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14er newbie - frequent urination while hiking, AMS??

FAQ and threads for those just starting to hike the Colorado 14ers.
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Re: 14er newbie - frequent urination while hiking, AMS??

Postby summerspirit » Tue Sep 18, 2012 8:41 pm

LuLuLuv wrote:It could be TBS, that is what I have...tiny bladder syndrome. Its nothing for me to urinate up to 8 times, I do drink a lot, usually carrying 3 liters. But I stay pretty hydrated most of the time.


Haha I think you may be right! :) I'm glad I'm not the only one making so many pit-stops along the trail :)

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Re: 14er newbie - frequent urination while hiking, AMS??

Postby summerspirit » Tue Sep 18, 2012 8:47 pm

iholdthepain wrote:...again, easy for me, but what about the Mrs? Should I just send her back to the Goblin Forest?! Nobody checks out the view from a 2ft high crouching position, pants around the ankles... it gets a little wide open o some of these hikes... especially above 11,500ft.


Every time I had to 'squat', I'd wish I was a guy! There's not much you can do though, if you gotta go, you gotta go! I just tried to find the tallest rock, squat as low as possible and not think much about it. Hopefully others just turned away if they noticed.

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Re: 14er newbie - frequent urination while hiking, AMS??

Postby GregMiller » Tue Sep 18, 2012 8:52 pm

I'll chime in as another frequent urinator, but again, I take 3-4 liters of water, and a liter of gatorade, and usually go through almost all of it. As far as squatting/not, here's some reviews on some newer products that might suit your needs:
http://www.backpacker.com/gear-zone-gear-review-female-urination-devices/gear/14173

Something that I've found prevents dehydration in the first place, or at least helps me feel a ton better on the trail, is to drink a liter of gatorade the night beforehand. That way I'm not trying to chase down dehydration in the morning (cue mountainmedic explaining how I'm full of s#$t on this one).
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Re: 14er newbie - frequent urination while hiking, AMS??

Postby MountainMedic » Tue Sep 18, 2012 9:12 pm

HAPE and HACE are life-threatening. With HAPE, your breathing will feel "wet." You can hear pulmonary edema with a stethoscope, or, in very severe cases, by simply putting your ear up to somebody's chest. There may be some chest pain. As a matter of fact, HAPE was misdiagnosed for years - doctors were trying to figure out why young men were climbing mountains and dying of "pneumonia."

This is a massive oversimplification, but if AMS is like a hangover, HACE is like being annihilated/intoxicated/inebriated like crazy. The HACE patient will probably be unable to walk in a straight line, will be confused, and will be extremely drowsy. Think the first time you drank heavily and had no idea what the hell was going on. This is thought to be due to brain swelling as well as a neurotransmitter deficit - the enzymes that make many key neurotransmitters require lots of oxygen to function, and just don't get enough at altitude. As HACE progresses, symptoms become increasingly stroke-like.

For AMS and HACE: Acetazolamide (easy to get), dexamethasone (hard to get)
For HAPE: Nifedipine (not easy to get), Viagra (well, depends on who you are...no, this is seriously gaining traction as a high altitude drug)
I do not advocate using any of these without the proper training! A clinical dose of Nifedipine may make you unable to walk at altitude, and Viagra can decrease your blood pressure to a lethal level. Acetazolamide is somewhat safer. If you know you have issues with altitude or you are sleeping frequently at very high altitude and have sleep apnea, it's not a bad idea to talk to your doctor about getting a prescription. People tend to use it wrong, though - it's really only effective for AMS prophylaxis and to promote better breathing while sleeping at altitude. While it can work to treat AMS, it's not as effective.

Fortunately, this is mostly useless in Colorado - we're only likely to suffer from these if we go pretty much straight from sea level to 12,000 or higher. If you've got a chest cold, though, the chance of getting HAPE increases significantly, so be careful...not fun, from what I've heard.

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Re: 14er newbie - frequent urination while hiking, AMS??

Postby MountainMedic » Tue Sep 18, 2012 9:14 pm

farcedude wrote:I'll chime in as another frequent urinator, but again, I take 3-4 liters of water, and a liter of gatorade, and usually go through almost all of it. As far as squatting/not, here's some reviews on some newer products that might suit your needs:
http://www.backpacker.com/gear-zone-gear-review-female-urination-devices/gear/14173

Something that I've found prevents dehydration in the first place, or at least helps me feel a ton better on the trail, is to drink a liter of gatorade the night beforehand. That way I'm not trying to chase down dehydration in the morning (cue mountainmedic explaining how I'm full of s#$t on this one).


What a farce. Nah, man, drinking stuff is good. I'm totally with you on this. Drink before you climb, so you don't have to spend the entire climbing day chugging water. If I prep right, I can climb for 12 hours with 2L of water. Not saying it's smart, but it is convenient.

Oh, and HAF is a serious condition. Many a climbing partner will keep their distance until my colon "acclimates."

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Re: 14er newbie - frequent urination while hiking, AMS??

Postby climbingaggie03 » Tue Sep 18, 2012 9:38 pm

iholdthepain wrote:
speth wrote:
iholdthepain wrote:Speaking as a fellow 14er newbie...

...since it's being discussed, what IS the proper etiquette for making pitstops on hikes/climbs?


Just turn your back on the people on the trail. They might even think you're just enjoying the view.


...again, easy for me, but what about the Mrs? Should I just send her back to the Goblin Forest?! Nobody checks out the view from a 2ft high crouching position, pants around the ankles... it gets a little wide open o some of these hikes... especially above 11,500ft.



This is easy, just hike in winter and on weekdays or at night. I hiked barr trail last week and could have peed off the trail any time I wanted. This spring I was on quandry on a tuesday, I checked all the trail heads I was the only one on the mountain, although the mountain goat did look a little embarrassed when he caught me squatting over a cathole.

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Re: 14er newbie - frequent urination while hiking, AMS??

Postby laxcountrypiper » Tue Sep 18, 2012 9:43 pm

I keep this scorecard in mind sometimes. It helps me assess how quickly I'm getting worse or better.

http://www.thepeakinc.com/downloads/lake-louise-score.pdf

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Re: 14er newbie - frequent urination while hiking, AMS??

Postby jdorje » Tue Sep 18, 2012 9:54 pm

If you drank over half a gallon of water in six hours in cool weather it wouldn't be surprising for you to be overhydrated. Matching this with some salt intake could help balance it, though risks nausea.

Athletic experts say you need 1 ml of water per calorie. What they don't say is whether this is per calorie consumed, or per calorie burned - which makes a fair difference for a day hike. You also need to consume enough water (and salts) to replace whatever you lose to evaporation (both sweat and saliva) - probably not a lot at this time of year.

In summary, drink less, and/or eat some salty snack with it. Also do more long hikes - the body adapts to long periods of exercise in extreme climate, but only by actually doing it.
-Jason Dorje Short

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Re: 14er newbie - frequent urination while hiking, AMS??

Postby TallGrass » Wed Sep 19, 2012 12:08 am

Fletch wrote:It might be a dikfur?
:lol:

*Uhem* Anyhow, trick I used for powdered Gatorade was to find a smallish pop-like bottle of several ounces with a small screw on cap. Rinse and get it completely dry to avoid clumping (air out for a day or two). Put a stretch of masking tape along the length of it. Using a funnel, pour in one scoop (for 1 liter) into it, shake it so it's level and mark that line with a sharpie. You can add a "1" if you like. Repeat until full (I got up to "8").

When refilling at base camp or while hiking, filter a few ounces of water into your 1L bottle first to avoid clumping, then pour powder in until it drops to the next line (e.g. "7), more water, shake well, then top off. Carrying just the powder and sourcing the water trailside is lighter than lugging G bottles and more flavorful than just water if you're going to be camping more than a day. I try to go for a 1:3 or 1:2 Gatorade:water (just G can lead to too much electrolytes). BTW, adapting to heat means you'll need MORE water, not less.

"Hikers should urinate at least 50 feet off the trail, preferably on rocks" to which I'll add down a gap goats can't lick dried urine off of because this draws them to hiker areas and a "salt lick" will extend there stay, perhaps even conditioning them to return. I believe it's also recommend to keep "number ones" at least 100' from water sources (creeks, ponds, lakes).
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Lastly, like the stomach, the bladder can increase capacity yielding longer trips between trips. Physical activity seems best as when you do construction it may be a few hours before you can get down to a honeybucket.

Congrats on your first 14er and hope some of that proves useful for you on your next one! :)
Not sure if I'll do more 14ers. The trip reports are too tiring. :wink:

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Re: 14er newbie - frequent urination while hiking, AMS??

Postby madbuck » Wed Sep 19, 2012 2:50 am

MountainMedic's description is great! I'm going to try to summarize in a sentence:

The body acclimates to elevation initially by reducing plasma and thereby concentrating red blood cells (for more efficiency in carrying oxygen, and to make room for subsequent increased production of red blood cells).

So you most likely peed a lot because of not being particularly adapted to altitude. If it was cold during the hike, that probably exacerbated it a bit. Spending more time at altitude will help. So, too, will more training, as you mentioned that you're planning on doing in the future -- there is a complex interplay of water-loss from respiration and sweat during prolonged exercise, and the more you can do that (more intense hikes/runs at any elevation), the more you can both train your body and learn about what works best for you.

Congrats on your first 14er!

MountainMedic wrote:I'm going to be a medical elitist here, so bear with me or just ignore this post.

Excessive urination, or polyuria, is not necessarily a symptom of AMS so much as a sign of your body adjusting to the altitude. You did everything right by drinking tons of water (overhydration is certainly possible, but is much harder to achieve than people think). The exact pathophysiology (mechanism) of AMS is poorly understood, but it starts with hypoxia. This is pretty basic - there's less oxygen up high, so you breathe faster. Breathing faster means you breathe off more carbon dioxide than you normally would at sea level or in Denver, where you live (and are acclimated to the altitude). This is where it starts to get complicated, which always seems to be the case when the kidneys get involved.

Your respiratory drive is based primarily off of high levels of CO2 (and less off of low levels of oxygen). As you exhale excess CO2, your respiratory rate slows again, and you are no longer getting enough oxygen. CO2 makes the blood more acidic (I won't go into this), which is a large part of what comprises your respiratory drive. Your kidneys compensate for this decrease in respiratory drive by essentially mimicking CO2 increases in your blood. In order to do this, they excrete bicarbonate, a salt, into the urine. If you all recall HS biology (hypertonic, hypotonic, isotonic), water follows salt. This means that as your kidneys buffer your body's pH, they also produce absurd amounts of urine. Diamox (acetazolamide) actually works on the kidney, making it excrete bicarbonate - one "side effect" is that you piss like crazy.

This "renal buffering" effect is diminished with adjustment, as hemoglobin molecules become more capable of releasing oxygen to tissue. In other words, this won't keep happening to you unless you're just unlucky (adjustment to altitude is almost entirely genetic).

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Re: 14er newbie - frequent urination while hiking, AMS??

Postby speth » Wed Sep 19, 2012 6:38 am

iholdthepain wrote:
speth wrote:
iholdthepain wrote:Speaking as a fellow 14er newbie...

...since it's being discussed, what IS the proper etiquette for making pitstops on hikes/climbs?


Just turn your back on the people on the trail. They might even think you're just enjoying the view.


Nobody checks out the view from a 2ft high crouching position, pants around the ankles... it gets a little wide open o some of these hikes... especially above 11,500ft.


I wholeheartedly disagree. I've had some of the best views like this. 8-[
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Re: 14er newbie - frequent urination while hiking, AMS??

Postby peter303 » Wed Sep 19, 2012 6:48 am

[-X [-X [-X [-X [-X [-X [-X [-X [-X [-X [-X [-X [-X [-X [-X [-X [-X [-X [-X [-X

djkest wrote:You might also try some ibuprofen when you are nearing the summit on the way up. It can help alleviate symptoms of AMS (although it does not prevent AMS in any way).


Very dangerous medical advice. Dehydration and iproprofen can terminate your kidneys.
http://articles.latimes.com/2011/feb/14/health/la-he-0214-painkillers-backfire-20110214
http://voices.yahoo.com/an-important-warning-pain-relievers-kidney-5793882.html

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