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Topic: Backpacking at altitude< Next Oldest | Next Newest >
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PostIcon Posted on: Aug. 27 2013, 7:45 pm  Skip to the next post in this topic. Ignore posts   QUOTE

I've had to put it off, but I've resumed planning for my next long trip - 3-4 weeks in South America, from the altiplano down into Patagonia.

The altiplano is a huge plateau at the far north of the Andes.  The elevation is roughly 12,000 - 13,000 feet - almost as high as the Tibetan plateau.

I live about 10 feet above sea level - I know this because a large tidal pond forms part of the border of our property.

Other than flying halfway across the country for 3-5 day trips to Colorado, is there any decent way of testing myself or acclimating prior to arriving?  I know I should take it slow on the way up and immediately back down if certain symptoms arise, but I'd like to have some reasonable expectation regarding how my body will react, and any symptoms which arise may indicate that it's too late, that I'm not thinking clearly enough to go back down.

I've briefly (a few hours) been at around 10,000 feet a few times and didn't have any issues, but another two or three thousand feet could be an issue, especially for a week straight.  Hypoxia's nothing to fool around with.

Most people don't have an issue, but I don't want to suddenly and unexpectedly become part of the minority.

Or am I being overly cautious/nervous?

And yes, this will be a solo trip.
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PostIcon Posted on: Aug. 27 2013, 7:48 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

Go here to read up on altitude:

http://www.basecampmd.com
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PostIcon Posted on: Aug. 27 2013, 8:39 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

Going up to high elevations intermittently or for a few hours at a time will not tell you if you are susceptible to altitude sickness at those elevations. Dr. Buck Tilton of the National Outdoor Leadership School (NOLS) makes the following recommendations:
    Unfortunately, you can’t expect any benefit from intermittent time at altitude. Acclimatization to higher elevations is lost at approximately the same rate as it is gained.Two or three days at high altitude followed by two or three days back down low and you're right back where you started—possibly in more ways than one. (Source.)

    . . . take plenty of time for gaining altitude to allow acclimatization. Above 10,000 feet elevation, most experts will tell you to gain no more than 1,000 to 1,500 feet of sleeping altitude per 24 hours. Also, take a rest day every few days, and drink plenty of water. (Source.)

    . . . a few highly susceptible people have become desperately ill from altitude at elevations below 8,000 feet. ¶ Great physical fitness, unfortunately, is not preventative. The cure with everyone comes with descent. ¶ Do you take the time to acclimatize? Do you spend a couple of days in the seven- to eight-grand range before going higher? (Source.)

    Here are a few thoughts on preventing altitude problems:

      1. Above 8,000 feet, ascend no faster than your ability to acclimatize–an average of 1,000 feet per 24 hours of sleeping gain (sleep no more than 1,000 feet higher than the night before).
      2. Drink plenty of water.
      3. Eat plenty of carbohydrate-rich, low-fat foods.
      4. Consult your physician about the uses of acetazolamide to prevent mild altitude illness. I think it's better to take the time to acclimatize, though.

    If you feel sick, do not go up until the symptoms go down, exercise lightly, and drink plenty of water. If the symptoms do not go down within two days, you should. People who do not acclimatize–meaning feel better–in two days might be developing a serious form of altitude illness.  (Source.)

    Q.} Do you think our bodies "remember" acclimating? I have been to Everest and many fourteeners, and seem to fare better at altitude than first-timers.
    A.} No study shows our bodies "remember" altitude. A few studies suggest our bodies forget: Quite a few climbers have succumbed to altitude illness after numerous successful trips to high elevations. . . . (Source.)

    Q.} We're going to Peru. What multivitamin/herbal remedy you suggest for overcoming altitude sickness?
    A.} Only ginkgo biloba has proven in tests to reduce the incidence and severity of Acute Mountain Sickness. Peter Hackett, MD, the guru of high mountain medicine, recommends 80 mg twice a day, but some others suggest 120 mg twice a day–morning and evening, starting 4-5 days before going high. Nothing else herbal or vitamin-wise has shown measurable results. . . . (Source.)


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PostIcon Posted on: Aug. 27 2013, 9:37 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

I live at about 1200 ft in Kansas, and most of my hiking is in the Rocky Mountain high country. Here's what works for me-- some of this may be all in my head, but it works for me.

--I abstain from alcohol for a least a couple days before the hike, and try to pre-hydrate well.

--I always try to plan a warm-up dayhike the afternoon before the BP trip begins. Ideally, this takes me up to about the altitude I plan to sleep at the first night of the BP. I find that this makes a huge difference as far as the misery factor on day one of the BP.

--I try (not always successfully) to make night 1 at a lower altitude than night 2.

--I try to plan one or more basecamp days. I often do scrambles or off-trail trips on those days, and usually the whole day is spent *above* the base camp.

--I try to plan scrambles or the otherwise highest climb of the trip on the later days when my body has had a chance to acclimate a bit more.

--A couple tylenol in the morning helps prevent the altitude headache for me.

--I know the science says our bodies don't remember, but my body seems to disagree. If I do three high altitude trips over the summer, going back home to regular low-altitude life in between, I swear it gets easier each time.
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PostIcon Posted on: Aug. 27 2013, 9:43 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

Drink lots of water and be gentle with yourself for the first week.  Hydration is key.  Marry your water bottle for the duration.

I like to take slow release iron supplements for two weeks before heading to CO to beef up the corpuscles.    It seems to help, so I recommend it.

If the headache and puking starts, get lower.  Ditto chest pain of any sort.

I've learned there's a wall I hit around 11,600'. If I push through it, I'm a-ok, but for a few feet there is nothing I want more than to never do it again.  Other people have told me they experience the same, although at their own altitudes.  If you start thinking "screw this" and are otherwise in no extreme discomfort,  keep going.  It'll stop in the next 50-100' or so.

You're not going to want to eat for a while.  Force yourself.  This is mandatory.

Also, I've found plain aspirin to be the best thing for the mild altitude-adjustment headache I get for the first few days.  Thins the blood.  Don't get cut.
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PostIcon Posted on: Aug. 27 2013, 9:48 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

Yep, the only way to know if you are susceptible is to stay at that altitude, especially overnight. Altitude sickness is due to your body's reaction to the lower oxygen levels, it will adjust but not right away for many people.

Best is to stay overnight no more than 2,000 ft higher than the night before. So, you might want to sleep at 6k, 8k, and 10k for the three nights before you ascend to that plateau.

There also have been some very small studies that are inconclusive but would indicate that ibuprofen can help alleviate altitude symptoms, so you could consider a regimen starting a couple of days before your ascent.

There is a medication, dioxin, that basically tricks your body into the physiological reaction that it would normally undertake to adjust to the altitude, just to do it much more quickly. It has some potential side effects, though, haven't read up on it lately. Talk to your doctor, it's a prescription medicine in any event.

Lastly, learn the difference in symptoms of AMS from HAPE and HACE. AMS is awful but ultimately not too serious, HAPE and HACE are life-threatening situations.


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PostIcon Posted on: Aug. 27 2013, 9:58 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

I don't think you can really test yourself... in the sense that even if you could go to CO, what's to prevent a mishap -- same as if you went to SA??  Essentially, you can't know for sure about your susceptibility until you are 'there'.

But two things can really help you:

1.  Take it slow.

Speaking in general terms, I think people have more control over their itineraries they they profess.  Spend a day or three at a lower elevation to give yourself time to acclimate.  There is no reason to "hit the ball running" -- to get the "mostest" out of vacation -- and then face the possibility of utterly ruining it -- or worse.

2.  Anticipate

When hiking / ascending, I find that it really helps to knowingly anticipate.   Starting our hikes fresh and from a lower altitude... we too easily get into a stride that turns out to be too quick (even if it feels easy and OK at the beginning).  Next thing we know, we are panting heavily, our base layer is soaked, and the dreaded headache starts all of a sudden!

Be cognizant about slowing down before  you start sweating and panting for air.

Be cognizant about taking deeper breaths -- before your body reflexively forces you to -- to minimize / avoid the dreaded shortness of breath and pounding headache!

Be cognizant about sipping water -- before your body tells you it's thirsty.

Be cognizant about putting on a layer -- before you actually feel cold.

Be cognizant about taking off  a layer -- before it really feels "too warm" -- with sweat soaking through.

My view -- if you hike along blithely and only react when your body is showing symptoms -- those symptoms will often acquire a life of their own -- meaning for example, that shortness of breath -- by the time you notice because you weren't paying extra attention -- can end with a pounding headache in mere minutes.  Try to not let the symptoms show at all.

I live at 800ft. elevation.  But acclimating and consciously anticipating -- my hike at around Everest Base Camp turned out to be very, very pleasant.  SA mountains can go much higher than EBC -- but I think most people will be fine by taking these two precautions.  Bon voyage, Reuben!!


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PostIcon Posted on: Aug. 27 2013, 10:13 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE


(JRinGeorgia @ Aug. 27 2013, 9:48 pm)
QUOTE
There is a medication, dioxin, that basically tricks your body into the physiological reaction that it would normally undertake to adjust to the altitude, just to do it much more quickly. It has some potential side effects, though, haven't read up on it lately. Talk to your doctor, it's a prescription medicine in any event.

Diamox (acetazolamide, and as long as you've no other medical problems and an understanding doc, you should be able to pick some up. DON"T take it if you're allergic to sulfa or prone to kidney stones).

Dioxin's a wee bit toxic...   :p
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PostIcon Posted on: Aug. 27 2013, 11:16 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

^ is why I don't use it.  Toxic is bad.
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PostIcon Posted on: Aug. 28 2013, 7:42 am Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

Barbecued marmot is the best preventative for dehydration.  They have some soft of chemical in their meat that helps prevent it.
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PostIcon Posted on: Aug. 28 2013, 7:49 am Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE


(Lamebeaver @ Aug. 28 2013, 7:42 am)
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Barbecued marmot is the best preventative for dehydration.  They have some soft of chemical in their meat that helps prevent it.

I thought that was grilled pika?
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PostIcon Posted on: Aug. 28 2013, 8:04 am Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

It's also possible you may be fine at 8 and 10 but not at 12. You never really know how it may affect you. So trips to the Rockies and Sierras where you can sleep at 12 a few nights in a row (after acclimating to lower levels) would be the best way to make sure. It's not necessarily easy to find such a route unless the weather cooperates (or you're prepared to sleep high and exposed in a storm).

I live at 600, flew into Aspen and slept at 10200 the first night, but could have bailed back to TH 2 miles away if needed. Went over 12400 pass and slept near 11 the second night because it took longer than expected off trail. Slept at 12200 the third night, which had been my objective the prior day. I could feel the altitude in my endurance above 11, which is expected when going up that fast, but seemed fine otherwise. This summer I did my first 14er. I was already in decent shape though hadn't had anything above 8 by the time we got to that part of the trip. We had slept ~11 the prior evening. TH was 11600 and I did the easy 7 mile trail to the top (14246) with no breaks and felt great. YMMV (greatly). :)
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PostIcon Posted on: Aug. 28 2013, 8:36 am Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE


(fifeplayer @ Aug. 27 2013, 10:13 pm)
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Diamox

Dioxin's a wee bit toxic...   :p

Thanks for the correction. Yeah, I don't think your physician will give you any dioxin...

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PostIcon Posted on: Aug. 28 2013, 9:42 am Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

Just do it man. You'll either die or not. You drive to work don't ya? Why worry about getting sick or dying while you are on vacation?
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PostIcon Posted on: Aug. 28 2013, 9:59 am Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

Water, water, water. And more water.

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I live in the death zone.
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PostIcon Posted on: Aug. 28 2013, 10:11 am Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

I have been traveling to CO from near sea level to ski and hike since I was about 5. I never have had a problem with altitude.

However, 2 of my 3 most recent trips to CO (Summit County) have resulted in episodes of vomiting during my first night. It generally felt like a stomach bug, and dissipated within 24 hours, but I think it was altitude rather than a bug.

I have noticed that I have developed a few allergies since I reached my forties--mainly alcohol (I barely drink anymore) and hayfever. So I wonder if these physiological changes might explain my recent issues with altitude, which have never manifest themselves before.

Thoughts?


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(fifeplayer @ Aug. 27 2013, 7:13 pm)
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Diamox (acetazolamide, and as long as you've no other medical problems and an understanding doc, you should be able to pick some up. DON"T take it if you're allergic to sulfa or prone to kidney stones).

I'll second the Diamox. Great stuff as long as you don't have any preexisting conditions that make it something you don't want to use. Makes carbonated beverages taste flat, and sometimes my fingers go numb, but it really makes a difference for me.

Also water - drink some, drink some more, and drink some more. This was this single thing I changed and it helped SO much.


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PostIcon Posted on: Aug. 28 2013, 12:38 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

So, to deal with altitude, drink more and do drugs.  Got it.

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PostIcon Posted on: Aug. 28 2013, 12:50 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

I've been above 20,000' without problems so far. I can't imagine having severe problems below 14,000', but everyone has a different physiology.

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PostIcon Posted on: Aug. 28 2013, 12:56 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

Viagra...

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(Reminiscence @ Aug. 28 2013, 10:50 am)
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I've been above 20,000' without problems so far. I can't imagine having severe problems below 14,000', but everyone has a different physiology.

I'm like you... other than being more short-of-breath, I've never had issues at altitudes I've been.  But I've gone with folks that were getting headaches and beginning altitude-sickness while backpacking at anything above 8500', which makes backpacking in the Rockies a bit of a trick. (Granted we were coming straight from sea-level, but still.)

Being in shape helps a lot, as does properly hydrating and giving time acclimate.  But all else aside, some folks' physiologies are just different.


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I heard turtle veal helps acclimatization.
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PostIcon Posted on: Aug. 28 2013, 2:01 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

I have nothing to offer that others have not, but every body is indeed different. My daughter has issues, luckily minor above 9K.  Above 12K she is miserable.
I have never had any problems with altitude. In 2005 I had two lung lobes removed, so my lung capacity is only about 2/3rds of normal. Yet since then, I have continued to hike and backpack like before, mainly overnighters or other short trips, but in 2010 spent an entire week above 10K, crossing two passes over 12K in altitude. And zero problems with altitude sickness. Go figure.


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PostIcon Posted on: Aug. 28 2013, 3:06 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

In my experience (given a highest hiking altitude of 16,500ft):
- Being in good cardiovascular shape may not help you acclimatize but makes hiking at altitude so much more comfortable.
- I don't believe that the body 'remembers' being able to tolerate altitude.
- Above 10,000ft the slower you move to a higher sleeping location the less susceptible you are to altuitude problems. Something like <1500ft of difference between the starting and ending altitude. Doing more cumulative gain, or going over a higher altitude before dropping down isn't that much of a problem.
- Sleeping at altitude is the key problem, since the body reverts to the last altitude is was acclimatized to, at night. The rule of thumb I was told is to wait for around 6hrs after exertion at your sleeping altitude before going to sleep.
- Eating dried fruit, staying hydrated and drinking green tea are all recommended. (I confess I only adhered to the second recommendation myself.)


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(Tigger @ Aug. 28 2013, 12:56 pm)
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Viagra...

+1
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(Marmotstew @ Aug. 28 2013, 12:58 pm)
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I heard turtle veal helps acclimatization.

Particularly combined with cigarettes.

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PostIcon Posted on: Aug. 28 2013, 4:17 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

One other thing: reaction to altitude is subject to random change in the same person from trip to trip. Nearly everyone I know has had an issue at some time or other, at elevations that normally don't bother them at all.  Often, there are reasons you can figure out but sometimes it just seems random.

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Sunscreen

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PostIcon Posted on: Aug. 29 2013, 4:53 pm Skip to the previous post in this topic.  Ignore posts   QUOTE

Thanks, everyone.  It's as I thought - there are a few things I can do to test my tolerance and mitigate the effects, but there's no way to tell what will happen.  I'll take it slow and hopefully get up to that altitude at least once prior to the trip.
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