14ers.com

tinman wrote:From what I've heard and read, AMS is not particular to who it hits. I've read that you can hike in the mountains a hundred times with no problems and then on then next trip, pow! Anyway, I'm a native Austinite and have lived now in Houston for the past 15 years. We've been hitting the 14ers for the last 5 years and find like others have noted above that hydration is the key. I drink a gallon of water on the drive up and continue to drink while we're up there and have never had a problem. We'll be back in August with the intent to finish the last 8 14ers on my list. Josh, if you want, send me a pm and we can talk 14ers.

On another note regarding hydration, i find that adding some type of electrolyte/energy supplement to a camelback works wonders in keeping energy levels up/endurance/balancing your electrolytes throughout the day.

Nuun.

Yeah - we had attempted to remain hydrated in the days prior to the hike. On the hike, we were both carrying 2.5 liters of water and an additional 700 ml of Gatorade, which we were consuming readily throughout the hike. As others have already said, I have noticed that Gatorade-type fluids really help in balancing out the body and its electrolytes. On hikes around water sources (I fish high mountain streams, so this is my usual scenario), I typically carry a small filtration system and a 700 ml of Gatorade. I drink water regularly throughout the day and drink the Gatorade on a schedule (about a quarter of the bottle every 2 hours or so). This and proper caloric intake has really helped me maintain energy on my adventures.

I'll have to check out the Nuun product. Thanks again for the feedback.

As far as doctors are concerned, I'd only suggest that you try to find one with some understanding and appreciation of backcountry and high-altitude hiking. When I lived in Florida and asked my doctor about getting prescriptions for things for a backcountry medical kit (like pain killers and an epi-pen), I got the response "oh, you don't need those things." This doctor apparently had no idea what can happen in the backcountry and how long it can take to get medical attention if something does go wrong there.

My (now ex-) wife climbed two 14ers, and spent a few nights above 11,000 feet (High Camp on Mt. Whitney and the Boulderfield on Longs) with no problems. Then she got AMS at about 9,000 feet in Breckenridge and Frisco. After that, she swore by Diamox.

Many of my friends are from out of state, so when they come to visit and want to climb a 14er, I make sure to get them drinking a ton of water the day before and day of the hike. Also, I give them 2 advil in the morning when we wake up, another at the trailhead, and 2 more during the hike (my friend is a physician assistant and assured me this is not overdoing it on advil). I make sure they eat during the climb and always check to see how they are doing, keeping a slow steady pace. I've been able to get everyone to the summit, without any issues. That is just my routine, but I know altitude effects are different for everyone.

Chinook wrote:Many of my friends are from out of state, so when they come to visit and want to climb a 14er, I make sure to get them drinking a ton of water the day before and day of the hike. Also, I give them 2 advil in the morning when we wake up, another at the trailhead, and 2 more during the hike (my friend is a physician assistant and assured me this is not overdoing it on advil). I make sure they eat during the climb and always check to see how they are doing, keeping a slow steady pace. I've been able to get everyone to the summit, without any issues. That is just my routine, but I know altitude effects are different for everyone.

Be careful with the Advil. The one issue you could run into there is if your friend was to become dehydrated while hiking, having taken Advil, they can end up with Kidney failure pretty easily. Advil won't cause problems if you stay well hydrated, but if you take it and get very dehydrated you could end up hospitalized with kidney failure.

Separately there has been some cases of exertional hyponatremia where NSAIDS have been mentioned as a potential contributing factor due to the altered kidney function.

Granted both of these are rare, but something to at least be mindful of prior to popping some pills.

Got my script of Diamox. Coming from Elv 750ft, and not much time to acclimatize, would like to quick strike or drive by climb Democrat Group or Sherman. Plan on camping at 7,000 1st night, camp @ TH 2nd nite and Climb on D3. Should the Diamox help with this plan or can I be even more aggressive and climb on day after arrival? I know this depends on the individual but opinions from those of similar situation and Diamox experience is appreciated. Thanks

My family group of four, coming from similar elevation, followed this script last year: Flew in Friday evening, motel at (?) maybe 8,000 feet first night, camped at ~11,000 ft. the second night, climbed Lindsey next morning - less than 48 hrs in-state. Three of us took Diamox and thought it helped, but it was still tough. Even when you don't have recognizable physical symptoms, I'm convinced the altitude has an effect on decision-making. Our plan this year: Fly in Sat. AM; motel at ~8,000 ft. Sat. night; climb Sherman Sunday; Quandary West Ridge Monday. We're counting on good physical conditions + Sherman being a short, easy hike by 14er standards + Diamox + massive hydration.

I live in Missouri. Was in Colo two weeks ago. Arrived on a Sat, did an eight mile hike on Mon, did a four mile hike on Wed, and attempted La Plata on Thurs. We made it to 14,000 feet on the SW Ridge Route, retreated because of lightning. We drank plenty of water frequently. I think the warm=up hikes and hydration helped a lot. Other than being tired, I felt great, no headache or anything. In years past, I have felt horrible, usually on the way down or later that evening. Hydration (water and Gatorade) was the key.

joshmcd wrote: We started out around 5:45 AM on July 11. Everything went well until we hit 11,500, at which point my wife began to become very emotional about the climb. It seemed kind of odd to me and she kept making statements about how steep the climb was and that she was becoming frightened. She insisted on continuing, but kept making comments of being scared.

This part of your narrative really stood out to me. I'm a CO native, so I'm more used to altitude, but I know I'm not immune to altitude sickness. I've been hit by it a couple of times, and seemingly completely at random. Luckily it was never a very serious case, just mild nausea and lightheadedness. I hydrate like crazy for a few days leading up to the climb and this really helps. But I have often found on my 14er trips that I get more anxious/emotional the higher I go. It doesn't fit a particular symptom, it's just an overall feeling of anxiety and discomfort, and sometimes being downright scared or upset. Does anyone know: Is this also an effect of the altitude, and is there a way to prevent it? If the verdict is that I'm just a worry wart, well, that's certainly a possibility too.

Lotso wrote:Got my script of Diamox. Coming from Elv 750ft, and not much time to acclimatize, would like to quick strike or drive by climb Democrat Group or Sherman. Plan on camping at 7,000 1st night, camp @ TH 2nd nite and Climb on D3. Should the Diamox help with this plan or can I be even more aggressive and climb on day after arrival? I know this depends on the individual but opinions from those of similar situation and Diamox experience is appreciated. Thanks

I have always lived close to sea-level as well and I have been over 14,000 ft a couple of time in CA within <24 hours coming from sea-level and never had any big issues even without Diamox but I have taken it in Peru to help sleep at higher altitude. For me, key always was being in good shape (lots of interval and endurance training), hydrate like crazy and aspirin, which thins your blood and helps to prevent mild headaches.
Your schedule looks fine but more important than simply being at altitude is to actually have some physical activity, such as a moderate hike, at altitude. For example last year the day I got to CO, I drove up to Loveland Pass and did Sniktau (easy hike with 3 miles rt to >13,000ft). Make sure you know your body and listen to your body!
Have fun!

I just reviewed this topic on Uptodate.com, a comprehensive review site/cheatsheet for physicians. Diamox helps speed up acclimatization but probably has little or no effect in treating altitude sickness once it has begun. It may prophylax against altitiude illness.

Mild altitude sickness can be treated with rest, fluids, NSAIDs and descent to lower levels. Severe altitude sickness (including HAPE and HACE) absolutely requires steroid therapy (decadron), as well as other measures such as descent, O2, fluids, etc...

I always bring steroids when climbing in Colorado since it seems to be the only potentially life saving medicine that can easily be administered before help arrives. I used to take Diamox prophylctically, but it gave me terrible tingling in the hands. I may try again this year at a lower dose.