How to handle elevation

S

sasha

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Feb 28, 2006
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I love to backpack at the high sierra. But I suffer from altitude sickness. Sometimes it worse then other times. I drink water take some aspirin. Is there anything else that helps. I might get dizzy, Its worse if i stop for an hour or so. When i start walking again it realy hits me hard. So i tend to make no more then 5-10 min stops. Last time it got so bad that had to make camp half way to the planed stop. Another time i done more then 19miles. I do know that i got weak lungs and that it dont help me any... Sometimes i run out of breath and need to stop for 5 min or so and im good to go again. I dont have asthma.

Sasha
 
it could just be a pressure thing, on some days, no matter what I do, a little altitude (ultralight aircraft or mountain) and lunch does not want to stay down. I very rarely get motion sick, so I assume its pressure. do you feel the need to "click" your ears often? what all symptoms do you get? (ie, nausea, headache...)
 
Please pay attention not to stay/sleep/rest at higher altitude.
Try to pass through such point and stop at lower altitude.
This is because only staying at higher altitude does damage to your body,
and often it's worse just to stay than working at high altitude.
If you go down, you can make recover from that damage.
 
It takes time to get the body used to significant changes in altitude. Your body will produce more red blood cells to carry oxygen.
 
I need to 2 to 3 days to adjust if I am going above 10,000' or it just kicks my butt. If I have that adjustment time of spending a few days between 6 to 8K' I am fine. Personally, I think hydration and adjustment time is the key. However, I did read in National Geographic Adventure that Viagra may help with adjusting to altitude quicker.
 
One of my friends (and his girlfriend) swear by ginko biloba. I researched it a little and initially there were some studies suggesting it might help. Unfortunately, later research seems to be to the contrary. Nonetheless, my friends certainly believe it's useful for them. [After reading the more recent research, I decided not to bother trying it.]

I've met some high altitude mountaineers who advocate a breathing technique that involves very briefly holding your breath periodically (every few breaths) and sort of compressing the air. The theory is that it helps air through the lung membranes a little better than plain breathing. I've never researched the technique to see whether it's credible but I could not get used to the interruption of my natural breathing cycle. Anyone know whether that can actually help or is just an Old Mountaineers' Tale?

Needless to say, spending time at altitude, moving at a relaxed pace, and staying hydrated (as mentioned above) are all good ideas.

DancesWithKnives
 
I've done a bit of research on this topic as I too suffer from altitude related problems. It seems to vary each year as to severity and duration. This year was the worst. I drove from sea level to 6000', stayed the night, then packed in to 8500'. I vomited for several hours the first night and generally felt lousy with a headache which was tolerable during the day, but would return with a vengence every night for four days. It was AMS (acute mountain sickness) that I had. I stayed hydrated, rested as much as possible, avoided alcohol all to no avail. Had I continued to vomit the second night, I would have retreated to a lower elevation but I was there to hunt and didn't want to leave. After about 4 fairly miserable days, I started to feel better. HAPE (high altitude pulmonary edema) is a more serious version which causes fluids to build up in the lungs. Immediate retreat to a lower elevation until the fluids are absorbed into the body is the best treatment. HACE (high altitude cerebral edema) is a life threatening conditon which again requires immediate retreat. I have heard there is a prescription drug which helps with AMS. I can't remember the name of it now, but I will definitely find out before next elk season. If anyone has any thoughts, I'd like to hear them.
 
I used to live summers at 9400'. Never did get "mountain sickness" but no matter how fit I became at 9400', it still kicked my butt to climb above 11000'. :D

I live at 6600' now. And although I'm perfectly functional for everyday activities, I'm not in an athletic condition. So I ~really~ suffer now going to 9,000'.

So the trick, I think, is to get in shape. People who aren't in shape at their own elevations naturally aren't going to do well at higher elevations. ;) And if you're not accustomed to performing a specific task at your own elevation, you certainly aren't prepared to do it at a higher elevation either. Not being rude, but it takes a couple of weeks to become acclimated to an elevation increase; people in good physical shape acclimate faster and with fewer problems. Going along with that, don't push yourself too hard to begin with - plenty of breaks, snack stops, water stops, photo stops, and keep a slow but steady pace.

So i tend to make no more then 5-10 min stops. Last time it got so bad that had to make camp half way to the planed stop. Another time i done more then 19miles. I do know that i got weak lungs and that it dont help me any... Sometimes i run out of breath and need to stop for 5 min or so and im good to go again.
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That sounds completely normal for an average-condition person coming from sea level. It'll be more noticeable as you get older too (ask me how I know), and will especially become more difficult if you don't maintain a physically active lifestyle at home.
 
I live at 300', and I like to go up to over 14,000' in the Sierras. If I go up too fast I get altitude sickness. Acclimating over time makes it a lot easier. If I stay below 12,000' for the first few days on a trip, it gets better. But if I push it hard I still feel it, and the first night at elevation above 10,000' is rough. But after sleeping at elevation at least one night I feel much better.

Another thing that I have discovered is that aspirin helps me deal with the elevation. You just have to remember that aspirin will also make it harder to stop bleeding if you are injured.
 
go2ndAmend (love your screen name, by the way!),

I believe you are thinking about the prescription medication Diamox. Last summer I did a five-day, 56 mile mountain hike over a number of 10-11,000 ft passes. One of the participants was a brilliant and very knowledgeable MD who frequently suffers from altitude sickness. I mentioned Diamox and he responded that he would not even consider it because of several potentially serious side effects. I forgot what they were but I expect they are in the literature if one did some research.

We stayed at about 8-8,500 ft. for a couple days before the trip, took it slow, made frequent rest stops, and drank plenty of water. One person needed a couple aspirin on two days for mild headache but nobody else had a problem.

Although I've read that two days at altitude is not enough to make a significant difference, the MD and others felt that it helped them personally.

DancesWithKnives
 
Diamox is approved for use and has evidence to help prevent and in some cases treat mtn sickness>

diamox-Acetazolamide
FDA Labeled Indication
1) Overview

FDA Approval: Adult, yes; Pediatric, yes (extended-release capsules only, 12 yr and older)

Efficacy: Adult, Effective; Pediatric, Effective

Recommendation: Adult, Class IIa; Pediatric, Class IIa

Strength of Evidence: Adult, Category B; Pediatric, Category B

See Drug Consult reference: RECOMMENDATION AND EVIDENCE RATINGS

2) Summary:

Indicated for the prevention or amelioration of symptoms associated with acute mountain sickness
Normalized sleep-disordered breathing associated with high-altitude

3) Adult:

a) Acetazolamide prophylaxis resulted in a substantial decrease in incidence and severity of acute mountain sickness in comparison to placebo treatment. In a large, randomized, double-blind, controlled trial comparing the efficacy of ginkgo biloba and acetazolamide, 118 healthy non-Nepali trekkers on the approach to Mount Everest received acetazolamide 250 milligrams twice daily, and 119 similar trekkers received placebo. Treatment was initiated at approximately 4300 meters (m)/14,100 feet (ft) elevation. None of the participants had mountain sickness at the initiation of treatment, according to the Lake Louise questionnaire, a validated standard for evaluation of acute mountain sickness in the field. Re-evaluation at 4928 m/16,168 ft revealed acute mountain sickness in 12% of the acetazolamide group and in 34% of the placebo group (odds ratio 3.76; 95% confidence interval (CI), 1.91 to 7.39). Mountain sickness was severe in 3% of the acetazolamide group and 18% of the placebo group (odds ratio, 6.46; 95% CI, 2.15 to 19.4). In the acetazolamide group, the number needed to treat was 4 to prevent one episode of acute mountain sickness and 7 to prevent one case of severe mountain sickness. Addition of ginkgo biloba 120 mg to the acetazolamide treatment did not improve outcome in comparison to acetazolamide and, in fact, appeared to somewhat reduce the efficacy of acetazolamide (Gertsch et al, 2004).
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The side effect risks he might have been thinking of was edema in the head. Of greater risk would be excessive loss of potassium.

IMO, it would be worth if someone gets enough altitude sickness to cause interfere with one of life's joys, but would not be worth it if altitude is usually not a problem for the hiker.
 
I routinely work and sleep above 5000m (16,200') here in Peru, and I can tell you from my own experience and from watching those that I work with that everyone reacts differently; how one reacts to the altitude today does not completely dictate how he/or she will react the next time. I think those that are physically fit have only a slight advantage; I've seen skinny fit guys that needed to get medevaced out and fat out-of-shape guys have no problem at altitude.

The locals here that live at these elevations are incredible, they run up and down the mountains carrying loads like they are at sea level, yet send one down to sea-level in Lima for a few days and more often than not he will have the same reaction as everyone else when he gets back up to altitude.


100_0473.jpg

Working at 5100m (16,700'), the volcano Tutupaca in the background, Moquegua, Peru

I have a good friend that was a guide and rescuer at Mt McKinley in Alaska. His climbing partner of 20+ years had altitude sickness the last time he climbed it, this was the first time he had had a bad case of it. Every time he has returned to altitude since then he has had the same reaction, which has basically put an end to him climbing the high peaks.

My advice:
1) take your time getting to altitude (in the order of days) to acclimatize
2) move slow
3) cut your pack load down considerably
4) make sure you are well rested before you start out (for me personally this makes all the difference!)
5) breath ! I like to force myself to breath heavy before I climb even the first step, twice as hard as my body it telling me to, climb ten steps, then pause for five seconds
6) sleep at a lower elevation, most can quite comfortably sleep at 3000m.
7) don't try to be macho and act like there is nothing wrong and that "I can handle it", or "I'm OK, I do this all the time", I see this one all the time, if you are with someone that is already acclimatized, let them carry the heavy load while you take it easy
8) stay hydrated
9) keep yourself covered from the sun, the sun is much stronger at altitude, combine heat/sun stroke with the effects of altitude and it can make for a miserable experience (I think that quite often sun stroke is mistaken for altitude sickness)
10) there is no magic drug that will completely mitigate the effects of altitude, the locals here in Peru chew coca leaves, this mostly masks the symptoms, it is no substitute for proper acclimatization


 
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