Altitude Sickness

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d_baker
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Re: Altitude Sickness

Post by d_baker »

BillMiddlebrook wrote:
Champion wrote:Very nice trip report

It can happen to anyone!

Be Safe
Champ, I thought you already said "Bye?" Welcome back.
Oh damn, I think I missed something today.....
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BillMiddlebrook
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Re: Altitude Sickness

Post by BillMiddlebrook »

JoeyJ wrote:I’ve been above 14k multiple times every year since 2001 and never had a problem. But spent one night this March above 13k in Nepal and didn’t sleep a wink while gasping for breath all night. Easily the worst nite I’ve ever had in the mountains... It was the onset of altitude sickness, and the next day I became an official member of the lollipop gut-wrenching guild and vomited most of the next day until I got down to Phortse Tenga
Joey,
Thanks for sharing. That had to be pretty scary being in a foreign land and having that happen during the night.

Just curious - how quick did you go from traveling to Nepal to sleeping at 13k?
"When I go out, I become more alive. I just love skiing. The gravitational pull. When you ski steep terrain... you can almost get a feeling of flying." -Doug Coombs
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Monster5
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Re: Altitude Sickness

Post by Monster5 »

Oi. Sounds like a rough trip. Cheyne Stokes? Altitude sickness susceptibility seems to be based heavily on genetics. If you know how you react, drugs and/or taking it slower might work.

Probably the worst case for me was sleeping at 10K one night and 17K the next. Three different "test cases:"

-Fireonthemountain: physically in okay shape. Bit lacking in the upper body, but hey, only so much time in a day. Training regimen includes going up and down and up and down Boulder bumps. Alternated between lethargy, headaches, and vomiting on the trip (potentially bad water, though nobody else was affected).

-Boggyb: Great shape. Training regimen alternates between driving to the San Juans and hiking 13ers. Occasionally he drives back from the San Juans. He also has a lot of SA high altitude experience. Either way, he had a rough night and could not climb the next day.

-Me: I've been compared to Thor. Might be the beard. Might be the biceps. Probably the abs. Training regimen includes pretending to be a climber but secretly hiking occasional 13ers because I climb like my little pony with screwdrivers taped to her hooves. No issues. Stayed up half the night with nerves wondering "Wait is this altitude sickness? Am I sick? Is that a headache? What does a headache feel like?" And then I passed out.
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Urban Snowshoer
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Re: Altitude Sickness

Post by Urban Snowshoer »

As far as physical fitness is concerned, there doesn't seem to be a correlation between susceptibility to and physical fitness: i.e. being in good shape isn't a guarantee you won't be affected by altitude sickness. However, altitude sickness isn't completely understood, especially with respect to who gets (or doesn't) and why.
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jsdratm
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Re: Altitude Sickness

Post by jsdratm »

The worst I've ever felt was at Huayna Potosi base camp, about 15500', where I couldn't sleep worth a damn and my throat was incredibly dry all night, but I've thankfully never had vomiting or anything that severe. I remember trying to set up our tent the night before and just by setting up the poles I got very lightheaded and had to lay down for a while. I also seem to have trouble with altitude where it gives me a persistent dry cough and I got it really bad at the Mt. Ararat high camp. I'm not sure if it is due to dehydration or some other issue.

I've taken Diamox on two trips and it is hard to say if it is really doing anything since I don't have a "control" trip to compare it to. Respiration is triggered by CO2 levels in the blood as well as the pH level in the blood, so Diamox drops the pH, which tricks your body into thinking it needs to breathe more frequently. Breathing more frequently increases the oxygenation in the blood, so you can cope with the lower oxygen levels better. The only side effects I've noticed are the occasional tingly feeling in extremities and weird taste of carbonated beverages.
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Fr3ako
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Re: Altitude Sickness

Post by Fr3ako »

I feel sick every time I climb Bierstadt, not as severe as you experienced but headaches and vomiting...every single time! That's also the 14er I climb the quickest.

I slept at 15k-17k lots of times and have never been sick or in need to take Diamox
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Wish I lived in CO
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Re: Altitude Sickness

Post by Wish I lived in CO »

martinleroux wrote:More than you probably want to know:

Identifying the lowest effective dose of acetazolamide [Diamox] for the prophylaxis of acute mountain sickness: systematic review and meta-analysis
British Medical Journal, 2012
http://www.ncbi.nlm.nih.gov/pmc/article ... .e6779.pdf

"This systematic review and meta-analysis summarises the current evidence on the efficacy of acetazolamide 250 mg, 500 mg, and 750 mg daily in the prevention of acute mountain sickness. A systematic search of relevant published and unpublished literature identified 11 [randomised, placebo-controlled] trials for inclusion in the review. The results showed that at all three doses acetazolamide was efficacious in preventing acute mountain sickness above 3000 m. Acetazolamide 250 mg was the lowest effective dose for which there was evidence for this indication".
The last sentence of 250 mg (per day) lowest effective dosage - I've found this to be true over the last several years. This is half the dosage of what is normally prescribed. It enables me to go from sea level to 14K in less than 24 hours and do well, yet with lesser / manageable side effects than the full dosage. I've tried the same without any dosage and it was a difficult experience. I now live at 5K and will have to see (on an easier peak) if I still need to dope up.
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jwendling
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Re: Altitude Sickness

Post by jwendling »

The last sentence of 250 mg (per day) lowest effective dosage - I've found this to be true over the last several years. This is half the dosage of what is normally prescribed. It enables me to go from sea level to 14K in less than 24 hours and do well, yet with lesser / manageable side effects than the full dosage. I've tried the same without any dosage and it was a difficult experience.
Yep. For me too. Coming from flat land and with limited time available I don't want to "lose" too many days waiting for my body to acclimatize. My first trip out--although successful in my mind--was difficult at best. The following years I've started a half dose of diamox a few days before the first 14er. World of difference. I cut a 250 mg in half and take one half in the morning and one in the evening.....with lots of water all day. My wife did the same last year (her first) and climbed LaPlata with no difficulties. We camp at 9,600 which helps also, I'm sure.

We have the same plan this year for July in the Sawatch/Sangres
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Re: Altitude Sickness

Post by palikona44 »

Hi,
I wanted to bump this good post and describe my experience on Mt Spaulding yesterday and get some feedback if possible.

I’ve been hiking CO 14ers for 15 years (have done most of the class 1 and 2s) but haven’t been above 13,500’ in two years, until yesterday. I went up for an “easy” hike up Mt Spaulding from Summit Lake and was planning on heading over to Mt Evans, which I’ve hiked 5 times. I took it really slow, took deep breathes, was well fed and hydrated with water w/ a Nuun tablet, and felt good until about 13,500’. Once on the summit of Spaulding (13,850’), I sat down and took a rest. I started feeling nauseous and a bit shaky. No headache at that point. After eating my sandwich, I decided to bail on Evans at that point and began to descend, knowing this was my best solution. I had mild nausea and the beginnings of a headache all the way down that got a touch better once I got to the car. I drove down to Idaho Springs and felt somewhat ok again, albeit tired and kind of “off”. During the ride down, I ate an apple, energy bar and continued to hydrate. Through the rest of the day, I ate and drank water normally, but felt drained and had a slight headache, for which I took Advil.

A little background: I used to have no problem with altitude when in my 30s. Now I’m 45 and the last few times I’ve been that high, the same thing has happened. Yesterday was sort of a test to see if anything has changed. My fitness has dropped off since my 30s but I still hike about once a week at lower altitudes (10-12k) and bike 10-15 miles a week, and in the winter ski once a week between 10-13k). I’ve always gotten fairly winded when doing things at high altitude and I attribute it to having a slightly elevated hemoglobin level. I think this means my cells don’t deliver oxygen as efficiently.

During the winter, I don’t feel the altitude during the day but afterwards usually have a headache if I ski 5-6 hard hours. This I attribute to dehydration and I’ve been working at that.

So I wonder if yesterday was a result of: not as good fitness as in my past, elevated hemoglobin, and/or not enough recent exposure to higher altitudes.

Should I try what is recommended in this thread: 600g of Advil, 2-3 times a day when hiking that high? Is that safe? Seems like a lot.

Any thoughts are very much appreciated!
Last edited by palikona44 on Fri Sep 13, 2019 3:24 pm, edited 1 time in total.
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mtree
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Re: Altitude Sickness

Post by mtree »

I'm not a doctor nor do I play one on TV.
I'd start with a physical and have your blood pressure and heart/circulatory system checked out, ECG, etc. and maybe a stress test. Then go from there. Don't make assumptions on something like this. Go see the pros.
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palikona44
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Re: Altitude Sickness

Post by palikona44 »

mtree wrote: Fri Sep 13, 2019 3:23 pm I'm not a doctor nor do I play one on TV.
I'd start with a physical and have your blood pressure and heart/circulatory system checked out, ECG, etc. and maybe a stress test. Then go from there. Don't make assumptions on something like this. Go see the pros.
I have. Everything checks out great.
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MichelleLW
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Re: Altitude Sickness

Post by MichelleLW »

palikona44 wrote: Fri Sep 13, 2019 3:17 pm So I wonder if yesterday was a result of: not as good fitness as in my past, elevated hemoglobin, and/or not enough recent exposure to higher altitudes.
Could certainly be any of the above, I certainly notice particularly when I don't have enough recent exposure to altitude. However, another cause that could be worth exploring, particularly if you have not had altitude issues in the past, is hypothyroidism. Last year, I began experiencing altitude sickness like clockwork every single time I went about 13,000 and most of the time above 12,000, with a couple experiences while skiing. I was born and raised in CO, and prior to that had done 20+ 14ers, multiple 13ers and regularly skied multiple times per year, all of which with no symptoms whatsoever of altitude sickness. Thanks to the recommendation of a friend, I got my thyroid levels tested. They came back in the subclinical range, but deteriorated over the year (while still technically remaining subclinical), until I was put on Synthroid in the fall. I have not experienced altitude sickness since. I have no real idea why this caused altitude sickness, but it was a little bit like magic once I got the medication level correct. I hadn't noticed any other symptoms beyond the altitude sickness, but once I went on the medication I realized that my energy levels had been quite low - which I had just attributed to being out of shape!
Last edited by MichelleLW on Fri Sep 13, 2019 4:31 pm, edited 1 time in total.
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