Friday, February 28, 2014

Quicky to Pinnacles National Park


Pinnacles National Park is located in central California just south of Hollister and I had hear about it a few times for the large amount of unimpressive climbing that it offered. Being only two hours away from Oakland meant that we just had to make a weekend trip to check it out.

During the drive down we made a stop in Hollister to eat some tasty Mexican food and get ripped on on firewood. We paid $17 for a block of wood!

Being the Sunday afternoon of President's day weekend I though that there was no way that we would get a spot and that we would be left to drive all over the area looking for a spot of dirt to pay someone to sleep on. We got lucky and there was a spot at the campground, as well as we got free entrance into the park because of the holiday!

After setting up our camp Kimber and I checked out some of the nearby climbing and did a few quick routs. Nothing to brag about but fun none the less. The first was a single pitch trad route that included a large roof called, "Tourist Trap".  Next I sent a quick bolted route on the same wall. It felt great to get on some rock again. The area is known for having loose rock, thus the helmets. Both climbs could be seen from the busy hiking trail and during the few evening minutes that we were climbing we could hear groups asking each other how we got the rope to the top. They obviously missed us using our 100ft long telescoping stick clip to hook the rope in at the top.


Due to fire restrictions we weren't allowed to burn our overly priced firewood and spent the night sharing one headlamp while we cooked our dutch oven dinner ingredients over a small propane stove in small backpacking pots. Entertainment was provided by what sounded to be two raccoon involved in a nasty throw down in a tree on the other side of our campground loop.



The next morning I took advantage of the many miles of trail in the park and was on the trail by 7:30am (no need to get a up too early). I headed up towards Bear Gulch Reservoir planning to go through the Bear Gulch Cave Trail but had to change course due to forgetting my headlamp. I did an out and back to the top of North Chalone Peak and then finished with a loop over the High Peaks trail. High Peaks had some pretty cool sections where there was narrow roughly cut stairs in the rock with old school railing preventing terminal falls. The views were nice. Not quite the green rough alpine mountains of Utah, Colorado or Montana but something new.




Running States
Distance: 13.8 miles
Time: 3 hours 8 minutes
Elevation gain: Approx 3,200ft

Kimber and I made an attempt to head up and do some more climbing after a lazy morning of breakfast and cleaning up camp but our plan was foiled due to no parking in the upper lot.

Pinnacles, in my opinion, doesn't really deserve the national park status.  It is more in the category of state park. There was interesting rock features and some good hiking but the park was pretty small and not glorious, as most would describe a national park to be. The amount of climbing and the sub 2 hour drive from home might bring me back however. Time will tell.


Wednesday, February 26, 2014

Playing the Game of Externships


The 4th year of podiatry school requires you to spend 3-5 months working and learning with podiatry residency programs throughout the country. As a student I had some control of where I was required to go by only applying to work with ones that I would consider as potentials for my upcoming 3 year residency training. I ended up spending time in Denver CO, Salt Lake City UT, Albuquerque NM and Portland OR. These "externships", as they are called, are like a month long interview. As students we are constantly being evaluated academically, socially and personally. We had to be ready at all times to be "pimped". Pimping in the process of a doctor asking a student whatever questions the doctor can think of. Questions can be super random facts about authors of research papers to anatomy questions. I am not much of a stress-er but I will have to admit that during this process I did find myself much more uptight and not acting like my usual self.

Then to wrap up the whole process we had our boards part II exam a week and a half before residency interviews. At these interviews every podiatry student and most of the podiatry residencies in the country met in Frisco Texas in one huge hotel. Interviews were kind of nuts. Each floor of the hotel had multiple hotel rooms or suites with chairs out front where you could sit nervously while waiting to be called in for questioning. The interviews could consist of anything; social questions, academic questions, demonstration of surgical skills, clinical scenarios and any sort of critical thinking activity the programs could come up with.  The hotel was full of stressed out students doing their best to act confident and likable and the fact that there was supposedly a huge shortage of residency positions available this year only added to the environment. Most evenings consisted of socials where residency programs tried to entice the top students to rank their program high and the students tried to impress those people who they thought were the decision makers. I interviewed with 12 programs and had 2nd interviews with some of them so it was a busy three days. I am glad it is over. After the interviews the students rank any of the programs that they would accept in the order that they want them. The programs do the same for the students that interviewed with them. These ranking get tossed into a magic box and we get the results on March 20th. So currently everything is out of my hands.

I was away from home for a three month stretch while I spent November in Utah, December in New Mexico and January in Portland. It wasn't so fun being away and living out of a suitcase but it was awesome seeing different parts of the country.

Overnight lodging while traveling through Nevada. 
Beautiful day of climbing up Little Cottonwood Canyon in Utah. 
Court on the traverse up Little Cottonwood. 
Corey sending a climb up Big Cottonwood Canyon while Skyler and Tori stand all amazed.
Running a snow trail up above Layton with Spencer, Steve,  his brother in law and Pete.
Toured up to Wolverine Cirque on a beautiful Sunday afternoon. Little Cottonwood Canyon, Utah. 

View to the west down into the small town of Alta. Little Cottonwood Canyon, Utah. 
Got a morning of skiing with my attending, Dr. Margiotta, at Ski Santa Fe Resort in New Mexico 
Study break! Running the trails above Albuquerque, New Mexico. 
Sunday drive to Mt. Hood in Oregon. If I wasn't sick I would have been all over that.
Kimber came to visit! Exploring some waterfalls in the Columbia Gorge outside of Portland, Oregon. 





Where will we end up for residency?



Monday, November 25, 2013

Alternative Medicine: How much trust does it deserve?


Alternative medicine is a topic that many people are very passionate about because it has this connotation that it is the more natural or pure way of treating the body, bringing it back into balance. Some people feel that there is almost a spiritual nature to it. On the contrary, "evidence based medicine", or "western medicine", is sometimes seen in a very suspect way because of the huge amount of money that is involved and the synthetic nature of many of the pharmacological treatments. While alternative medical treatments have helped many people it can receive more trust than it deserves putting people at great risk of rejecting life saving and quality of life improving treatments. For this reason I would like to point out a few things about these two types of medicine.

Alternative medicine isn't shown to work while evidence based medicine is. 

By definition Alternative medicine is any practice that is put forward as having the healing effects of medicine but is not based on evidence gathered using the scientific method. This definition of alternative medicine doesn't necessarily mean that it never works, it just means that it hasn't been proven to work using the scientific method under reasonable experimental conditions. It also points out the fact that there are some alternative medications that are used which have been scientifically proven not to work, which is a problem.

Evidence based medicine on the other hand is medicine that has been proven to work using the scientific method. These studies have been peer reviewed and the results of the study accepted with high statistical confidence within the community of the medical specialty.

More simply stated by Tim Minchin:
"Alternative medicine, by definition, has either not been proven to work, or proven not to work. Do you know what they call alternative medicine that has been proven to work? Medicine."
-Tim Minchin
Using these definitions it means that once any substance or method has been proven to work under reasonable scientific experimental conditions it automatically becomes evidence based medicine and ceases to be alternative. Ideally whenever a new treatment is shown to work with a high level of confidence it would instantly be implemented into our health care system but this is not always the case for many different reasons good and bad.

Alternative medicine is not regulated while evidence based medicine is. 

The FDA (Food and Drug Administration) was initially set up in 1906 for the purpose of keeping people safe. One of their jobs is the regulation of medical drugs. In order for a drug  to claim it works as a treatment of a specific pathology it needs to have been shown to be safe and effective (benefits outweigh risks). Once approved the FDA monitors the manufacturing process of the substance, labeling and advertising. Each drug has a known toxic dose and effective dose based on studies to ensure it is safe. Even after the drug is released it is monitored to ensure there isn't any long term negative effects.

Dietary supplements, being a large bulk of alternative medicine, is not regulated because in 1994 they were mandated to be regulated as foods rather than drugs under the Dietary Supplement Health and Education Act. Therefore they are not subject to safety and efficacy testing and they have no approval requirements. They are not allowed to state on the label that they specifically treat, diagnose or cure any illness and must include a disclaimer on the label.  A 2013 study that looked at 44 different herbal products from 12 different companies showed that:
"Most (59%) of the products tested contained DNA barcodes from plant species not listed on the labels. Product substitution occurred in 30/44 of the products tested and only 2/12 companies had products without any substitution,contamination or fillers. Some of the contaminants we found to pose serious health risks to consumers". 
"Most of the herbal products tested were of poor quality, including considerable product substitution contamination and use of fillers"
So the majority of the time when you are taking dietary supplements what is stated on the bottle isn't necessarily what is in the bottle. Often times the labeling on dietary supplement adds and labels give the notion that they cure specific problems without specifically stating that they do, which is very confusing to consumers.

Alternative medicine usually isn't based on sound scientific principles.

Most forms of medicine that fall under the realm of alternative medicine are based on unsound principles. For example:

Homeopathic Medicine, developed in 1796, is based on the principle that "like cures like", meaning that the substance that caused the disease in a healthy person will cure similar symptoms in a sick person. These remedies are prepared by repeatedly diluting a substance in alcohol or distilled water to a point where none of the original substance remains. In essence you are only receiving water and any positive affect that you are receiving is due to the placebo affect.  A current example of the damaging affects of homeopathic medication include Nosodes, which are homeopathic (diluted down to only water) vaccines that claim to protect people against disease like a normal vaccine.

Traditional Chinese Medicine is not based on any internal anatomy. It was against the law to perform autopsies in China until 1912 and because of this the Chinese had no system of anatomy comparable to western medicine.

Use of alternative medications is often supported by logical errors. 

The idea that just because it is natural it is good is incorrect. While it may appear that pharmaceutical drugs are more of a risk because they are required to list all of the known side effects, natural herbs and other substances have side effects  as well (click the link, I dare ya). These side effects are less understood because they haven't been as thoroughly tested. The consumer is less aware of these side effects because they are not required to release or obtain this information. All substances are toxic to the body at some level, even water. The problem with herbal supplements is that this toxic dose is not always known while with regulated drugs it is required knowledge.

Anecdotal studies and case studies are not adequate scientific proof. There are some very compelling documentaries out there that give the story of only a single person or a few people who benefit from a specific treatment. This is not adequate. There are many types of studies and each type provides a certain level of evidence and until an out come is statistically significant under scientific conditions it isn't proven. Case studies and anecdotal treatments are the starting point of investigation.

Just because something has been used for a long time doesn't mean it works. A common rational for supporting alternative medicine, such as eastern type medicine, is the fact that many methods have been used for thousands of years. This is not always true and could be attributed to a correlation vs causation fallacy. How many years did the native Americans perform rain dances?  The average life expectancy in China in 1960 was only 36.3 yrs while in the United States it was 69.8 yrs. Sam Harris put it well when he stated:
"But the mere endurance of a belief system or custom does not suggest that it is adaptive, much less wise. It merely suggests that it hasn't led directly to the society's collapse or killed its practitioners outright."
-Sam Harris, The Moral Landscape
DISCLAIMERS:

  1. I do not consider healthy eating or a healthy life style to be alternative medicine. All people should do their best to eat healthy and stay active in an attempt to prevent problems down the road.
  2. Also, I am in no way claiming that evidence based medicine is perfect or that it has all the answers. There are still a lot of unanswered questions that need to be looked at. With time and the use of the scientific method, evidence based medicine will continue to improve. 
  3. Evidence based medicine is not biased towards where it obtains its treatments, specific health care systems maybe but that is different. As long as something can be shown to work under reasonable scientific experimental conditions beyond that of current treatments available, whatever the source of the information, be it China or fresh vegetables, it is then considered evidence based. 
  4. Testing any hypothesis, takes time and money and I do agree that pharmaceutical companies have a lot of money which allows them to actually test their products.  Numbers probably have been fudged by dishonest companies on rare instances but I personally trust this process of medicine being shown to work over the alternative. 
  5. The burden of proof is on these alternative medicines to do high level studies that show with high confidence that their treatments repeatedly work. Until then they will remain under the umbrella of Alternative Medicines. 
A few words from Michael Specter on the matter:






Tuesday, October 29, 2013

Yosemite: The Grack and Running El Capitan

View of the valley and Half Dome from Eagle Peak

Kimber and I got invited to go to Yosemite for the weekend with four of her girlfriends. We headed out Friday evening around 5:30pm and didn't get to the Upper Pines Campground until around 10pm. It was great just hanging out around the fire with friends.

Moriah, Audrey, Leslea, Nate, Kimber (L to R)

Saturday morning I got up and was on the Yosemite Falls Trailhead by 7:50am. I would have got up earlier but didn't end up going to bed until around 1am. The first 3.2miles were straight up, consisting of slippery rock steps and loose sand. Once I was on the rim the climb became more gradual and I took a little off chute trail to summit out on Eagle Peak (7779ft) which provided some awesome views of the valley.

Area surrounding Yosemite Falls trail. 

Yosemite Falls trail.

I trucked on another 2 miles and eventually made it to the top of El Capitan (7569ft). The summit didn't have a sheer ledge as I had hoped and sloped down through some gnar before getting to the edge. I opted not to swack down as I was short on time. My run out was uneventful and I felt great except I rolled my ankle while running along the road at the bottom right in front of a car. No injury but why is it always right in front of people?

El Capitan from the Valley. 

Stats:
Totals Distance: approx. 18 miles
Total Elevation Gain: approx. 4900ft
Total Time: approx. 4hrs 50min

Later that evening after a nice nap on our huge air mattress with Kimber (when we car camp we go all out) we hiked up and climbed a famous route called "The Grack". Luckily there wasn't much of a line and we were able to get on it right away. It is supposed to be done in 3 pitches but we sort of did it in two. I lead the first pitch up some really easy low 5th class and belayed Kimber up, maxing out our 70m rope. The second pitch consisted of a thin hands to fingers low angle crack the petered out at the top. I tried to pitch it out to the top but we ran short by about 15ft and was forced to climb across a slabby face to a left facing 4th class ledge where I belayed Kimber up a few pieces on a half hip/half crappy nut. I finished it out and hooked into the chains to finish belaying Kimber. She did great, except her shoes were really tight, having not brought he looser fitting ones that she uses for multipitch. We both and fun and the setting was fabulous!

Me leading the 2nd pitch of "The Grack". 

Kimber following 2nd pitch. 

Kimber wondering why she hasn't been wearing stretchy pants to climb since the beginning. 







Sunday morning we almost got onto another famous climb, Bishop's Terrace at the Chruch Bowl, but it took longer to find and we didn't have time to wait in line. Maybe next time. We had a nice drive back and stopped in Walnut Creek so Kimber could do a family holiday photo shoot. Then we rushed home to show an apartment in an open house. Busy. Kimber brought home some kind of a stomach bug which had her over the toilet all night and Tuesday morning it hit me. Not fun.

Upper Pines campground. 

Liz and Kimber at the base of "Bishop's Terrace", before we bailed. 


Yosemite: Nutcracker


With the park being closed for the previous 2 weeks due to the government shutdown, I wasn't sure if I was going to be able to get back to Yosemite before leaving for 3 months of externships.  Luckily the park opened a few days before we had planned to go. With school, rotations, managing the apartment and whatnot our only option was to make a day trip. Binh picked me up around 7am Saturday morning and we were in the park by 11 and racking up to climb Nutcracker. The park was much quieter than we had imagined. I sort of thought it would be extra busy due to the closure. The weather was beautiful, clear skies and temperatures in the high 50's.

The Nutcracker is a 5 pitch, 500' climb in Yosemite Valley that is named such because it was one of the first climbs to be climbed protected with nuts, which was done by Royal Robbins in 1967. Binh and I took 3 sets of nuts (and a bunch of cams) with and thought that we might try to do the whole thing with only nuts. This thought was scrapped on the first pitch.



I gave Binh the first pitch which included him jumping over a wide off-width section which he had climbed above and a horizontal greasy under-cling. I took the second pitch which was a walk up ramp which traversed to a platform where we caught up to a couple from Los Angeles. They were having a hard time and we waited around, allowing a team of four Polish climbers to catch up. After the LA couple had finished the pitch I lead up a few various small finger to thin hand cracks and ended up continuing off route setting a belay and then leading another off route pitch up some vegetative features to the crux of the route.




The crux was a semi-good protected corner that required a committing reach up to a huge ledge and then a mantle move to get up on top of the ledge. Luckily you can just watch me do it on this awesome video that the girl from LA took of me climbing it. The rest of the climb was some easier linking crack systems that took me to top out. It was a great climb and the views of the valley were phenomenal! At the top we met a dude from Texas who soloed up an adjacent route and had been living in the valley for 6 months. Nice guy.




Friday, October 25, 2013

NorCal Trinity Alps: 4 Lakes Loop


Even though I recently learned that Christopher Columbus did many not so awesome things (http://theoatmeal.com/comics/columbus_day) and that his story has been whitewashed to the max like too many stories I have been taught in my life (others of which I have not based my knowledge on blog posts like I did here, but on credible primary sources), Kimber and I decided to celebrate Columbus Day by exploring the mountains of northern California.

We decided to hit the road Sunday morning early as Kimber had spent Saturday shooting a wedding in San Francisco and didn't get home until around 11pm. We headed to the Trinity Alps, 5 hours north of the Bay Area. The Trinity Alps are a beautiful mountain range to the northwest of Redding, CA and are a bit of a hidden gem. We needed a trip to get away from the busy city and enjoy nature and some time alone....and I planned the trip around a sweet run!



Kimber started shaking her head when we were driving into what appeared to be a deserted wilderness because I have this tendency of over planning adventures and she is well aware of it. We made it to the trail head where we luckily found a random camping spot about a half mile up the dirt road and pitched camp, car camping style (huge air mattress, camp chairs, firewood, table, cabin tent...etc). We spent the afternoon just basking in the woods wrapped in sleeping bags, drinking hot cocoa, reading thought stimulating books and discussing life. It was nice. We even wrapped up the night with a freaking old (like black and white old) Halloween movie on the laptop while sitting next to the campfire.



The  next morning I got up and ran the 4 Lakes Loop. It is a loop in the heart of the alpine wilderness that goes around Siligo Peak (8162ft) and in the process passes by 4 beautiful lakes. The loop is accessed by 6 mile, 4,100ft climb up Long's Canyon, making the round trip approximately 18 miles.

Up Long's Canyon.

Looking down Long's Canyon



The Long's Canyon climb consisted of dispersed forest that opened up into multiple meadows surrounded by towering red and granite peaks. The start of the loop is at Deer Creek Pass which gives you an awesome view before you drop down toward Deer Lake followed by steep switch backs up the NE face of Mt. Siligo.  At the saddle I had the option of climbing another 350ft to the top of Silgo but decided to pass because I had slept in a bit longer than I had planned and needed to get back. From the saddle I traversed around the back side of Siligo able to view Diamond Lake and then up another saddle and down into Luello Lake. Somewhere around there is where my GPS watch died. I think I slept with it running because it was only at 22% when I awoke. Bummer! The climb back up from Luello to Deer Creek pass was significant and I took it at a quick hike. I then  ran down Long's and eventually met up with Kimber who had started up the canyon much later and we finished running back down to the trail-head together. It was a gorgeous run.

Looking down at Deer Lake from Deer Creek Pass.
I always debate to myself if trips like this are worth it because we drive for so long and only get about 24hrs there. I never regret them when they are over so I think I am making the right decision to go.




Mt. Siligo from Deer Lake



Stats:
Total distance: approx 18 miles
Total elevation gain: approx 5,800ft
Total time: approx 5hrs.