A lesson in altitude

It feels rather ironic to be sat in my living room listening to Bob Dylan and wearing a giant plastic facemask attached via a long clear tube to a machine sat humming quietly in the corner. I'm currently sitting quite comfortably at 6560m breathing in oxygen at 78% being pumped into my lungs from the 'hypoxicator' and am now in the second 10-minute segment of a 90 minute long intermittent hypoxic training (IHT) session.
The fingertip pulse oximeter, attached to my finger glows, providing an 82% blood-oxygen saturation (%SpO2) reading and pulse rate of 68... All this to help with my acclimatisation on Everest and to reduce the potential for Acute Mountain Sickness - more commonly referred to as 'AMS' or 'Altitude sickness'...

George Leigh Mallory once said, "We will stomp to the top with the wind in our teeth" (1924)

The process of 'stomping to the top' involves one of the greatest challenges that faces mountaineers from all walks of life, all shapes and sizes, males and females alike. "Acclimatisation" can be simply defined as the deliberate, temporary modification of your physiology to cope with an increased in altitude. As you climb higher, the air gets thinner, so each lungful of air that you take in gives you less oxygen, which means that your body has to work harder to maintain the supply. The human machine is resiliant and responds in a number of different ways:

• breathing faster and more deeply
• heart beats faster in order to maintain the oxygen to your tissues
• brain limits the exercise intensity in a proactive response to the altitude
• body excretes bicarbonate in the urine and creates more red blood cells, making the blood thicker. The thicker blood means that it has more difficulty reaching the extremities (fingers and toes) which, in turn, increases the risk of frostbite.

Altitude Sickness occurs when the body is acutely exposed to altitude and commonly occurs above 2,400m. It can occur in varying degrees of severity:

1. Mild AMS - symptons can include headaches, tiredness, disturbed sleep, loss of appetite / nausea, shortness of breath, dizziness and swelling of fingers and face.
2. Severe AMS - mild / moderate AMS can develop into severe AMS if the symptoms and warning signs are ignored and the ascent is continued. All of the symptoms described above are indications that severe AMS may be developing. Severe AMS can be further broken down into two life threatening conditions associated with severe AMS:

High Altitude Cerebral Odema (HACE) which occurs when there is accumulation of water in or around the brain and High Altitude Pulmonary Oedema (HAPE), occuring when there is an accumulation of water in the lungs.

This is why altitude and the effects of altitude must be approached with a great degree of planning, caution and a high awareness of the symptoms. The best decision and best course of action, no matter how difficult, frustrating, or challenging it may be is to descend immediately, as low as possible (at least 500m) - under no circumstances should symptoms be ignored. It is important that adequate hydration is maintained as it will allow the body to regulate its chemical balance in response to the change in altitude.

In both cases, prevention is better than cure. On the mountain we will 'control what we can control' - giving our bodies the best possible change by controlling the stresses that are within our physical control. Hydration, nutrition, body temperature, mental calmness and getting a good nights slep. By looking after these things our bodies can concentrate on surviving with the stress of reduced oxygen. 

The photo to the right was taken during my Mera Peak expedition in 2008 where I suffered from mild AMS as seen through my swollen face - fortunately resolved through hydration, an altitude acclimatiation day and a good nights sleep.

More information regarding AMS can be found on the website, http://www.altitude.org/altitude_sickness.php

IHT Training

I'm now 50 minutes through my IHT session and am feeling pretty good..! I can however imagine that you're wondering why I'm regularly starving my body of oxygen and whether my employers are happy that Im burning valuable brain-cells in this way...! These daily 90-minute sessions alternating oxygen-starved air with short bursts of oxygen-rich air will hopefully pay off during the initial weeks on the mountain, improving oxygen uptake and efficiency. Rather than make the body weaker, when done in a controlled '5-minutes on / 5 minutes off' way, it has a cascade of beneficial adaptive responses without adverse effects:

IHT can be beneficial for the treatment of a wide range of degenerative diseases including chronic heart and lung diseases, hypertension, asthma and chronic bronchitis, liver and Pancreatic diseases, anxiety and depression, iron-deficiency anaemia, lack of energy and fatigue. It has also been proven to improve the body's mitochondrial status, as well as aerobic and anaerobic performance. Full details of the scientific studies associated with these results can be found be found via following this link: Intermittent Hypoxic Training, A Pilot Study or by contacting The Altitude Centre in Convent Garden, London.

Nearly 11pm - soon it will be time to turn off my Bob Dylan, switch from my IHT session to the comfort of my altitude tent, return to sea-level and shut down the laptop for yet another evening.

"The mountains will always be there, the trick is to make sure you are too" --Hervey Voge

And on a slightly 'lighter note' a quote to describe how AMS feels:

"I suggest going out to the nearest pub and getting completely, and utterly, wasted. Make sure you smoke at least 1 pack of unfiltered Camel’s. Get the full ashtray, pour a drink in it and then pour the mixture into a water bottle. When you get home (ideally around 3:30am) stick the vile mixture into your freezer. Put on your best goretex and thermal layer. Climb in. At 5:30am, get out, drink (chew?) the mixture and go run the biggest flight of stairs you can find. Run until your heart threatens to explode. Your dehydration caused by the alcohol should adequately simulate what you may experience at higher altitudes. Your lung capacity should be sufficiently impaired by the smokes to simulate a oxygen poor environment. The freezer episode should adequately replicate a bivy. Drinking the booze/butt mixture should simulate your lack of appetite….. Oh — once your finished your workout, go to work (to replicate the long walk out).” -- Greg Hamilton suggesting the feeling of climbing at altitude