Friday, 8 June 2012

ALTITUDE SICKNESS. OLD PILL-NEW HOPE!

As a sufferer myself this is a subject close to my heart,and i am allways on the hunt for new studies and treatments.I did a blog on this in March-2011 talking about pre-climbing blood tests and the use of Aspirin as an anti-clotting agent,you may want to check it out before reading further?

Medic on Mt,Rainier.

I allways considered Altitude Sickness a syndrome rather than a single illness with a single cause,as there are too many contributing procceses going on anatomicaly in each individual case.This of course is a deductive matter for research scientists rather than old bush medics like me.My interest is not so much the cause,as being able to interdict the symptoms before they begin to take their toll.Its unlikely that any concrete cure will be found in the near future as most research in this field is carried out by drug companies out for profit,and the altitude illness market is just too small to justify intense study.So we are pretty much left with the blunder-factor where a researcher may accidently hit on a cure as a by-product of a sexier study.

Ibuprofen Meltlet Anti-inflamatory Tabs.

Last week a facebook friend posted two realy interesting articles on the use of simple (over the counter) Anti-Inflamatories that just might be useful in this interdiction process.They came from TIME magazine and ABC-NEWS articles,and these two links should carry you through if i havent bollocksed up the process as i normally do!
The meat and potatoes is that common anti-inflammatories like "Ibuprofen" taken as a 600mg prophylactic dose can interdict the most critical part of the illness, "brain swelling" which is that phase of altitude sickness where the real damage begins.
It is brain swelling that causes you to feel nauseous, dizzy, depressed and lethargic. The more serious symptoms quickly follow. Ibuprofen can ease (and possibly prevent) these symptoms by reducing inflammation of the brain's surface layer and of the fluid sac which protects it, much in the same way that it reduces swelling in a bruise or a sprained ankle. This is truly remarkable stuff, and I will be using it in the Swiss Alps in July.


Like most sufferers I take "Acetazolamide", which has a load of side-effects, not the least of which is marathon-pissing-at-altitude, an effect which can cause dehydration and actually contribute to altitude sickness. Anything that gets me off that is more than welcome in my med kit! Oral anti-inflammatories are not without their own hazards, however, and are notoriously hard on the stomach and intestines. So if you have any gut or circulatory problems, be sure to see your pharmacist and/or doctor before even considering taking them. I strongly advise you to read and take the time to understand the linked study by Dr Grant Lipman. The guy is also a mountaineer, so he has a personal as well as professional interest in getting his research right.

Topical application.


 I had a "light bulb" moment after reading all this stuff, and it occurred to me that "patches" would be a huge improvement over taking this medication orally in a mountain environment. But I can't find any anti-inflammatory patches anywhere on the world wide web, so must assume that they don't exist as yet? If anybody can find some, please email me with the details, I would be most grateful.
The next best thing, of course, would be a standard gel, even though this is a topical application it is eventually absorbed through the tissues and into the bloodstream with exactly the same effect, even though much diluted. So I am taking some of this to Switzerland to give it a try out in tandem with the pills.  Should be interesting!

Good climbing.

Rob.


Wednesday, 23 May 2012

SOLO EMERGENCY ACTIONS.(Lost Crampon Procedure)

Ive thought about it a lot over the years so maybe thats why it hasnt happened to me yet? I should imagine few things could be more terrifying than being halfway up a verglassed Schreckhorn,and looking down to see your right crampon bouncing and skittering out into space below?!

If you dont want to lose them,attatch a loop of shockcord
to the crampon which fits round the lower leg.Works for me!

Most accidents can be prepared for but some are so serious and imediate there is no time to muck about thinking what to do,one simply "must know and act"! These situations can be called "Instant Actions",where you follow a set drill to get you out of trouble fast!
A lost crampon on an icy climb is about as serious as it gets,and quite a few climbers have died due to this accident,but there is a lot you can do to help yourself if you stay cool and follow the drill.

Chicken Chain rig (See blog list-Chicken Chains and Prusiks).

INSTANT ACTION-(1),MAKE YOURSELF SAFE. Get out of the fall-line,bang in an anchor of any kind and clip in with your Chicken Chain.Assess your situation.
                          (2),DISASSEMBLE. Remove your other crampon (making sure not to drop it!) and disassemble into two sections.Remove the bar or fold away.

Parts and Repair Kit.


                          (3),MAKE TWO INSTEP CRAMPONS.(Or one forfoot and one instep) Using Cable Ties and/or Rape Tape and Cordage turn the one crampon into two as per diagrams below,or flatten out crampon-lugs with an ice hammer or rock to make two Instep Crampons.The Cable-Ties in the pics are a bit short for this job,30cm Ties would be better! Instep Crampons go back 4000yrs in Swiss Alpine history,they are very efficient and many examples can be seen in village Heimatt Museums.

Grivel Spider.A modern Instep Crampon based on an ancient principle.

                         (4),FASTEN SECURELY.Using simple tie system as in pics that locks the crampon to the instep of the foot,you can back this up with rape-tape or whatever cord you have.(tape is best!)

Instep Improvisation.
(No way am i covering my boots with tape,so this pic will have to do you!)

The idea being,that once it is fastened securely to the foot.It stays on until you are safely off the mountain!
                         (5),ALTERNATIVES.You can use the forefoot crampon section as it is,and secure that if you so wish? Allso backing up with tape or cord.

Forefoot Cable Tie sytem.

                         (6),TEST AND DESCEND.Once the whole assembly is fastened and you are satisfied.Test on some nearby ice to ensure it is secure,and until you are confident to descend.DO NOT continue the climb on this arrangement unless there is NO OTHER safe allternative!


I took the term- "Instant Actions" from the Royal Australian Army manual for the FN,7.62cal-Self Loading Rifle,the weapon i first trained with when i joined up about a thousand years ago! The Instant Actions were those drills carried out under fire when you or the weapon fucked up (ie;Action on-Empty magazine or round stuck in the chamber).I thought it very appropriate for solo-mountain emergencies,as in both battle and ascent if you screw-up you may well die! So clear unambiguous procedures are essential to get you out of trouble.

Good climbing,

Rob