Bolts and Blood

I have a boat that I like to take out fishing on the salty waters of Puget Sound. While it is short enough to trailer, it is heavy enough to cut tire grooves in the hot asphalt. So it goes that the unfortunate trailer which carries this beast started breaking down soon after I bought it. There was one bolt in particular that kept shearing off where the frame attaches to the axle. With the boat riding on the fenders I would limp to the nearest hardware store and buy a replacement bolt, then set about making repairs there in the parking lot with a complicated network of jacks, oars, and scavenged cinderblocks. What I lacked in knowledge of metallurgy I made up for with a dillusionary sense of engineering.

A few weeks would go by where I was only fighting electrical problems with the taillights, then the same bolt would break again. I sought out the counsel of a neighbor who runs a machine shop. He listened respectfully as I described my hardship, nodding with a hand to his chin. “You need to get a better bolt, or a bigger bolt,” he said.

It’s kind of like that with blood too. With high altitude climbing there just isn’t the same amount of oxygen getting to your blood as would be the case at sea level. At 14,000 ft on Denali a breath takes in only 50% of the oxygen you are breathing now. At the 20,320 ft summit its down to about 18%. So that same old blood just won’t due. You need better blood, or bigger (concentrated) blood.

The process of acclimation tries to give you both.

Better blood, in terms of high alt climbing, means more red blood cells. These are the guys that carry oxygen in your blood and a “more is better” philosophy definitely works as oxygen becomes harder to come by. Red blood cells are produced in the marrow of your bones. Given a chance, a healthy body will respond to lower oxygen levels by producing more red blood cells. But you have to give it a chance. By that, I mean you can’t rush into high altitudes.

But first your body will temporarily throw off some of the important fluids in your blood to make room for those extra red cells. This is part of making bigger blood. It’s also part of edema, a medical term referring to the gathered fluids spun off by this process. They have to go somewhere. The problem is where? A person’s blood pressure typically increases as they ascend; this begins the process of forcing the fluids out of the blood. With a measured and reasonable rate of ascent the body may manage these fluids in a variety of ways. But if it doesn’t, the result may take the form of either HAPE or HACE.

HAPE, high altitude pulmonary edema, is the gathering of fluids in the lungs. It kills. If an afflicted person doesn’t die from HAPE, it is probably because the early signs were recognized and that person descended immediately. If you are going to go into the high altitudes you should know the signs of HAPE. Take this stuff seriously.

HACE, high altitude cerebral edema, occurs when fluids gather in the brain. I think you get the idea. Bad stuff here again. It is important to know the early indications and descend immediately at the first signs of HACE.

There are a number of drugs which may prove helpful in buying time while getting a climber stricken with HAPE or HACE down. Collectively they form the small but high octane pharmacy no high alt climber should be without.

Studies show that most people can go to 12,000 feet without difficulty. Between 12,000 and 22,000 some of us can acclimate. Above 22,0000 feet elevation your clock starts running down. It may run down quickly, or it may run down slowly. But to be certain it is running down. We are not meant to be at these altitudes and our bodies go to great lengths to communicate this to us. Light-headedness, nausea, sleep disorders, and a ferocious caloric burn rate all become commonplace. You probably can’t eat as many calories as your body burns at high altitude, so it starts feeding on itself. Substantial weight loss, and loss of muscle mass are typical.
As a result, most high altitude attempts incorporate a strategy designed to spend as little time as possible in the thin air. A climber will acclimate with hikes or load carries in the 12,000 to 17,000 ft elevations for many days, all the while beefing up his physiology. Then he will move into position at high camp and hope for that "Blue Bird Day," clear skies and no wind. Thats when he takes his shot and gets down. Success or no, he gets down. It is a very bad idea to linger, and being weathered in at high camp is among the least favorable outcomes one may encounter.

Our strategy on Elbrus features a series of acclimatization hikes. Each one taking us higher, then descending to sleep low that night. Two of these hikes will have us returning at days end to the comfort of a high mountain ski lodge. Nice. A great deal of thought has gone into how we will acclimatize in the most measured and sensible ways. We will also know the reassurance of having highly trained and experienced Guides leading us ...and I'm not just saying this because I know my Mom will be reading this Blog.