Gotta love those mountains

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Peter Headland - 11 Jul 2005 19:24 GMT

Within a couple of hours of my surgery, the nurse came around with a
little plastic gadget that tests lung capacity. The idea is that you
suck on a mouthpiece and a little piston moves up a scale to show how
much air you can draw into your lungs. The scale goes up to 5 litres; a
little way above that there is a stop.

Obedient fellow that I am, I sucked away and bounced the piston off the
stop. The nurese just gaped at me and said she had never seen anyone do
that before - apparently many folks struggle to get to 0.75 litres
immediately after spending several hours under a general anaesthetic
and a lot of people can't do the full range even when "healthy".

My surgeon also commented that my blood count was excellent going into
surgery, despite having donated two autologous units within the
preceding month; he said this contributed to me not needing a
transfusion (his skill at avoiding blood loss was undoubtedly also a
big factor, IMO).

Maybe I am off the mark here, but I believe that my two trips to the
Sierras to do some serious hiking at high elevations (over 80 miles at
6,000' - 11,000') in the month before surgery have a lot to do with
these facts (besides being very good for my mental health).

Bottom line: I would really recommend anyone heading into surgery to
try and get up into the mountains for a week or two immediately
beforehand.

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Peter Headland

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I. P. Freely - 11 Jul 2005 19:56 GMT

Last I read, we lose altitude acclimatization within five days after
returning to sea level. I'm guessing you hike alla time anyway, which is
probably the primary reason for your lung capacity.

I.P.

> Within a couple of hours of my surgery, the nurse came around with a
> little plastic gadget that tests lung capacity. The idea is that you
[quoted text clipped - 22 lines]
> try and get up into the mountains for a week or two immediately
> beforehand.

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Peter Headland - 11 Jul 2005 22:00 GMT

> Last I read, we lose altitude acclimatization within five days

Alta Peak (11,200') on Sunday, home on Tuesday, surgery on Thursday.
That's less than 5 days. I timed it so as to have just enough time to
get over sore legs from hiking before the surgery (don't want to divert
healing resources to micro tears in the leg muscles).

But as a general point, it depends what you mean by "acclimatization".
AIUI, the 5 day thing refers to avoiding "altitude sickness" (which is
in itself a complex set of loosely related issues). It's certainly true
that altitude sickness can strike down the most experienced mountaineer
when they go up to high elevation from sea level, no matter how much
time they have spent on previous trips.

Again AIUI, red blood cell count and heart/lung function is improved by
the exercise at high elevation for much longer than 5 days (which is
why elite athletes go on training camps in the mountains).

Given how fast I seem to be healing, I wonder if one can stimulate the
body's healing capabilities by stressing them with vigorous exercise?
It's certainly true that professional cyclists seem to be able to
endure terrible crashes and bounce right back, but that may just be
extreme tolerance to pain.

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Peter Headland

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I. P. Freely - 11 Jul 2005 23:19 GMT

"Peter Headland" <PHeadland@excite.com> wrote >

> But as a general point, it depends what you mean by "acclimatization".
> AIUI, the 5 day thing refers to avoiding "altitude sickness" (which is
[quoted text clipped - 6 lines]
> the exercise at high elevation for much longer than 5 days (which is
> why elite athletes go on training camps in the mountains).

I was referring to hemoglobin production and half-life. The day we return to
sea level our marrow stops crankingout extra red blood cells, and the extra
ones are pretty much gone within five days (last I heard, many years ago).
Can a few days at altitude generate any kind of lasting physiological
changes in our cardio-pulmonary system?

> Given how fast I seem to be healing, I wonder if one can stimulate the
> body's healing capabilities by stressing them with vigorous exercise?

Probably, but I'd guess it's very easy to overdo it and SLOW the healing
process.

> It's certainly true that professional cyclists seem to be able to
> endure terrible crashes and bounce right back, but that may just be
> extreme tolerance to pain.

It's probably about motivation. I'll tolerate WAY more pain to play than I
would to mow the lawn or go back to work.

I.P.

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Peter Headland - 12 Jul 2005 02:15 GMT

Red blood cells live between 100 - 120 days. I don't know whether the
spleen, etc. absorb the "surplus" when you come down from high
elevations, but I would think not because of the popularity of
high-altitude training amongst elite athletes specifically to improve
haematocrit.

I do know that it takes at least a month to replace the RBCs one loses
when one donates blood (2 weeks after taking a donation of about 10% of
my total blood volume my haemoglobin still was down by 5% relative to
the time of donation).

As to how long one has to train to produce a benefit, my experience is
that one can get a noticeable improvement in performance in just a few
days of a sensibly paced programme if one is starting from a low
baseline. In a trip of less than a week I got my 55 year old
inactive/unfit/mildly asthmatic sister up to the point where she could
hike 7 miles round trip in Yosemite from 4,000' up to 6,000' on a steep
trail (Mist Trail to Nevada Falls) without distress or difficulty. I
agree that starting with a highly trained individual you can't make
much change in a week (diminishing returns).

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Peter Headland

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Glassman - 13 Jul 2005 04:58 GMT

> Within a couple of hours of my surgery, the nurse came around with a
> little plastic gadget that tests lung capacity. The idea is that you
> suck on a mouthpiece and a little piston moves up a scale to show how
> much air you can draw into your lungs. The scale goes up to 5 litres; a
> little way above that there is a stop.

I always thought that device was to get you to breath harder, rather than
measure.

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JK Sinrod
Sinrod Stained Glass Studios
www.sinrodstudios.com
Coney Island Memories
www.sinrodstudios.com/coneymemories

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Joe Price - 13 Jul 2005 05:38 GMT

I just grabbed this from a Google search for "Incentive Spriometer":

"Lying flat for long periods of time can cause fluid to accumulate in the
lungs. The nurse helps the patient to sit up to breath deeply and cough.
This loosens secretions for elimination and helps to prevent pneumonia.

Deep breathing increases circulation and promotes elimination of
anaesthesia.

Some patients are instructed to breath into a spirometer. A spirometer is a
device used to measure how deeply a patient is able to breath (e.g. lung
capacity) and acts an incentive so you will see just how deeply you are
breathing."

From this and other references it seams you are both right. It indeed
measures the volume but also "tricks you" into adopting a breathing pattern
that helps clear the lungs and prevent atelectasis.

The same Google search turned up a tongue in cheek description of how to
turn one of these into a bong!

http://jatser.typepad.com/prognosis_negative/2005/02/my_latest_inven.html

>> Within a couple of hours of my surgery, the nurse came around with a
>> little plastic gadget that tests lung capacity. The idea is that you
[quoted text clipped - 4 lines]
> I always thought that device was to get you to breath harder, rather than
> measure.

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