Is mountain climbing to 14,500 ft unwise for CLL survivor with low platelets?

I am considering a climb to the top of Mt. Whitney which is 14,500 ft. Are there reasons such as low platelet count and other CLL related factors that make this unwise or risky?

[HopeME]

It’s a tough climb. Have you done a lot of climbing? I’d be very careful. I’ll leave the health issues to others as I’m not certain of that aspect of your question.

[Hidden in reply to HopeME]

I work out regularly running, cycling and swimming, and also participate in events. Each of the last 17 years including the 15 since my diagnosis I have gone on 6 day strenuous backpacking trips. While elevation gain has always been involved as high as 11,000 ft on some trips, I haven’t attempted anything this high. On those climbs I get winded, but not sick. I am being extra careful when thinking about this climb especially as it is 22 miles round trip in 16 hours roughly.

[HopeME in reply to Hidden]

My buddies did it years ago and I recall they left at day break and returned late afternoon early evening. They were in their early thirties at the time and they described the climb as incredible.

It sounds as if you are untreated and mutated but potentially nearing treatment? The one thing I noticed as I neared treatment is that my aerobic capacity declined but I only fully appreciated the decline after treatment was complete. Since the decline was slow and subtle and I attributed it to normal aging but it was really the result of my marrow getting crowded with disease and putting pressure on my hemoglobin. It’s sometimes hard to sort out the impacts of the normal aging process versus CLL disease progression. Your doctor will help you evaluate all this for you but if you are nearing treatment it might make sense to wait until after treatment?

Best,

Mark

[Hidden in reply to HopeME]

Thanks Mark. I was diagnosed 15 years ago this week, treated after 4 years, and just 3 month checks since then. And yes, mutated thankfully. I have often wondered if and how much the disease and treatment affected my aerobic capacity. One thing for sure, aging is a factor too. I am very blessed that I don’t (yet) have the body parts breaking down and limiting movement. My saying to my buddies is “motion is lotion”, but it also has to be my genetics. All I can do is keep making the effort to stay fit and be smart about what challenges I take on.

[avzuclav in reply to Hidden]

I say go for it. If you are taking the main trail, you can turn around and descend rapidly at any point. You may want to camp at the portal to acclimatize.

[AussieNeil Administrator]

Have you cleared this with your specialist? I would think that your major concern would be if you had anaemia, but if you are at any risk at all from your CLL, then you need to consider that evacuation to medical treatment would take time and put not just yourself but others in your party and those responding at risk. Considerations I would assess would be the health of your blood counts and to what extent your possible greater risk of infection may be a concern.

I hope that you can go for it - what an achievement, even without CLL!

Neil

[Hidden in reply to AussieNeil]

Thanks Neil. I haven’t spoken to my oncologist yet, but definitely plan to. I do strenuous backpacking every year without issue, but attempting 11 miles to 14,500 ft and back in one day gives me reason for extra concern.

[Quarry]

You sound like you are super fit and treatment not round corner, so why not! We need to live!

As Neil says, the biggest concern is probably anaemia (and so you run out of steam), so ask your specialist about that. If HB in normal band it should be ok as you are super-fit. One other thing - how low are your platelets - would it be a problem if you fell/cut yourself (not that you are going to)? Would you still get back from a situation that a normal-platelet person would?

If your specialist says risks are no different to a non-CLLer, go and have fun / achieve!!! And let us know of your achievement

[Jm954 Administrator]

My only concern would be if your haemoglobin was on the low side. You'll need every little bit for a climb like that at that altitude.

Definitely check with your Dr but if your Hb is less than 12/13 then I would think again.

Jackie

[Hidden]

Thanks for your message. My platelets fluctuate between 110 and 90. I haven’t seen any yet in the “normal” range over 130. My doctor says that’s typical of CLL. I live in the Dallas area so the only time I see elevation is trips to the mountains like for backpacking and skiing. Sometimes I get a headache just for a day. I haven’t had any issue at all with bleeding.

[cllady01 Former Volunteer]

Billtex, I am not a hiker/climber, however I do have some experience with acclimating to high altitudes and know doing so needs to be foremost in your mind.

The following link is quite detailed in dealing with the subject, and more. I hope it will be helpful.

I esp. took note of the following:

"Acclimatization

The major cause of altitude illnesses is going too high too fast.

Given time, your body can adapt to the decrease in oxygen molecules at a specific altitude. This process is known as acclimatization and generally takes 1-3 days at that altitude. For example, if you hike to 10,000 feet (3,048 meters), and spend several days at that altitude, your body acclimatizes to 10,000 feet (3,048 meters). If you climb to 12,000 feet (3,658 meters), your body has to acclimatize once again. A number of changes take place in the body to allow it to operate with decreased oxygen.

The depth of respiration increases.

Pressure in pulmonary arteries is increased, "forcing" blood into portions of the lung which are normally not used during sea level breathing.

The body produces more red blood cells to carry oxygen, (my note: Bone Marrow health is at issue here with CLL; as noted by JM954--hgb levels)

The body produces more of a particular enzyme that facilitates

the release of oxygen from hemoglobin to the body tissues.

princeton.edu/~oa/safety/al...

[Hidden in reply to cllady01]

CLLady, re: your bolded line; The adapatation of increased erythrocytes and increased 2-3dpg (the enzyme) takes around a week to occur at elevation. There are many people who go climbing or skiing for a weekend and this never happens for them. Part of the reason SO MANY people get AMS when going to elevation too high too fast.

[cllady01 Former Volunteer in reply to Hidden]

Yes, the article says what you say--some do some don't--in my experience some friends did not have a problem in their younger years, but as they aged that changed. Granted, fitness makes a difference and I know some of those friends were less fit as they aged. Then throw in CLL and you have a lot of unknowns in everything you do.

My experience was only in making a trip to a 9000ft elevated retreat center every summer for years. Those who drove from the lower altitudes usually had no problem, those who flew often had a few days of altitude sickness the first week.

One friend was told not to go to those heights any longer--was around 60 years old at the time.

[Hidden]

I was a alpine and cliff climber for over 40 years. There are a number of factors you might want to consider. Your age and overall condition, dealing with internal or external bleeding events, your body's ability to acclimatize and assimilate decreased oxygen at altitude and your ability to maintain and recover energy levels during and after prolonged physical exertion. Are you and your partners experienced in acute mountain medicine? Are you knowledgeable as to what equipment you may need for a safe climb? Have you all established and agreed to an adverse event evacuation plan? Alpine climbing experience?

Don't think your abilities at sea-level will be the same at elevation. I cannot tell you how many times I have gone climbing with several partners and spent the entire weekend evacuating someone who experienced an adverse event on a mountain.

If you experience an incapacitating adverse event in a remote area but still have cell phone service you can call for a helicopter rescue team. Depending on your location's accessibility and distance (=flight-time) from the helicopter home base, your out of pocket cost will vary from $2,500 to many thousands more ($45,000 remote Alaska mountain rescue). If you have no cell service and a friend has to descend to a vehicle to get help you could experience a delay of 24 hours to two or three days. The worst case scenario is bleeding events, with or without broken bones, and someone has to descend and drive to get professional assistance. Depending on platelet count, bleeding-out before help arrives is a distinct possibility.

Many have a tendency to grossly underestimate the difficulties one can encounter when climbing Mt. Whitney. Weather and snow and ice conditions can be unpredictable, as is true for most mountains of higher altitude. One of the oddities of Whitney is the number of people who have been incapacitated of killed by summer lightning strikes.

I gave up climbing when I was 63 and diagnosed with CLL (W&W). This was an easy decision since I had low energy and poor recovery. I have been on Ibrutinib for five months now (age 73) and due to bleeding and immediate small wound infections, my wife was forced to hire someone to prune her rose collection; one of the few perks of having CLL that I am grateful for!

If you do decide to give Whitney a go, be prepared, have a plan and know your limits. There is no shame in abandoning a climb if conditions dictate. As for myself, I will soon be on the golf coarse in Death Valley attempting not to injure myself and admiring the High Sierras from afar. Getting old and ill does have its pitiful comedic aspects!

Wishing you all the best!

[Hidden in reply to Hidden]

Everyone here has offered extremely helpful information and I sincerely appreciate the advice. This one from you with 40 years of experience is especially good for me to read and know. While I am obviously being cautious by as asking questions, I must admit to being too proud or whatever to admit age or health related limitations. Thank you and everyone for waking me up to the realities.