Friday, March 22, 2013

Moving over the mountains

Well, it finally happened... I up and left my massage career that was breaking down my body and found my place practicing emergency medicine AND I finally live once again in a 'real' climbers town.  I left Jackson Hole this December for a place I have always wanted to be, Lander, WY.

The move took a lot of guts.  I had to get training in a new career, which took about a year to nail down the basics, 5 K spent on school and I had to volunteer enough on the Jackson Ambulance to actually get another agency to see me a serious applicant. 

The move away from Jackson and away from massage was something I've been thinking seriously about for almost three years.  I was feeling burnt out from massage work and I was ready to challenge myself mentally and think about a potential job I'd like to work until retirement.  The dialogue with my partner at that time was interesting as well, he really loves Jackson and wasn't going anywhere, not even for me and that about sums up the fallout of our relationship.  I was surprised about his stance but in the end looking back now, this move and shift in careers was something I should have done sooner.   

I thankfully already had a few friends in Lander before I moved down and also got full time work right away for the Fremont County Ambulance out of Lander.  Being a medic here is awesome!!  The call volume has caught me by surprise, it's actually quite busy with the surrounding population and reservation that we serve.  The Lander ambulance responded to over 3,000 calls in 2012.  Riverton responded to 5,000 last year.   

Even though I moved here right as winter was ramping up in the mountains and the skiing was just getting good, winter climbing in Sinks can be the prime time for good temps and it's so novel to be outside mid-winter t-shirts and flip flops sport climbing!!

The other plus about the timing of my move is I was able to get into the county EMT-Intermediate course that will be over this summer.  I will be an Advanced Life Support (ALS) provider after the course is over, meaning I can start IV's, drill for IO's when IV access isn't available, push about 25 different medication for everything from cardiac arrest, to respiratory arrest and diabetic emergencies...  the list of interventions goes on.  Also in the EMT-I training is advanced airways, King and Combi-tubes for maintaing an airway.

Vance White on House of God 5.13a, Killer Cave, mid-winter climbing bliss!

Chris Marley crushing 5.13c - Endeavor to Persevere.... Chris and I started dating in February, he IS the nicest and most humble guy I've ever met.  He's a tad younger than me (9 years!) but we get along great and have been having an amazing time together.  ;-)
(Jill Hunter enjoying the crag all to ourselves...)

The climbing in Lander superb!!  I wrote a feature article about climbing in Lander a few years back that was published in Rock and Ice magazine and currently hangs in my good friends local bar, the Lander Bar (which is THE pub and grill west of the Mississippi).  Jill Hunter has owned the bar for a handful of years now and that place is the center of all climbers universe come summer.  Burgers, beers and ice cream!
Chris trying hard on Organics 5.14a

Jill showing me how to train in the local gym... it's small but packs a puch!!

I donated some blood this winter, trying a route in Killer Cave that I finally did after about a month of trying hard.  I had to pioneer a 'short girl' start, super bouldery, feet cut loose and everything.  Called it '-1 Degree', solid 5.12b. 


Saturday, October 6, 2012

Skin Cancer: What Is It, How To Detect It and Why Early Detection Is Vital To Our Health

This paper explores the three main different type of skin cancers: Basal cell carcinoma, squamous cell carcinoma and malignant melanoma.  Which of the three is most dangerous when it develops and how to recognize growth of a skin cancer lesion.  Skin cancer can be fatal and we will discuss how easy it is to detect and the importance of early detection.  We will also learn how to recognize the signs and symptoms of skin cancer and where to look on our bodies.  Risk factors will be explored, especially those under our control and those that are not, along with a look at the population that is most susceptible.  Tips on how to prevent skin cancer will be highlighted and treatment options will be discussed if skin cancer development occurs.  Abbreviations used in the paper are as follows: Basal cell carcinoma (BCC), squamous cell carcinoma (SCC), signs and symptoms (S/S), ultraviolet light, (UV), ultraviolet light long wave (UVA), ultraviolet light short wave (UVB).  

Skin cancer is the most common form of cancer, it is the abnormal growth of skin cells.  One million Americans each year are diagnosed with skin cancer and nearly half of all Americans will develop a cancerous skin lesion at least once in their lives by age 65.  If left untreated or undetected, skin caner can be deadly, skin cancer claims approximately 11,000 lives each year in the Untied States.  Fortunately, the two most common types of skin cancer, basal cell carcinoma and squamous cell carcinoma are both superficial, slow growing and highly treatable if found early.  Malignant melanomas are a more rare form of skin cancer, while also being a more serious type of cancer, it has the greatest potential to spread to other tissues in the body being potentially fatal if not detected and treated early. 
Knowing the risk factors for skin cancer development and being aware of the environmental component will help you avoid and identify skin cancer.  Most commonly skin cancer develops from improper protection and overexposure to the sun’s UVA and UVB radiation rays.  Generally, people over 50 year of age are at a greater risk for contracting BCC because of their prolonged sun exposure.  Having fair skin, less melanin provides less protection against the sun and it’s widely known if you have light colored hair, eyes or freckles you’re 20 to 30 times more likely to develop skin cancer in your lifetime.  Living at high elevation, in warmer climates, using tanning beds or having a history of sunburns increases risk of skin cancer development.  
Since melanomas are the most deadly form of skin cancer let’s discuss the signs and symptoms of this cancer first.  Melanomas develop usually in preexisting moles because of the concentrated melanocytes which is that pigmented mole or a beauty mark on your skin.  If you’re suspicious of a mole or spot on your skin, the American Academy of Dermatology has formed a self examination guide tool, the A-B-C-D-E guide.  A, is for asymmetry, look for irregular shapes where one half of the mole is different from the other.  B, is for border, irregular, notched scalloped or vaguely defined boarder.  C, is for color, uneven distribution of color or many colors within one mole.  D, is for diameter, any growth that is larger in diameter than a pencil eraser head which is 6mm.  E, is for evolving, changes over time, any itchiness, bleeding, or new S/S. 

Skin cancer usually develops on areas of the body that are most exposed to the sun, like the face, lips, scalp, ears, neck, chest, arms, hands, lower legs and feet.  Skin cancers don’t all look the same but they all involve a localized change in the effected area of the skin.  BCC’s S/S include, a pearly or waxy bump or a flat flesh or brown colored lesion which may ulcerate after a few months, are slow to enlarge or never completely heal.  SCC’s S/S include a firm red nodule or a scaly flat lesion with a noted crusted surface.  The tumor can ulcerate, causing local pain and  may possibly not completely heal.  SCC’s are a more aggressive skin cancer than BCC’s because it can metastasize to underlying tissue and lymph nodes.  For this reason SCC’s are not completely superficial but tend to be more so than malignant melanomas.
Treatment for skin cancers will vary depending on the type of carcinoma or melanoma, it’s location, stage of growth and tissues that have been effected.  Doctors will generally divide skin cancer into two stages: local, effecting only the epidermis, the most superficial layer of the skin or metastatic, spreading beyond the epidermis into underlying tissue, possibly nearby glands and organs.  A biopsy of just the skin will determine the spread of slow moving cancers like BCC and SCC’s.  If the cancer is a melanoma or has existed for a lengthy period, a biopsy of the nearby lymph nodes will be performed or specialized x-rays will be used to determine the potential spread of the skin cancer.  
With early treatment BCC and SCC’s have a cure rate of 95% which includes a variety of techniques like, scarping, cauterizing, freezing and radiation.  Some SCC’s might require the removal by surgery of surrounding skin effected by metastasis which also might require a skin graft to replace displaced tissue.  Melanomas are treated by surgical removal of the tumor along with a wide margin of healthy tissue.  Sometimes nearby lymph nodes are removed and if the cancer has spread to other organs, additional chemotherapy or radiation therapy will be necessary.  Often a reconstructive skin graft will be recommended especially if the cancer was on the face or neck.   
There are a few risk factors that are out of our control when it comes to being predisposed to developing skin cancer.  Genetics seems to play a role in some melanomas that develop in sun deprived areas of our bodies, like the soles of our feet or clefts, where creases are not exposed to sun radiation.  Having a parent or grandparent that had skin cancer might put you at greater risk as well.  Higher risk populations are also seen in people who have multiple moles, precancerous skin lesions, having fragile skin that has been burned or skin conditions like psoriasis.  Individuals who have undergone organ transplants, people with a weakened immune system like having HIV or people receiving cancer treatments are at a greater risk that is out of their control.

Your best defense against skin cancer is covering up from the sun.  Especially covering areas of our bodies that are more sensitive to the sun, like our face and lips.  Wearing hats, sun shirts and using sunscreens and lip balms with both UVA and UVB protection is best.  Sun exposure time should be limited and staying away from direct sun exposure when it’s at it’s strongest during the middle of the day is also recommended.  Avoid sun tanning and tanning beds.  In addition, having a regular medical examination can give your doctor a baseline on preexisting moles that may need to be watched in the future.  Your doctor my detect skin that is abnormal that you might have missed in your own self exam, self exams are recommended every three months.      

Monday, September 3, 2012

Making a 180 On An Iconic Climb, The Cathedral Taverse... a one day odyssey over rock and mountains.

(Summit #1 for the day, Teewinot)

It wasn’t until the 10 minute bridge that I really started to feel the day.  My heavy aching legs could only do the sherpa shuffle back to the car, I had no step in me.  Darkness was pulled over my eyes like a black cloak as my headlamp died and the sun set just as quickly as it had risen that morning.  The memories of my best day out in the mountains were already starting to fade along with the light and all I wanted to do was relive every moment all over, again. 

If you’ve ever read anything I’ve written before, I’m not a choss wrangler.  I like my climbs to be steep and clean.  My first (and really only) negative encounter with the Tetons came on the North Face of Grand.  I literally had to dodge a rock the size of large toaster that would have put my lights out.  It fell from the top of the face, or so it seemed and it fell for minutes before I could decide to dodge left or right about ten inches.  I went right and the toaster went left.  That was pitch one of the North Face.  I clutched my ice axe and cried... but luckily for me the day got better as we climbed higher and are helmets which seemed to be a bull’s eye moved into safer terrain. 

(Descending off Teewinot)

The North Face left a bad taste in my mouth but I went onto climb numerous not-so-perfect routes in the Teton Range.  I never quite fell in love with the Tetons though, I tried to deal with how I felt, whined a little and climbed in the range mainly because it was there and I did love climbing.  My perspective as of recently has changed 180 degrees.  All from one long mountain scramble, one iconic and epic traverse, the Cathedral Traverse, the Grand Traverse’s better half as I see it.

(Brendan, my guide, my partner in life and in the mountains. He always knows the way.)

I’m not sure if I was just ready for the challenge or I was ready to change my views but it all came together on the Cathedral Traverse.  It was the defining moment for me and I turned a new leaf with the Tetons. I think I am finally rising to range, excepting it for what it is, getting more comfortable with the objective hazards and loose rock.  Along with the bad comes the awesome greatness of being high in the sky and climbing to the top of big mountains.  I’m reaching a point where the rewards are finally worth the risk and in reality I haven’t had to risk all that much.  

(Summit #2, Mount Owen. The best climbing and position on the traverse)

The range seems tall, big and alive.  These things have scared me in the past.  Hearing the rock rumble, remembering friends who’ve lost their lives to the rocky and snowy slopes.  I want to live and not risk it all for a climb.  The mountains do have a way of humbling us and humbling us so far that we fear what we love, what makes us feel alive and living in fear is no way to live.  I had to breakthrough the Tetons, stand up, be confident in my skills and movements and put my mind in the backseat.  I finally did and it was so liberating. 

After 18 hours of climbing and descending three great and mighty mountains I arrived at the end that is finally my beginning.  Over seven years in the Teton range I have dreamed of feeling at home.  I almost gave up on loving the Tetons, it was no Yosemite, the land of steep and clean, where I learned to climb without reserve, with passion and confidence. The Tetons required a whole new set of mountain skills and a comfort zone that did not come easily to me.  I finally relished in the environment of mountains that once held a grip on my mind and struck me with fear.  

(Looking over at the mighty Grand Teton. The shaded left side is the North Ridge, our route to the summit. Excellent rock at 13,000 feet!)

As we descended from the lower saddle I was pointing to the sky with my index finger raised high, I felt like I won.  I rambled all the way down the trail, talking, laughing and trying to savor every memory from the day, from that turning point.  Every minute mattered to me, I was awe struck and in the zone mentally and physically.  I was like BRING IT TETONS! 

(Looking back at Teewinot and Owen and the Buffalo fire in the distance)

I think we keep going back because normal things are sweeter before, during and after times in which we challenge ourselves.  I want to always remember how the shadows look dramatic and how the light makes things look inviting.  I want to remember the constant movement of rock under my feet, how exposure makes my heart beat faster, how wind takes sweat off my brow.  It’s a special life, this climbing life and it’s worth savoring and pursuing. 

(Tired kids at the summit of the Grand... still psyched but need to refuel!)


Sunday, July 29, 2012

Elephant's Perch... my third trip to this granite paradise.

I first went to the Elephant's Perch in 2003 and again in 2007, I think... it's been a long time and the years and trips seem to blend together after awhile.  I do remember taking two pervious trip though and how incredible the rock was and also the surrounding area.  The 'Perch' as it's referred to by climbers is really a paradise for all recreational enthusiasts.  Hikers, backpackers, fishermen and of course CLIMBERS.  It rivals the best backcountry granite areas in the Sierras and the Perch is probably my favorite spot for a few special reasons...

The view right from the get go is jaw dropping, awe inspiring.  Granite spires and walls with crack systems running up every peak, begging for a first ascent. 

The boat shaves off five miles of hiking each way (well worth the $16 round trip fare).  The boat operates 7 days a week in the summer and will take a minimum of 2 people anytime.  The pick up times on the opposite side run at 9 am, 11, 1, 3, 5 and the last boat is at 7 pm. I'm not sure after Labor Day of the boat hours. 

The other huge perk is that it's a wilderness area and dogs are allowed, even on the boat and it doesn't cost extra.  So Archie got to join us on this adventure. Luckiest dog I know!  The hike is only 3 miles up to Saddleback Lakes after taking the boat and only about 1400 feet in elevation gain.  Pretty casual for alpine rock climbing in the backcountry!

The Perch is about 1000 feet tall with the longest climbs being 12 pitches.  Most of the routes are high quality pitches in the 5.10 - 5.11 range. Perfect!  All types of crack climbing but predominately finger and hand cracks.  Unfortunately there is a bolting ban, being in a wilderness area, which limits the new route potential.  The wall is perfect solid granite that would need little cleaning for some harder mixed routes to go up.   

The anchors could also use replacing.  There's a lot of old pitons, button heads and rusty 1/4'' bolts from first ascents in the 60's and 70's (I'm guessing the era here).  So with that being said, if you rap off or used a fixed anchor, check the gear and webbing.  The Elephant's Perch doesn't seem to be getting much love in the anchor maintenance department.  I cut off some tat while we were there just to clean things up a bit.  Most routes DO NOT have fixed anchors, especially after pitches 2 or 3 and none after 4 usually.  

I've climbed a good selection of routes now.  The Mountaineers Route III 5.9, Astro Elephant IV 5.10, The Fine Line IV 5.11 (climbed twice), Myopia IV 5.11 (twice twice), The Direct Becky 5.11 (stating 4 pitches), The Original Becky IV 5.11+ (starting 3 pitches only) and Sunrise Book III 5.12-. 

Brendan leading the crux of the Original Becky 5.11+.  A beautiful, technical stemming corner (which I got to follow in the rain!)

During our last trip we got rained off The Original Becky right after the crux pitch. The Direct Becky and Original Becky merge after the first three pitches and finish on the upper four easier pitches of the Fine Line, meeting at the obvious 'Becky Tree'.  So we missed out on four new 5.10 pitches not being able to complete the Original Becky.  Sound confusing yet? It's just a whole lot of great variations and cracks everywhere on the main face, incredible really!  The Original Becky alone will be worth going back to do.

We also got to trout fish in the stunning and pristine Saddleback Lakes.  Our camp was only a few minutes from the shore.  Granite slabs dive right into the water.  Cliff jumping, sun bathing (when it's out) and trout biting the line like crazy.  I crimped down the barbs on the hooks because we were catching so many fish.  We had a few hours every evening after climbing to fish, relax and take in the amazing view.

We're planning a return trip in September.  I'd like to spend enough time there to help Brendan put up a new route or try freeing one of the old aid lines.  The potential is staggering.  I should probably get the ball rolling with Forest Service about replacing anchors and adding a few bolts to new or existing lines... PSYCHED!

Brendan on the Sunrise Book crux pitch 5,12-, almost in the bag.  We have to go back if we want the send and I would happily repeat the route.  The route had some wild climbing, the last pitch is an overhanging bombay chimney rated 5.9+ (sandbag!) but knee bars out the slot and hand jams over the lip is the insane way up  ... totally classic and super exposed.

Friday, July 13, 2012

Letting go to win BIG... how guiding summits and saving lives has more in common than I originally thought.

(Guiding on the Upper Exum Ridge)

Changing careers has forced me to change part of my identity, the part of my identity that has ruled my every spring and fall decision, climbing.  When I moved to Jackson, WY in 2006 from Yosemite Valley, CA becoming a part time guide was a natural decision.  Not a lot of thought went into it, I was a climber and therefore I would guide and I did.  I had before in Moab, UT while living on the road for four years and it was great.  Not a care in the world, just where to climb, what to climb and how hard we wanted to climb.  Easy decisions.  
As I’ve moved into my 30’s I’ve thought a lot about my future.  Like where will the money come from as I get older?  What type of work can my body sustain and still allow me to pursue climbing at a high level?  Do I want to work until I’m 60 or would 50 do? 
I work currently as a full-time massage therapist and to say it’s hard on my body is an understatement.  I’ve had more work related injuries than I’ve ever had from climbing.  My one personality downfall at times, is that I work hard no matter what.  I can push through pain for the paycheck and to please my clients but it would be nice to change this cycle of burnout.  But the money and fairly stress-free work has attracted me since I moved to Jackson and I’m realizing it’s time for a grown up change. 
So I’m undertaking a new career as a medic and I’m finally on that path at the age of 31.  A lot of things have had to give in order for this change to happen and I’ve had a hard time adjusting to giving up my freedom for what will hopefully be a comfortable and secure future.  I had to tell Exum I’m out for good this summer and it was a hard thing to do, letting go of that identity and moving on. The life style of always being out in the mountains, on a quest for the summit or off on another grand adventure.  My days off will be more like this but not my day to day life.  I’m on that same road with massage, giving up a little more all the time in order to make room and time for this change.
(Training during the Wilderness EMT course December 2011)

I’m becoming a medic.  All the guides that thought guide training and auditing was a big commitment need to step into my shoes.  I’m working as a volunteer member of Jackson Hole Fire/EMS with the hope of getting a paid position.  We train four times a month and volunteer on the ambulance 24 hours every month.  We carry pagers when we’re needed to assist the community when there’s a fire, medical or traumatic incident.  It’s a camaraderie that’s similar to the guiding world, risk and rewards that are comparable but getting paid for this job takes time and the transition is much more difficult.
Coming to guiding as a climber is like being a doctor and learning to be a paramedic. It’s a language you already speak and know, it just needs a little polishing.  Being a climber and masseur, doesn’t mean that my transition into emergency medicine is a given or all that easy.  I feel like I’ve read the book on how to sail the ship but have never been at sea and here I am at sea.  We deal with saving lives and homes, it’s a huge responsibility, the clock is ticking and you have to perform now.  I have so much to learn and it’s awesome being new at something that requires critical thinking and action with responsibility and consequence. It’s a career I can tell I want and I’m taking off after it but I have to pay my dues.  So here I am making that room and time and letting go. 
I want a career I like, take pride in, one that is meaningful and also gives me the time off for climbing.  Giving back is also a huge priority as I age, it’s prevalent as guide and a medic.  Teaching people to climb as a guide is giving back to the sport.  I’m asking a lot from this new career.  Living paycheck to paycheck is great in your 20’s and for some, like Fred Beckey, his destiny has been written differently, he will be a dirtbag for life and the greatest example who has ever lived.  Kudos to Fred!  
(Work Capacity Test with Jackson Hole Fire/ EMS)

I have fond memories of guiding clients up the Grand Teton, normal people who had theirs eyes opened wide and now see the world so differently thanks to their guide.  People who come close to death see through the same eyes and when you rescue them and help them extend their lives it has the same rewarding feeling.  Being a medic is so similar to being a guide I’m finding, it’s just a harder transition for me and a more competitive field getting that paid position.  
(Climbing at Rock Springs Buttress)

I give all the climbing guides a huge applaud for taking the AMGA courses and dedicating their lives to a life in the vertical leading others, it’s hard work and a worthy career for some but ultimately wasn’t for me.  I was finding myself too tired after guiding to get out climbing.  I saw no retirement plan and what if I got injured?  
So here I am making big life decisions, taking a new road, learning new skills, getting humbled along the way and giving up some of my identity and it actually feels okay.  I just can’t wait until I feel that same mastery I’ve felt with climbing, that will be a fine day when I save someone’s life.  I will reflect on that moment like I did the first time I guided the Grand, a memorable day of achievement and fulfillment and something that’s greater than myself.  The mountains have taught me many lessons and thankfully at heart I am a climber and will always return to them for insight. 

Saturday, March 17, 2012


Well, I did it... I took the next step toward becoming fully immersed in emergency medicine. Making the commitment to Jackson Hole Fire/ EMS has been a huge turning point toward the ultimate goal, teaching wilderness medicine. The patient experience that I'll gain by volunteering on the ambulance will validate my teaching and give me the real time experience I'll need for this new career.

The Fire/ EMS department in Jackson is made up of 130 volunteers that come from all backgrounds... the members made a point to let me know that this is my new family and to think of station 7 as my second home. The department is tightly connected, I'm sure the work dictates such bonds. The members aren't all backcountry skiers and rock climbers but I am relating easily to them. Kind, caring and easy to talk to... they are people who are passionate and I share that connection with them.

The department reminds me of Exum, a community of people who are personable and want every one to reach their personal and professional goals. When you give, you ultimately receive.

I can see myself getting my EMT - I certification and eventually my paramedic certification. There are a lot of great opportunities at JH Fire/ EMS. If you commit to them, they commit to you... meaning I could take a rope rescue course that would be paid for and also my paramedic training. It's an amazing organization and I am so excited to be part of it for many years to come.

Saturday, January 28, 2012

Cody Ice and Celebrations!

Going to Cody, Wyoming to ice climb has been a trip I've been wanting to take since I moved to Jackson in 2005. This winter we finally made the 5 hour drive... We stopped in Thermopolis on the way over, a natural hot spring paradise. It's not quite like the backcountry soaking of the eastern Sierras but Thermop is a great stop while traveling. The city built a free hot spring pool where one can soak for 20 minutes, then you gotta go.

The ice climbing was outside the city of Cody by an hour, up the South Fork of Shoshone River. Cody is the gateway to Yellowstone National Park. The surrounding area, like the South Fork was really beautiful. Craggy hillsides that are prime Big Horn Sheep habitat. We didn't see any, only extra large cougar tracks...

(Brendan approaching High On Boulder WI 4/4+)

The ice was FAT and in great condition. The South Fork area is considered more 'alpine' compared to place like Bozeman or Ouray. I thought it was quite civilized, the longest approach we did was an hour and not much vertical gain at all. Just enough to warm up before you freeze your butt off on the climb!

High on Boulder was a great first climb in Cody. 3 long pitches of ice and Moonrise is right next door for easy access and linking up routes.

Brendan rappelling off High On Boulder

On day 2, Brendan's 40th birthday, we went to climb Mean Green. It's a classic, not just an area classic but a must do route in the U.S. The first pitch, which I don't have any photos of was a full 55 meters. The ice was all over the board. Plastic, plates, slushy, melted out... the whole gamut.

After the second pitch the climb got really unique. The pitch would top out in a flat gully, like a slot canyon and we'd coil the ropes and walk a short distance to the next pitch. Mean Green goes on for 7 pitches but most parties stop after the crux pitch, which was the 4th.

Brendan approaching the crux pitch of Mean Green... it looks so good! Super long and really steep.
This pillar you could walk around 360 degrees, it was fat and as solid as free standing icicles get. Brendan and I both got pumped on this pitch! What a way to end the climb. I'd bring a headlamp next time and finish Mean Green, there's 3-4 more easy ice slab pitches above this.

Me heading down on rappel. Both days we climbed in two down parkas, it was bitter cold at times. My hands suffered the most. The climbing wasn't all that hard but staying warm during pitches was... the joy of ice climbing. Burrr!!!

Heading back out to the car toward the frozen South Fork of the Shoshone River. Brendan stopped me on the ice and asked me to look at the view with him. I did and he asked me on his birthday to marry him. A present I was thrilled to give him.