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Transplant Athlete
Thursday, January 10, 2008
  Higher Peak Altitude Simulator

I've gotten a few email questions about the Higher Peak Altitude Simulator, so I wanted to post my final conclusions.

Normal hematocrit levels are between 38% and 50%. Professional cyclists like to have their hematocrit as close to 50% as possible, however over 50% is considered proof of doping (and is dangerous because the blood is mostly solids and is very thick making it hard for the heart to pump-leads to heart attacks among healthy pro athletes). Around 34 or 35 is considered Anemic and a person can't donate blood. Obviously the more red blood cells in your blood the more oxygen you can get to the muscles the better. When you are anemic, the lack of red blood cells leads to fatigue, weakness, and lethargy.

Before my kidney's failed in the late 90's, my hematocrit dropped to 29. I was on EPO for nearly a year and that got my hematocrit up in the low 30s. The EPO made a noticeable change in my energy levels, it gave me my life back.

When I received the transplant, my hematocrit jumped from the low 30s to the high 30s. I felt like Superman, I could have leaped tall buildings, was faster than a speeding bullet, etc.

I was expecting a similar boost from the Altitude simulator (I've struggled at Denver's altitude on trips in 2003 and 2004). I was expecting that it would raise my hematocrit a few points and that I would again feel like Superman. That did not happen. BUT, I didn't struggle at altitude during the Race Across America. I pedaled up Wolf Creek Pass (10,550 feet Above Sea Level) and felt strong. It's possible that the simulator acclimitized my body for the higher altitude in ways other than affecting my hematocrit (maybe it did something to my lungs, or heart...I don't know).

My transplanted kidney is now failing and my hematocrit dropped to a low of 26. I am on EPO again to raise my hematocrit. So, it's entirely possible that my transplanted kidney was unable to produce the EPO needed to raise my hematocrit even though I was using the Altitude Simulator as directed.

My conclusion, based on my experience, is that this unit would get a person acclimitized to higher altitudes, meaning it works as advertised. My guess is that it would provide performance benefits to a healthy person, even though I didn't see those performance benefits myself. If I had spent more money on CAT or Hypoxico, I feel I would have received the exact same results as the Higher Peak unit.

I think you will find that this unit works as well as the other more expensive units, they are all generating hypoxic air.

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Sunday, April 15, 2007
  200K PR

This saturday I set a personal record for the DC Randonneur's Warrenton 200km Brevet. My old PR (9hrs 45min) was set on my first 200k (back in 2003), I think it was on the same course. Last year, I posted a 10:50 and an 11:50 on the two 200k events I entered. To be fair, I rode to the start of the 11:50 event and that was a good 30 miles extra. During the 200k in January of this year, I covered the distance in 10 hours and 40 minutes. So I was quite pleased to finish in 9 hours and 16 minutes yesterday.

The pace started out very high, like the RBC tues/thur rides and I was able to hang with the first group on the road for 20 something miles, and then the second group to the first control point. I was going at roughly the same pace as Carol Bell and Chris Mento, I took a short stop at Yoder's Market and got in front of them (they also got a flat near the last control point). Unfortunately, a 30% chance of rain turned into 100% sprinkles. By Syria it was 100% rain. It stopped after Old Rag Mountain, but spritzed on and off the rest of the ride.

I am now a fan of Clif Shot Bloks Lemon-Lime, but not Black Cherry. The Black Cherry tasted like cough syrup and wasn't going down as easy as the Lemon-Lime, but they both provided good bursts of energy (similar to a gel). I think I'll try the Strawberry and the Margarita flavors next. Yum. I like Clif Bars as well, but I can't eat them during exercise for some reason.

I did have some issues.
First, it seemed like my lactate threshold was a lot lower, like in my aerobic zone. I'd be pedaling along with my heart rate in my aerobic zone and my legs would be burning like they were full of Lactic Acid. So I spent a lot of time noodling up climbs in my granny gear.
Second, when I would go slightly above my aerobic zone for a short climb, I would be panting for breath like I was climbing Alp D' Huez. I mean seriously panting like I couldn't get enough air in.

Setting a PR with these two issues, I feel that if I can figure out how to fix them, I'll be golden. If I could have climbed like I know I can climb, I would have definitely been faster. My first thought is to discontinue use of the Higher Peak Altitude Simulator to see if that's the culprit. Next weekend is the Katie Ride For Life(which is flat and fast), but the weekend after that is a DC Rand 300K and I'm guessing it'll have a ton of climbing. Then a much needed recovery week where I'll be volunteering for the DC Rand 300K.

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Sunday, March 04, 2007
  Altitude Simulator Update #2

Hopefully this will answer some more questions about the Higher Peak Altitude Simulator. I adjusted the altitude weekly until I was sleeping at about 9000'. I had issues with Labcorp and they didn't get a hematocrit reading the first time around. The second time around, they did get a Hematocrit reading (34.9). I've done some math and think that my hematocrit post altitude training was 36.9%. That's a percentage point above my December reading. So, if I had to draw a conclusion here, I'd say that the Simulator raised my hematocrit about 2.8% over my previous reading. Not really worth the expense and sleep problems for such a small improvement and probably within my margin of error for the math calculation.

Another issue I have is that everytime my blood is drawn for one of these tests, I'm guessing it'll drop my hematocrit somewhere between .5% to 1%, depending on how much blood is drawn.

With that being said, I will now raise the altitude weekly until I reach the highest altitude it is capable of and hopefully this will have a bigger impact on my hematocrit. My next blood draw is prior to the PACTour Brevet Week and several weeks before RAAM.

For reference, it takes several weeks at altitude for you body to acclimatize to the altitude. A good illustation of this was the show "Everest Beyond The Limit" on the Discovery channel. The climbers would spend a week just sitting around acclimatizing at base camp and Advanced Base Camp. I think it takes 3 to 4 weeks for you bones to grow new red blood cells. When my kidneys were failing and I was giving myself shots of EPO, it took about 4 weeks for the drug to have an effect. The EPO told the bones to increase the number of RBC and then 3 to 4 weeks later the bones were pumping out new RBCs at a higher rate.

Bottom Line: The jury is still out on the Altitude Simulator.

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Tuesday, January 23, 2007
  Altitude Simulator Update

I don't have definitive results yet, but I did want to state some observations.
  1. I may be killing myself I don't know. The system uses plastic tubing and what looks to be an ordinary plastic bag (inside the air receiver); some or all of the plastic in the system outgasses what could be toxic chemicals. There is a horrible plastic odor when you put the mask on, which I eventually get used to, but am I poisoning myself? To be fair, it has diminished a bit, but if I were Higher Peak, I would examine alternatives.
  2. The pipe ladder in the air receiver broke. The twine that supports the heavy pipes was folded over and secured with a zip tie and then this loop was placed over the hooks in the air receiver. The zip tie wasn't pulled tight enough and the twine slipped through, so when I checked it the pipes were hanging from just one side. There wasn't enough left at the end to tie it with any kind of knot, so I zip tied it to repair it.
  3. The hooks that hold up the pipe ladder are straining against the sides and my fear is that they will pull through. This part of the system was definitely not designed, more like cobbled together to solve a problem.
  4. I started at approximately 5500' for one week and just completed a week at approximately 7000'. My next step is to raise it to 8500'. I say approximately because I didn't get the $220 optional oxygen analyzer.
  5. My blood tests are two weeks away, so I don't know if this is worth it yet. I will let you know.

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Wednesday, January 10, 2007
  Higher Peak

My MAG-5 Mountain Air Generator arrived yesterday. It is an altitude training device intended to simulate higher altitudes to stimulate more red blood cell growth. The main unit weighs something like 50 lbs and looks exactly like what I would expect it to look like. When I opened the other box, I thought they had sent me a Rubbermaid bin for storing the hoses and miscellaneous items, but it turns out that's the air receiver. It looks a little ghetto, but it gets the job done. I'm guessing that to keep costs down, Higher Peak went with a single compressor design, so the air comes in squirts. The air receiver has a bag in it that inflates. Then there is a Pipe Ladder (literally a couple of sections of pipe hung like an emergency ladder) that you hang inside the Rubbermaid bin and it compresses the bag when the compressor is on its back stroke to supply air to the mask- Crude but effective. You hook that up to a virus/bacteria filter then hook up a mask and you are ready to go.

There's two main settings, low altitude and high altitude. Last night, I set it to the low altitude which maxes out at 7000'. I figured if the machine walked up a bit from the altitude I set it at, I could still survive. It was difficult to sleep, because the machine forced so much air into the mask and it wasn't in sync with my breathing, but I eventually fell asleep. I turned the unit off about 3 hours later when Q woke up crying. I was afraid the noise would keep her awake.

Noise Levels?

ABL was able to sleep, but she had nightmares of Darth Vader coming after her all night long. jk. She didn't like the noise, so I'll probably relocate the unit downstairs and run the hose up to the bedroom. There's 50' of hose, so I have lots of options. There is a compression noise, then sort of a sigh. The hose also makes a noise as the air comes rushing through it.

When I opened the instruction manual, the first page is Warnings. Here's number 15: Use of this device may have a negative effect on your marriage or relationships. Don't say you haven't been warned. Good Luck.
The optional oxygen analyzer seems a bit more required than optional when you read the instruction manual, so I'll probably have to buy one. I think, because I'm near sea level, I'll be ok for a couple weeks.

Is it Working?

I don't know, I will know in one month. You can see on my training calendar I'm going in to get my blood drawn then, so I can give you before and after Hematocrit with one months use. I'll also be getting blood drawn about 2 months after that and then 3 months after that, so we'll all know if this is working. If it does work, you can bet I'll be telling everyone I know they can get an altitude simulator for 1/4 of the cost of an altitude tent from Hypoxico and Colorado Altitude Tent (CAT).

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Thursday, January 04, 2007
  Yoga + Altitude = Fast & Bendy

I went to my first Yoga class today...It was pretty cool.

Better News? I ordered an Altitude Simulator and it is arriving on Monday. If you follow this blog, you know that my hematocrit generally wavers between 32 and 36. Normal for an adult male is between 38 and 50. Pro cyclists use Altitude tents to get their hematocrit as close to 50% as possible. The more red blood cells the faster and longer you can go.

When I was first transplanted my hematocrit jumped from 32 to 38 and I felt like superman. I'm looking forward to that feeling again. If my body responds to the simulated altitude I'll be a very happy camper.

Incidentally, I got busted when Discover Fraud Prevention called my wife to ask about a rather large purchase I had dropped on the card. She was not a happy camper.

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I've gone through kidney failure twice. The first time in 2000, my mother donated a kidney; and again in 2008, I'm on dialysis waiting for a breakthrough in immuno-suppression medicines before seeking a new kidney.

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