THE HIMALAYAS
62Trekking to Everest Base Camp – Gorak Shep (16,600ft / 5200m)
BEAUTY AND CULTURE OF THE HIMALAYAS
63Camp 1 – Mt Everest
BEAUTY AND CULTURE OF THE HIMALAYAS
64Crevasses – Mt Everest
• Jose Oberholzer and Team!
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Colorado 14er High Bivys & Cascade Volcanoes
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