tuesday, october 12, 2010

Preparing for a climb: Fitness, health, diet, and exercise

by Gideon Lasco, MD

This is an article belonging to the 'climb health' category in PinoyMountaineer. Information provided in this article are based on research and are not meant as a substitute to actual medical advice and healthcare.

While the financial prepration for a climb is perhaps considered as the most difficult, the physical preparation is also very crucial. Especially when you are embarking on a multi-day climb, physical prepration would make sure you are fit, not just for your safety but for your enjoyment.

1. Get aerobic. Running, swimming, hiking itself, among other sports, are aerobic exercises. They prepare your lungs and your heart for the demands of a sustained, streneous activity such as hiking. Weeks or even months before a climb, try to exercise at least three times a week for at least 30-60 minutes for each session. When we say aerobic, the goal here is pulmonary and cardiovascular training. Check your heart rate before and right after the exercise...the goal is to observe a decreasing trend with the same amount of exercise. This means that the heart is becoming more and more efficient.

2. Ready those leg muscles. Running for prolonged periods is challenging; running or even walking on a steep slope can be even more so. When there's the opportunity to jog on inclined surfaces, grab it, because you want the leg muscles to be prepared not just for locomotion, but for locomotion at an angle that the body is not really used to.

3. The best preparation for a climb is another climb. Training climbs offer what exercises on sea level cannot: the actual environment where you'll be. The steep slopes of a Mt. Makiling Traverse would condition the muscles for all the movements and sustained actions that are involved in hiking. Importantly, the muscle groups for lifting the body in an ascent (the quadriceps, etc.) will likewise be conditioned. Joining a training climb will also prepare your lungs to the thinner air of high altitudes; train your brain to coordinate hand-leg movements, and aid in mentally preparing you for the conditions of . Also, a training climb will serve as a "test" if your fitness level is good enough for the climb at hand. If every 10 meters of ascent leaves you gasping, more exercise might be needed. How often must one climb to be fit? Personally I try to

climb at least once a month, and a major climb at least once every quarter as the barest minimum. But of course this will depend on you.

4. Don't get too adventurous on food before the adventure begins. While the focus of physical preparation usually dwells on the cardiovascular and musculoskeletal systems, your gastrointestinal system must also be in good shape. Don't stress it unncessarily by introducing untested food.

5. Consider carbohydrate loading as an option - This is usually for high-intensity activites like marathons, but strenuous climbing may also fall under this category. The aim to store glycogen (energy stores) in the muscle. Take note, however, that there is a proper way to do this; it's not just a shotgun eating up of all the food in the table. Wikipedia offers one strategy, but this is just one of many: "7 days before the event, perform an exhaustive exercise to all but deplete your energy stores. Then for the next 23 days cut back on carbs and do low exercise to keep the carb level very low. Then 3-4 days before the event, eat a very high carb diet. This will initiate a response from the muscles to take in as much glycogen from the carbs as possible, over compensating for the starvation from the previous days." Take note that foods with low glycemic indices are preferred (they increase short-term energy storage without increasing blood glucose levels). Examples include whole wheat pasta and grains. Take note, rice has a HIGH glycemic index.

6. If you have a medical condition, go see a doctor before the climb. Examples include asthma, diabetes, hypertension, or heart disease The doctor can then advise you on what medications to bring and what special precautions to take. With proper prepration, hiking is actually a very healthy activity and I'm sure your doctor will be happy to see you embark on such an endeavor. If you have a muscle, tendon, bone, or sports-related injury, go see your orthopedic surgeon or sports medicine specialist to guide you.

7. Choose your gear well. A well-designed bag will actually reduce the stress on your shoulders by transferring the weight to your waist. Also, a shoe can make or break your climb. If it fits well, your movements will be more natural and there will be less impact on your toes, knees, and hips. If it does not fit well, the adjustments your body make to avoid painful movements may require compensation from other muscle groups - and demand more energy - thus making your hike more difficult.

These are just tips that I have, based on my knowledge as a doctor and my experiences as a hiker. However, as they say personal experience is the best teacher and you may have your own stratagies and

tips on how to prepare for a climb. There is no right or wrong way. The important thing is that you are aware of the need to prepare for a climb, physically. Let the beautiful views take your breath away, not the steep ascent!

Mountaineering and ultraviolet light exposure: impact to your skin, eyes, and general health
by Gideon Lasco

This is an article belonging to the 'climb health' category in PinoyMountaineer. Information provided in this article are based on research and are not meant as a substitute to actual medical advice and healthcare.

There is a prevalent misconception that UV protection (i.e. use of sunblock) is a matter of choice; use it if you're sensitive about your skin and you don't want to get dark. It may then be perceived as an act of true hardcore-ness to eschew these uncomfortable sun protection lotions. Often neglected, however, are the harmful effects of UV light that has bigger implicatons on health. Thus sun protection lotions are not accorded the importance that it ought to have in responsible, healthy mountaineering.

Moreover, an even more neglected thing is the impact of UV light not only to the skin but to the eyes. Awareness of the harmful effects of UV light on skin, eyes, and general health, as well as preventive measures to counteract them, then, is a vital knowledge for all mountaineers, and provides the rationale for this article.

Mountaineers get the most ultraviolet light For those of us into mountain climbing in the Phiippines, our UV light exposure is increased for several reasons. First, the altitude: the higher you climb, the more UV light you get. Also, our latitude being close to the equator orients us towards the sun more and thus, more UV light. In fact, in the UV factor scale designed to quantify the amount of UV in a given place, the Philippines gets 10-11 out of a maximum of 11. Thetime of day is also a risk factor: if you climb between 10 AM to 2 PM you get the most UV light and in

many cases, we mountaineers are exposed to the sun during these hours.

Misconcepcion: clouds block UV light. Indeed, being invisible radiation, ultraviolet light can penetrate clouds so even on cloudy or overcast days, you can get high doses of UV exposure.

Misconcepcion 2: If you dont feel the hot rays of the sun you wont get sunburnt. Sunburn is caused by UV radiation which cannot be felt. Most of the heating is caused by the suns visible and infrared radiation and not by UV radiation.

Excessive ultraviolet light is harmful to the skin The harmful effects of UV light, both UVA and UVB, on skin is well established. Prolonged exposure to UV light causes sunburn and skin cancers, particularly basal cell carcinomas and squamous cell carcinomas.

Sunblocks and sunscreens protect the skin from UV light Sunblocks or sunscreens are lotions that absorb UV light, preventing it from reaching the skin. The effectiveness of this "block" is measured as SPF (Sun Protection Factor) - something that is frequently encountered in the labels of sunblocks, whitening creams. An SPF of 30 or higher is more than enough. When using sunscreens make sure you reapply every 4 fours to ensure maximal protection because the lotions wears off especially with excessive sweating etc.

Appropriate gear adds protection Wearing of hats, long-sleeved clothing is also recommended to protect from UV light especially between 10 AM to 2 PM and situations with intense sunlight exposure. Newly-developed fabrics are now being marketed as "UV resistant" - such as Columbia's Titanium series.

Excessive ultraviolet light is harmful to the eyes Extended exposure to the sun's UV rays has been linked to eye damage, including cataracts, macular degeneration, pingueculae and pterygia and photokeratitis that can cause temporary vision loss. The Wikipedia article warns that "If too much UV light is absorbed, eye structures such as thecornea, the lens and the retina can be damaged."

Sunglasses can protect your eyes There is, then, more to sun glasses than aesthetics and more comfortable vision and glare reduction. They

are also protective eyewear that are recommended especially for frequent climbers. The question is, which kinds of glasses offer protection? Although even the cheapest plastic lenses can block off UV rays, you can derive the best protection from new technologies such as polarized lenses (Ray-ban, Oakley, Optic Nerve) which almost completely blocks off UV light.

Conclusion: be UV-protected whenever you climb The issue of sun protection, then, is a health issue; mountain sun exposure is a health risk and certain precautions must be done to protect yourself from this risk. UV protection is an essential part of healthy mountaineering and we recommend that whenever you climb, use sunblock, protective clothing and when climbing in long, open trails always wear sunglasses.

Assembling your first aid kit for camping, hiking, and the outdoors
by Gideon Lasco, MD

This is an article belonging to the 'climb health' category in PinoyMountaineer. Information provided in this article are based on research and are not meant as a substitute to actual medical advice and healthcare.

"First aid" is self-explanatory: it comprises the first steps one does to deal with health and medical problems in the absence of medical professionals. Outdoor first aid becomes much more crucial than first aid in urban centers and lowlands where there are hospitals within a matter of minutes. What if you have an allergy at the summit which is 10 hours away from the jumpoff, which in turn is 4 hours away from the nearest town?

Hence, a first aid kit is really important; every team must have one. Your first aid kit is a first line of defense against what I perceive to be the most common health complaints in the outdoors, namely: itchiness, insect bites, abrasions, fever, headache, dizziness, stomache, diarrhea, fractures, and

For instructions on what to bring for particular medical conditions such as asthma, diabetes, and hypertension, please consult your doctor. These medications are beyond the scope of this article.

Meanwhile, go get a portable container and place these essential medications, topicals, and materials for a comprehensive first aid kit for the outdoors:

MEDICATIONS 1. Antipyretic (Paracetamol)- for fever and headache 2. Analgesic (Mefenamic Acid) - for pain and headache 3. Antiemetic (Meclizine) - for motion sickness, nausea and vomiting; very useful for nauseatingly long trips across the Cordilleras 4. Antihistamine (Dipphenhydramine/Loratadine) - for itchness, allergic reactions such as hives "pantalpantal". Careful though, drowsiness is a common side effect of this drug class. 5. Antidiarrheal (Loperamide) - for diarrhea; not advisable when you're at home but is useful during hiking trips when you do not have the time to relieve your bowel. 6. Antacid (Maalox) or *H2 Blockers (Ranitidine) - for upset stomach or reflex disease 7. Decongestant (Phenyephrine / Phenypropanolamine) - may be of some benefit with colds that can be caused by high altitude and cold temperatures. 7. Oral Rehydration Salts (OreSol, etc.) - useful for dehydration with can be caused by overfatigue or diarrhea 8. *Antibiotics (Amoxicillin) - not advisable for daytrips or overnighters, but may be useful in very long treks when no other medication is at hand and someone is down with fever. Ideally still precribed by a doctor. 9. *Acetazolamide - a diuretic that is said to be useful for high alititudes (may have little application in the Philippines; consult your doctor)

TOPICALS 1. Sunscreen - Sun creams with SPF15 or higher aren't just for people who don't want to get dark; they are medically advisable because they protect the skin from UV rays, not only preventing acute conditions such as sunburns but also long-term complications such as, possibly, skin cancer with prolonged exposure. 2. Insect repellant - This is very useful. Lower elevations would usually have common mosquitoes which can be more than a nuisance when they're in great number. Malaria 3. Hydrocortisone cream - Useful for itchiness in the skin, as well as inflammations, especially if localized 4. Calamine lotion - This is useful for itchiness and insect bites, as well as exposure to poison ivy (lipa) 4. Efficasent oil - I recommend this for muscle pains, spasms, and the oil (along with other oils) has an additional effect of protection against the cold

5. Teramycin or any antibiotic ointment - May be applied in wounds to prevent infection or abscess formation 6. Betadine - disinfectant, in case of wounds; otherwise plain soap and water will do

MATERIALS 1. Adhesive tape (Leukoplast) 2. Adhesive strips (Band-Aid) 3. Bandage - may be used to support sprains and fractures 4. Splints - this may be fashioned out of whatever is available (i.e. branches) 5. Hot compress packs - added with hot water, can help relieve inflammation

*Those in asterisk are prescription drugs; better consult your doctor

SOME POINTERS: 1. Make sure the medications are labelled properly; you don't want to take a decongesant for your diarrhea! 2. Alcohol does not offer warmth for the cold - contrary to popular belief. It has little value as a "first aid" substance even though it was used in the past. 3. Make sure your medications are not expired, and are not exposed to water which might affect their potency 4. Make sure that you are aware of your drug allergies, because it is hard to manage it in the mountains

DISCLAIMER This article is for health advice and information only, and does not intend to replace actual medical consultation. The author cannot be held responsible for any loss, injury, or damage that happens as a result of compliance or non-compliance to this list.