Media 250 internship Piranha Productions Final Report
The Most Important Thing I Learned - the novella
by Richard L. Gilmore
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Introduction:
In the summer of 2000, I developed a large blood clot in my left leg. This
condition is called deep vein thrombosis (DVT). Pieces of a blood clot can
break off and migrate to the brain, lungs, or heart and is potentially fatal.
Because of my general level of health and physical activity, it is strongly
suspected that the cause of my DVT was the long sedentary periods I spent
sitting in front of my computer. Recently a 28 year old female flew home from
the Olympic games in Australia back to England. Upon landing in Heathrow, she
walked off the airplane, collapsed, and died from a pulmonary embolism caused
by a DVT. DVT is not an "old person's" disease. Clots seem to form much more
quickly than they are reabsorbed by the body. In my own case, the clot was
formed and was growing despite my almost daily exercise including bicycling
home from my internship.
* * * * *
Few people knew about my plans for the Labor Day weekend of September 2000.
The sports I participate in are mostly solitary and personal challenges.
Climbing Mt. Rainier is something I have done many times. I was a cold weather
survival instructor in the Army and after my discharge in 1976, I continued to
lead climbs on the north side of the mountain through camp Sherman until the
early 80s. I never climbed the south side (starting at Paradise and going up
through Camp Muir) because I heard that the trails were crowded and that the
route was less technically challenging.
Fast forward to 1999. On the Sunday before I lost my job and started classes
at Bellevue Community College, I got the bright idea to go to Paradise and hike
up to Muir at the 10,000 foot level. Having been trapped on Rainier by sudden
changes in weather, I tend to carry more in my pack than other day hikers.
Also, I was testing myself to see what kind of shape I was in. I arrived at
Camp Muir a little less than three hours after I had started from the parking
lot. I felt pretty good about myself that day.
During the following year, I promised myself a climb of Mt. Rainier as reward
for completing the Multimedia/Web Authoring program at BCC. Labor Day weekend
proved ideal logistically. Piranha Productions uses Labor Day as a 4-day
weekend. This would give me the Friday before my climb to devote entirely to
checking all my equipment and organizing my pack.
While at BCC I took advantage of the workout facilities. I was spending so
much time sitting in front of a computer, that the four days a week in the gym
was the only exercise I could count on. There had been no skiing in the winter
and almost no bicycling in the spring. But I was conscientious about going to
my workouts. When I started at Piranha, I found that I could take my bike to
work on the bus then ride the 12 miles home in reasonable time. I was feeling
pretty good and looked forward to the climb.
In the days before the climb I noticed some soreness around my knees. It was
not joint pain. My years of experimenting with bicycle design have taught me
what joint pain feels like. The pain did not seem serious and did not affect
my bicycle riding, so I ignored it.
Saturday morning, 5:00am found me in the parking lot at Paradise. I
checked in
with the ranger to get the permits needed to climb past the 10,000 foot level.
There was a little problem in that my permit for a solo climb had not been
passed through to the rangers for approval. I filled out my climbing resume
and was told that the person who could approve it would be arrive in the early
afternoon. I decided to climb to Muir and wait for approval to be radioed up
to the rangers at Muir.
One of the climbers from another party came into the ranger station and
reported that he had just gotten a "suckers view" of the mountain. For a few
moments he had seen the brilliant, sunny slopes of the upper mountain through a
break in the thick fog that currently enshrouded the lower slopes and parking
lot.
The main trick in surviving cold weather is staying dry. The exertion of
climbing with a full pack will produce a lot of sweat. This is good - if the
sweat has a chance to evaporate. Unfortunately fog is air that already has a
lot of moisture in it. Not much evaporation takes place. The challenge in
these conditions is to travel slow. But the slower you travel, the more
insulation you need from the cold. It is a real art to find a comfortable pace
that works. This slow-climb strategy, that comes so naturally to me, masked
the fact that I had medical issues. Had the weather been clear, I would have
noticed my pace was far slower than it should be. That realization would have
to wait until the next morning, much higher on the mountain.
One thing you can say about the damp weather, it kept the tourist traffic down.
As I climbed, the weather deteriorated. By the time I reached the 9,000 foot
level (about 5 hours after leaving Paradise) a moderate snow was falling and
visibility varied from 100 yards to near whiteout conditions. I was nearing
the 6 hour mark and beginning to get concerned that I had not reached Muir.
Stopping to consider the situation, I was surprised by a young couple appearing
out of the gloom coming up the trail behind me. They asked me how far it was
to Camp Muir. I turned around just in time to see a break in the fog. Muir
appeared less than 50 yards away. I pointed and said, "Congratulations, you're
here."
Dropping the pack is always a wonderful feeling. However, now that I had
stopped climbing, I needed to add clothing quickly. It seemed that the weather
had waited for me to stop moving before it really started to blow. Fortunately
it was cold enough that the snow was easily brushed off as if it were dry sand.
I added my layers and got comfortable again. My original plan was to climb
past Muir to Ingram flats at the 11,000 foot level. The weather had other
ideas. It was all but whiteout conditions and there was a crevasse field to
cross before ascending a rock ridge that would put me on Ingram Flats. With a
rope team I would hesitate to move in these conditions. Being solo, I felt it
was out of the question to continue that day.
Camp Muir ranger station is a small A-frame structure packed with supplies,
climbing gear and radios leaving just a bare minimum of space for the occupants
- but it was warm. Checking in with the rangers, I was informed that my
request for a solo attempt had been granted. I told the rangers that my plan
to climb higher today was not going to work due to the deteriorating weather.
They heartily agreed saying a pattern of afternoon snow storms had developed
over the past few days.
The weather may have reduced the one-day hiking crowd, but this was Labor Day
weekend and Camp Muir was full to the rafters with climbers. There was no room
in the shelter, but I hadn't planned on using the shelter anyway. I found a
flat piece of real-estate with a snow berm already built. There were lots of
tents around the camp. I don't use a tent on mountain climbs. I have always
used a foam insulation pad, a sleeping bag, and a 6' x 9' blue tarp. I love
sleeping under the stars at high altitude, because you are so much closer to
them. People who don't climb really don't have a true feeling for how many
stars are out there. You just have to see it to understand.
As far as I was concerned I was going first class on this climb. I used a self
inflating insulation pad on the snow and my tarp had been replaced by a
high-tech bivouac sac. For added protection of my face, I used a "space
blanket." This produced a little condensation problem, but nothing too bad.
There were several comments from neighbors about my "camp." A brief rundown of
my experience on the mountain seemed to convince most of them that I might
survive the night.
Not long after sunset, the weather cleared and I was treated to a perfectly
cloudless moon-less sky. The stars did not disappoint. I always watch the sky
long enough to see at least one shooting star. You never have to wait more
than a few minutes. I slept comfortably until morning.
Morning for climbing Mt. Rainier comes just after midnight. This side of the
mountain gets more direct sunlight and the chance for ice falls increase as the
day goes on. At least that's the theory. I got up and informed my friends in
the nearby tents that indeed the old guy had managed to survive the night.
Breakfast was the first order of business. Hot chocolate is more for the
psychological lift you get from hot food than any actual food value. I also
had fresh milk and cereal. I put a lot of stock in a good breakfast before a
climb.
My pack was supposed to be lighter because I was leaving my sleeping bag, pad,
and some emergency clothing behind, but it didn't seem any lighter. I was
taking my time watching the various climbing teams moving out across the
crevasse field. The trail was well marked. Most people are amazed at the
amount of light stars alone provide high on the mountain. Not nearly enough to
safely navigate ice fields, but you can see the general lay of the land. For
early morning travel, everybody wears a head lamp. This makes for an
intriguing display as lines of glowing dots move slowly through the star lit
landscape. Where the route moved onto rock, it was almost like the points of
light were ascending into the darkened sky completely leaving the bounds of
Earth.
Crossing the crevasse field involved little elevation gain. Being alone and
therefore unprotected in case of a fall, I moved a bit more slowly than I might
have otherwise. When I gained the far side of the ice field, I stopped to
remove my crampons (the metal prongs that give you traction on snow and ice).
Then I started the first serious ascent. I climbed about half way up the
crumbling rock trail and stopped. I seemed tired. I was breathing easily and
my legs seemed strong, but I just felt tired. I told myself that I would warm
up, that it had after all been several years since I made a high altitude
climb, and that yes, I am a little older. I got up and pressed on.
At the top of the rock ridge, you make a gradual climb to Ingram Flats.
Ingram Flats is a stable area at the base of the direct route up the ice falls.
There were people camped up here. It is a popular site. Several years ago a
freak fault under the ice opened up and killed a number of climbers. There was
no prior record of anything like that having ever occurred here. But then,
there are no guarantees in life. That is particularly true in the mountains.
Crossing the flats, I watch several strings of lights moving up the mountain.
I reflect again on how slowly I seem to be moving relative to all the other
climbers. Crossing the flats, a number of people pass me headed down the
mountain. This is common, lots of people don't make it for any number of
reasons. A few people give me odd looks. I guess a solitary climber is a
somewhat peculiar sight.
After crossing the flats, I have some route decisions to make. I am supposed
to be climbing Disappointment Cleaver, a rocky spine that goes up to 12,500',
so as to avoid as many crevasse crossings as possible. As I scan the terrain
in the shifting light of the sunrise I can not spot any obvious path leading to
the broken volcanic debris that make up Disappointment Cleaver. At a "Y" in
the path, I take the trail that descends to the right and seems to head toward
the rock. I hate loosing any altitude, but it seems that I must if I am to
find the route.
Broken clouds cover the lowlands, but they are far below and the as the sun
nears the horizon the hue shifts quickly from dark blue to a much lighter blue
than you get at lower elevations. The sun appears over the horizon with a
tremendous intensity amplified by the fact that I am standing in the middle of
a vast reflective surface of snow. I put on my three layers of eye protection
that include prescription sun glasses, wrap around sunglass inserts, and a pair
of ski goggles. Given the brightness of the terrain, it is definitely not too
much.
Soon the trail turns back up slope. I stop for several minutes and scan for a
route. It looks extremely uninviting. Looking back up the ice-fall, it seems
obvious that the trail is staying to the right side in an apparently stable
area. I decide to climb a bit thinking that the route to the rocks may be a
bit higher than my current position. I keep telling myself this as I climb.
As it turns out, the route up the ice-fall does not cross any crevasses. All
the crevasse activity must be on the other trail I avoided earlier making my
way towards the rocks.
My progress seemed slow. I use a climbing step that I have only seen used in
films of people high on Mt. Everest. You hold your ice ax with both hands and
place it directly in front of you, then you take two small steps up. Then you
move the ice ax position and repeat. I was leaning on the ice ax a lot, trying
to use my arms in the effort to climb.
Upon arriving at 12,500' I met a woman from another climbing party who had
stopped because of altitude sickness. At the top of the ice fall was a fairly
stable and level area. Her team had made an encampment for her and she rested
getting ready for the descent. Her team mates had continued their climb for
the summit. She was obviously an experience climber that just had a bit of bad
luck. I am convinced that altitude sickness is mostly a matter of luck. I
have never had it, but I have had to turn back when a team member has been so
afflicted. Because I usually guided novice climbers, I never had the luxury of
being able to let the sick person bivouac while the rest of the team went on.
We talked for a moment then I set out on the traverse that would lead me to
Emonds glacier and the final pitch to the summit.
Shortly I came to my first major crevasse crossing. I surveyed the situation,
telling myself that I was doing this to determine the necessity of setting
anchor points. Of course I was actually letting myself rest. The crevasse was
not deep and the bridge was large and appeared solid all the way to the bottom
of the gap. Deciding to forego the anchors, I trotted across the snow bridge.
Very heavy breathing was the result. Continuing the traverse, I made minor
elevation gains.
Clouds suddenly enveloped me and reduced visibility to about 100 yards. The
trail was well established and easy to follow. Presently I thought I saw some
climbers in the distance and slightly below. This didn't make much sense. The
slope I was traversing had become quite steep, probably 40 to 45 degrees. My
pace slowed considerably given the low visibility and slope angle. I moved to
a point above the dark shapes I had thought might be climbers. They were
actually yawning holes in the snow. I was in an area of significant crevasses,
I kept moving.
After several minutes the clouds cleared and the sun revealed the extent of the
crevasse field I was negotiating. I had basically crossed the crevasse area
while hidden in the mist. A flat area presented itself and I dropped my pack.
I felt that I had earned a mid-day break. I decided I would grab a little
extra to eat, call it lunch, and consider my situation. I sat for about 5
minutes and realized that I was absolutely not interested in eating. It was
about 10:30 and my turn around time was noon. At 13,000 feet, I had another
1,400 feet to climb. Normally I would be able to make that, but then normally
I would be at the summit by now. I was beginning to think that I would not be
seeing the summit on this trip.
Looking at my watch, I realized that I had been sitting for fifteen minutes -
and I was breathing heavily. This was not making any sense. My recovery
wasn't just slow, it wasn't happening at all. Standing up and climbing seemed
like a bad idea. I had no reserves left for a self rescue if something went
wrong. I started down the mountain. Normally as you move to lower altitudes,
you start feeling a lot better. You are moving into higher levels of oxygen
and a climber's hemoglobin enriched blood delivers more oxygen. I believe this
is one of the factors that lead to the majority of climbing accidents occurring
on the descent. There is this sense of physical well being combined with the
psychological effects of moving toward safer terrain. My struggle down the
slopes was as difficult and slow as the climb. I stopped to rest many
times and for the first time noticed an occasional cough.
A snow storm (the daily afternoon blizzard) appeared upon my reaching the
crevasse field at 10,000' that separated me from camp Muir. I slowly picked my
way across as fresh snow made the trail progressively more difficult to follow.
The fog also thickened to near white-out conditions. I lost the trail.
Stopping, I reflected that dying within a half mile of Camp Muir would not look
good on my resume. I decided to do a quick search pattern (10-step left,
20-step right) and then set up an emergency bivouac if I did not pick up the
trail again. Within 5 steps, I found the trail. In five minutes, I was back
at Camp Muir. My plans for getting off the mountain would have to wait for the
morning. There was room in the emergency shelter and for the first time ever,
I spent the night under a solid roof on the mountain. I was exhausted beyond
all reason. My fatigue was noticeable to other climbers who asked if I was all
right. I joked with them about how much is sucks to get old. However, the
excuse of age really didn't make any sense. I had some trouble sleeping as the
odd, non-productive cough shook me awake occasionally through the night.
A bright and absolutely clear morning greeted me when I walked out of the
shelter. I slowly made my preparations to get off the mountain. This included
stowing my crampons and making sure I had a heavy duty plastic bag tucked into
my pack's waist belt so that the bag hung in front of me like a loin cloth. I
wanted to get off the mountain, and I didn't. I wanted to make another summit
attempt, and I didn't. I had the time and the provisions, but I knew something
was wrong and that ascending was out of the question. Stepping onto the trail,
I descended below 10,000 feet into the oxygen rich lowland air.
Not far from the camp, I found my first glissade trail. Actually, it is a sit
on your butt and slide trail. This is what the plastic bag was for. You stuff
it between your legs, sit down, and use your ice ax to control your speed. It
is the easy and fast way down snow fields. Usually easy. Every so often you
have to stop to traverse to a new trail or just because the slope is not steep
enough for a small distance to keep sliding. I was weary to my bones and
breathing heavily. A totally alien experience for me with this activity. I
was beginning to think that I might not be able to hike once I got off the snow
fields.
The walk down the Paradise trails was slow, but I managed to keep going until I
reached the parking lot. I was feeling pretty good just from the fact that I
could now toss my pack into the back of my car. I reported to the ranger
station and thanked them for the opportunity to climb solo. On my drive down
the mountain, the afternoon snowstorm once again moved in and traces of snow
could be seen on the ground as far down as Longmire.
On Tuesday morning I had my Mt. Rainier photos developed and played stoic macho
mountain climber at Piranha Productions where I was doing my internship. At
lunch I walked up town to see a friend for lunch. I could not keep any kind of
reasonable pace and was quite winded by the two story stair climb to the lobby
of the building where I would meet my friend. My dry cough persisted. She was
already waiting and we went out and started to climb another short set of
stairs. I couldn't keep up with her. That was the reverse of the normal
situation. Back at Piranha I was making plans to do some after hours personal
work on one of the scanners. I decided that I was not feeling quite right and
decided to go home and do the work on Wednesday. I jumped on my bicycle and
rode off.
Not long after getting home, my left leg started to ache. I was surprised that
only one leg would feel like this. In addition, the leg seemed tight, like it
was swelling. I went to bed promising myself that if my leg still felt this
way in the morning, I would head into my doctor's office and get something for
the pain. Laying down helped. The pain eased enough to let me sleep. I had
never had a muscle strain that got better when I laid down.
In the morning, the pain was still there and increased when I stood up. I
called in to work and said that I would probably be back in the afternoon. At
my doctor's office he questioned me about the symptoms. He finally broached
the possibility of deep vein thrombosis (DVT). He said that he didn't think
that was what I had, but that given the presentation of symptoms, he couldn't
rule it out. Because DVT is serious, he felt the wisest course was to have a
sonogram (ultra sound) done on my legs. The mention of DVT got my attention.
A friend of mine from high school had nearly died from DVT when he was 24. My
doctor confirmed that you can indeed die from DVT. I headed off for the test.
I lay on my back while the technician moved the sonogram sensor up and down my
leg. The sensor is used not only as the imaging device, but as a testing
devise. Light pressure is systematically applied to test the compressibility
of the veins in the leg. Incompressibility is an almost 100% sure sign that a
blood clot has developed. The procedure is recorded on video tape for review
by a staff physician. When the 20-minute test was through, I sat in the
waiting room wondering what was going to happen next. The receptionist handed
me a phone and said it was my doctor. He had just finished talking with the
staff physician. My doctor told me that I had to check into the hospital now.
That if I didn't I had a 75% chance of being dead by the end of the week. He
had me at "hospital now."
When the first doctor I saw at the hospital said "You are to young and healthy
to have this happen to you." I immediately fell in love with her. When she
found out that I worked on computers, she said that there has been some
speculation about people who sit at desks for prolonged periods having problems
with blood circulation in their legs. People who get really fixated on a
project can spend many hours not moving much. Often the evidence of a forming
blood clot is the sudden onset of soreness and swelling triggered by exposure
to lower air pressure. While most people don't go to the extreme of climbing
mountains, many people do take airplane flights. What many people don't know
is that even though jet aircraft are pressurized, the cabin pressure is allowed
to drop to the equivalent of being at 10,000 feet in altitude. The worst that
usually happens is that someone might experience a nose bleed. Because you are
not required to do any physically strenuous activities while on a jet, most
people simply feel their ears "pop" a few times and nothing more. But airlines
are seeing enough victims of DVT now that the term "economy class syndrome" has
been coined to refer to passengers on longer flights in cramped sections of the
aircraft who develop DVT. A recent example was that of a 28 year old female
flying home from the Olympic games in Australia back to England. Upon landing
in Heathrow, she walked off the airplane, collapsed, and died from a pulmonary
embolism caused by a DVT.
Initial tests could find no reason for this clot to have developed in my leg.
Simple process of elimination seems to indicate that my sedentary occupation is
the prime suspect. In fact, I have had problems with the chairs I used both at
work and at home. These problems included legs "falling asleep" and general
stiffness and soreness after sitting for hours at a time. I am obviously going
to pay special attention to this issue in the future.
I was started on IV heparin then discharged 24 hours later with a bag full of
syringes to continue injecting myself with heparin at home. I was also started
on a course of warfarin. These two drugs are designed to thin the blood and
allow the body to reabsorb the clot. This is preferable to surgery. It seems
that soon after starting the blood thinning medication, the danger of embolisms
and stroke is greatly reduced. Managing the warfarin dosage, however, is a
major pain. Diet drastically affects the efficacy of the warfarin. So you
have to pick a dietary regimen and stick with it. Then you have to get fairly
frequent blood draws to test how much medication you should be taking. I was
told that the warfarin treatments can last between 3 months and a year.
Because the cause of my clot is suspect, doctors are recommending the
conservative route of a full year of warfarin.
What that means is that I am in effect a hemophiliac for the next year. I have
indeed found that minor scratches bleed profusely. In addition, I must refrain
from many of my normal activities like bicycling. Not because the exercise is
bad, but because I must avoid trauma. If I fall, a hard bump could cause
internal bleeding. Being hit in the head could cause a cerebral hemorrhage. I
had know idea that working on a computer could be so damn dangerous.
Conclusion:
Human beings were not designed to be immobile for extended periods of time.
Risks associated with sedentary occupations are still being discovered. Carpal
tunnel syndrome and eye strain are two recognized risks to the general health
of people who work with computers. Deep Vein Thrombosis and the attendant
secondary risk of embolism and stroke, seems to be another risk - a deadly
risk. Preventative measures must be developed to mitigate the risk of blood
clots.
Currently there are only suggestions (not backed up by any long term studies)
about preventative measures you can take to avoid DVT. The most obvious is to
do something to keep the blood moving enough to prevent the start of a clot.
What I now do is run a timer program that tells me every 20 minutes to stand
up. That's it, just quickly stand up and sit down. This does not break
concentration very much and takes almost no time. The muscles of the leg flex
and any veins that might be compressed are momentarily opened. Leg muscles are
a large part of the circulatory system that helps the heart pump blood when you
are walking, running, or bicycling. I also don't cross my legs anymore when I
sit. When sitting, the heart must do all the work. Will these things reduce
or prevent DVT? I don't know. I am not a doctor. But I do know that it won't
hurt me to follow the simple rules of standing every 20 minutes and not
crossing my legs when sitting.
Some people who have heard my story have asked me about the advisability of
taking aspirin to keep blood thinner and flowing better. I do not advise
taking any medication, supplement, or dietary regimen. I am not a physician.
Not crossing your legs and standing up once every 20 minutes shouldn't hurt,
but I don't know if it will help. I give these disclaimers not only to protect
myself, but to reflect the fact that medical opinion varies on the issues of
prevention and treatment.
Before taking any blood thinning medications, check with your doctor.
Before taking any blood thinning herbal supplements, check with your doctor.
Before changing your dietary intake of vitamin K - check with your doctor.
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