We Don't Talk About Altitude Sickness Enough

[amsprone]

I just returned form a disastrous trip to Breckenridge and came across this thread while searching google - thought I'd add my 2 pennies and share my experience.

Let me preface this by saying I have a 40+ year experience with some altitude sickness. Since childhood family ski trips to now taking my own kids on the same experience 1-2 times annually. The usual headache, trouble sleeping, loss of appetite, etc at nearly all the Summit County, CO resorts.

So when those same symptoms came on this past week, I just figured "here we go again, drink a lot of water, take Advil, avoid alcohol, use the humidifier", etc. I also spent a pre-ascent overnight in Denver hoping it would help with acclimation; and took Ginkgo in an attempt to stave off the effects. I should also mention I'm a active/physically fit, 50-yr old male with no other medical conditions. Anyway, on the second night at the base I woke up at 2am with a headache like no other. This was followed by violent bouts of vomiting. I could barely function. I'm now starting to wonder if I'm having a stroke or an aneurysm and this has nothing to do with altitude. At that point, my wife decided to load me up in the car and go to the hospital.

I was shocked to find out that the reading on the pulse oximeter in the ER was 72%! The obvious remedy was supplemental oxygen and cutting the trip short and returning down to Denver. Within 48 hours of diagnosis and treatment I felt nearly fully recovered at the lower elevation.

Thus for some of us, almost no amount of prep or whatnot can avoid being stricken. Now my quest begins. Why am I predisposed to this condition? Am I just genetically unlucky? Is there an underlying contributing problem? Why was it worse this time? And most importantly, is there anything I can do to prevent it (would diamox help me)? Otherwise, my search for the next ski vacation may have to start with base elevation as the first cut-off (lower resorts like Whistler have never given me a problem).

 

[mdf]

I'm not a medical professional or an altitude sickness expert, but I do have a few ideas to throw against the wall and see what sticks.

First, you have my sympathy.

The standard wisdom is to "play high, sleep low". So Summit County is not a good match. Somewhere like Salt Lake or Taos where you stay down-valley and drive up each day might be a better match. And obviously slope-side lodging is not your friend.

I don't think Denver is high enough for good acclimation. Somewhere like Idaho Springs (7500 ft and rumoured to have one good motel), might be a better choice.

There is a large element of luck in altitude sickness. I know people who have gone years with no problems who suddenly did have a problem. Maybe the luck will go the other way for you, and one acute incident doesn't mean it will always happen.

 

[Monique]

I'm a active/physically fit

Unfortunately, everything I've read says this isn't a factor. I'm glad you were able to get down and seem to be doing okay now.

 

[ken]

Unfortunately, everything I've read says this isn't a factor. I'm glad you were able to get down and seem to be doing okay now.

Sorry to hear your situation. To so look forward to a ski vacation, and have it destroyed is heartbreaking. I can tell you our situation, and it could answer one of you questions. My wife and I have come from the east (500 feet), and ski Summit County 2 and sometimes 3 times a season for ten years. First time there, the only issue was shortness of breath, and restless sleep, no big deal. The next several trips my wife became very ill, headache and vomiting. Several times she ended up in the clinics, with supplemental oxygen, and we also at times had an oxygen compressor brought to our rooms. We discussed our travel arrangements with doctors, and they offered ideas from staying in Denver for a night, to Diamox. We tried these, and still did not get great results until the nurses at the Copper Clinic informed us you need to take Diamox 4 days prior to ascent! Our doctors in the east knew very little of altitude sickness and prescribed it from a book of meds. When she started this method of taking Diamox, its like she is cured! We know thats not true, but even if we fly to Denver, skip the sleep there, go directly to Summit County, she is good to go. This has been a great improvement. we too were thinking at one time of skiing somewhere other than Colorado. Diamox, taken properly, has been the answer for us. Hope this helps,

Ken

 

[Fuller]

My wife and I both have had bouts of altitude sickness sleeping in Dillon CO. We live at 3 feet above sea level so it's quite a shock to the system for us. The last trip we started the Diamox 48 hours before and though it makes you feel a bit spacey it works pretty well. However I will say that we feel a lot better at 4000' here in Montana.

Good luck and welcome to Pugski!

 

[amsprone]

Thanks all! Sounds like I need to give Diamox a try.

 

[DanoT]

The best solution for altitude sickness could be to just go skiing in British Columbia where all of the resorts are low elevation. And a cheap Canadian dollar, low ticket prices, and low crowds for areas not named Whistler also means great value.

 

[Kneale Brownson]

When your doctor gives you the prescription for Diamox, make sure you get enough pills to last the entire time you'll be in the mountains plus the three-four days before you go. You need to keep taking it until you go back home.

 

[LiquidFeet]

^^That is what works for me. The directions as written say take the pills the two days before ascent and the first three days at elevation. That's not enough.

 

[Jersey Skier]

Anybody ever try Altitude RX? I have a Sulfa allergy so some recommend not taking Diamox, others disagree.

 

[Monique]

Anybody ever try Altitude RX? I have a Sulfa allergy so some recommend not taking Diamox, others disagree.

I've tried it (as someone coming from the front range, not sea level) - It *might* have helped, but I'm not sure. It definitely gave me some heartburn (or what I assume is heartburn - an unpleasant sensation in my chest).

 

[Jersey Skier]

I've tried it (as someone coming from the front range, not sea level) - It *might* have helped, but I'm not sure. It definitely gave me some heartburn (or what I assume is heartburn - an unpleasant sensation in my chest).

I'd prefer a week of heartburn to headaches, nausea and dizzyness.

 

[Monique]

I'd prefer a week of heartburn to headaches, nausea and dizzyness.

I'm just providing the info I have (limited). I would be surprised if it has anywhere near the impact that Diamox seems to, but compared to the cost of a ski vacation, it's certainly worth trying. I would suggest taking it a while before bed so that you don't have to lie down right away. Also, I think the ingredients could potentially make it hard to fall asleep right away - not sure on that.

 

[Kneale Brownson]

For Jersey Skier from a web search: Acetazolamide is a nonbacteriostatic sulfonamide that contains a sulfonamide functional group but lacks antibiotic activity. ... Thus, a type 1 hypersensitivity cross-reaction between a sulfa antibiotic and a nonantibiotic such as acetazolamide, which lacks the N1 ring, is unlikely.

Is your reaction to that type of sulfa or to absolutely ALL sulfa's?

 

[Jersey Skier]

For Jersey Skier from a web search: Acetazolamide is a nonbacteriostatic sulfonamide that contains a sulfonamide functional group but lacks antibiotic activity. ... Thus, a type 1 hypersensitivity cross-reaction between a sulfa antibiotic and a nonantibiotic such as acetazolamide, which lacks the N1 ring, is unlikely.

Is your reaction to that type of sulfa or to absolutely ALL sulfa's?

Unknown. Had a reaction during early stages of cancer treatment 13 years ago. Turned bright red and itched for a day or two. I have no idea what the actual medication was.

 

[focker]

The best solution for altitude sickness could be to just go skiing in British Columbia where all of the resorts are low elevation. And a cheap Canadian dollar, low ticket prices, and low crowds for areas not named Whistler also means great value.

It's crazy that many of the Summit Co resorts base area is higher than the top of other areas.

Whitefish's top elevation is like 6,850 ft.
Bridger Bowl's top elevation is 8.800 ft.

My wife had major issues when we were in Summit Co so we've avoided skiing there as I know a weekend trip there for her would be an issue.

 

[DanoT]

It's crazy that many of the Summit Co resorts base area is higher than the top of other areas.

It is not crazy it is fantastic because if we were skiing out of anything but a warm helicopter in Canada at 11,000+ feet it would be way too cold most of the time. Reliable season long skiing in western Canada starts at about 4,000' asl base elevation which would be too low, too warm for much of the western USA ski resorts.

 

[ForeverSki]

Anybody ever try Altitude RX? I have a Sulfa allergy so some recommend not taking Diamox, others disagree.

I have a Sulfa sensitivity / allergy as well and my doctor prescribed Dexamethasone for my trip to Breckenridge and Taos. My main symptom at altitude is period breathing between 3 am and 5 am, where I’d wake myself up feeling suffocated and gasping for breath. It‘d happen again just as I fall asleep again. Curiously it doesn’t happen if I take a nap during the day or when I first fall asleep at night. Dexamethasone works well but I think I need to take it the whole time I am there instead of stopping after 3 days. When I stopped after 3 days, the period breathing came back. Bonus is Dexamethasone is a steroid, so my bad knee gets very happy.

 

[palikona]

So since the shutdown in mid-March when my last day was at Winter Park, I’ve done two hikes that topped out at 12,000’.

I live in Denver and have done some biking and hiking in the foothills since late March, but have only been able to escape the family to get in those two higher elevation hikes (not terribly long - maybe 6-7 miles, 1,500 vert).

While hiking, I was ok, but I felt just awful (headache and exhaustion) afterwards during the whole late afternoon and evening back at home. I know dehydration would be the first thing that comes to mind, but I drank a ton of water and electrolyte water during and after the hikes. I also had no alcohol later. So even though I was back down at 5280’, I felt like crap both times.

I assume I’ve lost my tolerance to higher elevations? I ski once or twice a week throughout the season in Summit County, Grand County and Eagle County with little problem other than a mild headache here and there.

I’m 46 and have been in Denver for 15 years. I’ve done well with altitude until about age 43. Since then, I’ve had more incidents like this. Have people had this happen as they’ve aged?

I assume one of the strategies for dealing with this is to get back up to altitude more (in prep for ski season)? Would driving up to Loveland Pass (12,000’) or Berthoud (11,300’) and hiking around for 2 hours every week help or is that too little?

Also, for those who have altitude headache trouble: do you take Tylenol before heading up (sort of head off the headache before you get it) and find you feel better throughout the day and evening?

Sorry, long winded...any help is appreciated.

 

[DanoT]

While hiking, I was ok, but I felt just awful (headache and exhaustion) afterwards during the whole late afternoon and evening back at home. I know dehydration would be the first thing that comes to mind, but I drank a ton of water and electrolyte water during and after the hikes. I also had no alcohol later. So even though I was back down at 5280’, I felt like crap both times.

I once heard a football coach talk about drinking large volume of water on a hot game day and he said that if you wait until game day it is too late. You need to drink extra water a day or two before the big excursion but I suspect that this only partially addresses your problem.