| Acknowledgments | p. xv |
| Introduction | p. 1 |
| How to Use This Book | p. 2 |
| For the Non-Scientist | p. 3 |
| For the Scientist | p. 4 |
| Recommended Reading | p. 4 |
| The Altitude Challenge | p. 7 |
| Human Responses to Altitude | p. 8 |
| You Are a Unique Individual | p. 9 |
| How High Is "High Altitude"? | p. 9 |
| The Air, the Body, and Oxygen | p. 13 |
| Altitude and Atmospheric Pressure | p. 14 |
| Biological Differences | p. 15 |
| The Quest for Oxygen | p. 19 |
| Respiratory System | p. 19 |
| Mechanics of Ventilation | p. 22 |
| The Control of Breathing at Low Altitude | p. 23 |
| The Control of Breathing at High Altitude | p. 24 |
| Cardiovascular System | p. 26 |
| The Structure and Function of the Heart | p. 27 |
| The Flow of Blood through the Body | p. 28 |
| Blood Pressure, Heart Rate, and Cardiac Output | p. 28 |
| Blood | p. 29 |
| Transport of Oxygen and Carbon Dioxide | p. 29 |
| Carbon Dioxide Transport | p. 29 |
| Oxygen Transport | p. 31 |
| The Oxygen Cascade | p. 33 |
| The Cascade at Sea Level and at Rest | p. 35 |
| The Oxygen Cascade at Altitude | p. 37 |
| The Effect of Exercise at Low and High Altitudes | p. 37 |
| Increasing Oxygen Delivery to the Tissues at Altitude | p. 39 |
| The Biology of Exercise | p. 47 |
| Skeletal System | p. 47 |
| Muscles | p. 48 |
| Types of Muscle Fibers | p. 48 |
| Muscle Control and Strength | p. 49 |
| Arrangement of Muscles, Muscle Actions, and Types of Contractions | p. 49 |
| Concepts of Exercise Physiology | p. 51 |
| Limits to Performance | p. 51 |
| Factors That Determine Performance | p. 52 |
| Maximum Oxygen Uptake and Muscle Limitation | p. 54 |
| Oxygen Supply to Other Organs | p. 56 |
| Muscle Fatigue | p. 56 |
| The Brain | p. 56 |
| Biomechanics and Economy of Movement | p. 57 |
| Lactic Acid and Performance | p. 58 |
| So, What Really Limits Performance? | p. 59 |
| Fatigue, Will, and Performance | p. 60 |
| Direct Environmental Stresses | p. 61 |
| Physiological Stresses | p. 61 |
| Indirect Psychological Stresses | p. 62 |
| Will and Motivation | p. 65 |
| Acclimatization | p. 71 |
| Factors Affecting Acclimatization | p. 73 |
| Changes That Occur during Acclimatization | p. 75 |
| Acclimatization versus Deterioration above 5,500 m | p. 76 |
| How Quickly Do You Deacclimatize after Return to Lower Altitudes? | p. 77 |
| Age and Sex | p. 77 |
| Sex | p. 77 |
| Older Travelers | p. 78 |
| Children | p. 80 |
| Acclimatization Strategies | p. 80 |
| Preacclimatization | p. 81 |
| Practical Advice | p. 83 |
| Specific Situations | p. 84 |
| Day Hikes/Climbs | p. 84 |
| Overnight Backpacking Trips | p. 85 |
| Trekking | p. 85 |
| Climbing Expeditions | p. 86 |
| Drugs as Aids to Acclimatization and Performance | p. 88 |
| Altitude Illness | p. 91 |
| Encountering Illness at Altitude | p. 93 |
| Physicians at Altitude | p. 93 |
| A General Approach to the Potentially III | p. 94 |
| Primary Symptoms of Altitude Illness | p. 95 |
| Prevalence of Altitude Illness | p. 95 |
| Risk Factors for Altitude Illness | p. 96 |
| Acute Mountain Sickness (AMS) | p. 96 |
| High-Altitude Cerebral Edema (HACE) | p. 97 |
| High-Altitude Pulmonary Edema (HAPE) | p. 97 |
| High-Altitude Retinal Hemorrhage (High-Altitude Retinopathy, HAR) | p. 99 |
| Treatments for Altitude Illness | p. 99 |
| Other Medical Issues at Altitude | p. 102 |
| Experiences at Altitude: Circulation, Respiration, Nervous System, and Immunity | p. 105 |
| Circulatory System | p. 105 |
| Carbon Monoxide Poisoning | p. 106 |
| Respiratory System | p. 107 |
| High-Altitude Pulmonary Edema (HAPE) | p. 108 |
| Periodic Breathing | p. 108 |
| Cough | p. 108 |
| Pleurisy | p. 109 |
| Smoking | p. 109 |
| The Nervous System | p. 109 |
| Behavioral Effects | p. 111 |
| Critical Altitudes | p. 113 |
| Peripheral Nervous System | p. 113 |
| Sleep | p. 113 |
| Practical Advice | p. 114 |
| Daytime Somnolence (Excessive Sleepiness) | p. 115 |
| The Immune System | p. 117 |
| Practical Advice | p. 118 |
| Experiences at Altitude: Food, Digestion, Hydration, and Hygiene | p. 121 |
| Appetite, Digestion, and Weight Loss | p. 121 |
| Appetite | p. 122 |
| Digestion | p. 123 |
| Cellular Respiration and Fuel Supplies for the Cells | p. 124 |
| Insulin and Other Hormones | p. 127 |
| Energy Expenditure by the Body | p. 128 |
| Fuel | p. 129 |
| Practical Advice | p. 130 |
| Diet and Supplements | p. 132 |
| Performance-Enhancing Aids | p. 134 |
| Oral and Gastrointestinal Experiences | p. 134 |
| Mouth and Throat | p. 134 |
| Gastrointestinal Issues | p. 135 |
| Dehydration and Thirst | p. 136 |
| Pathways of Water Loss | p. 137 |
| Effects of Dehydration on Performance | p. 138 |
| Thirst | p. 139 |
| Electrolytes | p. 139 |
| Practical Advice | p. 141 |
| Food and Water Safety | p. 143 |
| Practical Advice | p. 146 |
| Alpine Climbs, Hikes, and Backpacking Trips | p. 146 |
| Less-Developed Countries | p. 146 |
| Treks and Expeditions | p. 146 |
| Away from Base Camp or the Kitchen | p. 149 |
| Garbage | p. 150 |
| Heat and Cold | p. 153 |
| Cold | p. 155 |
| General Effects of Cold | p. 155 |
| Maintaining Temperature Homeostasis | p. 156 |
| Nonfreezing Peripheral Cooling | p. 157 |
| Frostbite | p. 158 |
| Practical Advice | p. 158 |
| Hypothermia | p. 161 |
| Practical Advice | p. 162 |
| Heat and Solar Issues | p. 165 |
| Peripheral Heat Injury | p. 166 |
| Sunburn | p. 166 |
| Canker Sores, Cold Sores, and Fever Blisters | p. 168 |
| Snowblindness | p. 168 |
| Overheating the Core | p. 169 |
| Glacier Lassitude | p. 170 |
| Heat Exhaustion | p. 171 |
| Heat Stroke | p. 172 |
| Interpersonal Relations | p. 173 |
| The Team | p. 173 |
| Friends versus Strangers | p. 175 |
| Guided Trips | p. 176 |
| Experience | p. 177 |
| Relationships Among Team Members | p. 180 |
| Choosing the Team | p. 180 |
| Interactions within the Team | p. 182 |
| Women and Men | p. 185 |
| Interactions with Teams or Individuals from Other Cultures | p. 186 |
| Leadership | p. 187 |
| Local Cultures | p. 189 |
| Theft | p. 191 |
| Gender Issues | p. 191 |
| Communication Issues | p. 192 |
| Other Advice | p. 193 |
| Extreme Altitude | p. 195 |
| Basic Questions | p. 195 |
| How Long Can You Stay in the Death Zone? | p. 195 |
| What Factors Influence Your Ability to Function in the Death Zone? | p. 195 |
| Supplemental Oxygen | p. 198 |
| Is Oxygen Ethical? | p. 198 |
| Style and Ethics on 8,000 m Peaks | p. 200 |
| Crowding | p. 200 |
| Fixed Ropes | p. 200 |
| Parasitism | p. 202 |
| Speed Climbing | p. 203 |
| Rescue at Extreme Altitude | p. 203 |
| I'll Rescue You If You'll Rescue Me | p. 205 |
| Practical Advice | p. 205 |
| Family, Friends, and "Why?" | p. 206 |
| Mental Outlook at Extreme Altitude | p. 209 |
| Decision Making and Accidents | p. 213 |
| Decision-Making Issues | p. 213 |
| Direct Effects of Hypoxia | p. 213 |
| Emotional Infrastructure | p. 214 |
| Indirect Stresses | p. 216 |
| Group Dynamics | p. 216 |
| Danger versus Effort | p. 217 |
| Intuition | p. 218 |
| Practical Advice | p. 218 |
| Accidents and Tragedy | p. 219 |
| Causes of Accidents | p. 219 |
| How Accidents Happen | p. 221 |
| Inadequate Equipment | p. 221 |
| Passion | p. 221 |
| Fatigue | p. 222 |
| Poor Decision Making | p. 223 |
| Luck and Fate | p. 223 |
| When Accidents Happen | p. 223 |
| After an Accident | p. 224 |
| Death | p. 224 |
| Your Responsibilities | p. 225 |
| After a Death | p. 225 |
| Preparing for Altitude | p. 227 |
| Limits to Performance | p. 229 |
| Response to Training | p. 230 |
| Developing a Training Program | p. 232 |
| Determine Your Goals | p. 232 |
| Determine Your Weakest Link | p. 233 |
| Musculoskeletal System | p. 233 |
| Cardiovascular System | p. 236 |
| Metabolic/Physiological System | p. 237 |
| Psychological System | p. 237 |
| Construct Your Training Program | p. 237 |
| Training | p. 238 |
| Debriefing | p. 238 |
| Practical Advice for Training | p. 239 |
| Where to Train? | p. 239 |
| General Pitfalls | p. 240 |
| Strength Training | p. 240 |
| Aerobic Training | p. 241 |
| Training the Ventilatory Muscles | p. 243 |
| Overtraining | p. 244 |
| Pretrip Body Weight Management | p. 244 |
| Before, During, and After Your Trip | p. 247 |
| Before Your Trip | p. 247 |
| Planning | p. 247 |
| Organizing the Trip | p. 249 |
| During the Trip | p. 251 |
| After Arrival | p. 252 |
| Techniques for Backcountry Travel | p. 252 |
| The Importance of Rhythm in Movement | p. 253 |
| Typical Ascent Rates during Climbs | p. 255 |
| Getting Up in the Morning | p. 255 |
| Enforced Inactivity | p. 256 |
| Dealing with Altitude, Stress, and Emotional Issues | p. 258 |
| After the Trip | p. 259 |
| Physical Issues | p. 260 |
| Immune System | p. 261 |
| Some Scientific Background | p. 263 |
| The Atmosphere | p. 263 |
| The Behavior of Gases | p. 264 |
| Biological Concepts | p. 266 |
| Homeostasis | p. 266 |
| Getting Work Done in the Body | p. 268 |
| How Do Substances Move from One Place to Another? | p. 268 |
| How Do Molecules Get Assembled and Taken Apart? | p. 272 |
| Lake Louise Scoring System for Acute Mountain Sickness (AMS) | p. 275 |
| Children's Lake Louise Scoring System for AMS | p. 277 |
| Literature Cited | p. 279 |
| Recommended Reading | p. 297 |
| Index | p. 301 |
| About the Author | p. 311 |
| Feet and Meters Conversion Chart | p. 312 |
| Table of Contents provided by Ingram. All Rights Reserved. |
