First, amazing. Go those dudes!
Second, before I got to the photograph I wondered if that was what @Eric was up to these days.
Third, because I haven’t had a cup of tea and I’m snarky in the morning, I thought that they should’ve trained with @daisymae and @Nickyghaleb under @Eric’s tutelage and they’d have way less lows and highs.
That being said, I am positive that altitude complicates things, and that what they’ve set out to achieve is incredibly hard. I’m sending good thoughts their way!
Great article…and very well written. The writer seems to have a good understanding of the challenges these two are overcoming. They got well past the “gee whiz” aspects and into some of the details, for instance dealing with -25 F temperatures, backup supplies, etc.
Now I have to read the article, @TravelingOn. Or at least go look at the picture and the title. And guess at the rest.
You did al this before tea? I’m going to overlook completely the fact you drink tea in the morning instead of coffee (unless it’s what you drink before your coffee) because that was pretty coherent for no caffeine. And not all that snarky at all. You even ended it with positive thoughts.
I really should just read it before commenting, but altitude has been coming up recently in conversation. I don’t know if these guys were wearing pumps or not, but I’ve only recently learned that the OmniPod and t:slim can both stop working at very high altitudes, leaving the 670G as the only option for people living or traveling in those conditions?? And yet… Medtronic has just put up a recall for “sticky buttons” during takeoff and landing of a flight.
Now I’m not sure they have anything to do with each other… or where I was going with it.
I’ll go look at the picture.
I’m guessing that altitude messes with the human body as much as it messes with technology. And really, Eric would suggest a mastery of The Force to help those doing extreme things in extreme places.
And yes, I’m sorry to let you down, I’m a tea drinker. Coffee rips my stomach up something fierce, badly enough that I remember being super sick after the last cup of joe eight years ago and won’t repeat that. It does make me feel like a social outcast and there are fancy coffee places (in SF at least) that don’t even serve tea!!! But I’m glad I wasn’t a complete jerk in my reply.
Pump and CGM; Dexcom based on the picture, Tandem pumps based on the text in the article. There’s one Omnipod PDM in one of the pictures below that but I didn’t bother to work out whether it was one of the two people doing the 50, the text message suggests they are both using Tandems.
The most interesting thing I saw was the diet discussion at the end. It sounds like they have their basal set right, so they don’t have to eat. I’ve had bad experiences in the past on some day hikes (10 hours, no more than about 20 miles round but with maybe 5000ft cumulative ascent) but I put those down to a high basal putting me in a position where I simply couldn’t supply enough glucose. I did a long two day trip with my father a few years ago and the only problem was that I supplied the food. He was not impressed by a diet of tea and bulgar wheat (hey, it’s easy to cook!)
The altitudes are well over those experienced in airline travel; that maxes out at 10,000ft (because of the pressurization), whereas many US mountains exceed 14,000ft. Denali is over 20,000ft high and the air pressure up there is (if my brief research is correct) about 40% of that at sea level. The comment in the article observes that Tandem only test their pump to 10,000ft, matching the requirement of airline (but not light aircraft) travel and I suspect that is true of all manufacturers.
Potentially 20,000ft can cause anything with enclosed air (gas) spaces problems, but the only enclosed space in the Omnipod is the insulin in front of the plunger and the insulin is not a gas. On the other hand if the insulin freezes it will expand and I’m pretty sure that will destroy an Omnipod; it seems to be sensitive to having the plunger pushed back, I think because of the occlusion detection.
I guess if you inject enough air in with the insulin then expansion might trigger the occlusion detector as the air bubbles expand, but if the pump is delivering insulin for the basal as you ascend I don’t see how that can happen. On the other hand if you ascend rapidly, for example using a hot air balloon or a light aircraft, it might but that’s not altitude it’s rate of ascent. (Commercial airliners have a controlled drop in pressure which is, I believe, independent of altitude.)
The real issue with altitude is that lowland humans haven’t evolved to handle it; https://en.wikipedia.org/wiki/High-altitude_adaptation_in_humans Altitude problems potentially affect anyone and are very serious; there are lots of warnings in Hawaii, which is below 14,000ft. In Colorado if you drive over the Rockies (over 14,000ft) you will be treated to signs at the pull-outs warning you about it. Potentially speeding up that road in Colorado could expose you to a very rapid pressure change and, I guess, that might promote a pump failure, but it might also promote altitude sickness and that has certainly happened; stopping over in Denver (at 5,000ft) helps. The problem with Hawaii is that the top of the mountain is over 13,000ft above where most people start; sea level.
So far as I can see the real issue is the unpredictability of altitude sickness(es), the issue that a pump might fail is always with us but seems, to me, to be relatively minor. I’ve certainly done things that strike me as much more likely to cause altitude sickness than cause a pump failure; heading over the rockies (but I started from Denver) for one thing and I do always have procedures to handle a pump failure (normally a pen of Lantus.)
Don’t you think that if the omnipod was in danger of freezing so would the wearer? (Clearly you’ve got more cold weather altitude experience than I do, based on your reply about the G6 and skiing on the other thread.) They did mention they had to be careful about the tubes of insulin not freezing - so I assumed a Tandem or Medtronic pump.
And yes, your points about starting and ending at sea level then up to 10,000ft plus make sense. And the altitude sickness being the largest variable.
The article wasn’t clear about whether or not the 50 days were in a row - because it took them 9 days to summit one of the peaks, so maybe it’s 50 days of climbing over a longer period? (I doubt that, but I am curious.)
I assume too that maybe neither of these dudes are prone to altitude sickness?
Interested in hearing about their experiences though!
(And another entry for excellent post of the day from you!)
They can be followed at project50in50.org. Here’s the schedule: https://project50in50.org/projected-schedule It is 50 days in a row, but the clock started at the summit of the Denali, so those 9 days aren’t counted.
They also have a live GPS tracker: https://share.garmin.com/50in50
Well, that’s cool! And clearly a much more supported project than I was thinking. Which clearly shows how I think when I have not had enough caffeine. I sort of thought it was two dudes out there climbing mountains.
The fact that they are inviting people to climb with them must be one of the hardest parts of the trip. I suppose that they don’t have a lot of folks show up who can’t handle it, but it seems like it would be hard to be “on“ for the public every day. And be climbing some massive mountains in the process.
Yes, and frostbite is one of the other dangers of climbing mountains as high as Denali. I think the Omnipod would actually be better than a tubed pump because it is pretty much guaranteed to be in skin contact, but you need a backup source of insulin and putting on a new 'pod at high altitude in adverse conditions could be extremely difficult.
My own altitude/cold experience, apart from skiing (particularly cross country) is pretty much limited to stuff I did in England, Scotland and Wales when I was much younger. The altitude was just 4000ft maximum (the highest mountain in Great Britain is only 4411ft), however the environment can be very challenging; cold, rain and snow drifts remaining in summer with very low visibility at times. I remember crossing the Cairngorm plateau once with a visibility no more than 10ft.
I was on MDI then, PZI initially then Novotard. The problem with both is that the dose I was taking meant I actually got most of the bolus I needed from the long acting insulin. Consequently I needed to eat very regularly and most day hikes resulted in low blood sugar at some point. I don’t think I can remember a single hike where I didn’t start to go low, but it was still periodically incredibly enjoyable and certainly memorable even when it wasn’t fun.
The general wisdom is that it can affect anyone and is unpredictable. Acclimatization helps though; I assume they did a lot of altitude training before Denali otherwise that would have been starting at the wrong end.
The project has been paused. Unfortunately, they had an accident while descending from Granite Peak and one of them got seriously injured.
Granite Peak in Montana I believe (the SM link didn’t do anything for me). This description of an ascent and descent:
Look for the description of the accident on the talus/scree toward the end; it’s understated.