The MountainWorld™ Blog

Charlie Houston, Yvon Chouinard, Bob Bates, Bob Craig, Ed Viesturs, and more!

Save the date for a night of mountaineering lore on April 10, 2010, as we celebrate  the accomplishments of four great figures in American mountaineering: Charlie Houston, Bob Bates, Bob Craig, and Yvon Chouinard. 

On April 10th, the American Mountaineering Museum will celebrate the first annual mountaineering gala and induction into the Hall of Mountaineering Excellence. The award goes to these four individuals to recognize their commitment and contributions to the sport of mountaineering as well as their accomplishments while not wearing crampons and a rope. 

The event will feature Yvon Chouinard and Bob Craig in the flesh; family and friends of Bates and Houston - who sadly passed on recently - will be in attendance to accept awards on their behalf. Additionally, the evening will feature a keynote presentation by Ed Viesturs, a climber whose accomplishments speak for themselves.

So, mark your calendars and come on down to the American Mountaineering Museum on April 10, 2010, for an event not to be missed! Rub elbows with some greats of American mountaineering past, present, and future, celebrate the lives and accomplishments of those who have directed our passions, and have a great time!

Tickets for the event are on sale now via the American Mountaineering Museum website; click here to buy yours today!

Learn more about the award, the evening, and our sponsors on the Museum website.

Sponsored by First Ascent.

Jake Norton is an Everest climber, guide, photographer, writer, and motivational speaker from Colorado.

Thursday Thought: Ego and Thoughts on the Top

I don't know who said it...Perhaps I did. But, regardless, I try to live by it:

Life is too short for ego.

Perhaps that's why in my life I've tended to gravitate toward, and be friends with, people who, while often quite accomplished, don't brag about their successes. Rather, the people I value most tend to be quite the opposite, downplaying their accomplishments, recognizing the part fortune and hard work played in their lives and, most importantly, always looking ahead with respect and reverence to the next challenge, the next mountain.

As I write this, I think of Marc Webb, my college housemate and friend who recently directed (500) Days of Summer. Marc is as humble as he's always been, and also introspective about the road that led him to success, and the road yet to travel.

In 1963, Willi Unsoeld made the first ascent of the West Ridge of Everest with Tom Hornbein, an ascent that still ranks as one of the greatest in Everest history. Afterward, however, Unsoeld refused to succumb to the pull of ego, sharing this sentiment on various occasions:

You've climbed the highest mountain in the world. What's left? It's all downhill from there. You've got to set your sights on something higher than Everest.

I've been fortunate enough in recent years to get to know Tom Hornbein through my work with the American Mountaineering Museum. Like Willi, Tom would have every reason to be less-than-humble about his life. From Masherbrum in 1960 to the West Ridge in '63, his climbing career is impressive and illustrious. In addition, he served as Professor and Chairman of the Department of Anesthesiology at the University of Washington School of Medicine from 1978 to 1993.

But, Tom is anything but egotistical. I've seen many occasions when Tom has politely conversed with climbers as Museum functions, listening honestly and intently to their stories of triumph and tragedy on Colorado's 14ers or other peaks, never making the slightest mention of his climbs unless asked directly.

And, Tom is a thinker. Climbing, I would venture, was never to Tom about something as simple as standing on top, but rather about a journey of desire and uncertainty, much like the journey of life itself.

His 1963 book Everest: The West Ridge is, to me, no less impressive, raw, and powerful as the climb it documents. Tom's prose is direct, pensive, and honest, and, at its core, reflects on he and Willi's climb not as one for the record books and soapbox, but a part of the great journey. His last words in the book make up this week's Thursday Thought:

Beneath fatigue lurked the suspicion that the answers I sought were not to be found on a mountain. What possible difference could climbing Everest make? Certainly the mountain hadn't been changed. Even now wind and falling snow would have obliterated most signs of our having been there. Was I any greater for having stood on the highest point on earth? Within the wasted figure that stumbled weary and fearful back toward home there was no question about the answer to that one.

It had been a wonderful dream, but now all that lingered was the memory. The dream was ended.

Everest must join the realities of my existence, commonplace and otherwise. The goal, unattainable, had been attained. Or had it? The questions, many of them, remained. And the answers? It is strange how when a dream is fulfilled there is little left but doubt. 

If you want to hear some more of Tom's thoughts and perspectives on Everest, climbing, and life, watch the video interview below from the American Mountaineering Museum's YouTube channel:

Jake Norton is an Everest climber, guide, photographer, writer, and motivational speaker from Colorado.

Slideshow tomorrow night in Golden at Vital Outdoors!

 Tomorrow night (Thursday, February 19, 2010), I'll be presenting my Three Favorite Trips slideshow at Vital Outdoors in downtown Golden, Colorado. 

As many of you know, I've been fortunate enough to go on some pretty amazing expeditions and trips over the years. I've guided and shot images on 5 continents, working and climbing in areas ranging from the jungles of Borneo to the Kalahari Desert. 

But, the question often arises: What is your favorite expedition? Well, the answer - or answers - come tomorrow night as I discuss my favorite trips of all time...and why they are my favorites. 

Tickets to the show are $3 at the door, and benefit the American Mountaineering Museum. And, along with great gear and discounts up to 60% at Vital Outdoors, we'll also have some light food and excellent beer courtesy of Golden City Brewery. 

Want a little teaser of tomorrow night's show? Check out the video below. 

Jake Norton is an Everest climber, guide, photographer, writer, and motivational speaker from Colorado.

New video for American Alpine Club

Check out the new video for the American Alpine Club. There's some pretty stunning imagery in there, and just one more reason why if you're a climber and not a member, you should join the AAC now!

Enjoy!

Jake Norton is an Everest climber, guide, photographer, writer, and motivational speaker from Colorado.

North Face movie premiere at Mountaineering Museum - for FREE!

North Face, a film inspired by a true story, follows the adventures of two soldiers, Toni Kurz (Benno Furmann) and Andi Hinterstoisser (Florian Lukas), as they attempt the then-unclimbed (and still epic) North Face of the Eiger. 

The film's gotten great reviews, and was one of the official selections at the Locarno Film Festival after it's German debut in 2008. 

And, from the reviews, it sounds like not only is the story epic and engaging, but the cinematography is stunning, pulling you into the adventure. 

Best of all, for you Golden locals, the film will premiere at the American Mountaineering Center this Friday, January 29th, at 6:00 PM (with a preceding Museum reception at 5:00 PM).

Check out the film's trailer below, and be sure to come down to the Museum on Friday for the premiere!

PS - If you can't make it Friday, but live in the area and want to see the film in theater's, here are its other openings around Denver:

Feb 5th Esquire Theater - Denver
Feb 12th Wheeler Opera House - Aspen
Feb 18th CU - Boulder

Jake Norton is an Everest climber, guide, photographer, writer, and motivational speaker from Colorado.

Lost on Everest & "Thin Air" at the American Mountaineering Museum

Mallory & Irvine at the North Col, June 6, 1924.

This Thursday, December 3rd, please come on down to the  American Mountaineering Museum to help celebrate the opening of our newest exhibit, THIN AIR: An Exhibit on Altitude and Oxygen. 

And, if you're interested, stay after the reception to hear me share Lost on Everest: The Enduring Mystery of Mallory & Irvine.

The reception, opening, and my presentation are free for Friends of the Museum and the American Alpine Club Library, $3.00 for AAC and CMC Members, and $5.00 for non-members.

It'll be a fun evening, so come on down to the Museum!

Jake Norton is an Everest climber, guide, photographer, writer, and motivational speaker from Colorado.

The Basics of Altitude: A Primer on AMS, HACE, & HAPE, Part III

Members of Nepal's cabinet will meet on December 4th in Gorak Shep in an effort to raise awareness about the effects of climate change on the delicate Himalayan environment. The move is quite similar to the underwater meeting held by the Maldives' cabinet a few weeks ago.

While the cause is worthy, it's more than a bit concerning to think of Nepal's ministers hopping in a helicopter from Kathmandu (about 4,600 feet) and flying - with a brief pit-stop in Lukla for a medical checkup - to 17,000 foot Gorak Shep. Even though the meeting is supposed to be brief, clouds come in quickly in the Khumbu, and helicopters there can only operate in VFR, and thus are grounded when the weather comes in. Thus, even though a short meeting is planned, the weather might make other plans...and the potential for AMS, HACE, and HAPE increases dramatically. 

So, that brings us to the final part of this series on altitude sickness: how do we avoid - or at least reduce the chances of - getting AMS, HACE, and HAPE in the first place?

As a high altitude physician once said to me, the first thing to do is choose your  parents. This is because medicine is now discovering that much of high altitude physiology, of who does well and who does not do well at altitude, may depend on your genetic makeup.

Unfortunately, no matter how much we want to, none of us can choose our parents! So, we've got to take some other steps when traveling to high altitude to reduce the chances of getting sick.

• Rule #1: Plan. This is pretty basic, but important. The altitude rule of thumb is to ascend no more than 1,000 feet per day to allow your body time to properly acclimate.
  
  So, set your schedule accordingly, especially if your itinerary involves altitudes higher than you've been before. If you must go up more than 1,000 feet in a day, try to fit in a day of rest and acclimatization. And, of course, monitor yourself and your teammates for any signs and symptoms.

• Rule #2: Hydrate. Water pretty much helps with everything, altitude included. And, keep in mind that at high altitude, the air is drier, resulting in increased fluid loss. So, drink up...and keep it to water or other non-alcoholic and decaffeinated beverages!

• Rule #3: Know Your Body. This is perhaps the most important rule. While I, as a guide, can watch my clients for signs of trouble, only they can truly know and understand what their body is telling them. Likewise, your teammates can only know so much about you and your body. So: know your body, listen to it, trust what it is telling you.
  
  If you have a headache at altitude, take an aspirin. But, remember that the headache is your body telling you something important: it's not getting enough oxygen. It may be dehydrated. So, take the aspirin, kill the pain, but remember to breathe and drink.

• Rule #4: Let your body do the work. In today's world, we tend to want to pop a pill and let chemistry solve our problems for us rather than letting our bodies do the work. Often, this can be counterproductive.
  
  I can't tell you how many times I've had clients on a trip who, on the advice of a physician, are popping Diamox prophylactically without ever having tried to let their bodies adjust to altitude first. As a result, many have suffered the side effects of Diamox (tingling in the extremities, antsyness, dehydration, etc.) without ever knowing if they could have gone to altitude without chemical help.
  
  So, my rule here is let your body try. Give it the benefit of the doubt. Breathe a lot. Take it slow. Monitor for any signs and symptoms and treat accordingly. And, finally, take Diamox when and if needed, but give your body a fighting chance first!

• Rule #5: Be flexible and relax. Altitude, like mountain weather, is a fickle thing. I've climbed with people who have done fine on big mountains and then suddenly got sick at an altitude they had been to before. Simply put, you never know. There seems to be little rhyme or reason to altitude sickness.
  
  So, be flexible. Rest if needed. Build extra days into your itinerary. If you get stopped by a storm, don't rush upward to make up days as soon as the sun comes out. Take your time, relax, make sound, safe, smart decisions...and enjoy the hills!

And, if you want to learn more about altitude and oxygen, be sure to stop on by the American Mountaineering Museum and see our new exhibit, Thin Air!

Jake Norton is an Everest climber, guide, photographer, writer, and motivational speaker from Colorado.

The Basics of Altitude: A Primer on AMS, HACE, & HAPE, Part II

Last week, I wrote about the tragic death of Morgan Boisson, which in turn led me to  a post about High Altitude Cerebral Edema, or HACE.

This morning there was yet another sad reminder of the dangers of altitude in my inbox. Today it was the story of John Campbell. Mr. Campbell was on a trek to the Basecamp of Kanchenjunga - the world's third highest peak - with Jamling Tenzing Norgay when he came down with what sounds like HACE. While valiant efforts were made by the Sherpa trek staff and by his daughter, Campbell sadly passed away on October 28, 2009. 

While Mr. Campbell seems to have passed away from HACE, his death is still a reminder that we all should be prepared for high altitude ailments, and be ready to act on them, when we go into the mountains. Campbell was not a newcomer to altitude. According to web resources, he was an avid hiker, going on many trips into the High Sierra, and has already done treks to the Basecamps of Everest and K2.

So, last week we talked about HACE, and now it's time to discuss a bit about HAPE, or High Altitude Pulmonary Edema. 

In my experience, HACE is a bit more common than HAPE, perhaps because studies point to it being a more intense form of Acute Mountain Sickness (AMS). I've personally run into cases of HACE on many expeditions. Last week, I mentioned the story of Miguel Tello, who had both HACE and HAPE on Nevado Huascaran in Peru.
On Everest in 2001, we had another, quite similar situation. 

On May 7, 2001, Tap Richards, John Race, and I were ascending the East Rongbuk Glacier en route to Advanced Basecamp and the beginning of our summit bid. At about 20,000 feet, near the old pre-World War II Camp 2, we came upon 3 Tibetan yak herders carrying a sick Chinese glaciologist, Mr. Gao, down the mountain. Another Chinese scientist, Mr. Li, staggered behind; he was sick, too, but in much better shape.

We knew immediately that our summit bid was off; it was obvious to us that, if we did not act, Mr. Gao would most likely die before reaching Basecamp. He was barely breathing, unresponsive to pain, cold, and generally looking awful.

And so began a challenging rescue, carrying the 180 pound Mr. Gao on our backs, with amazing help from the yak herders and other Tibetans who came up, as well as additional members of our team. For hours, Mr. Gao slipped in and out of consciousness, at times choking on his swollen tongue and often looking like, despite our efforts, he was not going to make it.

But, finally, after about 10 hours of work, we got Mr. Gao into a jeep at the mouth of the Rongbuk Valley. Soon he was in our expedition Gamov Bag and being tended to by our expedition doctor, Lee Meyers. Early the next morning, in stable condition, Mr. Gao was loaded into a jeep and driven off to the hospital in Shigatse.

It was a close call, but Mr. Gao survived. (A week later, Mr. Li drove back into Basecamp with a box full of apples and pears, a nice thank you from he and Gao for helping save their lives.) Had Gao's teammates known the basics of high altitude medicine - and warning signs to look for - this all might have been avoided.

So, what do we look for as signs and symptoms of High Altitude Cerebral Edema? Here's some basics:

• Often one of the first telltale signs is a headache. Cerebral edema is fluid gathering inside the cranial cavity and putting pressure on the brain; thus, a persistent headache, which most often will not go away even with aspirin or ibuprofen, and coupled with ascent to a new altitude, is an early sign of HACE.
• Ataxia, or loss of balance resulting in unsteady walking, is another common sign of HACE. However, much depends on where the pooling fluid in the brain is putting pressure; various changes in mental and physical state can be evident:
  
  • uneven pupil dilation
  • slurred speech
  • inability to remember basics like name, date, time of day, etc.
  • loss of fine motor control

As with HAPE, these are the early warning signs, but things generally deteriorate rapidly afterward. In general, someone with early signs of HACE who is not treated will, within 24 hours, become unconscious, slip into a coma, and pass away. This is serious stuff!

But, again like HAPE, HACE does have some simple, effective treatments.

1. DESCEND, DESCEND, DESCEND! Descent is the only surefire treatment for HACE, and again the rule of thumb is descent of 3,000 feet or more.
2. If descent is not immediately possible, there are some options to "buy" some time:
   
   • Put the patient in a Gamow bag, or Portable Altitude Chamber (PAC)
   • Put the patient on high flow oxygen, 8 liters per minute or more
   • If available, dexamethasone is a great medication for HACE. Dex is a powerful anti-inflammatory steroid which in this case helps reduce cerebral pressure from HACE. Whereas niphedipene works only sometimes in treating HAPE, I've found that dexamethasone is very effective in reducing the severity of HACE. Dex comes in tablet and injectable forms; I always carry both. As with any drug, know how to use dex before you go, and make sure your climbing companions do, too - it could save your life, or theirs!

Those are some of the basics of HACE. Again, these are the rules of thumb and actions I take whenever I'm climbing or guiding in the high mountains. I've seen HACE in climbers and others on Rainier, in Colorado, on Kilimanjaro, and of course in the Himalaya.

We all go into the mountains prepared physically, and prepared with our equipment. But, many people forget to be prepared medically as well. Know your body. Know the dangers. Know what to look for.

And, remember, the mountain will be there another day...the important thing is that you are around to climb it another day!

In the next - and final issue - of this primer, I'll talk a bit about the most important aspect of high altitude medicine: How to prevent these ailments from occurring in the first place! Rule #1: Choose your parents!

Jake Norton is an Everest climber, guide, photographer, writer, and motivational speaker from Colorado.

The Basics of Altitude: A Primer on AMS, HACE, & HAPE

Altitude has been on my mind a lot recently; my colleagues and I at the American Mountaineering Museum are putting the final touches on a new exhibit called Thin Air: Altitude and Oxygen. It will open at the Museum this month.

I awoke Tuesday morning to a sad story in my inbox about a University of Arizona student, Morgan Boisson, who died near Rongbuk Monastery, at the foot of the Tibetan side of Mount Everest, on October 20, 2009.

Boisson was on a study abroad program in Nanjing, China, and traveled to Rongbuk with classmates on a a 10 day tour in Tibet.

Judging from the article I read and the symptoms described, Boisson was died from HAPE, or High Altitude Pulmonary Edema. And, sadly, he was not the first to die this way at Rongbuk, nor will he probably be the last.

We tend to think of severe altitude sickness like HAPE, and it's equally dangerous cousin, HACE (High Altitude Cerebral Edema), as something that only effects climbers. When we're "just trekking" or - like Boisson and the thousands of others who travel in Tibet each year - visiting the high country in a vehicle, we rarely give much thought to the effects of high altitude and the accompanying hazards.

But, these are major dangers for climbers, trekkers, tourists, and anyone traveling to altitude. In fact, Telluride's Institute for Altitude Medicine (IFAM), estimates that altitude sickness costs the Colorado ski industry upward of $200 million each year!

Thus, it's always a good idea to know the basics of HAPE and HACE - and even the more benign AMS, or Acute Mountain Sickness - and to have some tricks up your sleeve to deal with it if it hits a companion, or you.

For today, let's talk a bit about HAPE. I'll write later on about HACE if people are interested.

To begin, keep in mind I am not a doctor, and I don't even play one on TV. But, I do play one in the mountains quite often, treating clients and fellow travelers and local people we encounter along the way. Anyone wanting to know all the in-depth analysis of AMS, HAPE, and HACE should read articles available online at IFAM and the Altitude Research Center. That said, the following are some rules of thumb for altitude, and the things I look for in my clients - and in myself - whenever I travel to altitude.

HAPE, although very dangerous, is fairly rare, especially in travels below 15,000 feet. But, it does occur. IFAM tabulated only 150 cases over a 3 year period in Colorado's Summit County, and estimates that only about 1 in 10,000 skiers develops HAPE during their travels to the high country.

However, in my travels to mountains around the world, I've seen it a lot. From 10,000 foot Camp Muir on Mount Rainier to the 19,000 foot Garganta Camp on Nevado Huascaran in Peru to climbers dying high on the North Side of Everest, HAPE occurs all over the place, and is never a nice thing.

In general, the first signs of possible HAPE, and the ones I am on the lookout for in the mountains, are:

• A sudden and marked decline in ability to "keep up"
• Inability to catch one's breath, even when at rest
• Unnaturally elevated heartrate, even when at rest
• "Rails" or rattling/wheezing/crackling sound in the lungs

If you see these symptoms in yourself or your teammate, it's time to act. While it may not be HAPE, these are generally telltale signs, and the symptoms will progress rapidly downward if HAPE is indeed at play.

If a pulse-oximeter is on hand, it can be used and, in the case of HAPE, will show a decreased oxygen saturation level in the patient. Without a pulse-ox, oxygen saturation can be "guesstimated" by looking for a bluish, somewhat ashen look to the skin and a blue-gray look to the lips and nail beds.

For most trips in the mountains, however, we'll need to decide and act fast. And, in my opinion, it's always best to be conservative with HAPE and HACE, and err on the side of caution. So, how do we treat HAPE?

Go down!

Seriously...go down, and go down now! The only true treatment for HAPE - and HACE - is to descend. And the rule of thumb is to descend at least 3000 feet.

But, what if descent is not an immediate option due to injury, weather, or other factors? Then, it's time for alternate plans which have hopefully been thought out in advance.

If oxygen is available, it should be administered at a high flow rate (i.e., 6-8 liters per minute). If a Gamov Bag or Portable Altitude Chamber is on hand, it should be used immediately. And, Nifedipine can be administered to help you buy some time as well. (Nifedipine, in layman's terms, reduces pulmonary arterial pressure and helps slow the leakage of blood and fluid into the lungs. 

Again, though, the only true treatment for High Altitude Pulmonary Edema is descent.

Here's a classic example: in 1998 on Huascaran in Peru, Jason Edwards, Maximo Henostroza, and I rescued Miguel Tello from high on the mountain. When we found him at 19,000 feet, he was ashen, hypothermic, wheezing, unconscious, and had an oxygen saturation of about 40%. Diagnosing hypothermia, HAPE, and HACE, we administered drugs accordingly and began immediate descent, with concurrent monitoring. After the textbook 3000 feet of descent, Miguel was responsive and moving in our makeshift litter. He made a full recovery, but may well have passed away high in the Andes if we hesitated in our descent.

So, next time you head for the hills, be prepared. HAPE and HACE are rare, but they do occur, and they do kill. Know your body. Know your treatment options. And, have plans at the ready to deal with these ailments if they occur.

Let me know via the comments if this was even remotely interesting to people. If so, I'll write something up about HACE as well. And, if not, I'll drift on to other topics!

Jake Norton is an Everest climber, guide, photographer, writer, and motivational speaker from Colorado.

Secrets of Shangri La

Cave complex in Upper Mustang, Nepal.

He looked like Indiana Jones...really. And, it was probably intentional, a modern-day archaeologist/anthropologist of the far reaches of Nepal. Regardless of appearance, Dr. Charles Ramble was no impostor, no wannabe hero, but rather a dedicated man who had made significant discoveries in the remote, semi-autonomous kingdom of Mustang, a remote fin of Nepal jutting onto the Tibetan Plateau.

For the better part of 3 hours in 1993, Charles Ramble spoke to all 26 of us (we were studying for 6 months in Nepal on a semester abroad program), and not a one was anything but rapt. He told us of a faraway region, until 1991 sealed off to foreign visitors. And, of ancient Buddhist and Bon cave complexes high above Lo Monthang. And, even more intriguing, the fact that these caves date back to perhaps as far a 2,000 B.C. - long before the Buddhist era.

Fresco in cave (left); Charles Ramble inspecting artifacts (right)

And, he spoke of the dangers of his find. Not dangers to himself, but rather dangers posed to the ancient, irreplaceable treasures in the caves: frescoes, artifacts, possibly texts and more that lay unprotected from the elements, and also from art thieves and looters who had already laid waste to many such sites throughout Nepal. (Literally thousands of ancient artworks have been stolen from Nepal's temples and sites over the years; see the website Stolen Art of Nepal and the book by Lain Singh Bangdell, Stolen images of Nepal.)

It was a lecture I never forgot...And, thus it was with great excitement that I heard about an expedition in 2008 by Leisl Clark, Pete Athans, and led by my friend Brot Coburn, would be heading to Mustang to explore and document this amazing site deep in the Himalaya.

(Broughton "Brot" Coburn is a legend in Nepal, and for good reason. He lived and worked there for 2 decades, and wrote 2 of the best books in my opinion on Nepal, Nepali Aama and Aama in America. And, he's a great guy to boot!)

The expedition to Mustang was filmed and is in production by National Geographic, due to air on PBS later this year.

But, you can get a sneak preview with Brot Coburn himself on November 11, 2009, at 7:00 PM at the American Mountaineering Museum! Brot will be our guest speaker for November's sPEAKer Series at the Museum.(You can read a PDF on Brot's presentation here.)

So, come on down and learn for yourself about the Secrets of Shangri La from Brot Coburn! And, check out the video below - a short preview of the film, with old "Indiana Charles Ramble Jones" making a great climb!

Jake Norton is an Everest climber, guide, photographer, writer, and motivational speaker from Colorado.