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Altitude Sickness...

FAQ and threads for those just starting to hike the Colorado 14ers.
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Re: Altitude Sickness...

Postby Jim Davies » Sun Jan 15, 2012 12:31 pm

Very fit people are often more likely to get AMS, because they ascend too fast.
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Re: Altitude Sickness...

Postby bking14ers » Sun Jan 15, 2012 1:48 pm

In a discussion about AMS a year or so ago, a responder said it may be CO2 build-up or something. They went into detail and it certainly sounds very possible, but I can't remember what post they made that comment under. They learned about that problem in a mountaineering class. I think the speed of ascending was the biggest culprit.

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Re: Altitude Sickness...

Postby speth » Sun Jan 15, 2012 4:44 pm

SeracZack wrote:
bking14ers wrote:My nephew gets altitude sickness really bad, and he is very fit. Does Diamox work as good for very fit climbers? Has any fit climbers prone to AMS been cured of it by using Diamox? The dumb thing is, the closer we get to the summit the AMS goes away, and he becomes Super Man. On the way down it all comes back just as bad.


That doesn't sound like AMS. AMS will get worse as you go up and will go away only with descending. I could be wrong, but that sounds like something else. But I am certainly no expert here.


I would tend to agree, that sounds like bad pacing to me. He was probably pushing it too hard and his body let him know - by the time you've been hiking for hours on end, you're bound to 'work into' the pace that is comfortable and safe for your own body. My two cents.
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Re: Altitude Sickness...

Postby atbaritone » Sun Jan 15, 2012 6:05 pm

I can second what many relate here regarding their trips. Numerous times I drove 18 hours overnight from near sea level in Indiana or Kentucky and would arrive in the morning at a 14er trail head and begin climbing right away. Besides feeling generally sluggish, neither I nor my buddy felt headaches, nausea, etc. We were in very good shape when we were doing this, and were always conscious of hydration. Only once did I feel any symptoms, and that was a very decreased appetite the second day of a trip. (We drove 18 hours overnight, climbed Mt Evans upon arrival, stayed overnight in Georgetown, climbed Grays and Torreys the next morning, then drove back east. 36 hours in the car, 36 hours in Colorado. My appetite left after climbing Torreys and returned in Kansas.)

Always be ready for the onset of symptoms because previous good experiences may make you loath to accept current physical conditions. Always listen to your body and be ready to get to lower altitude as soon as possible.

Something I am interested in, perhaps you can experiment: do you fart more at higher altitude due to the natural decrease in atmospheric pressure?
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Re: Altitude Sickness...

Postby Yikes » Sun Jan 15, 2012 6:23 pm

atbaritone wrote:Something I am interested in, perhaps you can experiment: do you fart more at higher altitude due to the natural decrease in atmospheric pressure?


yes, HAF (High-Altitude Flatulence)

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Re: Altitude Sickness...

Postby asbochav » Sun Jan 15, 2012 8:27 pm

bking14ers wrote:In a discussion about AMS a year or so ago, a responder said it may be CO2 build-up or something. They went into detail and it certainly sounds very possible, but I can't remember what post they made that comment under. They learned about that problem in a mountaineering class. I think the speed of ascending was the biggest culprit.


CO2 does NOT build up in your body, in fact the opposite happens, because of the low air pressure the environmental partial pressure of CO2 is also low, and that makes it EASIER for CO2 to get out of your system via the lungs. So your CO2 goes down, not up. But this causes a problem, because the main stimulus to breathe is rising CO2 levels, not as you might expect low oxygen levels. So you are now breathing less, and this is obviously NOT good as the environmental partial pressure of O2 is already low because of altitude, so breathing more slowly means your system gets even less O2 to meet its needs.

Diamox or acetazolamide is a carbonic anhydrase inhibitor that has the effect of stimulating respiration, thus helping the body get more oxygen. There's lots more to this, especially WRT the development of potentially fatal pulmonary and cerebral edema. This whole subject comes up quite a bit here and there are usually plenty of anecdotes but a dearth of good medical information.
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Re: Altitude Sickness...

Postby Monte Meals » Sun Jan 15, 2012 9:26 pm

While agree with (most) of the comments regarding altitude problems -

Please *do not forget* the arid / low humidity impact as well.

I am a runner and it took me longer to adapt to the searing dryness in my throat than the low oxygen content.

Suggestion - swab your nose (Q-tip with baby oil) before bed -

And of course, a HEALTHY dollup of Jameson is always a good idea ;->

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Re: Altitude Sickness...

Postby DeTour » Mon Jan 16, 2012 12:00 pm

bking14ers wrote:The dumb thing is, the closer we get to the summit the AMS goes away, and he becomes Super Man. On the way down it all comes back just as bad.

Sir, your nephew clearly suffers from a well-documented medical condition known as Summit Fever.
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Re: Altitude Sickness...

Postby IAmtnclimber » Mon Jan 16, 2012 8:00 pm

We usually take 3-4 days to acclimate as we live at about 800 feet above sea level. We take some shorter hikes at different elevations slowly working up higher. Everyone is different. Plenty of water before, during, and after the hike and a good slow pace early on. No magic recipe works for everyone. Tried Diamox one year, didn't really care for it.

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Re: Altitude Sickness...

Postby dmdoug » Mon Jan 16, 2012 8:23 pm

24 - 48 hours before climbing I do the following which works for me coming from 900 feet:

Increase hydration - include electrolytes or you'll get water intoxication.
High carb diet - Fat and protein need more oxygen to metabolize and carbs are a more efficient energy source at altitude.
No caffeine or alcohol - for the first couple days anyway.
Take a snack break on the hike every hour or so and include electrolyte replacement.
The 13ers above Loveland Pass are perfect for getting to altitude quickly and they are still close to the Interstate if you need to descend quickly.

I've tried pressure breathing the last time I was up but I don't know if it helped me because I was feeling good anyway. Here's a video showing someone measuring their blood oxygen while pressure breathing. It goes from 84% to 98% after about 7 pressure breaths.


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Re: Altitude Sickness...

Postby Nelson623 » Mon Jan 16, 2012 8:57 pm

Pulmonary hypertension resulting from hypoxia is the foundation for these problems.
Last edited by Nelson623 on Tue Jan 17, 2012 6:27 am, edited 1 time in total.

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Re: Altitude Sickness...

Postby HighCountry_Tiger » Tue Jan 17, 2012 3:09 am

As for the CO2, it decreases in your blood. There is no debating that. As you ascend your breathing becomes more rapid meaning you "blow off" your CO2. As a consequence you progress towards a state of respiratory alkalosis (increase in pH). To compensate the body must excrete bicarbonate ions which in turn helps to decrease your pH. This is the purpose of diamox. Diamox will help your body more quickly reach a state of compensated respiratory alkalosis, not mask symptoms.

Your body also reacts to the hypoxia through vasocontriction of the pulmonary circulation in an attempt to match vent/perfusion. This vasoconstriction can cause pulmonary hypertension which can lead to pulmonary edema and HAPE. Cerebral circulation also increases and I believe the pathology is similar for cerebral edema.

Another compensatory mechanism is your body increasing its red blood cells (hematocrit). It does this by releasing EPO which "calls out" reticulocytes from your bone marrow. It also increase mature RBCs production but this takes about 30 days to complete.

In understanding this you can see how diamox will work. Note: don't take diamox if you are allergic to sulfa. Hydration is important. There isn't too much you can do to stop pulmonary vasoconstriction and unless you have EPO shots or a bag of PRBCs, you really cant increase your H&H. None of this is really about how athletic you are, but your body's ability to compensate.

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