Monday, May 12, 2014

Mt. Whitney's East Buttress: The Epic

Andrew on the approach. 

Mt. Whitney is the highest peak in the lower 48 states, at 14,505ft (updated elevation since the printing of the book in the below picture). It has been on my radar for a long time and with the move to Seattle getting closer I had to make it happen. I mentioned it to a fellow mountain charger, Jeremy Koons, who cautiously agreed to join. We also got two more  guys, Nate Tang and Andrew Yue, who I had done a few other adventures with and lived in the Bay Area.

With over 75 emails sent back and forth over a few month period of time, a 15 page itinerary including emergency contact information and a weekend practice climb at a nearby crag we were able to put together a plan that got the four of us on the mountain with a permit. Jeremy bit the bullet and traveled down a day early to sit in line and ensure that we could get one of the limited walk-in permits. We were going during the first week in which the quota was activated on the mountain, May 2nd-4th, which worked in our favor for obtaining a permit.

Our initial plan was to climb one of the nations 50 classic technical routes, the East Face. However, after getting there and talking to a few guides and locals we were informed that this route still had a fair amount of ice on it and would likely be very difficult.We changed to plan B, the East Buttress. The East Buttress is a 5.7, 11 pitch route and considered by many to be even better than the East Face for its consistent quality climbing.


Following normal adventure fashion, myself, Nate Tang and Andrew, left the Bay Area Thursday night at about 7:45pm. All three of us had to work that day. We pulled in next to Jermey, who was sleeping in his car at the Whitney Portal Trailhead at about 2:30am and slept on the ground in the parking lot.

Tang on the approach. 



Jeremy and I on the approach. 

Andrew and Jeremy at the 4th class Ebersbacher Ledges on the approach. 
We awoke to being surrounded by giantic granite peaks and blue sky's and hit the trail at about 8:30am, just ahead of a group of 17 who were being guided up the mountain professionally by a guide service. The 6 mile hike up was beautiful and grueling. The trail started at approx 8,400ft and it wasn't until 4pm that we reached Iceberg Lake which was at 12,600ft, an elevation gain of 4,200ft. That is an average of a 20% grade over the whole hike in, and it felt like it. The hike included climbing some 3rd class slabs, crossing creeks and slowly ascending snow fields that were being heated and softened by the sun. Each step through the snow fields were taken cautiously for fear of your foot plunging down into the snow up to your thigh, also known as "post holing". Combine these factors with heavy packs and four guys who live at see level and it was slow moving. We were completely exhausted by the time we reached Iceberg Lake at the base of Whitney where we set up camp and filtered water from the ice covered lake. The East Buttress towered over us, quite intimidating. We had a serious discussion about backing out and taking the Mountaineers route which is basically a steep snow hike up series of long chutes and is the more common route taken because it is less technical. In the end we decided to tackle the beast and attempt the East Buttress.

Me just below Iceberg Lake. 
Jeremy pointing out the objective.  
Due to our complete exhaustion and the fact that we were so close to the base of the climb we decided to sleep in until around 7am. Normally alpine starts are in the 4-5am period. I slept like a rock, feeling the affects of the elevation. We awoke to other climbers hiking past our camp and heading up the mountain. We were moving pretty slow and seeing a few groups ahead of us not wanting to be right on their tail waiting for them allowed us to take our time.  With ice axe in hand, I headed up the steep snowy face first and we were climbing by about 10:30am.

Tang, late morning start. 
High above Iceberg Lake on the East Butrress route. 
I lead every pitch. We worked out a system where I would drag up two ropes, belay up two climbers at a time (one of which drug up a third rope) and then I would start the next pitch while the last guy climbed the previous pitch. It was a bit slow but we were moving things along ok. The first pitch was a left facing corner that followed up along a large blocky pillar. Awesome. The second pitch went up and into a notch, the third up a a thin ramp and onto a steep red face, the fourth up and onto a large ledge.....it all kind of blurs together. The climbing was great, consistently going at 5.6/5.7. The group was doing pretty good, moving along. This was Andrew and Tang's first multi-pitch alpine climb and it was Jeremy's second.   On pitch five I headed up a crack that widened out in a corner with a thinner crack running just above the corner for placing pro. I ended getting pulled right when I probably should have headed left and made a few hard moves around a corner to an area where I hoped would get us into some 4th and low 5th class terrain to speed things up a bit as it was getting later in the day. This pitch took a long time due to the difficult move and the large drag on the rope. By the time I got everyone to me it was probably 7pm, getting dark around 8pm. We had to start moving. I climbed up a 6th pitch which was only low fifth class moves but the rope drag made it difficult to move and slowed things down. At this point the sun was almost down, temperatures were really dropping and I was starting to feel the seriousness of our situation. I built an anchor and got the group moving. I was able to get up one more pitch before it was totally dark. The climbing was fairly easy so the group was able to manage ok in the dark but the wind was howling and we were getting cold with about 500 feet of elevation to gain through the cliffs in the dark.

Andrew on the ascent. 
Tang on the ascent. 
We held up between some rocks for awhile discussing the best game plan. We could just hold up where we were, which would be a very very long and dangerously cold night or we could continue on slowly through the dark which would keep us moving but could potentially cause me, the leader, to wander off into some difficult terrain. On the summit we knew that there was a summit hut that would provide some shelter from the wind. We had read reports of people spending the night in there, those reports emphasizing how cold it was to try to sleep in there but it would at least keep us out of the wind. Luckily we all had headlamps and down coats. While we were discussing our options and resting I finally switched out of my climbing shoes into my boots. My feet and toes were pretty numb. I defecated in a "wag bag" (meaning I got to carry it out) which helped me feel a lot better as I had been holding it in for the second half of the day hoping to top out. We decided to continue on slowly and cautiously. For the next 8 hours I lead pitches wandering up routes, down climbing routes that didn't appear to be headed the correct way and belaying up my group. I was exhausted and freezing, constantly holding back chills. Pulling up the rope for the climbers below me was draining. My movements were slow and it took intense focus to keep my balance as I climbed up and down the boulders and faces. We did 5 pitches in the dark. Andrew was shaking worse than he ever had before and on one pitch he vomited twice while climbing, probably due to exertion combine with the effects of altitude. Jeremy had a great attitude and really brought up the morale of the group. We all were so tired that we just didn't want to move but knew that we had to. Both Andrew and Tang had altimeter watches (my battery died) but they were a few hundred feet different in how close they said we were to reaching the top. We never really knew how close were were.

Andrew ascending with Iceberg Lake in the background.
Whitney's summit hut that saved our bacon. 
In the hut after a cold night.
We ended up topping out at around 3:45am. Seeing the summit marker imprinted into the rock I didn't want to believe it but looking onward and seeing the hut, I knew that we had made it. A sense of relief came over the entire group knowing that we would be out of the wind and somewhere safe where we could rest.

Jeremy, morning summit pic. 


Morning summit group pic. 
The summit hut had an unbroken window, a door, a wood floor, and a single emergency blanket and pad. There was ice covering about 1/4 of the floor. We let Andrew have the blanket and pad as he was being affected by the altitude the most. The rest of us each took a rope to sit on and sat up against the wall and tried to sleep. It was a long 3 hours. I was shivering so bad that my teeth were chattering and preventing me from sleeping. I took off my boots and tried to massage my feet to get them to warm up a bit. It was a long cold night.

Tang with the morning summit silhouette.
When the sun came up we got our stuff together and headed out for the decent down the icy mountaineers route. I decided not to bring crampons and only went with an ice ax which made things a bit more dicey but I made it down back to camp in about 2 hours. Even walking down the steep snow was exhausting. As I passed a group that was on their way up they mentioned how windy it had been the night before and we went on our way. Within view of our camp we noticed that our tents weren't there. I had also been looking at a dark spot on the far end of the frozen Iceberg lake which looked like a tent but didn't have foot prints around it causing me to dismiss it as an exposed rock. We eventually realized that during the night the wind had blown our tents away with our sleeping bags and some of our other gear. Jeremy and Tang's tent still had the loops from the tent attached to the stakes in the ground. I had been dreaming about curling up in my sleeping bag, getting warm and sleeping for a few hours ever since I sat down along the wall of the hut and tried to sleep. When I got to what remained of our camp I laid down on the group, curled up in my down coat and slept in the bright sun for two hours. We searched the area and picked up what gear we could find. Luckily that was my tent on the frozen lake and it still had all of my stuff in it even though it was banged up a bit. The other tent was never found, but we did find Tang's backpack and Jeremy's sleeping pad about a half mile down toward Lower Boy Scout Lake on our way out.

The tent before it was swallowed up by the mountain and never to be seen again. 
The hike out was long, as it is with every decent. The last few miles felt like fifty. We made it to the car exhausted and happy to have accomplished what we set out to do. We had one of the "best burgers in Lone Pine" on our way out and alternated drivers to make it home by 1:30am, just in time to get some rest for work/clinic the next day.

Finishing the long hike out. So glad to be done. 
It took me about a week to recuperate. Kimber said I looked worse after doing this climb than I did after my 50 mile race. After a week my two big toes are still pretty numb and achy, kind of ironic that I am almost a foot doctor and I messed up my feet. I attribute it to my lack of insulated boots. I wore my heavy leather fire boots which weren't water proof. With all of the mountain sports I do I rarely use insulated non-ski boots, usually doing fast and light ascents in trail running shoes. Great trip none the less. Glad to have experienced it. Everyone had a great time!

Fire boots for mountaineering boots. 





Monday, March 31, 2014

California Coast: SF to SB (~400 miles in 4 days)


Just prior to starting podiatry school in 2010, myself, Kimber and a buddy, Jeremy Koons, rode down the entire Oregon coast. We did the roughly 400 miles over an enjoyable period of 10 days. We were able to stop and see the sights and relax in the afternoons on the beaches. It was a pleasant trip. I had always hoped that eventually I would be able to do more sections of the west coast but I never really got an opportunity until just recently when the doctor I was working with was going to be out of town for a few days, giving me some time off. Having just matched at a residency program in Seattle Washington (yay!!) I was due for some adventure. Jeremy and I discussed various plans including riding from Oregon to San Francisco, San Francisco to Santa Barbara and I even presented the idea of doing a climb in a the Eastern Sierra's following by a multi-day ride in Owens Valley. Due to weather forecasts and logistical reasons we settled on the SF to SB option a few days before departure.  Having only 4 days for the ride meant we were planning to ride roughly 100 miles on day 1, 100 miles on day 2, 120 miles on day 3 and about 100 miles on day 4. Quite ambitious since I had only ever ridden over a 100 miles in a day a few times and Jeremy never had before.

Day #1: San Francisco to Santa Cruz, 93.3 miles, 7.5hrs peddling time, 5,300ft elevation gain. 

We caught the BART to the Embarcadero St. station and met up with one of Jeremy's buddies who joined us for a quick tour of SF. Jeremy wanted an iconic start and talked us into peddling up an insanely steep hill allowing us to ride down the famous Lombard Street which has 8 hair pin turns within a one block section. We headed over to the south side of the Golden Gate Bridge and then down through Golden Gate Park on onto Highway 1. It was a beautiful day. We took stops at Half Moon Bay and San Gregorio State Beach and made it to the Santa Cruz New Brighton Beach Campground around 6pm. Hike and Bike campsites are basically awesome; $5 per person, right next to the showers and no need for reservations. Slept like a rock. While there we met a guy who was riding from Montreal Canada to San Diego and then over across to Louisiana. He said he started in freezing temperatures. What an adventure.

BART Elevator

Lombard Street


Day #2: Santa Cruz to Big Sur State Park, 85.5 miles, 6.5hrs peddling time, 4,700ft elevation gain. 

We were on the road by 8:15am. My ischial tuberosity was screaming but would intermittently go numb after being on the bike for about an hour. The route took us inland and we ended up stopping at an awesome fruit stand and loaded up on some avocados, oranges and apples. Tastey!  We stopped in Monterey near the Aquarium for lunch and basked in the sun. The second half of the day we traveled around Monterey on the famous 17 Mile Drive which follows some beautiful coast line and through the prestigious Pebble Beach Golf Course ($500 per 18 holes!) We came up through Carmel and then over the hills and into Big Sur. We were spent when we arrived at the Pheiffer Big Sur Campground and set up camp in the redwoods. 



17 Mile Drive, Monterey CA

Big Sur, CA






Day #3: Big Sur SP to Pismo Beach, 125.3 miles, 10.2 hrs peddling time, 9,200ft elevation gain. 

Up at 5:30am and on the bikes with lights flashing at 6:30am (we had to wait a few minutes for it to get light enough to see the road). We started the morning off with one of the bigger climbs of the trip and then up and down along the shear cliffs along the crashing ocean below as the sun came up. It was amazing. Jeremy's knee had been painful the second half of yesterday and was much worse this morning. He was digging deep to keep going. We took things real slow and were constantly considering bail out options. I took the majority of his gear and loaded it on my bike. The plan was to do 120 miles which seemed impossible at lunch when we had only traveled about 40 miles in 5hrs. We talked it over and decided to just keep peddling and see how it went. After lunch we got out of the mountain section and onto some flatter road which was better on Jeremy's knee and allowed us to make up some time. We ended up bending Jeremy's back rim, popping a spoke and having to do some crude roadside spoke work with some pliers to stop the rim from rubbing on the brakes. We rolled into the Pismo Beach area at sunset exhausted and then spent the next hour riding back and forth through town trying to find a hike/bike campsite. We eventually found on, got a hot shower in and hit the sack. Dead. I haven't slept that hard since salmon fishing in Alaska.




My view for many many hours. 

Enjoying my daily ration of Nutella and Peanut Butter

Roadside trueing session anyone? 



At mile 100, 25.3 to go, just outside of San Luis Obispo CA

Finally found a hiker/biker camp spot.

Day #4: Pismo Beach to El Capitan Beach (20 miles short of Santa Barbara), 80miles, 6hrs peddling time, 4,000ft elevation gain. 

We were on the road by 6:45am in good spirits. We spent the morning peddling through rough farm highways. We even almost got crop dusted by a helicopter. After only a few miles I was really dragging. Even though I was drafting off of Jeremy I could barely keep up. I attributed my lagging to the rough roads and all of the extra gear I was hauling. I pushed on for probably 20 miles and at a quick break discovered that my rear wheel was bent and rubbing on my brake. The combo of the rough roads, heavy weight and my bike not being made for touring did it in. We once again pulled out the pliers and did some spoke work to true the wheel and pushed on. After a big climb we dropped down into Lompoc where we had lunch followed by a final big climb and decent back down to Highway 1. Once we hit the coast things fell apart. Within a 10 miles span we got 3 flat tires. I had a CO2 air pump with enough cartridges to fill two tires and Jeremy had a worthless air pump that only offered us a false sense of security, as it could get the tire pressure high enough to prevent the rim from hitting the ground. The 3rd flat tire in combination our bent rims and we just couldn't make it the last 20 miles!!! We were sunk! Luckily a friend living in Santa Barbara was available to come and pick us up at El Capitan State Park. It was a pretty unrewarding feeling, although relieving, knowing that we made it so close. 




So close but yet so far.....
We spent this night with friends and Kimber was kind enough to come down and pick us up the next day. It was a great adventure and felt oh so good to push our limits. It was rewarding to know that it wasn't us that broke down but our bikes. Better planning in the future.

4 Day Total
384 miles ridden
30hrs peddling time
23,000ft elevation gain. 

Sunday, March 9, 2014

The Scoop on Toenail and Foot Fungus.

Tinea is a fancy name for fungus. There have been shown to be more than 80 different strains of fungus on the average person's foot with the highest concentrations being on the heel. These fungi live in a balance that isn't a problem until that balance is disturbed. People at risk for fungal infections include those with:
  • Compromised immune systems (HIV, Diabetes, Oral Steroid use)
  • Advanced age
  • History of trauma to the toenail.  
  • Poor blood flow in their toes. 
  • Frequent use public/locker room showers (thus the term athlete's foot). 
  • Poor pedal hygiene (improved hygiene has even shown to cure 35% of existing fungal skin infections).
  • Genetically prone.  
ANATOMY INVOLVED

While tinea can get into the blood and cause systemic infections it most commonly affects the most superficial layer of skin, the epidermis, and the nail plates. The areas that are most resistant to treatment are the plantar foot and the nail plates due to the high amount of keratin which makes it difficult for topical medications to penetrate the structure.

THE EXAM AND DIAGNOSIS

Signs of a fungal infection of the skin, also known as athlete's foot or tinea pedia can include:
  • redness (erythema)
  • itchiness (pruritus)
  • foul odor 
  • macerated (white over-hydrated skin) or hyperkaratotic (dry callused skin) scaling
  • fissures (cracking)
They present in three main patterns; interdigital, moccasin, and vestibulobullous(fluid filled blisters). Interdigital infections are usually more macerated while the moccasin pattern in more hyperkaratotic.

Research has shown that the most common fungal strains resulting in tinea pedis are Trichophyton rubrum and Trichophyton mentagrophytes (more aggressive strain). T. mentagrophytes has been shown to be more common in the younger healthier individual.

Signs of a fungal infection of the toenails, also known as onychomycosis, include:

  • nail discoloration; yellow, orange or brown patches or streaks. 
  • nail detachment from nail bed (onycholysis).
  • subungual (under the nail plate) debris. 
  • nail thickening
  • nail crumbling
The "gold standard" method for diagnosis of pedal fungal infections is microscopic examination of skin subungual (skin under the nail plate) scrapings prepared in potassium hydroxide (KOH). The examiner can see hyphae. Today's podiatrists send these scrapings to a lab where they are read.

TREATMENT

Treatments for fungal infections include topical powders and creams for less severe infections and oral medications for more sever or resistant infections. Due to the resistive nature of onychomycosis (toenail fungus) the most effective treatments are oral medications. The downside of oral antimicrobial medications are that many have been shown to cause liver damage to a very small percentage of individuals. The internet is full of many home remedies and other remedies for treatment of toenail fungus (Vick's Vapor Rub, Colloidal Silver, Tea Tree Oil....). Due to the high number of these types of treatments and the low level of effectiveness I am not going to discuss all of them. The below list of medications that have been proven with varying degrees of effectiveness which I have put in order of effectiveness.

Topical Treatments:
  • 2% Miconazole Nitrate Powder - Available Over the Counter
  • 1% Clotrimazole Cream - Available Over the Counter
  • 1% Clotrimazole Solution (better penetration into nail plate) - Available Over the Counter
  • 1% Terbinafine Cream (Lamisil) - Available Over the Counter
  • 1% Terbinafine Gel - Available Over the Counter
  • 0.77% Ciclopirox Cream/Gel
  • 8% Ciclopirox Solution (Penlac Nail Lacquer)
  • 20% Urea Cream*
  • 40% Urea Cream*
  • Salycilic Acid*
*can be used with topical medications to soften the nail plate and callused skin improving penetration of medication.

Oral Medications:
  • 250mg Terbinafine (Lamisil); liver enzymes from a blood test are also monitored while this medication is given to ensure that there is not irreparable damage occurring. 
Other Treatment Options
  • Cleaning feet daily has shown to cure about 35% of cases. 
  • Laser Treatment (for onychomycosis) is available and is very expensive. Its efficacy is still being investigated. 
  • Toenail Avulsion (removal of toenail). In sever cases the complete removal either permanently or temporarily, is always an option. This options will prevent spread to other toes and is a sure cure. Toenails serve no real purpose beyond their aesthetic appeal. 
PREVENTION

The best option is to take proper precautions to prevent fungal infections from getting out of control in the first place. Most toenail infections begin as athlete's foot that has been neglected and the fungus gets into the nail. Once in the nail it is extremely difficult to cure and the fungus can damage the cells that cause the nail to grow making the nail thick and disfigured. Once a nail has become thick and disfigured the chances of being able to return to nail to its appearance prior to the infection if very low. Here are some suggestions as for prevention:
  • Wash your feet daily with soap. Fungal spores are EVERYWHERE and washing them will decrease the amount on your feet and will remove the dirt and grim that harbors colonies. 
  • Alternate shoes to allow them to dry out. The environment in your shoes (moist, dark, warm) is prefect for fungus to thrive so allowing your shoes to dry out will inhibit growth. 
  • Wear well ventilated shoes, synthetic socks and use shoe powders occasionally to keep feet dry. 
  • Treat fungal skin infections early on to prevent them from getting out of control and into the tissue that is more difficult to get to with medication like callused skin and toenails. 
  • Avoid going barefoot in public area such as showers and pools. Fungal spores and live on for months to years. 
Hsu AR, Hsu J. Topical Review: Skin Infections in the Foot and Ankle Patient. Foot & Ankle International. 33(7):612-619, 2012 

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.