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HighHorse said:
Sorry, I was talking about American Alpine Institute.


I have heard great things about them as well - know a person who did the 6 day'er on baker with them - she said positive things -

you won't go wrong with any of these outfits.

t
 
altitude

"Altitude is a funny thing...its one of the most overated and underated aspects to climbing. <note: by altitude I mean 10-20K ft, 20+ is a different issue, I would call "extreme altitude">"

I beg to differ with those who think altitude is overrated. Back when I was in high school, I lived at 11.5K in South America and was up at 12.5 or 13K whenever we went up the hill into the city (La Paz, Bolivia). Altitude is nothing to sneeze at. After coming back to the states for college,I came home for a holiday and woke up with what probably was HAPE-I spent about a week in the hospital recovering-on oxygen and IV most of the time. No idea what caused it, but it almost killed me. I'd been up to around 16-17K down there as well with no ill effects at all so I guess my acclimatization had worn off after a couple of months at sea level.

I just saw the PBS show, Deadly Ascent, which documented the effects of cold and altitude on climbers. Anyone thinking of going to Denali should get a copy and check it out.

Altitude sickness is nothing to take lightly. It happened to me without the complications of freezing cold weather or heavy exertion and I had been living at altitude for a long time before it happened.
 
Great thread! From everything that I have experienced and read, everyone responds differently to altitude, and some who have never had a problems on 8000-meter peaks can later die of HACE or HAPE at considerably lower altitudes. One friend of mine had to be helicopter-rescued from Titcomb Basin in the Wind River Range of Wyoming at around 11,000 ft. Based on my experience in South America last February, I am a believer in staying hydrated at altitude. I began a regimen of diamox at the 14,400-ft Plaza de Mulas base camp on the normal route (Horcones valley) on Aconcagua, but the resident doctor there said to get off it (diamox not only dilates vessels allowing more transport of O2 to vital organs in your body, but is also a diuretic). Instead, he told us to drink at least 5 liters of water per day (we thought that we were doing well at 3 to 4 liters per day, but he said that was not enough if we wanted to summit). He tested the O2 content of our blood with a finger sensor, which would probably be a good investment for any team going to high altitude (I believe many high-altitude guides carry these). So, we followed the base camp doc's suggestions, were up peeing all night long, etc., but I made the summit in a 5300-ft hike from our 17,600-ft Nedo camp in about 12 hours on our tenth day on the mountain (long and slow was the way we did it, and I did not even have a headache on the summit). I was 55 years old at the time. My 42-year-old Aconcagua hiking partner summited from his bivi at 19,100 ft (Berlin Refugio) just before me. He then summited Everest via Rongbuk basecamp and the North Col route three months later. So, drink lots of water, but do not overdo that either (five liters per day max, I think), as more marathoners die of overhydration than underhydration, so I have read.
 
TomD said:
I beg to differ with those who think altitude is overrated. Back when I was in high school, I lived at 11.5K in South America and was up at 12.5 or 13K whenever we went up the hill into the city (La Paz, Bolivia). Altitude is nothing to sneeze at. After coming back to the states for college,I came home for a holiday and woke up with what probably was HAPE-I spent about a week in the hospital recovering-on oxygen and IV most of the time. No idea what caused it, but it almost killed me. I'd been up to around 16-17K down there as well with no ill effects at all so I guess my acclimatization had worn off after a couple of months at sea level.
Acclimatization wears off at about the same rate as it is built. Several months at sea level will remove essentially all of it and turn you into a "lowlander".

Doug
 
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Doug

Doug-that's what I figured. Dealing with altitude, as already posted is pretty much hit and miss. Some people would come down to La Paz and it wouldn't bother them and yet other people would keel over as soon as they got off the plane-literally. Once I had been there for a while-like a month or two, I could go up to 16K and not feel much of a difference. I wasn't climbing, carrying heavy gear or in really cold weather-big difference.
 
TomD said:
Dealing with altitude, as already posted is pretty much hit and miss. Some people would come down to La Paz and it wouldn't bother them and yet other people would keel over as soon as they got off the plane-literally.
I don't think it is entirely hit-or-miss. There is certainly a range of individual and per-exposure variation, but there are also well understood ways of dealing with it that work for most individuals most of the time. The primary methods of dealing with it involve slow ascent and immdediate descent if a serious problem develops.

The fact that one was ok at altitude can lull one into forgetting that one has to reacclimatize after a visit of any significant duration to the lowlands. And, of course, it is difficult to know exactly how much acclimatization has been lost in a short visit. Mechanical methods of transport exacerbate the problem because they make it very easy to get to high altitudes very quickly and easliy.

Doug
 
altitude sickness

Doug-by "hit and miss" I meant that individually, you may not know if you are susceptible to altitude sickness until you are exposed to altitude, not how to address the problem. Bad writing on my part.

The documentary "Deadly Ascent" which I saw this week on Nova (PBS) followed the effects of cold and altitude on a climbing team on Denali. The doctors also did a study using college students taken from sea level to 14K (Pike's Peak). The study showed that taking Ginko lowered the number of affected members of the group by about 1/3.

I'm certainly no expert on this, but in my personal experience, who did or didn't suffer from altitude sickness where I was did not seem to have a predictable identifier such as age or body type.

Another really interesting thing they did was give the Denali climbers a pill that contained a thermometer and radio transmitter so they could monitor a person's core body temperature with a little receiver. One climber, a former astronaut, had a radically fluctuating temperature-it spiked very high while he was climbing and dropped way down when he stopped-not a good sign. He had to abandon his summit attempt because they were worried about what was happening to him. Too hot, then too cold meant his body wasn't adjusting to the altitude and cold like the other two climbers (experienced Denali guides).
 
My experience on Rainier was very similar to DaveSunRa. I felt great until 12,800, then had issues until 13,500. After that I felt fairly good again once I realized that I was not breathing correctly :eek:

I was with giggy in the RMI customized class. I would rate them highly, both in experience and knowledge. I went expecting to get embarrassed by a bunch of hotshots. Instead I got a very accurate assessment of my abilities, and that of our group and some very timely little hints to augment what I already knew. RMI is a bit more expensive than others, but it is simply because they pay their employees more to attract the best out there. One of our Instructors told me that just to get the job he needed to go through the Alipne equivalent of "The Apprentice". He was in a group of 40 trying for 4-5 positions. He said it was by far teh hardest job he ever had - but absolutely the best. Another little thing that impressed me was that our bus driver was Joe Horiskey, one of the owners. That says a lot about "attitude", and I never felt any coming from them. It is a hard thing to project both an affable demeanor while demonstrating extreme competence in any endeavor. These folks are top notch at both.
 
I have used both Alpine Ascents and RMI. I had a good experience and would reccommend either one.

I did the 8 day Denali prep course with AAI. It was first class learning experience. We were on Mt. Baker, WA. The first few days we hiked for half the day and then had school in the afternoon. Once we reached about 9,000 we set up camp and stayed 3 nights. We did the whole winter camp thing. Built snow walls , etc. They also did an extensive amount of self arrest training with the ice axe. We had a great steep snow slope that flattened out with no obstructions. The wildest ride was be dropped over head first on your back. You really build up speed before you got yourself turned around and stopped. It was also a good workout climbing back up each time. They also spent alot of time on crevase rescue. How to set up the pully system and the proper way to get someone without further injury to them. Some of the afternoon session were on mountain phisiology, compass & map reading and using the avalance beacons to find someone. Then we moved our camp to about 10,500 and tried to make a summit attempt. We awoke to winds and snow. We set out that morning and were eventually turned around. It was almost better than making it however as we had to use many of the skills we learned about travelling on a rope team and setting the flags to find our camp on the way down. Only caveat is to be in the best shape of your life as it was a cruling 8 days. My only wish is that I started this when I was alot younger. I would rate them a 10/10 for this. :D :D

I used RMI for Rainier. They do a nice job for what it is. There goal is to get you up and down the mountain and its done in 2 days. You have to do a mandatory 1/2 day training course, which hits the highlights of traveling on a rope team, walking in crampons and self arrest. I must say that after the self arrest training I had with AAI the training with RMI doesn't compare on this item. They were very serious about the safety of the trip. They were constantly evaluating the performance and shape of each climber and were not bashful about telling someone that they were becoming a liability and should think about going down. They have a bunch of guides going up with the group so they can take people down if needed. I did the Disappointment Cleaver route and we started with 19 people and 7 summitted (me included :) ). Most turned around at the top of the cleaver which is around 12,000. Part of the problem with this trip is there is no time to aclimatize. You spend the night at Camp Muir which is 10,000 but your up at midnight and on the trail by 1:30 or so. The second day is also the longest. Climb the last 4,500 feet and 4mi or so to the summit and then all the way down (9,000 ft and about 9 miles). you get back to Paradise Lodge around 4 PM. Both RMI and AAI do a three day climg up the Emmons Glacier. AAI has a very limited number of permits and the trip fills up in about 2 days when they open it up. RMI has the majority of the permits for the mountain. There was a move out there to get that changed to allow the other Guides more. I don't know if it has changed or not.

The effects of altitude seemed to effect everyone a little different. Two of the people on my rope team that turned around were in there mid twenties and in great shape (marathoners). They made it to about 13,000. I did Kilimanjaro 19,340 (10 day trip) last February and found the first night at 12,000 was where I felt the most effects. after that it wasn't to bad. My wife , who doesn't do much climbing at all, made it without to much difficulty. She used Diamox and i didn't.

Hope this helps.

Chuck
 
I may do the Denali prep this year on Mt. Raineer, then join in a 2007 Denali attempt. Then, who knows, maybe Mars in 2008. Just kidding :)

It is a real curiosity that some young well conditioned runners can have difficulty with altitude. I suspect it would be an interesting thing to investigate if reponse to altitude is inversely related to age to some extent like the sherpas seemed to think. Of course a well conditioned athlete may have a low blood count due to insufficient iron supplement which results in mild fatigue in the lowlands but becomes a problem with altitude.

Going by these posts there appears to be a to do or not to do question on the virtues and risks of Diamox premedication. Some people are doing it successfully (Chuck's wife) somewhat against medical advice as Dr. Dasypodidae indicated in his post as well as others. What is the advantage of overhydration? It must increase blood volume but how does that improve O2 saturation?

Also since RBC count is critical why not do what runners do. Train at high altitude(a Presi traverse 1-2times a week making sure to include all summits even Clay?) for six weeks before attempting a climb, or if such time is not available store a quart of blood then get a "boost" just before the expedition begins. :D I heard of a doctor who would run his own dextrose IV while driving to a marathon. Made for interesting conversation when a policeman pulled him over because he was having trouble starting the IV while racing(in his car :) ) to get to a big race on time.

I have a small O2 Sat monitor I can bring with me. So when the AAI guide is in my face yelling at me to get down the mountain, I can say in my defense, "but look coach, my O2 sat is 93%. I'll be okay, honest."
 
I have often wondered if some of the new drugs out like EpoGen that promote new red blood cell growth after cancer treatments might be a way to boost the RBC count prior to a high altitude climb. I'm sure there are a million of reasons not to do it however.

With regard to your O2 sat, you be happy if its that high. :D
 
I would love to do Denali but I think that window of opportunity may have passed for me. :D :eek:

Just a sidebar on O2 sensors. 93% sounds good but we would be concerned at home (not necessarily on Denali) with an O2 sat that low. Anything below 95% makes us wonder what is going on and we would start you on supplemental O2. Obviously at altitude it probably would make sense why it’s that low.
With regards to using O2 sat meters. They can read incorrectly if a person has very cold hands and fingers. And mark this particularly well. People suffering from CO poisoning will read with great O2 sats even though they are very ill. Keep this in mind for people who are sick or lethargic in a tent running heaters or stoves. They may have CO poisoning and you need to treat the patient, not the machine. If they present with CO symptoms then treat them for it, no matter what the machine tells you. :D

Keith
 
****** said:
It is a real curiosity that some young well conditioned runners can have difficulty with altitude.
Why?
Physical fitness is more about performance of the muscles (including oxygen delivery to same). Altitude acclimatization is probably more about delivery of oxygen to the brain and organs.
BTW, the studies show little correlation between physical fitness and acclimatization.

I suspect it would be an interesting thing to investigate if reponse to altitude is inversely related to age to some extent like the sherpas seemed to think. Of course a well conditioned athlete may have a low blood count due to insufficient iron supplement which results in mild fatigue in the lowlands but becomes a problem with altitude.
Acclimatization involves a number of adaptations--read "Climbing Higer" by Charles S. Houston or "Medicine for Mountaineering" by James A Wilerson (ed).

Going by these posts there appears to be a to do or not to do question on the virtues and risks of Diamox premedication. Some people are doing it successfully (Chuck's wife) somewhat against medical advice as Dr. Dasypodidae indicated in his post as well as others. What is the advantage of overhydration? It must increase blood volume but how does that improve O2 saturation?
Overhydration also increases urine output which helps the system adjust its blood chemistry. Diamox increases the amount of bicarbonate in urine.

Also since RBC count is critical why not do what runners do. Train at high altitude(a Presi traverse 1-2times a week making sure to include all summits even Clay?) for six weeks before attempting a climb, or if such time is not available store a quart of blood then get a "boost" just before the expedition begins.
RBC is only one factor. In fact a high RBC from acclimatization can result in sluggish blood flow in the extremities and thrombophlebitis (clots in the veins).

Spending a week in Denver (alt 5K ft) will do more for your acclimatization than a Presi traverse.

Doug
 
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....or, better yet, hang out in Leadville at 12,000 ft, or even Nederland at 9000 ft, for a week or so before heading to Alaska.....or even before heading to Rainier, which turned us away in June 1972 when were unacclimatized, but was a piece of cake during that same September after we had been climbing in the Tetons all summer.
 
pills, etc.. I don't know - I like listening to the body - if your trianing on rainier - your not going that high - 14.5k give or take.

FWIW - this is what i did in for training for rainier and I felt a bit of altitude at about 13500K - but it wasn't bad at all (maybe just tired as far as know) and felt strong the entire trip pretty much. However, rainier was 2.5 days - not 21 and its not denali - by any means. But it does have 9000 ele gain from sea level in 2 days. (5k to 14.5k) and thats alot of gain in that short time.

I always run about 20-25 miles per week. year round, all the time.

for the 4 to 6 months prior to rainier I was also putting 40-50 pounds on my back and 2 times per week (sometimes 1) climbing on old hill nearby up and down 5 to 7 times. ( about 90 minutes)

2 times per month I was trying to get to the whites doing at least 4000 ele gain per trip and usually 8 to 15 miles per weekend (1 or 2 days) . I would stick to the pressies or something like that as they have the good ele gain and short distance . carry 30 -40 pounds.

On the weekends I couoldn't get to the whites, I would do monadnock very fast - I was climbing it in 50 minutes with 50 pounds on my back - almost running really. This really got the cardio going - bettr than running really.

I rested a full 7 days prior to trip to recoup and while on the mountain, ate as much as I could and drank water alot - probably 4 to 6 liters per day - was always pissing - it helped - I know it did.

get out there and run, climb whatever, drink water ansd stuff

there is probably some truth to the studies, this that and the other thing - but be in the best shape you can be and everything else will work out - and you will enjoy it much better. you don't need to be doing a traverse 2 times per week but be in great shape. - you might just risk and injury doing that and then your porked.

AND - get out in march/april/may and climb the easy snow gullies in tuckermans and - if you have the skills - the easy snow gullies in huntingtons - these get you in the "steep snow mind frame" - stuff like lowes path,mt islolation, etc.. - is not the terrain you will be on - on rainier - you need to get comfy with the exposure and snowfeilds that you will be on. I would stick to washington and northern pressies.

have fun - rainier is a beutiful mt and no matter how far you get and what you do - you will enjoy it big time.

just my 2 cents - keep it fun and simple and you will be fine.
 
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Rmi

I have used RMI on 3 occassions 2 - 3 day summit trips and February 2005 6 day winter expidition seminar. The Febraury seminar was with George Dunn and a very capable Paul Maier. The information was invaluable and is good prep for Denali. Crevasse rescue, avalanche assesement and all the rest.
The preparation is for a Denali expidition with RMI this June, with Dave HAhn, very exciting.
One thing I took away from all the trips was after working with a dozen different guides all through RMI (and some like Dunn and Hahn and Cussan who all run an independent operation) that there is a finite number of these folks and they will all work toghether or for each others company. RMI, IMG, Etc did'nt get in the way of how clients were treated.

My RMI experience has also been on the front end they are really good with information and support.

Best wishes for success in your adventures.

SABERG
 
HighHorse said:
What about AAI? I've heard really good things about them... Anybody with firsthand experience or thoughts?

AAI being the American Alpine Institute. i was on denali with them this may, excellent guides, tim connelly, dawn glanc, and joey elton. i would stongly recommend them and AAI. one thing i noticed about the guided trips on denali is that the guides of the other companies tended to do everything but wipe there clients a$$e$! for example when other outfits arrived at camp the clients would sit around while the guides setup tent platform, pitched tents, etc. this wasn't the case for us, which i greatly appreciated! i wasn't paying some sherpa to drag me up the mtn, i was paying to compitence, experience, and good judgment in an area i've never been in before.

personally, i'd call AAI before anyone else if i'm looking to go on a guided trip in the future.
 
Alpine Ascents International

Just to be clear, no one set up my tent up for me or dragged me up the mountain. When when arrived at camp the guides would set up the kitchen while the clients set up the tents, including the guides. I did quite a bit of research before I decided on climbing Denali with Alpine Ascents, the deciding factor for me was the group size. Alpine Ascents has a maximum of six clients with two guides (smallest on the mountain). American Alpine Institute has a capaicty of nine (clients). I saw other guided groups with twelve clients and three guides. I can't imagine the logistics of making / breaking camp, or eating with fifteen people. I believe having a smaller group (eight total) made the difference while we were on the mountain between summitting and not, mostly due to logistics (getting out of camp in the morning).
 
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My experience with Alpine Ascents was the same as Hampshire's. Small group and each person is an integral part of the team as is expected to carry thier share of the load.
 
Again thanks to everyone for their invaluable experience and expertise.

Normally, when hiking, I take Ibuprofen(800mg) approx. 3x a day. Based on this discussion I am concerned that this may mask the AMS headache symptom. Is this a real concern or will I be okay taking anti-inflammatories?

Another concern is that I have a chronic lower urinary tract history. My eyes start to cross and see stars when my bladder is about 450cc full. Meds for that I take at bedtime. So if I am drinking 5Litres of water a day I may need to pee twice as frequently as others. Hopefully, I'll sweat twice as much and still moisture manage okay.

Conditioning will be what it will be. I won't be in the best shape of my life. Right now I am somewhere between 3.5 to 4hr marathon shape. I'll know better once I run the marathon March 12th. Since the Denali training manual suggests increasing upper body strength as much as possible, I will increase resistance 10% every week for the next nine weeks. Also I'll incorporate the stairmaster as a medium effort workout 2times/week with the goal of 40lbs for 40-50min at about a 150bpm intensity.

I do not have vacation time to spare to acclimate to high altitude before heading out to Washington. And I'll be lucky to get 3 consecutive weeks if and when I go to Denali, so no time to preacclimate. The question will be whether I will be able to acclimate according to the expedition schedule.

As I understand O2 saturation a prolonged period below 90% can start to mess up blood gases which is a downhill and slippery slope physiologically. Maybe I'll just paste the O2 sat sensor to my forehead if it gets too cold. :rolleyes: Actually I'll weigh the monitor first and decide if it's worth the bother to bring it.

Innumerable times I will let go of all the concerns about keeping up and learning new things and remember why I am there and will return: the breath-taking and unique exhilaration that only comes with this kind of challenge.
 
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