The staff of Avalco Travel and partners have been visiting the highest mountains of the world since more than 30 years. Alltogether we have climbed all 14 8000ers in Himalaya and Karakorum and over 50 peaks exceeding 7000 m.
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Ski and Mountaineering at HIGH ALTITUDE
Questions & Answers, critical issues and … some commercial gimmicks
For our purposes, we define as “High Altitude” any mountain environment above 6000 m a.s.l. (in traditional Medicine the high altitude threshold is nornally established at 2500 m).
The approach and the experience required for a high altitude enterprise are very different from the ones of any adventure (even extreme) at lower altitude, and this applies to the individual climber as well as to the organization.
Why ? let’s try to find out from the following Questions and Answers.
D. How do you organize a high altitude expedition ?
R. The general principles are the same as for a “normal” expedition, however we apply specific criteria, particularly in relation to the assessment of the preparation of the team members and of the services supplied by the local partners, and to safety.
D. How do you assess the preparation of a potential participant ?
R. First we have a talk over the phone, then we evaluate the mountaineering background (with special emphasis on previous experience at high altitude) and the motivation. We have to assess with a good precision the physical, technical, and psycological level of all participants, in order to form homogeneous groups and provide the highest chances of success. It will be necessary to arrange one or more outings in the Alps, prior to departure, to check all above and also to help generating the best harmony within the team.
Obviously, everything is much easier and simplified if we are dealing with a pre-established party of friends who have an active experience in practicing mountaineering together.
D. What about a mountain guide with her/his own clients ?
R. In that case, it’s the guide who will perform the above mentioned assessments, after having agreed with us the general objectives and the relevant trip parameters.
D. Do you supply oxygen cylinders ?
R. We prefer ti promote high altitude climbing without supplementary oxygen, and optimize the training and acclimatization, as to best manage the effects of hypoxia. However, we always make available oxygen cylinders at the base camp for any emergencyand to whomever decides to utilize them for the progression on the mountain.
D. Without supplementary oxygen the progression at high altituded is much slower…
R. Certainly it takes more time for the acclimatization and the progression itself. It’s a choice, also ethical and very personal; everybody is free to decide whether to utilize or not supplementary oxygen. In any case, if we offer the assistance of a sherpa or mountain guide, these will allways carry one or teo oxygen cylinders also for themselves; in fact, if a sherpa or mountaun guide had symptoms of mountain sickness due to hypoxia, she/he would no longer be able to provide the necessary support.
D. Some operators offer high-speed expeditions even to 8000m peaks, almost cutting by half the duration of a “standard” expedition…
R. Yes, this is made possible after a long “training” (8 weeks or more) at home by sleeping in an hypobaric tent, where the partial pressure of oxygen at 6000 – 7000 m is simulated. Then, once on site, oxygen cylinders are extensively utilized; some operators allow for oxygen flow upto 6 lt/min or more.
Then there is the particular case of a well-known successful nepalese mountaineer who promotes rapid ascents even without specific training with the hypobaric tent. This only works for already expert and well-trained climbers, already practicing speed ascents here in the Alps. It is a niche of a few well-determined athlets who are also aware of the risks associated with extreme performances.
We too can offer these “rapid” expeditions, but in general for the “normal” climber we suggest the traditional approach of a progressive acclimatization.
.D. Why ? you don’t like the “rapid” expeditions ?
R. On the contrary, we do like them and we make several ones every year. A rapid expedition paradoxically is less tiring, is safer by definition (since the duration of the exposure to hazards is reduced), and is more compatible with the life’s committments of the participants. We achieve high speed thanks to a mix of factors (small teams, well selected and trained participants, 1:1 sherpa of high technical skills, light equipment, minimal or none use of fixed ropes, utilization of skis whenever possible, etc.), rather than taking advantage of artificial means such as hypobaric tent and oxygen cylinders.
D. Hypobaric tents and oxygen cylinders: which would be the downsides ?
R. Well, sleeping in a hypobaric tent for 8 weeks may produce the desired effects on the hematocrit and so generate a given level of “acclimatization”, but not all physicians agree on how this can be sustained and, in any case, is a sacrifice that few are willing to accept.
As to the cylinder – regulator – mask kit, it is rather bulky and heavy (almost 4 kg). Some climbers choose to use supplementary oxygen only when sleeping at night at the higher camps, and this is quite a good compromise to our opinion. Among the drawbacks of the system we have to consider the risk of malfunctioning (such as interrupted oxygen flow due to freezing parts, oxygen leaking due to insufficient mask tightness, defects in the valves) and the extra logistics involved.
Moreover we shall not ignore that the use of supplementary oxugen generates addiction to it. Any possible failure in the oxygen flow or a depleted cylinder may have dramatic consequences. It looks therefore safer to ascent with the one’s own strengths following a progressive and natural acclimatization.
D. Some operators promote rapid expeditions with 100% success guarantee (or almost…). How is it possible ?
R. We cannot deny that for some operators the “rapid” expeditions represent an opportunity of extra revenues, often by applying exaggerated prices. The reduced duration of the trip is in itself an attractve commercial feature, as well as the success guarantee. To this regard, a 100% success rate is not always achieved (data are not easy to be checked and can be manipulated) and in any case it implies the preventive “acclimatization” with the hypobaric tent and a massive use of oxygen cylinders on field… One of our guides once said “with 8 lt/min oxygen flow even my grandmother can summit Mt Everest…”.
On the other hand, there are operators who promote the exact opposite, a slow progression ascent with small vertical gain per day and intermediate camps (camp 1 – camp 1,5 – camp 2 – camp 2,5 – etc.)-
D. The remote transmission of physiological data may be of any help ?
R. At high altitude it may be useful to monitor mainly three parameters: the saturation level of the blood (related to the oxygen content), the hematocrit (related to the quantity od red cells in the blood), and the heart rate. The first two parameters allow to prevent the severe consequences from hypoxia (such as HAPE or pulmonary edema and HACE or brain edema), the latter is a control parameter of the general fitness and more specifically of the respiratory and cardio-vascular systems.
These parameters can nowadays be detected with simple wrist instruments and transmitted in real time to the doctor at base camp or to any remote medical unit. However, this data monitoring is really useful only when complex algorithms, developed ad hoc upon the subject’s characteristics, are used by specialized physicians and correcly processed.
The whole thing has high costs and is not free from errors. For example, the high altitude physiologits themselves do not unaminously agree on how to interpret the saturation levels recorded. Saturation values may have huge fluctuations even in a few seconds; some physicians recommend to measure the saturation at rest, preferably at night; other want to monitor also the variations under stress.
Here again, some operators offer their own branded physiological data processing system at high prices, promising increased perfomances and safety, but sometimes omitting to mention the inevitable limitations of such procedures.
D. Ultimately which physiological controls do you recommend ?
R. If no expedition doctor is available at the base camp, we suggest to avoid any do-it-yourself practice with the oximeter. If you well know your own physiology under stress, it may be useful to have a heartreate monitor in order to adjust your progression, especially during the trekking to the base camp. Other than that, the traditional warning signals (headache, nausea, vomit, fever, diarrhea, insomnia, abnormal dyspnea) shall drive your own strategy on field.
If you feel any AMS (acute mountain sickness) symptoms, it is mandatory and urgent to descend to lower altitude as to avoid more serious damages (HAPE, HACE) and, in these most serious situations, it is necessary to dispense oxygen or place the victim in hyperbaric bag (Gamow bag).
D.What about the Diamox…
R. Here again not all physicians agree. Generally, by listening to them and considering our experience on field, we find it useful to tale Diamox® (acetazolamide) upon the first symptoms of mountain sickness, following the prescribed doses (normally one 250 mg tablet every 12 hours). It looks as the Diamox is capable of limiting the carbonic anhydrase at the level of central nervous system, with a reduced production of liquids, and therefore opposing the phenomena of pulmonary and brain edema. By determining a swelling of the blood vessels, it helps the blood circulation in gneeral and the distributuin of oxygen witih the tissues; however, we believe is is better not taking it as a preventive measure, as we see often in the expeditions, due to the many possible collateral effects (ecxessive diuresis, sleepiness, dizyness, loss of mental lucidness. diahrrea, tingling of hands and feet).
D. According to your experience on field which are the most frequent phisical issues at high altitude ?
R. It looks to us as most problems come from frostbite and not from hypoxia. In fact, the symptoms of AMS (acute mountain sickness) are well known, most climbers can diagnose them and they accept that the best remedy is to quickly descend to lower altitude.
Instead, the damages from extreme cold are more frequent because the symptoms are less apparent. When one realizes that the toes are blue, it is already too late and any treatment on site hardly allows to fully recover. Therefore it is imperative to be proctected as appropriate against the cold and the wind, by utilizing the best technical clothes and possibly new.
D. Why new clothes ?
R. It happens that the perfomances of most technical clothes decline very rapidly in time and after intense utilization. For example a new sleeping bag made of goose down with a comfort temperature of -25°C may guarantee not even -10°C after a few years.
D. Which other problems are to be dealt with during an high altitude expedition ?
R. To prevent sunburns, which are a common problem, there are highly protective creams which are very effective (if new !) . Possible lip wounds and eczemas are prevented also by applying specific creams. Special care is to be used to protect the eyes; high quality anti-UV goggles are recommended to prevent any damage such as conjunctivitis, snow ophthalmia, eye swalling and even partial blindness).
Another frequent issue is insommia. Who suffers from this disorder may take specific drugs which allow to fall asleep easily, the downside being the possible sleepiness and loss of mental clarity during the day.
D. Do you have any special suggestions in regard to nutrition ?
R. The good general rules that we already follow for any lower altitude venture may apply. Obviously at high altitude we shall drink more as to compensate for the increased dehydration rate and favor foods that are easy to chew and digest.
At the base camp one has to eat and drink a lot, adopting a varied diet rich in carbohydrates (needed to build up the stock of glycogen in the muscles and for the energy supply) and also proteins. Being quite difficult to have fresh fruits and vegetables available, it might be necessary to take vitamin supplements.
For all meals at higher camps (above base camp) it is very common to utilize the pre-cooked freeze- deydrated food bags. These are light and practical to use, it is just necessary to pour some hot water in the bag and mix. In time you may get tired of this food, but nowadays a huge offer of various meals and flavours is available.,
It is also a matter of choice and habits. Some people cook their owm meals at home, then they freeze-dry and put them in small bags under vacuum. In this way they have full control of the ingredients and the nutritional parameters.
At base camps especially in Nepal, India, Pakistan, and China, we must be careful about the hygiene in the kitchen and avoid spicy meals which may cause diarrhea, an unpleasant affair which can completely ruin the whole trip.
As for the cooking at high altitude and especially at low temperature (-20°C or below), the traditional gas stoves may not function properly. I is therefore recommended to use gas with a high content of propane and keep the cartridges warm inside the sleeping bag during the night. Alternatively, one may use the white gas stoves, less easy to operate, nut more efficient in a very cold environment.
D. Do you have any other special tips ?
R. There would be an endless list and you may find hundred of books on this topic. But fundamentally a very sound experience is required or, lacking that, it is recommended to start with an easy objective such as a trekking peak around 6000 m, supported by a reliable organization or mountain guide. In time and progressively knowledge ans self confidence build up.
D. Fixed ropes: yes or no ?
R. This is a complex issue. In the most visited mountains, such as Everest and Cho Oyu for example, you may have hundreds of climbers simultaneously along the route. Most of them have little experience and are rather slow in climbing; they are supported by a number of sherpas and porters carrying heavy loads. As a result, for the safety of these people, it becomes indispensable to use fixed ropes. The teams who arrive first on the route will install the fixed ropes which will then be utilized (for a fee) by all following teams. It is understood that if a clinber wishes to ascend or descend without touching the rope, she/he is totally free to do so.
However we promote (whenever possible) the expeditions in “alpine style”, therefore small size teams of well prepared members, quick progression on the mountain without fixed ropes, installation and use of high camps according to the strategy of progression and taking into account of the acclimatization and safety of alla climbers and supporting staff.
D. Avalco Travel is much dedicated to ski-mountaineering. Are there any special considerations about the utlization of skis and snowboard at high altitude ?
R. On all peaks, even of 8000 m, suitable to be skied, we suggest to utilize skis, at least for the descent. If they can be used partially on the way up too, so much better. Skis offer the possibility of a fast and enjoyable descent; they are safer when crossing glaciers with crevasses. And do not forget that, in case of a long approach to the peak. skis may be the only way to progress in deep snow.
But there are also important limitations. First, not many peaks exceeding 6000 m are well suitable to ski, and generally a very high technical level in skiing is required, becauso of steep slopes, hard snow and ice, etc.). Moreover, skis add some extra weight in the way up on the mountain and along alll logistic phases.
These are all factors to be taken into account and which affect the choice of the objective, the route, and the period of the year (with skis often we favor a period with abundant snowpack, situation whch is normally avoided by the standard expeditions).
D. The same applies for the snowboard ?
R. Generally yes, except that the snowboard (recommended in the splitboard version) may be slower in the way up (also due to the extra weight) and might be a problem in the descent wherever you find flat sections. As it is the case in any mountain, after all.
D. How to choose the best operator for a high altitude expedition ?
R. Difficult to tell which is the best operator, let aside the many marketing gimmicks. To our opinion, you shall undertake a high altitude expedition with much common sense, choosing an objective in line with your experience, technical level, and fitness, relying upon a valid organization and guides who follow the good safety rules without claiming super amazing promises just to attract your attention.
One example ? Some organizations advertise their own record of “zero accidents”. What does it mean ? … absolutely nothing. The professionals in Risk Management tell us that not having experienced any accident to date does not guarantee of not having accidents in the future, since accidents are events always including a high content of randomness, and “zero risk” situations simply do not exist.
On the contrary, if an organizatio had already experienced an accident, very likely it will be better prepared to avoid any future accident and generally will be more careful and efficient in managing risks.
On the other hand, what is the definition of “accident” ? Nobody will precisely tell you. By the way, near-misses (events where no fatalities occured but, with minor changes in the parameters, could have occured) are much nore frequent than accidents (with fatalities) and often more miningful of the capability of the organization to manage risks.
Which organization adopts a professional risk management system, providing a statistics of accidents and near-misses, where the causes are analyzed and measures are taken for optimum risk mitigation in the future ?
D. 8000 m peaks and some 7000 m are visited by too many climbers within a short time window, is it a problem ?
R. Surely it is. Particularly on some 8000 the base camp is too much crowded, there are huge difficulties with the supply of drinking water and waste disposal. The concentration of the demand on the 8000s and some “easy” 7000 involves at least two problems. The first one is price levitation: the local logistic suppliers rise their prices and the local authorities increase the peak royalties; nowadays we reached crazy cost levels in Nepal and Tibet. The second serious problem is that the local economy benefits from the mountaineering tourism only in the most visited areas, such the Khumbu valley (Everest) and the Annapurna region, whereas the less visited areas remain in poverty.
Avalco Travel has always been fostering the choice towards 6000 and 7000 m peaks, instead of the more expensive 8000, and preferably in the less known moutain regions. Of course is subjective, but for us you get more satisfaction when facing a 6000 ot 7000 m in a remote area, perhaps never climbed before. There you taste the real adventure and also the contact with the local people is more authentic.
There are whole regions in the world thare are almost neglected, such as the Pamir (in Kyrghyzstan and Tajikstan) for example, providing a true wilderness experience at reasonable costs, without the detestable royalties applied in some countries.
Chile, Argentina, Peru, Bolivia, offer many magnificent peaks above 6000 m and little visited, feasible without restrictions nor royalties. They also have a simple logistics and costs much cheaper than the famous 7000 and 8000 of Nepal.
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