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Jan
Mountain climber
Okinawa, Japan
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Sep 11, 2013 - 09:41pm PT
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If I weren't too old, I would definitely volunteer as a control subject. I've been to 20,200 without even a headache. I've also felt very sick at 17,000 (headache and vomiting). The difference was in the length of time at altitude and the speed at which I went up.
I'm wondering if the corelation of speed of ascent is figured in to your study and also, if there are any gender differences in who gets HAPE?
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andy@climbingmoab
Big Wall climber
Salt Lake City, UT
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Sep 11, 2013 - 09:48pm PT
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When do you need this done? I'm in SLC and have no plans to be in southern california anytime in the near future, but I can let you know if I happen to be down there.
I volunteered for Jenni's study at UC Davis a few years ago - I got HAPE on Aconcagua back in 2001.
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matisse
climber
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Topic Author's Reply - Sep 11, 2013 - 10:39pm PT
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Hi Andy. Jen was nice enough to offer to send our recruitment notice to her subjects so you may have gotten it from her. We are planning last two weeks of October or first week of November. We will cover travel expenses for you. I will be in touch via email and we can discuss.
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andy@climbingmoab
Big Wall climber
Salt Lake City, UT
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Sep 11, 2013 - 10:50pm PT
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I just got off a 17 day Grand Canyon trip, so i'm slowly working my way through a thousand email backlog - i'll look for her email. The weekend of November 10th would be really convenient so I can go to the Broncos game.
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matisse
climber
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Topic Author's Reply - Sep 12, 2013 - 06:23pm PT
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^^^^^^^^^^^^^^^^^^^^^^^^ I don't even know where to start with this, and since I have a major deadline looming, forgive me for not correcting the garbled physiology, partial facts and misinformation in the above.
edited to indicate that I am not dissing Andy but that the post in question was deleted.
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matisse
climber
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Topic Author's Reply - Sep 17, 2013 - 03:30pm PT
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Still trolling for subjects...I've nabbed a couple of you and I am looking forward to seeing you.
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matisse
climber
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Topic Author's Reply - Sep 23, 2013 - 02:24pm PT
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We have all the control subjects we need but this is last bump for HAPE subjects before I let this die. If you know someone who knows someone who has had HAPE please pass this along. I'd be grateful.
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Jan
Mountain climber
Okinawa, Japan
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Sep 23, 2013 - 03:09pm PT
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One person to contact about this would be Dr. Peter Hackett who established the Himalayan Rescue Center many years ago and continues to do altitude research. The last I heard he was living in Grand Junction, Colorado?
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matisse
climber
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Topic Author's Reply - Sep 23, 2013 - 04:08pm PT
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Hey Jan,
Thanks for the suggestion. The world of altitude research is really tiny and we all know each other and have already contacted Hackett.
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Reilly
Mountain climber
The Other Monrovia- CA
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Sep 23, 2013 - 04:15pm PT
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With all due respect I would be interested to know how how this research
fits into the big picture. It seems pretty tangential to me, if not a 'first-world problem'.
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matisse
climber
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Topic Author's Reply - Sep 23, 2013 - 05:48pm PT
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Happy to try to answer this:
HAPE is a rare disease, and obviously will never affect most of us even if we insist on running around the mountains like the fools we are. HAPE is interesting because someone who is by all accounts healthy, and maybe even has been to altitude a whole bunch before is peacefully minding their own business and all of a sudden they are desperately ill. As in gunna die if they don't get treatment/get down/both. But the really weird thing is here is someone who really is on deaths door and as soon as they do go down they get better, remarkably so. 1-2 days later? Perfectly fine
So why do people with HAPE get sick? why do they get better so quickly? what are the mechanism of the changes? These are general questions that help us understand how the lung circulation works. Understanding how it works and why it fails so dramatically may help us understand other conditions in which pulmonary edema rapidly develops such as one called adult respiratory distress syndrome (ARDS).
In ARDS you get smashed by a rock or hit by a car or have a bunch of tranfusions or maybe you vomit and aspirate stuff into your lungs or get some kind of infection and blammo, you end up in a ventilator with just horrible wet lungs that don't get better no matter what you do. up to 50% of people who get ARDS will die and while they are doing so rack up huge expensive costs associated with their care, in addition to leaving behind grieving family and friends. Patients that are so sick are really really hard to do research on, they are so fragile obviously you don't want to do anything that could possibly make them worse. So an awful lot of research (not mine) gets done on animal models, which may or may not be good models of the human disease. For example there is some evidence that a lot of inflammatory pathways in infections are different between humans and mice (probably the most common animal model).
So HAPE people, are 1. Human, 2. not gunna die at the time we study them 3. have a similar (but not identical) disorder of the lung circulation and 4. we can introduce stimuli like low oxygen (for short periods that aren't going to make them sick) and see how their lungs respond and we can compare the response to other people who have not been sick.
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Reilly
Mountain climber
The Other Monrovia- CA
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Sep 23, 2013 - 06:52pm PT
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matisse, thanks, I am relieved to know your research could help those smart
enough to avoid intentionally harming themselves on a regular basis. I've
my share of high altitude experience and have seen extremely fit people
struck down to the edge of death's door, to the point of the frothy bubbles
issuing from the lips. Luckily, I have always been a disciple of the Don Whillans
High Altitude Training Regimen which, so far, has stood me in good stead. :-)
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matisse
climber
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Topic Author's Reply - Sep 23, 2013 - 08:36pm PT
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Osward Oelz, Messner's physician, friend, climbing partner and pretty fair alpinist in his own right once told me that he and Messner relied on a diet of garlic, white wine and rye bread to prevent illness in the mountains :)
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aguacaliente
climber
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Sep 24, 2013 - 12:16am PT
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Matisse,
This is kind of a long shot but you might consider sending the request for subjects around to a couple of observatories that operate high altitude facilities. Most observatories are not super high elevation but Mauna Kea is at 14000 feet and there are some facilities in Chile around 15000 feet. Regular staff at these places are typically acclimated (and sleep at lower elevation) but visiting scientists typically go to the summit with only one night of acclimation. It is not unusual for people on short term visits to Mauna Kea to get AMS symptoms, I doubt cases of HAPE are common but it may have happened.
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matisse
climber
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Topic Author's Reply - Sep 24, 2013 - 12:37am PT
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Good suggestion. Thanks.
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ontheedgeandscaredtodeath
Social climber
SLO, Ca
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So I went down to be a control subject last week and met the lovely Matisse. She and her team were very professional and friendly. The test consisted of two MRI sessions, one while breathing non-hypoxic concentrations of oxygen and one breathing air equivalent to being at 12,500. The first session lasted about an hour and a half and the second about 30-40 minutes. Both included holding my breath and timed breathing patterns. There was also a breathing test that included inhaling and exhaling more 12,500 foot elevation air.
It was all super interesting. I have not really been around medicine much at all and certainly not as any type of subject or patient. The MRIs were a little more intense than I expected. I'm not really claustrophobic but being in the small tube with a mask on and hooked up to an EKG and heart monitor coupled with many people watching and evaluating me made me feel anxious-- I could hear my heart rate increase on occasion! Like any good climber Matisse gave me a beer when I was finished!
No pictures but my family came along and we went to legoland the day before the test. They went to the zoo and beach the day I was at UCSD. Great trip!
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Yury
Mountain climber
T.O.
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Feb 28, 2017 - 08:23pm PT
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What does it mean?
What should I do to prevent HAPE?
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