mt. everest: the body at altitude · • professor at colorado mountain college •professional...

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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Staying healthy on high altitude expeditions is

always a concern

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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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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


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


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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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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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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• 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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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


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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HACE and

Hypothermia

• Hallucinations for a

South Korean climber


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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


2019 Everest Stats

• 1136 Total Climbers

(including Sherpa)

• 876 Total Summits

(77% Success Rate)

• 11 Deaths (2006

Deadliest – 15 deaths)

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Everest ER

Video – 17 mins

Video – 2 mins

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https://www.youtube.com/watch?v=VPqI8NsF9Fc

https://www.youtube.com/watch?v=gJb1gArt_Yk


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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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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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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Acclimatization Graph 28


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Full body coverage to protect against the sun


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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.


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Hypothermia & Hyperthermia

• Balancing the extremes

• Travel early in the day


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Effects of using bottled oxygen


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Helicopter rescues up to Camp II

Rescues in the death zone


352019 Case Study

2012 – Canadian Climber

CASE STUDY 2019 – AUSTRALIAN CLIMBER

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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


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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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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


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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.


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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


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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


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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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The world’s most dangerous airport?

Lukla, Nepal


58Trekking to Everest Base Camp


62Trekking to Everest Base Camp – Gorak Shep (16,600ft / 5200m)


63Camp 1 – Mt Everest


64Crevasses – Mt Everest

• Jose Oberholzer and Team!

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Colorado 14er High Bivys & Cascade Volcanoes

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mt. everest: the body at altitude · • professor at colorado mountain college •professional...

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