Monthly Archives: August 2019

Accessibility, High Altitude, Mountaineering, Technology

Accessibility at Altitude

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How accessible are the places you go?

This past weekend, volunteers from Ebert Family Clinic in Frisco teamed up with the Northwest Colorado Center for Independence for No Barriers, a non-profit program that, among other impactful things, works to empower people with disabilities and bring communities face-to-face with what it means to be accessible.

This particular program, called “What’s Your Everest?“, takes place every year at various outdoor venues, connecting people with all sorts of disabilities with their ropes teams who assist them in ascending literal mountains. This year, held at Arapahoe Basin on the Continental Divide, participants navigated narrow, single-track trails over large rocks, through forest, up increasingly steep inclines to reach a summit well over 12,000′ (3657 m).

Volunteers and organizations across the state contributed to this weekend’s success, including STARS, Steamboat Adaptive Recreational Sports, providing a fleet of adaptive equipment to facilitate the ascent.

Some of the adaptive equipment provided at the No Barriers hike at Arapahoe Basin: we saw people on all kinds of apparatuses from hiking poles to one-wheelers to three-wheelers equipped with every kind of pedaling, wheeling, steering and braking device!

I imagine most people associate accessibility with wheelchair access in a restaurant, braille menus, audio signaling at crosswalks, ASL interpreters … this is just the tip of the iceberg. I promise you have never seen gear like adaptive equipment, and even if you have, you haven’t seen all of it.

How do you navigate a wheelchair up a mountain when it’s wider than the trail?

How do you operate or steer a wheelchair if you cannot grip the wheels or handles?

How do you navigate a trail without sight?

One of a fleet of adaptive cycles used for our No Barriers ascent and descent of Arapahoe Basin ski area. This particular apparatus allows the user to steer using pressure against a chest pad while “pedaling” with their hands. You can’t brake while using your hands to pedal!

None of this is easy, and even the current adaptive equipment has inherent flaws. It’s important to recognize that each person’s disability is unique, and can’t always be compensated by the same equipment produced for the next person.

Our ropes team with Leo in a wheelchair engineered for off-road ascents. Handles in the back for pushing, a handle inside either wheel for moving the wheels, steering and braking — but what if your disability prevents you from gripping the handles??

How do you start thinking about accessibility?

Accessibility is about cost. Adaptive equipment is expensive. Custom-making a recumbent bicycle that allows you to pedal without the use of your legs or feet is thousands of dollars, and people who need this equipment to partake in activities everyone without a disability enjoys should not have to pay more for being disabled.

Accessibility is about comfort. After volunteering at this year’s annual Colorado Youth Leadership Forum, where young adults with disabilities are empowered and educated about advocating for themselves and living independently, I realized you cannot expect people to stay focused and engaged in your programming if the room is too hot or the provided meal is unfulfilling. If someone without a disability is distracted by the temperature, you can be sure the attention of someone with autism is long-gone.

Accessibility is about time. Whatever expectations you apply to the amount of time someone needs to put clothes on, eat, use the bathroom, speak a sentence – forget all about it. People with disabilities often need more time. If someone needs more time in the bathroom or walking/wheeling to a destination, adjust your expectations and wait. Your impatience and intolerance is not improving access.

Two teams taking a break half-way up to Black Mountain Lodge at Arapahoe Basin ski area, after navigating some of the narrowest portions of the trail.

Accessibility is about language. Learn sign language. It is just as much a part of our culture as spoken English and Spanish. People with hearing impairments often learn to read lips because they are taught that their hearing counterparts can’t be bothered to learn a form of communication other than one spoken language. And this isn’t just about being deaf. Having a disability sometimes means you have a speech impediment, or that your brain doesn’t organize thought and speech the same way others do. Communicating effectively takes all forms for all disabilities: physical, mental and emotional.

Northwest Colorado Center for Independent Living (NWCCI) Independent Living Coordinator Carlos Santos hauling down the mountain at Arapahoe Basin ski area on an adaptive cycle after making his ascent to over 12,000′ on foot with hiking poles.

Accessibility is about attitude. Sometimes, people with certain disabilities can be very loud and blunt. Sometimes, they can walk, but with a limp. Sometimes, they speak very slowly. This does not mean they are rude, drunk, can’t think for themselves or can’t express their own opinions. Accommodating these situations means being prepared to shift your expectations and perspective.

I’ve been scolded by people sitting behind me at an opera for whispering translations to my blind companion next to me, before headsets with translations were provided. I’ve helped my friend into an outdoor trash elevator to get from the street level to a downstairs bar. And there was still a step onto the elevator platform. I’ve witnessed someone being thrown out of a bar for being “too intoxicated”, when in reality, he was just paraplegic and walked with a limp. And how is someone in a wheelchair supposed to use a port-a-potty at an outdoor music festival?

Is this the best we can do?

Our indoor establishments are barely held to any minimum standard of accessibility. Why are we doing so poorly, and why does access stop when it comes to the outdoors?

Ebert Family Clinic’s team, Medicina Para Montañeros, ascending the final 100 meters at Arapahoe Basin.

I continue to learn more and more about what it means for any particular event, establishment, activity or location to be truly accessible and inclusive, and it is important to me that my friends and family with disabilities are able to partake in the same experiences that I enjoy. I’ve realized that recommending a place that is “accessible” depends a lot on the disabilities present. Determining whether or not someone in a wheelchair can navigate a trail depends on what kind of wheelchair they are in as well as the grade and width of the trail.

12,500′ after hours of hiking, pushing, pulling, wheeling, carrying our way up to the top of Arapahoe Basin, discovering that ‘what is inside us is truly stronger than what is in our way’.

Accessibility is about problem-solving. It is up to all of us as a community to find solutions that enable our friends and family with disabilities to interact as freely with our environment as those of us without disabilities, both indoor and out. I encourage anyone and everyone to start with a simple visual assessment: take a look around you, next time you are on a hike, in a brewery, by the lake, at the farmer’s market, at your favorite coffee shop and ask yourself if your disabled counterparts would be able to join you. Start there.

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Roberto Santos on an epic powder day at the opening of The Beavers lift at Arapahoe Basin ski area.

Roberto Santos is from the remote island of Saipan, in the Commonwealth of the Northern Mariana Islands. He has since lived in Japan and the Hawaiian Islands, and has made Colorado his current home, where he is a web developer, musician, avid outdoorsman and prolific reader. When he is not developing applications and graphics, you can find him performing with the Denver Philharmonic Orchestra, snowboarding Vail or Keystone, soaking in hot springs, or reading non-fiction at a brewery.

Acclimation, Child Growth & Development, Health, High Altitude, High Altitude Training & Fitness, Medicine, Mountaineering, Technology

What’s Going On in La Paz?

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The 7th Chronic Hypoxia Symposium was held this year in La Paz, Bolivia, in February and March. La Paz, sitting at 11,942 ft. (3640 m), is home to one of the world’s leading researchers of the effects of chronic hypoxia, Dr. Gustavo Zubieta-Calleja, with whom Colorado’s own Dr. Christine Ebert-Santos was able to meet with during her attendance of the symposium. You can refer to her previous article on the gathering of experts from over 16 countries for her own account of Dr. Zubieta-Calleja’s impressive work.

Below is the renowned Dr. Sanjay Gupta’s own account on video of his introduction to the experience of hypoxia and altitude with Dr. Zubieta-Calleja.

Always keep in mind, there are many physiological reactions going on when your body and brain are at altitude, and the higher the altitude, the more extreme the effects. Benefitting from a hypoxic environment isn’t as simple as staying hydrated. When we talk about chronic hypoxia, we are typically referring to a population who have spent many years in a high altitude environment.

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Roberto Santos on an epic powder day at the opening of The Beavers lift at Arapahoe Basin ski area.

Roberto Santos is from the remote island of Saipan, in the Commonwealth of the Northern Mariana Islands. He has since lived in Japan and the Hawaiian Islands, and has made Colorado his current home, where he is a web developer, musician, avid outdoorsman and prolific reader. When he is not developing applications and graphics, you can find him performing with the Denver Philharmonic Orchestra, snowboarding Vail or Keystone, soaking in hot springs, or reading non-fiction at a brewery.

Child Growth & Development, Health, Medicine, Technology

Technology in Health Care: Interview with Family Nurse Practitioner Tara Taylor

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After over a decade of serving pediatric patients in the high country communities of Colorado as Ebert Children’s Clinic, we opened up our health care practice to serve the needs of the adult population several years ago. As Dr. Chris can attest to, the world of health care has grown and evolved incredibly since she first opened up her practice in Colorado in 2000, and we all continue to learn from the providers we welcome to our team as well as the students we mentor.

Family Nurse Practitioner Tara Taylor.

This past year, we’ve had the pleasure of having Tara Taylor, FNP on our staff. She’s brought a wealth of knowledge and unique experience from having practiced on a medical campus much, much larger than our little mountain clinic, and her insight into everything from patient care to our own high altitude research projects continues to be an invaluable asset to both our practice and our community. She was so gracious one afternoon to have a chat with me between patients:

How did you find yourself in Colorado’s high country health care community?

So, I have actually lived here since 2004, so I’ve lived here 15 years. I came out here for 6 mos to ski, and stayed for 15 years. I found myself loving it, bought my first house and decided to stay out here. I’ve actually commuted down to Denver all this time, because I had originally started in New Jersey in 2002 in Critical Care. So when I moved out here I wanted to be in the mountains, but I also couldn’t do Critical Care up here at that time. So I decided to commute down to Denver for three 12-hours shifts a week, and then live up here four days a week. So I had an apartment in Denver … when I went back to NP school, my goal was to work and live in my own community. I think that’s huge for me … and not only be serving the population of Denver, but to be serving the people of my actual community.

How long had you been practicing in Denver?

Since 2005, because I worked 6 months at Keystone Clinic, so I’ve been in Denver working for 14 years  prior to this in the ICU. And I’ve worked at Children’s hospital in the pediatric ICU, burn ICU’s, bone marrow transplant, open-heart surgery, neuro-trauma, multi-system trauma, all of it.

How is it different working up here, for a small clinic, at that?

This is a huge change … I’m still working down there once a month, so I get to go down and play and enjoy that type of intensity. But at the same time, coming back here, I think that the critical care aspect … it still plays a role here. And in my letter, when they said, “Why do you want to go from [being] an ICU nurse to family practice?” … I said for so long, I’ve seen patients in the ICU [whose] admission or … critical portion of their admission could have been avoided if they had better focus on primary care and had their needs met. If they had been on the right medications, if someone had spent the time — and sometimes it’s because of their own compliance — but with adequate primary care, we’re avoided what I was seeing in the ICU. 

Now, being in primary care, I get the stimulation I need from the independence of it, making these decisions, and I really enjoy finding out what’s going on with the patient, deciding what tests to run, and getting back these results and being able to properly refer them. I enjoy the time that I’m able to have with those patients here at a private practice. So each patient gets the time that they need to be properly cared for. 

And I’m just seeing extremely sick patients. I’m not seeing a lot of sore throats and earaches, unless you’re 2 years old; besides that, the adults have really complex diagnoses that require a lot of thought. And in its own respect, it’s critical to me.

Great segue: what are the greatest challenges you’ve seen practicing up here?

I think some of the biggest challenges that I have seen up here is limitation of services. That’s why this clinic is bringing up Nephrology, … [expanding] mental health services here, and then, to bring in … pain management specialty, and give them a place to practice … It’s really hard for these additional specialties. We have Cardiology up here, we have Pulmonology, but some of the smaller things like Rheumatology for rheumatoid arthritis, for osteoporosis and kidneys … how do you establish your practice up here? So hopefully, as focused as [Ebert Family Clinic] is in the community about being able to provide the care we want for our patients …  we’ll be able to get that door open for those specialties and help them establish their practice up here, which is our goal.

How do you get connected to these services like Genomind?

[This patient] came to me with Genomind. I had not heard of that before. He said, “I got on the right medications because this genetic testing gave [Compass Health] the ability to treat me properly.” [Certain health care providers in Denver] require it, almost, for every patient walking in their door as a prerequisite to help them make medication decisions. 

Genomind is a swab in the cheek. I think it’s huge, because we’re not able to “draw” neurochemicals. We’re not able to draw your blood and say, “oh, look, you’re deficient in serotonin.” Because that’s not an option, what’s the best way for us to figure out what’s the best medication for you? Because medications are very specific to what they’re treating. So the only thing we’ve been able to do for the last decade is to guess; to put you on something, and if it doesn’t work, then we know that’s not the thing. And that’s a terrible process, because it leads patients to trying five medications, over a ten-year period, and finally we get them on the right thing. But how frustrating that is for patients; they lose confidence in their providers, they lose confidence in the system, they feel neglected, they feel frustrated. And to have that stamina to even go through that process … I think we have a lot of patients drop off. [They] end up saying, “Forget it. Medications don’t work for me.” Then [they] become non-functional … their quality of life is hindered by their [unwillingness] to spend ten years trying five medications.

That is not the best process. And I think the people that went ahead and engineered Genomind said, “What else can we do? What if we went back to genetics? What if we went back to genes?” We can swab a 1-day old infant or a 95-year old man, and we are going to get their genetics. And when they did the Human Genome Project, and we got our entire genetic profile as human beings, the science behind Genomind was they were able to take anyone who’s been diagnosed with schizophrenia, people who are known bipolar, generalized anxiety disorder, major depressive disorder, took their DNA … laid them over each other, and said, “What gene is predominant in all these patients?”

So they were actually able to use hundreds of thousands of mental health patients to establish what genes these were that led to the cause of their mental illness. So now we’re able to send off DNA with a swab in the cheek. It’s not a perfect science, but it’s what we have.

Is this better than nothing? There’s so much controversy about this test. How can you think this is controversial when you come from a science background as a provider, as a physician. You’ve got this, or you have nothing to guide you for the mental health of these patients. If we have this over nothing, I will take this.

[Genomind testing] is not only [about] mental health disorders, but also [for] people [suffering from] eating disorders, difficulty losing weight, ADHD, alcohol addiction and propensity for opioid addiction. It would identify what patients we may never want to start on narcotics if at all possible. It tells us, “Don’t start this patient on this particular drug because they’re at risk for gaining weight with this drug, like as an atypical antipsychotic.” It would tell us which medications an alcoholic would respond to best, if they were wanting to quit drinking and needed medication assistance. We have a lot of kids who seem like they’re ADHD, but really they have signs of anxiety and depression as well. And it’s our job to distinguish [whether] it’s the ADHD that’s causing the depression and anxiety, or it’s the depression and anxiety that’s causing the inability to focus? It’s absolutely fascinating! I want the community to know that we’re offering that here at the clinic.

Is Genomind available to children?

We can test anyone of any age. We can swab the cheek of a one-day old. I actually had a mom in here that said she was tested positive for both genes for the lack of ability to metabolize L-methylfolate, which causes bipolar disorder or mood instability. She came in here with her 4-month old son and said, “When can I get him tested to know?”

So I actually asked Genomind, and Genomind said you could test a brand new newborn baby, which at some point may be the standard of practice!

But at this point, it’s hard to want to test that child, because we’re not able to treat that child [without symptoms]. Once that child becomes 6 or 8 years old, and they are having mood instability, they are showing signs of some sort of mental illness, we do realize we are able to identify this in children. We don’t need to wait until people are 18 to say they must have a mental illness. We are identifying that in the behavior of hyperactive two and three year olds, and we’re seeing them grow up to be bipolar adults. So we are seeing early signs and symptoms of mental illness in these children. 

Could we test a 6-year old who is showing signs of something and have them be positive for these genes and be able to supplement them with L-methylfolate or an approved psychiatric medication in the pediatric population based on their genetics? This is absolutely going in that direction. Genomind said they’re 100% approved for adult and pediatric testing.

How do you find balance for yourself and maintain a healthy lifestyle?

Tara with Dr. Chris (center) and Kristen Duffy, A/GNP, at Ebert Family Clinic.

Working at this clinic actually provides me with the exact hours I need to have good work-life balance. That’s extremely important to Dr. Chris Ebert-Santos. When I started working here, she said, “What are your husband’s days off?” And I said, “Sunday-Monday,” she said, “Okay, well you’re not working Sunday-Monday then.” I just honestly couldn’t believe it, that my happiness was that important to her. I work reasonable hours. [Dr. Chris] provides me with the days off that will match my husband’s. I have great quality of life due to my husband. He’s an amazing person, wonderful and spirited, and we get along great. So we have that, and we have our two dogs, and we live a comfortable life up here. We love to do all the great stuff that Summit Countiers do: snowboarding, hiking, biking, camping, just getting outside in general together and playing with our dogs. And that’s what’s most important.

What have been your greatest takeaways from working in Summit County so far?

I think it’s running into that patient at the supermarket who, I know in the back of my head I have their diabetes controlled. To know that I’m specifically helping patients in my community. That I’m doing yoga next to someone [whose] blood pressure is controlled now because of me. I think that’s something really special and it’s not something that I had before when I worked in Denver, and I would come home and I would never see those people again. And then, having the opportunity in this clinic to deal with so many pediatric patients, since this was originally a pediatric clinic [before] expanding to adult services as well, which is amazing. But the amount of pediatrics in this clinic really improves both my exposure to every age group. I love kids. To have patients hug me in this office who have had a very challenging diagnosis … that “thank you” from patients is something I cannot replace.

Tara continues to be a passionate advocate for mental, women’s and sexual health, and a valuable resource as a health care practitioner. Ebert Family Clinic is proud to have her.

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Roberto Santos on an epic powder day at the opening of The Beavers lift at Arapahoe Basin ski area.

Roberto Santos is from the remote island of Saipan, in the Commonwealth of the Northern Mariana Islands. He has since lived in Japan and the Hawaiian Islands, and has made Colorado his current home, where he is a web developer, musician, avid outdoorsman and prolific reader. When he is not developing applications and graphics, you can find him performing with the Denver Philharmonic Orchestra, snowboarding Vail or Keystone, soaking in hot springs, or reading non-fiction at a brewery.

Acclimation, Health, High Altitude, High Altitude Training & Fitness, Medicine, Mountaineering

Coloradans on the Annapurna Circuit

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One of our nearest and dearest, Shelbie Ebert, a certifiable high country local born at Vail Valley Hospital, has been an adventure guide for the last decade. She is currently working on her nursing degree, and is an Emergency Medical Technician. While she has done some multi-day backpacking in the past, she says her recent trip to Nepal was her “most ambitious journey to date.” I was able to sit down with her and her mother, Karen, and hear all about the literal ups and downs on the Annapurna Circuit, in the central mountain region of Nepal, where they reached the highest point at 17,769 ft (5416 m)! They were in Nepal from April 17th to May 17th.

This trek is of international fame, and there are many resources to inform those looking to embark on this historical, spiritual, mental, and physical adventure. All in all, they spent 14 days on the trail. But I was so curious what it was like for those more familiar with the unique challenges posed by Colorado’s high altitude environment.

Did you do anything different from others you observed on the trail?

Most people had porters; we decided not to do that. Even those who didn’t have porters hired a guide.

Having been born and raised at a higher elevation than most, did you notice a difference between your own process of acclimation and that of your colleagues?

I did get sick in Nepal, but it was mostly stomach sickness. No headaches or anything like that. Mom didn’t feel a headache until we got pretty high up. We noticed a lot of people dropping; a lot of people bused into Manang, and from there, it’s a two-day hike up to the base camp, and from there you cross the pass. They got on the trail from there. Manang is at about 10,000 ft. Those people definitely struggled more. 

A father and son hiked the trail side-by-side with us. They didn’t hire porters. Shortly after we got over [Thorung La Pass], the son got really, really sick. The pass tops out at about 17,200 ft. When we saw him at the top of the pass, his lips were bright blue. I think he started to get sick on the ascent. I think he was probably about my age, and he was a doctor. He had some drugs stocked up and he felt pretty confident about doing the hike. 

They started their hike at about 2600 ft. above sea level. In a matter of 10 days, they would climb to over 17,000 ft. over 70 miles.

How long did you take before you started hiking?

We flew into Kathmandu, spent two days there, then took a long bus to the city where we started hiking, and we started hiking as soon as we got off the bus. We did take an acclimation day in Manang, at 10,000 ft. We hiked to it, then we spent an extra day there, about 48 hours. 

What was the greatest challenge about this excursion?

How much constant up and down it was, with the altitude gain. The day that we went over the pass it felt like a good day to me, because it resembled hiking in Colorado. But those days of up and down prepared us well for the pass. 

Did you do any training in particular in preparation for this excursion?

No, absolutely not. I read a lot of blogs so I knew what to expect. I tried to have just a really good plan for what we could and couldn’t do, and when we got to Kathmandu, I stocked up on all kinds of drugs, because anyone can buy them. Diamox. I think I maybe only took one once on our ascension day, just to get ahead of the game. 

Did you change or adjust your diet at all to prepare for this excursion?

I thought I did. I looked up some Nepali food online and tried cooking it at home to prepare my stomach for the type of food that we would be eating, but I found it was nothing like actual Nepali lentils and rice. 

Learned some hard lessons about food. A lot of the lentils in Nepal made me sick. Luckily they have a lot of potato-based dishes. 

[There was a] surprising amount of good snacks available, [lots of pre-packaged cashews, nuts, cookies and snacks]. I would recommend for anybody to bring five or six cliff bars for the harder days.

Also kept some sugar on me: Snickers, chocolate, gummies … I forced Karen to eat some sugar when she wasn’t feeling well, and that seemed to improve her condition.

Karen did experience some symptoms of altitude sickness as they ascended the highest point of the trek, Thorung La.

In retrospect, is there anything you would have done differently in preparation and/or on the trail?

I would have packed a lot less. We had about 35 – 40 lbs. in our bags, and that was way too much — and totally unnecessary. Less is more on the trail. We did end up hiring a porter to carry my mom’s pack on our big day, and that was an excellent decision. 

Did you notice anything different upon your return to a much lower elevation?

I felt really strong! I was really grateful for my body. I think it was mostly a mental shift. I felt more capable doing most activities, whether it was mental or not. I started taking better care of myself. I started running in the mornings before school, which is something I never would have felt before. 

I thought, “I hiked 17,000 ft, I can probably run a mile and be okay in the morning.”

Any other advice you’d give in particular to other travelers intent on similar excursions?

You know what, go for it! It’s not as hard as you think. I came to a country I’d never been to before with a book in my hand, and we did it! I think anybody can really do it.

Shelbie is honored to have shared this experience with her wonderful, strong mother. And this isn’t the first or last adventure they will have been on together. True backcountry buffs, I can always find them on all types of gear on the snow, on the river, or on the trail.

Shelbie and Karen victorious at the height of Thorung La Pass.

If you’d like to read more details about their Annapurna Circuit Trek, Shelbie maintains a blog where you can find all kinds of tips and recommendations on backcountry gear at lahlahdesigns.com.

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Roberto Santos on an epic powder day at the opening of The Beavers lift at Arapahoe Basin ski area.

Roberto Santos is from the remote island of Saipan, in the Commonwealth of the Northern Mariana Islands. He has since lived in Japan and the Hawaiian Islands, and has made Colorado his current home, where he is a web developer, musician, avid outdoorsman and prolific reader. When he is not developing applications and graphics, you can find him performing with the Denver Philharmonic Orchestra, snowboarding Vail or Keystone, soaking in hot springs, or reading non-fiction at a brewery.







Acclimation, Doc Talk, Health, High Altitude, High Altitude Training & Fitness, Veterinary Medicine

Dogs at Altitude

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The mountain communities are home to more animals than people in Colorado. Every Spring, we’re likely to see everything from foxes to moose in our yards and on our streets. About a month ago, I watched a juvenile (but plenty large) black bear on an evening walk in front of the houses in our neighborhood, peeking into the garbage bins lined up for pick-up the following morning.

Claire Tinker with her Dachshund Baxter on Bierstadt.

Dogs are natural companions to many up here as well, with plenty of space to run around, smells to sniff, and communities that seem to welcome their company indoors as well as out. Having seen so many of our dog friends on trails all across the state, we’ve wondered how they might be coping with the altitude. 

Most recently, we ran into a German short-haired pointer named Moose on an ascent up Mt. Bierstadt, one of Colorado’s 14ers, sitting at 14,060 ft (4285 m). He and his human, Nick, moved to Colorado permanently about a year ago, after a two-week visit turned into several months. 

Moose is 13 years old, Nick tells me, “but you have to believe that my dog acts like he’s 6.” Nick and Moose have been enjoying a lot of time outdoors together since moving to Colorado, and Bierstadt was their first 14er together, which they did with some other friends from Louisiana, where they’re from. 

“It was awesome. Took [our friends] a long time to summit, but Moose did really well. He liked the breeze and the birds coasting right next to him. It would have been hard without a harness to [lead] him up to the top. He’s 65 lbs. Boulders weren’t too bad for him. Just have to be careful coming down, so he doesn’t slip and break a leg.” 

Moose and his Louisiana posse on their way up Mt. Bierstadt.

This is a very legitimate concern. Many hikers have found themselves carrying their canine counterparts: they get tired, the terrain is difficult for them to negotiate or too rough on their bare paws, etc. You definitely don’t want to have your hands full as you ascend or descend a 14er.

Dr. Danielle Jehr, who has been a veterinarian with Frisco Animal Hospital for years after studying and practicing in Nebraska, also recommends waiting to take your puppy on the longer, more strenuous hikes.

Dr. Danielle Jehn with hiking and car ride enthusiasts Libby and Liam.

“Unfortunately, we do not get a chance to discuss this with many owners unless there are new puppy owners. Usually, we just see the aftermath from a hike and help guide them for future incidences. I would love to be able to tell all new puppy owners that activity needs to be limited up until 6-8 months of age while they are experiencing enormous amounts of bone growth. This means no major hikes on uneven surfaces and no 10 mile runs while the owner mountain bikes. We just want the pups to grow normally without complications for them or the owners.”

And as you might have speculated, animals are also prone to certain risks at high altitudes, although, “In general, healthy animals do not function any different at high altitude,” says Dr. Jehn. “Animals and pets with known blood pressure, cardiac or respiratory disease can decompensate at higher altitudes, and we do see this in practice. Just as human hearts have a difficult time at altitude, so do cats, dogs and livestock!”

Ike, about 8 months old, seriously reconsidering his choices on his way up Mt. Bierstadt.

So how do you know if your furry buddy is struggling with acclimation?

“Most often, an owner will call and have a presenting complaint of their pet experiencing exercise intolerance while on a hike or constant panting/lethargy/anorexia since the pet has been up in Summit County. If a dog presents in any type of respiratory distress, we place them on supplemental oxygen, check their heart and lung sounds, heart rate, respiratory rate, blood pressure and ability to oxygenate. We do this by utilizing a tool in the clinic that measures the percentage of oxygen carried in the blood.” Sound familiar? “We always want to see a dog at over 92%. If the dog or cat cannot maintain that or better without being provided oxygen, we need to see other diagnostics for reasons why.

“Common canine ailments we see that are drastically exacerbated by altitude are: cardiac disease (heart murmur, pulmonary hypertension, congestive heart failure), general hypertension, lung disease (asthma, allergic bronchitis) or vascular volume abnormalities (i.e. anemia).”

The most common injuries Dr. Jehn sees, she tells me, are “lacerations and abrasions from the rough terrain. We also see exacerbated lameness after hikes that are too long for our canine friends that are not otherwise used to it (i.e. 14ers).”

Nick and Moose currently live in Boulder, at 5328 ft (1624 m), but they moved there from a house in Bailey, at about 7740 ft (2359 m). I ask Nick if Moose has ever had trouble with the altitude since they moved to Colorado. 

“Not at all. Not even when we first got here. He was ready to rock and roll. The only thing he didn’t like was the snow at first. Once he realized there were rabbits and stuff that went in the snow, he was about it.”

Being from Louisiana, one of Moose’s greatest challenges is the relative scarcity of water. Colorado doesn’t have as many lakes and ponds that Moose can cool off in and drink from, so Nick says he’s sure to carry water for him.

Nick also tells me that Moose is a pretty fit dog, and has never experienced any major health complications. He is careful, however, not to work him so hard that he’s limping the following day. I think it’s safe to say that’s something humans are wary of for themselves as well. If you’ve ever hiked a 14er, you already know. 

Dr. Chris with grand-dog Ike on their way up Mt. Bierstadt.

Another factor that affects Moose and people alike is exposure. “If there’s no shade or wind, it’s a lot harder on him,” Nick notes. We also relate over the challenge of descending a mountain, when the resistance of gravity is especially stressful on your knees and hips. Nick works for Sacred Genetics, a company that cultivates feminized hemp seeds, who are partners with a company, Verdant Formulas, that specializes in CBD products, utilitzing the relaxing, remedial properties of the oil from cannabis. Among other applications, balms and oils infused with CBD have grown in popularity as a naturopathic treatment for muscle soreness and inflammation. Incidentally, more and more similar products are being marketed for the same afflictions in dogs. Nick tells me it helps with his own post-adventure soreness.

My main takeaway from all this insightful doggo dialogue is that we are all the more similar. It certainly seems like the same precautions apply for avoiding a serious situation outdoors. And don’t forget, if anyone in your party is having trouble on your hike, it is not advisable to continue; you are only as strong as the weakest member of your team, whether that is a dog or a person. 

A last bit of advice from Dr. Jehn:

“I would also love to be able to tell all tourists to take it easy on their canine counterparts while visiting us in Summit County as well. Altitude sickness is real for humans and dogs, alike. Accomplishing a crazy hike with your dog should not be the first priority within the first few days at elevation. Dehydration and prior health conditions are real when experiencing altitude. If you know your dog has history of a heart or lung issue, especially, let them take it easy. We want you to enjoy Summit County for everything it has to offer….without the emergency visit!!”

Happy Trails, all you trailhounds and trail … hounds!

robert-ebert-santos
Roberto Santos on an epic powder day at the opening of The Beavers lift at Arapahoe Basin ski area.

Roberto Santos is from the remote island of Saipan, in the Commonwealth of the Northern Mariana Islands. He has since lived in Japan and the Hawaiian Islands, and has made Colorado his current home, where he is a web developer, musician, avid outdoorsman and prolific reader. When he is not developing applications and graphics, you can find him performing with the Denver Philharmonic Orchestra, snowboarding Vail or Keystone, soaking in hot springs, or reading non-fiction at a brewery.