RIDGWAY – It had already been a busy morning for Dr. Peter Hackett when we met for coffee at Cimarron Bookstore in Ridgway.
Hackett had fielded one phone call from the Bechtel Corporation, one of the world’s biggest privately held companies and the biggest engineering and project management firm in the U.S. (Bechtel built the Hoover Dam, and the Big Dig in Boston.) Bechtel wants to build several mines in South America at altitudes ranging from 10,000 to 16,000 feet. They asked Hackett to advise them on altitude sickness.
The second call came from a media outlet in New York. Word had gotten out that Hackett will be giving a speech in Denver next spring to the American Thoracic Society. “All the pulmonary docs in the U.S. and, well, the world will be meeting in Colorado,” he said, not without pride. He told me he plans to feature in his talk “the rich history of research in altitude medicine in Colorado, starting in the 1910s and 20s with physiology expeditions to Pikes Peak.” It’s a history that continues today.
“I’ll tell some Everest stories, too,” he said, grinning. “Everybody likes to hear about Everest.”
Peter Hackett is likely the world’s pre-eminent authority on altitude sickness and high-altitude medicine. He comes by his expertise honestly. He spent six years in Nepal researching the effects of altitude on the body at Everest base camp at 18,000 feet. He summited the world’s highest peak in 1981. He has written scores of articles and edited three books on hypoxia, or oxygen deprivation.
Western Slope neighbors know him as the director of the Institute of Altitude Medicine in Telluride. Even more familiarly, he is the director of Emergency Services at the Telluride Medical Center. If you get sick from the altitude or crash on the ski hill, Hackett is likely the one to put you back together.
I’d asked him to meet me and talk about a new study he has just completed atop Pikes Peak, in which he conducted a double-blind test on a bunch of college-student volunteers to find out if an herbal product made in Ridgway might work to prevent or ameliorate altitude sickness.
The product is called “High Altitude Help,” and it’s grown and extracted by Tim and Sheila Manzagol at their Shining Mountain Herbs farm. The concoction, taken as a tincture, has about 15 ingredients, including ginko, ginseng, cordyceps, osha root, ginger root, cardamom seed, various berries and leaves, a little grain alcohol and water.
Hackett thinks that ginko is the most likely candidate for success, though he wouldn’t rule out other ingredients in combination.
“We had some promising results [in an earlier study] that showed that ginko works,” he said. “And four or five others have confirmed it, though there have also been a couple of tests that show it doesn’t work. It’s tough. Plant compounds are so complex. Which is the active ingredient that is beneficial? None of these things are controlled by the FDA, so you don’t know exactly what you’re getting.
“One of the important things about this study is that Nutrilite, a health supplements company in California, did exhaustive chemical analysis on the tincture for us. Twenty-five thousand dollars worth. That’s unheard of in this business. So, we do know what it is we are testing.
“I give Tim and Sheila credit for wanting to find out” if their product works or not, he said. “They could market the stuff [with unproven claims] just like everybody else. But they wanted to do this.”
What Hackett did was round up about 50 Mesa State College students who were willing to make the trek over to Colorado Springs. He and his staff tested them first at their “home” altitude of 4,600 feet for baseline information. They checked blood oxygen levels, heart rate and maximum oxygen uptake (VO2 max) while exercising. He also used an ultrasound machine to measure the volunteer’s optic nerves. Or more precisely, the width of the fluid-filled sheaths surrounding the optic nerve between the brain and the back of the eyeball. “In simple terms, altitude sickness is brain swelling,” Hackett said. We know that pressure in the brain causes the spinal fluid in the optic sheath to expand. So if we see what’s happening there, we learn something.
“It’s based on the assumption that the eye is the window to the brain as well as the soul. Every study I do I try to add something new, trying to figure out what altitude sickness is. ’Cause it’s still a bit mysterious.”
The students were checked again at the base of the mountain road and given the tinctures. Half of them got the actual drug; the other half got a placebo. Then they drove the “rapid ascent,” about an hour and a half, to the top at 14,000 feet.
Pikes Peak is great place to do research, Peter said. “It’s because of the cog railway they built there in the late 1800s and the road that went in all the way to the summit in the early 1900s. It’s much more accessible than any other site.”
The City of Colorado Springs loaned them a big, heated dorm-like building in which to stay overnight. Hackett checked all the volunteers’ signs again, including the VO2 max after running a 30-meter shuttle course.
“We ended up having to take seven or eight of the kids out of the study; they got too sick. That’s not an unusual number. If we’d started at sea level, all of them would have been sick. They had severe headaches, some nausea, some dizziness. We gave them oxygen and dexamethasone,” a steroidal anti-inflammatory.
Next morning, they repeated the tests: the blood-oxygen prick, the heart rate, the optical nerve sheath measurement (the ultra-sound is non-invasive; it can see through a closed eyelid), the exercise test. “Though only about a half dozen volunteered for that the next morning,” Peter said, with understanding. Then they came down.
Results are tantalizingly close; Peter said he might have some results this week. But he can’t tell me what they are. It’s part of the protocol in a “well-controlled study” like this, Peter said, that the results have to be published in a peer-reviewed journal before they are released to the public.
“I sure hope the herbs worked,” he said. And promised to keep me posted.