2016.06.30 09:03
2016.06.30 09:25
2016.06.30 13:11
Somewhat related to this story above,
There is a lore (or legend) among the mountain climbers.
It says when we enter physiologically demanding low oxygen level of the high altitude,
millions of our brain cells die from lack of oxygen, especially when we sleep there.
In the very high altitude, we breathe fast and deep to catch as much oxygen as possible.
This hyperventilation leads to respiratory alkalosis. This is how Diamox helps the situation by
inducing metabolic acidosis by diuretic function.
While awake, by doing hyperventilation, we can almost keep up with the oxygen demand of our brain and body.
However, when we fall asleep, we can no longer breathe fast and deep (because we are not conscious enough to do that).
There, frequently we wake up from the sleep due to extreme shortness of breath and feel real vague awfulness.
Then, I used to say to myself, "Oh, my God, millions of my brain cells have just died !"
This episode happens every nights during the climb until we reach the summit.
On the way down, I say to myself, "With so many brain cells dead, I will be a fool by the time I get to my home."
I used to be a reasonably smart guy when I was young, but having killed millions of my brain cells
in the repeated attempts of reaching the high summits, I think I have become a fool.
Or, to have made such attempts, I must have been a fool even before the climb.
Whichever came first, I like let you know that's what I am now.
2016.06.30 15:02
There are only anecdotal and small reports on brain systematic magnetic resonance imaging (MRI) studies in mountain climbers. The purpose of our work is to study the risk of brain lesions in mountain climbers by means of conventional MRI and magnetic resonance spectroscopy (MRS).
We recruited 35 climbers consecutively (12 were professional and 23 were amateur) in 4 expeditions without supplementary oxygen: 12 professionals and one amateur went up to Mt. Everest (8848 m), 8 amateurs to Mt. Aconcagua (6959 m), 7 amateurs to Mont Blanc (4810 m), and 7 amateurs to Mt. Kilimanjaro (5895 m). The mean age was 33.8 years (range: 22-46). All of them underwent general medical examination, standard blood tests, and MRI of the brain after the expeditions. MRI also was carried out in a control group of 20 healthy subjects. Single-voxel MR spectroscopy was carried out in 14 amateur subjects after the expeditions and in 10 healthy controls. As outcome measures, we evaluated changes in the hematocrit value, presence of cerebral lesions on MRI, as well as atrophy and dilatation of Virchow-Robin spaces, and differences in the metabolite ratios obtained from brain MRS in comparison with controls.
Only 1 in 13 of the Everest climbers had a normal MRI; the amateur showed frontal subcortical lesions, and the remainder had cortical atrophy and enlargement of Virchow-Robin spaces but no lesions. Among the remaining amateurs, 13 showed symptoms of high-altitude illness, 5 had subcortical irreversible lesions, and 10 had innumerable widened Virchow-Robin spaces. Conversely, we did not see any lesion in the control group. We found no significant differences in the metabolite ratios between climbers and controls.
We conclude that there is enough evidence of brain damage after high altitude climbing; the amateur climbers seem to be at higher risk of suffering brain damage than professional climbers.
2016.06.30 15:21
https://www.mountainproject.com/v/health-effects-of-high-altitude-climbing/108825143
Your story prompted me to dig out a couple of studies that support what you said.
This is a news to me. I learned something.
You have more brains in my opinion than any contemporary of yours I know.
No matter what, we are very proud of what you achieved in mountain climbing.
2016.06.30 20:48
http://pubs.rsna.org/doi/full/10.1148/rg.274065722
This is a reference on Virchow-Robin space
2016.07.01 04:31
I will give you one more information that medical science does not know yet.
After prolonged exposure to the low-oxygen level in the breathing air while climbing up,
we will be soon descending into lower altitude where oxygen become plentiful again.
Then, this incredible phenomenon happens !
I have felt this mysterious phenomenon every time after the high altitude trips.
I would name this phenomenon as "Hyperactive Cerebral Syndrome."
With my limited neurological knowledge, I speculate that the frontal lobe which may suffer most
in the low oxygen environment may play major role in this phenomenon.
As we approach the summit with lowest oxygen level, climbers become emotionless with no facial expressions,
and our minds simply become dull and poorly emotionally responsive.
My guess is that this may indicates hypo-function of the frontal lobe.
On the way down as I approach the lower altitude, I develop enormous creativity in my thinking
and beautiful imaginations. Not like watching Korean dramas, they are not just a day dream or groundless fantasies.
They were actually real and scientifically truthful.
There, it may not be just the frontal lobe recovering. Entire brain is coming alive.
During that time, I could have written numerous beautiful poems, novels, or scientific papers
if I was given enough time to sit down and write down the things in my brain.
But such chance never came as descending mountains is always very dangerous.
The climbing team has no time to fool around as a lot of accidents happen on the way down.
I have to pay full undivided attention to each and every foot steps of mine,
yet my brain is bursting with new ideas and imaginations.
During this phase of descent, nobody talked to the others. We generally all remained silent.
It seemed that the same thing must be happening to the other team members.
By the time, I reached the base camp or the highways, the stupid worldly things got hold of me
and my brain cooled down and got confused into the normal dumb self of mine.
The pure pristine innocent brain of mine with the incredible hyper-creativity slowly disappeared.
I felt so sad because I became as dumb and plain as I was before the climb.
Some researchers should run MRIs during this descending phase to see what's happening to our brains.
Also, this momentary hyper-cerebral activity could be replicated by putting people into a hypobaric chamber
and then get them out slowly later without the danger of mountain climbing.
For the price of this incredible mental experience you get, you may lose millions of your brain cells.
Will you do it? Well, I will do it again if I can.
Now, there's nothing much left in me. Another few million brain cells won't matter very much.
Another thing in life.... Even though you stay and live in the comfort of your home,
still... millions of your brain cell will die anyway in your age.
2016.07.01 06:22
It is fascinating to hear what you have to say about the mysterious, real experience only the high level climbers may have.
I can only imagine and find myself in awe once again with the realization of how little we know
about our brain and ourselves.
I googled to see if I can find any statements or studies by other climbers but have failed so far in finding
what you call "hyperactive cerebral syndrome" shortly after climbing.
Thank you for sharing the precious experiences with others.
This important study demonstrates sleep apnea in later life is a high risk factor developing dementia and
precedes dementia in subsequent follow up in many patients.
As the author pointed out, they did not prove sleep apnea caused dementia.
They didn't rule out the possibility that sleep apnea and
dementia may indeed have the same underlying genetic etiology.
In my own experience, I had a couple of patients who had been treated for early dementia with drugs
were found to have sleep apnea some years later.
When they were treated properly with C-pap, their memory was dramatically improved
so that repeated hypoxia during sleep apnea certainly may well be a significant contributing factor
to dementia in some patients.