Altitude: Thin Air, Big Strain

If you’ve visited altitude, you’ve noticed that it makes you uncomfortable. If you live up here, you might remember your first month in the sky (bloody noses, constantly itchy skin, headaches, constant dehydration, worse), and you’ve probably noticed that when you leave, even for a week, you’ve already lost that magical adaptation called acclimatization, and you have to work your way back into living the hard but sweet thin air life. We all know that altitude puts a strain on our body, and those of us who live here are always telling tourists not to underestimate it, but how big of a strain is it really? And why?

14,440, not the highest I’ve ever been but I’ve spent the most time here.

Altitude affects oxygen saturation, which is the amount of oxygen the hemoglobin in your red blood cells is carrying at any given time. At sea level, the atmospheric pressure and concentration of oxygen in the air is highest, which is optimal for oxygen saturation in humans. As altitude increases, atmospheric pressure decreases exponentially, while the fraction of oxygen remains the same, which leads to lower saturation. According to Princeton, it takes 1-3 days to begin acclimatizing, and months to adapt fully. The biggest change is the increase in hemoglobin specifically, and red blood cells in general, which is an adaptation that we lose quickly when we lose altitude. Other adaptations include: increased depth of breathing, increased pressure in pulmonary arteries (which increases blood flow in the lungs, and utilizes a higher portion of the lungs than you’d use at sea level), and increased production of enzymes that release oxygen from hemoglobin.

So the reason this is all top of my mind right now is that I’ve just returned to Ouray 7,792ft, after two weeks in southern Missouri, at approximately 1,004ft. You may remember that I’m now wearing a Whoop device 24 hours a day, and the data it’s given me around this trip is astonishing. Obviously, we know that altitude is a big physical stressor, but seeing it quantitatively, it’s bigger than I ever imagined.

I didn’t take a lot of photos on this Missouri trip, here’s a festive mailbox from one of our bike rides.

For simplicity, let’s start with the Whoop’s overall recovery metric. They use an algorithm that takes into account my average resting HR, heart rate variability, and respiratory rate while I slept, and then other stuff like the previous day’s HR variations and the amount of physical strain from previous days, that results in a percentage. I don’t strictly adhere to this number, but it paints a clear picture of my journey from 8k to 1k and back. Here’s three weeks worth of my recovery scores:

The first photo is a full week spent in Ouray (all fairly low, which is average). The second includes my drive to Missouri and a full week there, the third is a full week just in Missouri, then the last photo I started driving on Saturday and arrived home in Ouray on Sunday night. The four days of red, then, were all spent in Ouray. Once I left Ouray, I had subpar recoveries on Saturday, after a stressful day of snowy mountain driving, then there’s two particularly intense cycling days that resulted in low recovery that quickly bounced back, another one of those on 12/22, then you can see the decline starts again after the drive back to CO.

140 million people live above 8,000ft. People who were born and raised in the Andes and Himalayas show particularly impressive evolution, being born with larger lung volumes and excellent oxygen saturation even as high as 16,000ft. High altitude dwellers in Ethiopia are less evolved, and show the same type of adaptations as people from low elevations that moved to high elevations during their life, and of all the high altitude populations studied, only Himalayans can move between altitudes without losing any of their altitude adaptations. Which means a Sherpa could go to Missouri for a month and they would not lose any red blood cells or have a change in stroke volume or cardiac output or anything, then on their return to the Himalayas, they would not need to re-acclimate. While someone born in the Andes would go to Missouri and have a similar reaction to me, then on their return to the mountains, they would have an increased HR and lower HRV and begin the process re-acclimatization. Himalayas also have another leg-up on us, with a sustained increase in cerebral blood flow, low concentration of hemoglobin, and an obvious resilience to chronic mountain sickness (CMS).

In studies of permanent high altitude residents, those that are born into it and those that live high by choice share a decreased instance of all types of cardiovascular disease and obesity, but an unexplained increased rate of suicide, even with controls in place for known suicide risk factors.

Let’s dive deeper into the data. Most people measure resting HR by taking their pulse the moment they wake up in the morning, while the Whoop measures your HR every second while you’re sleeping then takes an average. My resting HR at altitude before OTS was 50. Since OTS, I haven’t seen it get lower than 55, and it’s generally somewhere in the 60’s. Let’s take a look at the trends for the same four weeks:

For the week in Ouray, it was 63-68. It went up during the drive, then decreased steadily over the next two weeks, going all the way down to 50. It starts going back up after a day of driving, 57, then 65-74 over the next four days of being at home in Ouray. This is interesting, because an increase in HR is to be expected, as one of the first short-term adaptations to altitude is a decrease in overall blood volume, my body is trying to increase the ratio of red blood cells, and a decrease in blood volume corresponds to an increase in HR to pump it. My average HR, taken throughout the day, and including any exercise, actually didn’t change that significantly during the trip. It’s generally 70-80, and while I was in Missouri it was 67-78.

Another reason HR increases at high altitude is that hypoxia activates the sympathetic nervous system. This isn’t great news for me, as my tendency towards sympathetic dominance is one of the biggest driving factors for how I got Overtraining Syndrome in the first place, but it’s possible to do things to counteract it. Basically, you can expect your HR and blood pressure both to increase while at altitude, and not just within the first couple of days, because of pulmonary vasoconstriction, particularly during exercise, is caused by sympathetic nervous system excitation (which happens because hypoxia, which is lowered oxygen saturation, which happens because of the change in pressure at altitude). This link, from altitude to nervous system imbalance, was exactly what I hoped to find in my research today, because it is obvious from the Whoop data that I’m having cardiovascular effects, but they’re likely nervous system related, as we’ll discuss in this next section about HRV.

Now, here’s Heart Rate Variability (HRV). It’s a controversial metric, mostly it seems like because since it’s been introduced to the wider world, folks put a little too much stock in it and it’s true that you can’t base all your decisions around a number that’s so squirrelly. What I really like about it though is that it reflects the health of your nervous system specifically. Mostly when you’re training, you’re thinking about your cardiovascular system (resting HR) and the health, feel, and fatigue of your body itself (neuromuscular). Both your parasympathetic and sympathetic nervous systems are exerting control over your heart rate at any given time, and if both sides are healthy, that competition results in a high HRV. Parasympathetic is what’s damaged in OTS, so while you’re in a state of overtraining, your HRV is low because the sympathetic system is dominating the decision making. There’s still plenty we don’t know about OTS, and even in healthy folks it fluctuates rapidly. But these graphs are still telling:

To sum up these graphs, before I left it was typically pretty low. I forgot to mention above that HRV is highly individualized and part of what makes it a squirrelly and controversial metric is because it’s only relevant compared to extended data in the same person. So my HRV is only comparable to my HRV at other times. Moving on, before I left it was low. During my trip, it fluctuated a lot (mostly in relation to exercise) and occasionally skyrocketed, much higher than it’s ever been since I got the Whoop device. Most interesting I think is the steady decline since I’ve gotten back to altitude. When I got up this morning, I thought, it’s so low (19) that am I going to survive the day? (Just kidding, that’s not how HRV works).

So this was all so interesting, I thought I’d look back on our UT/AZ trip in October, and the results at first were uninteresting, there was a period where everything was slightly better for a couple days, probably associated with the relaxation and fun of the trip, but mostly it all was similar to when I’m in Ouray. Then I realized, we were mostly at 7,000ft which isn’t any great improvement to 7,992. 🤷

Thanks so much for reading and following along. If you’re interested in mountain running and coaching for adventure, learn more on my website or check out coaching options and training plans here or on Training Peaks, there’s training plans for the Grand Canyon, general base building, and 14ers up now. Also, Pippa Climbs Rainier is available in paperback, check it out on Amazon.

kitchari cleanse (total mindf**k)

So a teacher friend and I decided to start a spending freeze challenge for one month (our rule is that the one exception is produce). We had a couple weeks to prepare for it, I stocked up on food essentials and made a few purchases that I knew I’d need for climbing and SAR training. Like two days before we were scheduled to start, she texts me “I think I’m going to start the spending challenge with a cleanse” and I was like “oh?” [I’ve never cleansed and never wanted to. I have no interest in fasts, particularly]. But, she tells me about it (kitchari is basically rice, mung beans, ayurvedic spices that agree with you, veggies that you digest easily) and I was like “HEY, I can totally do that. And it sounds like a decent idea.” It’s not fasting, you eat as much as you want, except you’re restricted to not eating until after you poo in the morning, and stopping eating 2-3hrs before bed. But it covers all the good food groups, and you drink tea (but not coffee. goddamn it. not coffee.) And I knew it would be good for me to cut sugar and caffeine and flour.

So I was in. For a cleanse. In addition to our spending freeze. Then I also decided I would cleanse from Facebook and Netflix/TV in general.

I don’t know if you’ve cleansed before. But a monodiet gets intense FAST.

Day one: I wanted to eat everything in the entire world but kitchari. But the end of the day, I couldn’t even stomach eating more kitchari.

Day two: I’ve never hated anything in the world like I hate Coriander. I fucking hate coriander. I’d rather die than eat any more coriander.

Day three: me “I’m suddenly tired, like, my eyebrows and fingertips are tired” my friend “ah! I see you’ve reached the detoxing stage. Your energy will come back. In a day or a few.” The most interesting thing about this day was, I became incredibly motivated to get rid of old clothes. I just had this fuck it mentality, I don’t need this shit! This shit either! It all goes!

Day four: things got better. At this point, I was craving things I don’t even want to eat, and never do eat (boxed mac and cheese, what the hell?) Although, by the end of the day I did just stop eating, which was bad. But it was only one night. This led me to eat an entire avocado plain.

Day five: I had to skip a training run because I was too tired. I made banana bread for the weekend intensive backcountry training and I couldn’t even lick my fingers (yeah, I mix things with my hands. so what). Things were a little rough because of those two things. But, overall it wasn’t too bad. By the end of the day, I was eating plain rice because I couldn’t stomach the spices or the beans anymore. Interesting, making the banana bread was a project in health…I adjusted the recipe to make it gluten free and cut nearly all of the sugar out because I was worried I wouldn’t be able to stomach it.

After the cleanse: so I had two full days of backcountry training right after, I brought a bunch of healthy food with me. The interesting thing was, though, that I felt like I should still be eating kitchari. As much as I thought I’d make a big breakfast feast on Saturday morning, I made plain oatmeal and added peanut butter but nothing else. I actually made some kitchari after the weekend was over. Even weirder than wanting to eat kitchari even when I don’t have to is, I feel like I’ve made some progress psychologically about the way that I eat and think about food. I don’t think of myself as someone that emotionally eats but I realize that to a certain extent I do. When I’m tired after a long day of training or teaching, I daydream about the things I’m going to make to eat. Now, I’m planning ahead better and having things already made. I’m making slightly better choices in terms of nourishing my body than what just sounds good. It was a great look into why I do things, and why I think about food the way that I do.

Up next: what is the NEXT ADVENTURE?! It’s a big one, I’m telling you. The biggest of all time.

Training for greatness (how to schedule all of your free time)

Don’t get me wrong, I love laying face down on the floor of my apartment watching Awkward, drinking Coke, and eating junk. But those things are fun in the moment, and not even a little bit epic.

I grew up hoping to wake up before my dad left for work, at like 6 o’clock in the morning, to kiss him goodbye, and I can remember like it was yesterday my dad sitting on the stair by the side door putting his shoes on. To ride his bike 6.3 miles to work (and that’s one way, I just looked it up). Rain or shine, and all winter long (and we lived in Michigan…). Epic. He helped me move to Colorado…and rode his bike home (TO MICHIGAN). He’s been doing this his whole life.

So now you know where I get it.

Every day it seems like there are more amazing things I want to do. I’m not going to lie, I dove face first into climbing, I’ve been at the gym every single day. Contrary to breakdancing and ashtanga, I’m actually getting so much better and more comfortable with all of this practice. Everything has sort of overlapped, at the moment I’m just rocking as hard as possible running and putting miles in the saddle. I need to make a sched…yikes! My yoga schedule is finally calming down, luckily, so this is getting more possible.

With all the madness, here’s what I’m currently working on:

Running: mainly, training to be able to run 14ers. I’m planning next week to knock out the four collegiate peaks in two days, which means I’m going to need to run some to get the mileage done in time. I’ve considered doing one more race before the season’s over…but I’m unsure if racing is something I want to do again. Such a different mindset.

Climbing: mainly, just trying to get better, stronger, more comfortable so I can get back out on the real rock before the weather goes. I love it so much, but I quickly realized that I have A LOT of strength to gain before I can get serious outdoors.

Hiking: 28 14ers before 10/3/14. That’s pretty self explanatory, right? I’m thinking on 10/3, my birthday, we’ll do Capitol Peak…my biggest, hardest climb yet and one that makes me tremble a little, it is on the list of the top 5 most difficult Colorado 14ers…and barely misses the cut for top 4 most deadly. See you at the Knife Edge?

Riding: So I’ve just been gifted a new bike (A NEW BIKE. I KNOW.) Which means I can finally race if I want to…looking at the Steamboat Springs Stage Race over Labor Day weekend…and I am terrified, just considering it as a possibility. I mean. Holy shit, right?! Cyclists are fancy mf. Scared of this for so many reasons. …but…maybe?

Ashtanga: relegated to once a week. I know. Better than not at all? My regular practice has to be a compliment to all of my wild training in other directions.

Gosh, is there anything I’m forgetting? I’m going to try abandoning my regular diet (and by diet I mean the food I normally eat-I don’t do “diets”) and subscribe to Alicia Silverstone’s vegan macrobiotic cookbook (I’m already vegan…but I eat a lot of bread and pasta. and sugar). There’s millet porridge in my fridge…is this going to work? We don’t know. In the meantime, I’ll share the raw energy balls recipe I just made in another post (and let me tell you, they are f***ing amazing).

xoxo love you, internet!