Supplementary Oxygen

[Kneale Brownson]

Is you goal to keep yourself oxygenated appropriately so your heart is not overtaxed or is it to avoid altitude headache?

Overnight Oxygen only keeps you properly oxygenated because you breathe less deeply at night. There is no carryover. If you can take a couple deep breaths and raise your oxygen percentage from the low 90s to the high 90s,, you should be OK as far as "feeling" the altitude. If you can't, you may need diamox.

I don't "feel" the altitude in Breckenridge when I sleep with Oxygen and then go about the day's activities without oxygen OTHER than that I have shortness of breath. I never "felt" that my body was creating excess red blood cells to compensate and therefore had to go to a lower altitude permanently. I'd probably still be there (or dead) if I hadn't had my annual blood CBC and discovered the increase.

 

[palikona]

Is you goal to keep yourself oxygenated appropriately so your heart is not overtaxed or is it to avoid altitude headache?

Overnight Oxygen only keeps you properly oxygenated because you breathe less deeply at night. There is no carryover. If you can take a couple deep breaths and raise your oxygen percentage from the low 90s to the high 90s,, you should be OK as far as "feeling" the altitude. If you can't, you may need diamox.

I don't "feel" the altitude in Breckenridge when I sleep with Oxygen and then go about the day's activities without oxygen OTHER than that I have shortness of breath. I never "felt" that my body was creating excess red blood cells to compensate and therefore had to go to a lower altitude permanently. I'd probably still be there (or dead) if I hadn't had my annual blood CBC and discovered the increase.

Got it. My goal is to try and not feel the effects of altitude that I’m currently experiencing, that include headaches and wooziness.

How high did your blood cell count or hematocrit get before you left Breck?

 

[Kneale Brownson]

I can't recall the figures. It was significantly above normal--like two or three times.. The GP said we could deal with it by regular (weekly) blood donations. The cardiologist said get the hell out of Dodge. When we were spending summers in Michigan and winters in Breck, I'd use diamox to address the headaches and weakness. My MI GP prescribed that years earlier, the first time I told him I'd had altitude issues when I first visited Aspen. We used to travel west the end of every MI ski season.

 

[Yo Momma]

For those interested in a holistic approach, before heading out west to altitude I take for two weeks prior, a mixed tincture of Ginkgo Biloba, Red Clover, and Meadow Sweet as directed by an herbalist. The latter two grown in our own organic gardens at the homestead. It's been my faithful formula to ease acclimatization for over 20 years along w/ vials of Panax Ginseng and Ginkgo drops in water during the trip. ( I do no more than one 1500 mg vial every 2 days as Ginseng does not like to be abused. For the ladies, ask your herbalist about American Ginseng for better results). No alcohol (other than what's in the tinctures) until maybe during the very end of the trip depending on sleeping altitude and daily recovery... Europe is the exception here....... I'll be having wine at every meal!!!!

CAUTION: Assure that you do this process w/ a trusted herbalist or naturopath with whom you have a health based relationship. Some high quality herbs can be extremely powerful and may have unintended effects if administered by an untrained source.


When I lived in northern Jersey, LT and I were the only two Black guys showing up at the local health food store in that neighborhood buying out all the Ginseng vials. They thought I was on the NY Giants (HA HA NOT!!!!!!) because they said he and I were always buying it. He was buying it for that amazing NY defense back in the day and told them it was their "secret weapon"!!!!!!!! LOL

 

[Uncle-A]

For those interested in a holistic approach, before heading out west to altitude I take a two week prior mixed tincture of Ginkgo Biloba, Red Clover, and Meadow Sweet as directed by an herbalist. The latter two grown in our own organic gardens at the homestead. It's been my faithful formula to ease acclimatization for over 20 years along w/ vials of Panax Ginseng and Ginkgo drops in water during the trip. ( I do no more than one 1500 mg vial every 2 days as Ginseng does not like to be abused. For the ladies, ask your herbalist about American Ginseng for better results).

CAUTION: Assure that you do this process w/ a trusted herbalist or naturopath with whom you have a health based relationship. Some high quality herbs can be extremely powerful and may have unintended effects if administered by an untrained source.


When I lived in northern Jersey, LT and I were the only two Black guys showing up at the local health food store in that neighborhood buying out all the Ginseng vials. They thought I was on the NY Giants (HA HA NOT!!!!!!) because they said he and I were always buying it. He was buying it for that amazing NY defense back in the day and told them it was their "secret weapon"!!!!!!!! LOL

That is interesting and for those that are not Giants fans LT would be #56 Lawrence Taylor.

 

[Yo Momma]

That is interesting and for those that are not Giants fans LT would be #56 Lawrence Taylor.

Ha ha ha Sorry about that.... I just assumed EVERYONE knew who LT was once I mentioned the Giants!!! LMAO..... That's like saying Bird, Jordan, Parcells (the guy who taught Belichick!), or Kobe!!!!!!

 

[Uncle-A]

Ha ha ha Sorry about that.... I just assumed EVERYONE knew who LT was once I mentioned the Giants!!! LMAO..... That's like saying Bird, Jordan, Parcells (the guy who taught Belichick!), or Kobe!!!!!!

Maybe some of the younger people might not remember LT after all he has been retired a long time. 1993 is almost 30 years ago. Yes there are some individuals in sports and entertainment that are single name recognition people. Not sure if there is an expiration date on them after they retire. A very few hold beyond their life time.

 

[S.H.]

Maybe some of the younger people might not remember LT after all he has been retired a long time. 1993 is almost 20 years ago. Yes there are some individuals in sports and entertainment that are single name recognition people. Not sure if there is an expiration date on them after they retire. A very few hold beyond their life time.

1993 is almost *30* years ago

 

[Uncle-A]

1993 is almost *30* years ago

Thanks, I fixed it. Must be senior math

 

[James]

Maybe some of the younger people might not remember LT after all he has been retired a long time.

They might remember him for constantly getting arrested for drug use and admitting he smoked crack during the season in the mid 80’s frequently.

Taylor of Giants, in a New Book, Says He Used Cocaine Frequently (Published 1987)

www.nytimes.com

 

[ScottB]

My wife ended up in the ER after 2.5 days straight of unrelenting headaches the last time we went to A basin. Ended up her PO2 was in the basement and responded nicely to oxygen by face mask in about 30 minutes. Now she buys canned O2 anytime we travel to altitude. She takes a couple of hits a few times a day the first few days and feels that it helps a lot. Maybe placebo effect, but whatever works.

I doubt it is a placebo effect. I typically was jogging a lot when younger and had no real issues with ski trips at altitude. I live at sea level. (east coast). Fast forward several decades and a few years ago went to Breck for a ski week which is 10,500 feet at the base, above 13,000 at the top of peak 8. First day a bit short of breath but no big issues, didn't go that high. Second day went to 13,000 feet twice and got really dizzy (maybe call it vertigo). Really hard to ski with it till I got below 12,000 feet then it went away. Took 2 runs off the top that day and happened both times. Worse the second time. Was feeling pretty sick later that evening, nausea, headache, weakness. Found some "canned O2" in town and bought a couple bottles. You put the mouth piece in your mouth and hit the button for a "aerosol" shot. Helped a little that evening after a couple of shots, but nothing dramatic. Felt good next AM and went skiing and back up to the top. Again at 13K got vertigo. Did a couple of shots and it cleared right up. It wasn't placebo, it was real. Next run got smart and did a shot half way up the chair ride and felt great. After long traverse and little skiing down, symptoms came back, another shot and all good. By the 5th day didn't need it anymore, no more symptoms and shortness of breathe was going away to. At my age and on that trip, I had a ceiling of 12K feet until my body got acclimated to the altitude. My take away for future trips is try and sleep at lower elevation and bring canned O2 for shots as needed initially when skiing from the top. Its a bottle a little smaller than a shaving cream can, so it can fit in most pockets. There might be smaller sizes as well.

Just a little more info, my teenage son only experienced shortness of breath and my wife was sick in bed for almost 3 days with similar altitude sickness symptoms. O2 didn't help her that much and my son didn't need it. For me, it was just right.

 

[palikona]

That’s great the canned O2 helped you.

 

[James]

If you’re having major issues you might want to contact this group started by Dr Peter Hackett.

General important info-

Physiology — Institute For Altitude Medicine

www.highaltitudedoctor.org

Optimizing Health At Altitude — Institute For Altitude Medicine

www.highaltitudedoctor.org

 

[James]

Does anyone know if it’s possible to have a lower amount of O2 going to your brain vs what is being shown on a finger pulse ox?

I watched a couple videos with Dr Hackett.
As I remember, there’s a discrepancy between the finger pulse oximeter reading,. SpO2, oxygen saturation, vs the arterial partial pressure of oxygen, PaO2. (You could also measure oxygen saturation more accurately, directly in the artery, SaO2) The arterial partial pressure of oxygen, PaO2, is what really matters to get oxygen to the bodies cells, not as much the oxygen saturation. (My knowledge is about as thin as the paper this is written on, so don’t ask me to explain that) **
PaO2 has to be measured invasively, or I guess they can use ultrasound now.

Here’s his slide-

.

Top curve is pulse oximeter reading, SpO2, oxygen saturation. Bottom line is the arterial partial pressure of oxygen, PaO2, level. He’s pointing to Denver, the next vertical line is Leadville, which is about 10k ft, less than the parking lot at Abasin or Loveland. So weird that those two are almost exactly the same altitude.

So you can have ok pulse oximeter readings for the altitude, but be quite sick with Acute Mountain Sickness.

On a side note, pulse oximeters are good for diagnosing HAPE (high altitude pulmonary edema) I forget the specifics, but it’s in the video

Slide above is about 8:20 :

(click on the “watch on youtube”)
Presentation in 2017 for Special Operations Forces.

Oxygen is definitely a treatment listening to that. But Spec Ops don’t carry oxygen in helicopters when inserting troops at altitude, so it’s a not an option. Somewhere in there he’s saying what would be good is a small pocket sized solar powered oxygen concentrator. Maybe that exists now, 5 yrs later.

Age, gender, fitness, are not factors in being susceptible to AMS. Altitude is called “the great equalizer”

Another note. He says when more than one in a family staying in Telluride get
mountain sickness, it’s usually CO poisoning from the condo. (That’s at about 48:20)

** I think this has to do with the Oxygen -Hemoglobin Disassociation curve. Yeah…
Maybe @Jwrags can explain it.

What’s The Difference Between Oxygen Saturation And PaO2?

Clear discussion of the difference between oxygen saturation and PaO2, why it's important, and how to use this knowledge to identify respiratory failure.

airwayjedi.com

 

[palikona]

If you’re having major issues you might want to contact this group started by Dr Peter Hackett.

General important info-

Physiology — Institute For Altitude Medicine

www.highaltitudedoctor.org

Optimizing Health At Altitude — Institute For Altitude Medicine

www.highaltitudedoctor.org

Thank you.

 

[ForeverSki]

If you’re having major issues you might want to contact this group started by Dr Peter Hackett.

General important info-

Physiology — Institute For Altitude Medicine

www.highaltitudedoctor.org

Optimizing Health At Altitude — Institute For Altitude Medicine

www.highaltitudedoctor.org

Thank you for the links. Flatland doctors can be wholly unhelpful. It took me 3 years and lots of googling to find out (1) the proper diagnosis for what I was experiencing (periodic breathing during sleep); (2) why it was happening: and (3) to get a drug challenge for Diamox even though I am allergic to sulfa drugs. Reading the information at the link, I can now ask my doctor if I can cut back to only one dose of Diamox at night, since I don’t have headaches or other symptoms of AMS. I’m hoping not taking a dose during the daytime could eliminate the fatigue side effect.

 

[James]

Reading the information at the link, I can now ask my doctor if I can cut back to only one dose of Diamox at night, since I don’t have headaches or other symptoms of AMS. I’m hoping not taking a dose during the daytime could eliminate the fatigue side effect.

Yes, Colorado has a lot of opportunities for testing altitude response. One in 10,000 skiers in Colorado get HAPE apparently.

In that video he mentions they were beginning a study of low dose Diamox, 62.5 gms. That was 5 years ago.
Sounds like you need to slow down your acclimatization. Maybe send that group an email, possibly one of the other drugs might be better for you.

Came across this, the best concise summary I’ve seen-

High-Altitude Travel & Altitude Illness​

Peter H. Hackett, David R. Shlim

High Elevation Travel & Altitude Illness | CDC Yellow Book 2024

Information about how to order the U.S. government publication about traveling titled "Health Information for International Travel" (also called the "Yellow Book"). Provided by the U.S. Centers for Disease Control and Prevention (CDC).

wwwnc.cdc.gov

 

[ForeverSki]

Yes, Colorado has a lot of opportunities for testing altitude response. One in 10,000 skiers in Colorado get HAPE apparently.

In that video he mentions they were beginning a study of low dose Diamox, 62.5 gms. That was 5 years ago.
Sounds like you need to slow down your acclimatization. Maybe send that group an email, possibly one of the other drugs might be better for you.

Came across this, the best concise summary I’ve seen-

High-Altitude Travel & Altitude Illness​

Peter H. Hackett, David R. Shlim

High Elevation Travel & Altitude Illness | CDC Yellow Book 2024

Information about how to order the U.S. government publication about traveling titled "Health Information for International Travel" (also called the "Yellow Book"). Provided by the U.S. Centers for Disease Control and Prevention (CDC).

wwwnc.cdc.gov

What’s baffling is the symptoms don’t appear until after the third or fourth night at altitude. The very first time it happened was on the fifth night at altitude AFTER I descended from Breck to Colorado Springs. Freaked me out as it felt like I was suffocating. That was not the first time I skied at Breck, so the periodic breathing is something I developed as I age. Never had to take medication before.

I think I’ll email them for more suggestions to send my doctor’s way. If I can cut down on the Diamox that would be great. The fatigue throws a cold blanket on skiing.

 

[James]

What’s baffling is the symptoms don’t appear until after the third or fourth night at altitude. The very first time it happened was on the fifth night at altitude AFTER I descended from Breck to Colorado Springs.

Yeah you best detail your altitude/time profile and get their diagnosis and professional advice. Only so much one can get from reading publications staying in a Holiday Inn Express.

Just from watching the video, technically I don’t think that’s AMS as it takes too long to show up. Clearly seems to be altitude related.

More documents-
2019 Clinical Guidelines

DEFINE_ME

 

[Jwrags]

@James thanks for the invite to try and explain oxygen carrying capacity and oxygen-hemoglobin dissociation curves I have debated weighing in on this thread but avoided it thus far. When I have time later today I will try and write something understandable.