We Don't Talk About Altitude Sickness Enough

[Pequenita]

I think the answer to your ski prep question is that ultimately to adjust to high elevation, you need to gradually make your way up and do nothing for a period of time, and then go higher - e.g. the way mountaineers do it. Or sleep in one of those tents that simulate low O2/ high elevation. The weekend warrior up and down doesn’t work if you’re always exerting yourself or sick when up high.

 

[Unpiste]

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.

I'm certainly not a medical expert, but this seems odd to me. Excess water, AFAIK, is removed from the body pretty quickly. I suppose if you're normally a little dehydrated, this could help.

It is also possible to drink too much water. I think the common wisdom is that people are much more likely to under- than over-hydrate, but sometimes I also wonder if certain symptoms reported may be related to drinking more water than the body can process in a given amount of time. Headaches and confusion, for instance, can be a symptom of either over- or under-hydration.

 

[DanoT]

I'm certainly not a medical expert, but this seems odd to me. Excess water, AFAIK, is removed from the body pretty quickly. I suppose if you're normally a little dehydrated, this could help.

Yeah, the football coach's philosophy of staring to drink lots of water a day before game day is likely addressing at situation where a 300+lb player will loose 10 or 15lbs in a game, mostly sweat.

 

[Tricia]

@palikona I'm no medical expert, but I know it took me a bit to get really adjusted to the altitude when I moved to Reno. The top of our back yard is 5,600 ft, and we usually ski between 8-9,000 ft
I was told to expect my altitude adjustment to take about 2 years to acclimate, and only about 2 weeks to lose the acclimation.

I'm not sure thats entirely accurate, but the point is, it takes a lot longer to be come acclimated than it does to lose it.

When we were back in Michigan for 3 weeks last fall, I lost a bit of my altitude acclimation but it didn't take too long to get it back.

 

[palikona]

What I’m surprised by is that I don’t feel bad until later on, when I’m back at 5280’. That’s when the headache and some dizziness sets in
Maybe just exhaustion from the day at altitude, after not having been up that high in months?

 

[SkiNurse]

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.

There are different high altitude sicknesses which include HACE (high attitude cerebral edema) which can present with, but limited to,headache, fatigue, confusion, nausea and vomiting. Try putting eletrolytes (ie Nunn tabs) in your water and talk to your doc about getting a prescription for Diamox which is a diuretic that can work on decreasing the brain swelling that can occur with high altitude. Ibuprofen, which is an anti-inflammatory, instead of acetaminophen. https://www.nhs.uk/conditions/altitude-sickness/

 

[Rainbow Jenny]

What I’m surprised by is that I don’t feel bad until later on, when I’m back at 5280’. That’s when the headache and some dizziness sets in
Maybe just exhaustion from the day at altitude, after not having been up that high in months?

How long did the symptoms last? If the onset of you symptoms didn't start until you got home, I’m thinking AMS is less likely. Repeat the trip and see what happens. In addition to hydrating, were you snacking? Hypoglycemia can certainly manifest with HA and dizziness.

Recently I was quite concerned about going up above 14k ft, did 3 hikes between 10-11k days prior. My only symptom on the big day was shortness of breath. I live in Tahoe at 6300 ft and am close enough in age to you.

 

[palikona]

There are different high altitude sicknesses which include HACE (high attitude cerebral edema) which can present with, but limited to,headache, fatigue, confusion, nausea and vomiting. Try putting eletrolytes (ie Nunn tabs) in your water and talk to your doc about getting a prescription for Diamox which is a diuretic that can work on decreasing the brain swelling that can occur with high altitude. Ibuprofen, which is an anti-inflammatory, instead of acetaminophen. https://www.nhs.uk/conditions/altitude-sickness/

The symptoms I felt were headache and exhaustion, none of the others. I’ve been using Nuuns for water during and after the hikes but I haven’t seen a difference.

I’ve heard Diamox can make one feel funky? Is it bad for long term use?

Oh, sounds like I should use Advil instead of Tylenol for these headaches? Should I take the Advil during the hike at altitude before symptoms occur?

 

[palikona]

How long did the symptoms last? If the onset of you symptoms didn't start until you got home, I’m thinking AMS is less likely. Repeat the trip and see what happens. In addition to hydrating, were you snacking? Hypoglycemia can certainly manifest with HA and dizziness.

Recently I was quite concerned about going up above 14k ft, did 3 hikes between 10-11k days prior. My only symptom on the big day was shortness of breath. I live in Tahoe at 6300 ft and am close enough in age to you.

They last for the late afternoon/evening after the hike at altitude and then I feel better in the morning. I was snacking with cliff bars, nuts, sandwich for lunch, and an apple.
I could see it being a hypo issue though because I deal with that during a normal day. When I wake, I have to eat immediately or else I get shaky. And I snack often (try to make them healthy) between meals to keep the blood sugar at an even keel. I do the same hiking but maybe the calorie burn is high enough that I’m not replacing the calories?

 

[Monique]

They last for the late afternoon/evening after the hike at altitude and then I feel better in the morning. I was snacking with cliff bars, nuts, sandwich for lunch, and an apple.
I could see it being a hypo issue though because I deal with that during a normal day. When I wake, I have to eat immediately or else I get shaky. And I snack often (try to make them healthy) between meals to keep the blood sugar at an even keel. I do the same hiking but maybe the calorie burn is high enough that I’m not replacing the calories?

Appetite is often lower at altitude, which can also mess with you. I can't make myself eat enough on high altitude hikes, then get back to base elevation exhausted and suddenly starving.

 

[skibob]

I'm certainly not a medical expert, but this seems odd to me. Excess water, AFAIK, is removed from the body pretty quickly. I suppose if you're normally a little dehydrated, this could help.

It is also possible to drink too much water. I think the common wisdom is that people are much more likely to under- than over-hydrate, but sometimes I also wonder if certain symptoms reported may be related to drinking more water than the body can process in a given amount of time. Headaches and confusion, for instance, can be a symptom of either over- or under-hydration.

Agree. But also to add, the importance of salt to hydration is underappreciated. Makes it last much longer and actually get into cells.

 

[skibob]

How long did the symptoms last? If the onset of you symptoms didn't start until you got home, I’m thinking AMS is less likely. Repeat the trip and see what happens. In addition to hydrating, were you snacking? Hypoglycemia can certainly manifest with HA and dizziness.

Recently I was quite concerned about going up above 14k ft, did 3 hikes between 10-11k days prior. My only symptom on the big day was shortness of breath. I live in Tahoe at 6300 ft and am close enough in age to you.

Hypoglycemia at altitude is real, even if you have no blood sugar issues normally. The ideal solution is to consume a little sugar constantly rather than taking big hits of sugar (which can cause hypoglycemia on rebound). Some kind of juice or candy (easier to carry) is great for this. Just make sure it is sweetened with sucrose or other natural sugars and not HFCS. And in this case it would be advantageous to start before getting to altitude.

 

[Monique]

Just make sure it is sweetened with sucrose or other natural sugars and not HFCS.

Why?

 

[palikona]

Agree. But also to add, the importance of salt to hydration is underappreciated. Makes it last much longer and actually get into cells.

Does the use of Nuuns do what you’re talking about or should I add some salt when skiing/hiking somehow?

 

[palikona]

Hypoglycemia at altitude is real, even if you have no blood sugar issues normally. The ideal solution is to consume a little sugar constantly rather than taking big hits of sugar (which can cause hypoglycemia on rebound). Some kind of juice or candy (easier to carry) is great for this. Just make sure it is sweetened with sucrose or other natural sugars and not HFCS. And in this case it would be advantageous to start before getting to altitude.

Interesting. What kind of candy are you talking about? Candy bars or candy you suck on?

 

[skibob]

Why?

Lots of general health reasons. But the only reasons related to altitude sickness are:

-HFCS contains more sugars and other carbohydrates than labeling says. Not inherently a problem, but if you don't know how much you are consuming, easy to overdo

-HFCS contains fermentable sugars. The lipopolysaccharide side effects will enhance altitude sickness

-HFCS contains unknown contaminants and antinutrients which may also contribute to altitude sickness

 

[skibob]

Does the use of Nuuns do what you’re talking about or should I add some salt when skiing/hiking somehow?

Electrolytes help, but I definitely wouldn't neglect salt either. BTW, non-iodized is much better in general, and in particular, in regard to altitude sickness (all Kosher salt is non-iodized). There should probably be a caveat here about heart disease and consult your Dr. I am not one.

 

[skibob]

Interesting. What kind of candy are you talking about? Candy bars or candy you suck on?

Hard candies are great if there is enough sugar. 50-100 grams of carbohydrate from sugar per hour if you are exerting yourself. Maybe half that if you are just adjusting to altitude but not exerting yourself.

Caveat . . . diabetes . . . doctor . . .

 

[palikona]

Electrolytes help, but I definitely wouldn't neglect salt either. BTW, non-iodized is much better in general, and in particular, in regard to altitude sickness (all Kosher salt is non-iodized). There should probably be a caveat here about heart disease and consult your Dr. I am not one.

How do you recommend getting it on the go? Like a salted pickle, as was mentioned in this thread somewhere? Yes, will consult doc.

 

[Monique]

How do you recommend getting it on the go? Like a salted pickle, as was mentioned in this thread somewhere? Yes, will consult doc.

I definitely crave salty things like pickles at altitude. It's easy to keep a few spears in a snack sized baggie.