Wednesday, January 20, 2010

A Medical Miracle Nears a Milepost

After a hiatus from blogging, I came upon this follow-up article on Diane Van Deren in the New York Times. Since I've barely logged a blog entry since the first article appeared, I thought this would be a nice way to revive the blog, while passing along a compelling story about a phenomenal trail runner.

Enjoy -- and see you on the trail!


Photograph by Matthew Staver for the New York Times.

Medical Miracle Nears a Milepost
By JOHN BRANCH
Published: January 19, 2010

In the dozen years since brain surgery brought relief from debilitating epileptic seizures, Diane Van Deren has become one of the world’s top endurance runners. She regularly competes in long-distance tests of perseverance, 100 miles or more through wicked terrain and tortuous conditions. She won the 300-mile Yukon Arctic Ultra two years ago, pulling a sled through the depths of winter, and was the first woman to complete the 430-mile version last year.

Preparing for her next adventure, Van Deren, a 49-year-old from Colorado, recently did something she had never attempted.

“It was the first time I’ve ever run on a treadmill,” she said.

Van Deren left for South America on Monday to climb Mount Aconcagua, the highest mountain in the Western Hemisphere — twice. Two things make this trip different from anything she has done.

First, Aconcagua, in Argentina near the Chilean border, is 22,841 feet (6,962 meters), and Van Deren has never climbed higher than 15,000 feet. As part of an expedition with the North Face, Van Deren and about 15 others will embark on a two-week climb. Once back down, Van Deren plans a speed ascent with the well-known mountaineer and Aconcagua climbing veteran Willie Benegas. It would be a 75-mile (120-kilometer) round trip with 18,000 feet in elevation gain. They think it can be done in less than 35 hours.

Second, Van Deren’s body and mind will be continuously monitored by a research team from the Mayo Clinic, using state-of-the-art equipment.

Not only had Van Deren never been on a treadmill — “If I’m an endurance athlete, and sponsored by North Face, I have no excuse why I shouldn’t be able to train outside,” she said — she had only once tried to run with a simple heart monitor, she said.

For someone missing a kiwi-size portion of her right temporal lobe, which disabled much of her memory and organizational skills, a heart monitor was “too much detail,” she said.

“I know my body by feel,” she said during a phone interview from Colorado last week, where she ran ridges between 13,000-foot peaks near Loveland Pass. “I’m so in tune with how I feel and how I need to perform at my best.”

But Dr. Bruce Johnson, a professor of medicine at the Mayo Clinic, wants to know how Van Deren does it. He and several associates will accompany the expedition to the summit the first time, testing Van Deren’s physical and cognitive skills as she fights the effect of altitude. During Van Deren’s speed ascent, the Mayo team will use wireless instruments to monitor a wide range of vital signs.

“We’re not only interested in human performance and the limits of human performance, but we’re interested in how it integrates with environmental issues — altitude, cold, heat,” Johnson said in a phone interview.

Van Deren, profiled in a New York Times article last July, had her first grand mal seizure when she was pregnant with her third child about 20 years ago. For most of a decade, seizures struck unpredictably several times a week. When Van Deren was home in the foothills southwest of Denver and felt one coming, she hurriedly laced her running shoes and ran out the door.

Sometimes she ran for hours. Sometimes she ran through the night. It kept the seizures at bay. Surgery seems to have put an end to them altogether.

“My obstacle now is the brain injury,” she said. “That’s a huge part of my puzzle.”

Most of Van Deren’s brain was not affected by the lobectomy. She is bright and bubbly, seemingly hardwired with enthusiasm and optimism. But inside, she lost many things, including memories of her honeymoon and an ability to find her parked car.

Van Deren finds it difficult to pack for races, read maps or follow directions along a course. But her mind also seems free from the toil of time and distance, and some wonder if the surgery actually helped her run.

In December, Van Deren went to the Mayo Clinic in Minnesota for three days of baseline tests for the Aconcagua ascents.

“They threw 35 pounds in a pack, and they had electrodes all over my body, and I had a sealed mouthpiece and my nose was pinched, and I had to go on, I think, a 15 percent grade on the treadmill,” Van Deren said of the hardest test. “And I had to go as long and as far and as hard as I could for an hour.”

It was just one part of a battery of tests to see how Van Deren would respond to various conditions.

Her maximal oxygen uptake, one way to measure fitness level, Johnson said, was about twice the average for a woman her age. She could sustain heart rates of 97 percent of her maximum for long periods. Her lung surface area is about one and a half times the average size. Her muscle efficiency was much better than normal. Her “peak aerobic capacity,” Johnson said, is well above what would be normal for a 20-year-old, never mind someone about to turn 50.

“My guess is that she’ll do a lot better than we will,” Johnson said of the Aconcagua trek, with a laugh. “My only worry is trying to keep up with her to do some of our monitoring.”

Van Deren will wear a strap around her chest to track heart rate, respiration rate, temperature, oxygen saturation and other signs. A finger probe will track heart rate and oxygen saturation, too, as she sleeps. An armband will measure motion, her number of steps and estimate physical activity. A machine will occasionally measure oxygen consumption and carbon dioxide production. Cognitive testing will gauge the effect of altitude on her mind, too.

“She’s a proven entity in extreme environments,” Johnson said. “She can run continuously for 10 to 12 days, with intermittent catnaps and extreme cold, and so the only real question is how she handles the altitude. And she’s probably trained for it about as good as you can. So I think she’ll do phenomenally well.”

Still, among the nervous is Dr. Don Gerber, a clinical neuropsychologist at Craig Hospital, a neurological rehabilitation hospital in Englewood, Colo.

Van Deren calls Gerber her coach, the man who trains her mentally for the adventures. Gerber helps her organize and set strategy. He has her put several copies of route instructions in different pockets and compartments, for example.

In the case of Aconcagua, Gerber — despite coordinating the cognitive testing part of the research — tried to talk Van Deren out of going.

“My concern is the altitude, and the effects of high altitude on her,” he said.

“I don’t know anyone with her kind of surgery and medical history who has attempted anything like this.”

Van Deren is not the type to be stopped. During a dinner near Lake Tahoe last year with North Face executives, she learned that Jacob Uhland, the company’s director of Latin America, was organizing a trip up Aconcagua for about 10 South American managers.

“Diane said: ‘Wait, I want in on this. Can I come?’ ” Uhland said.

Sure she could. She could go up Aconcagua twice if she wanted, maybe even try to set a speed record.
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1 Comments:

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7:51 PM  

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