Trouble in Paradise: Altitude Illness in SEKI

[Addie Bedford]

Companion forum thread to:

Trouble in Paradise: Altitude Illness in SEKI

[M G]

Johanes,

Sorry to be getting back to you so late.

Here is my experience doing essentially the same as you in 1998.

I left Equator after a month of travelling at higher altitudes out of Quito ( Chimborazon climb, Inca Trail in Equator, Tungurahua volcano, etc…) I was well acclimatized. I travelled by bus to Huaraz over a 2.5 days. I showed up in Huaraz and felt great Two days later I did the Santa Cruz Trek. Santa Cruz has one high pass. Otherwise it is fairly easy walking. Steadily uphill most of the time, but not difficult IMO. It's well worth doing the side trip to the Alpamayo base camp.

Huaraz is a great place to take it easy and spend a few days acclimatizing if you feel you are not ready to go back up high after Lima. It's plenty high enough to acclimatize for the Santa Cruz Trek for most people. Check out Cafe Andino while there and say hi to my friend Chris.

I left Huaraz on a night bus and spent a full day in Lima and flew out the next morning to Cuzco. I had no problems there. I did several long hikes at high altitude ( Auzangate trek solo) I did not lose acclimatization that quickly.

But I did spend a few days in Cuzco before heading back up higher. There are lots of good days hiking around there to test yourself. It is quite cold at night. In the Vilcanota I slept in a WM Ultalite and was cold. I probably wasn't ingesting enough calories on that trip but I just remember it being very cold at night above 4500m

[johannes Eichstaedt]

Martin,

thank you for the lightening fast reply… indeed our intenararies seem to be very similar. Thank you for the insights, it´s actually quite helpful. I know the santa cruz trek is quite straightforward, and I rest assured that the northern return loop (which is described as longer and harder in the books) should be quite doable as well.

I know the the Cordillera Vilcanote is said to be pretty cold… Mollepata-Yupanca is not too far from there. I will have to think of something, because if you were cold in a WM ultralite, I´ll be quite frozen stiff in the UL 180 quilt with the UL 60 cocoon hoodie and powerstretch long johns… I wish I had those cocoon puffy pants (as Mike! once said on the WTS I "believe me, they changed my life".) But ok… maybe I rent a sleeping bag that is a little more serious in cuzco…*sigh* it´s probably gonna be some kelty 2000 waytooheavy bag…

Kudos on the solo circuit of Azungate…it´s quite a demanding route they say. I can relate… I do all tours solo as well, as a matter of principle …(but I am not climbing as seriously as you are).

again thank you for you insights. I feel a little more relaxed about losing acclimatization now… I will still try not to sleep below 3000 m the next 6 weeks.

Good day from Quito, johannes

[Nate Meinzer]

Just wanted to add my experience to this thread.

I've suffered from altitude sickness several times (usually at 10,000 feet) and recently returned from a trip along the PCT heading south from Sonora Pass.

The trail starts off high and stays above 10,000 feet for about 10 miles.

Fearing altitude sickness, I took 250mg of Diamox (acetazolamide) twice daily a few days before the trip and during it.

It worked brilliantly. I've never felt as comfortable at high altitude and am planning to return to even higher elevations further south.

I did have a few side effects (tingly hands, soda tasting funny) but nothing major, and it was WELL WORTH IT.

So for those of you who have recurring bouts of this problem (Cary!), you might want to consider Diamox. I was very impressed with the results and will be taking it again on future trips when I don't have time to acclimate properly.

[Lori P]

I was very interested in Diamox until I learned it was a sulfa based drug – I am highly allergic to sulfa. Not wanting to hike around with hives and swollen face, I guess I will just have to go slow, camp low and bail out if I have to…. I am glad that I don't tend to have problems but very aware that they can happen to anybody, any time.

[David W.]

Very informative article. Thank you.

Lori,

Thank you for mentioning Diamox is a sulfa drug. I am also allergic to sulfa drugs. My parents learned this when I was a child and I was hospitalized with a case of Thrombocytopenia resulting from a reaction to sulfa.

I now know to decline Diamox or altitude sickness may end up being the least of my problems.

[EndoftheTrail]

Someone once said to take only light meals — to prevent more blood working around the digestive tract and away from the head. I am not sure this makes sense or not. Anyone?

[Bob Gross]

You need to define "high altitudes." I would define normal PCT altitudes to be 8000-10,000 feet. Go to the Andes and you can easily get to 20,000 feet. Go to the Himalayas, and its even higher.

Many of the early Everest climbers were trying to eat everything in sight, up to a certain altitude. Then their appetite would wane, which contributed to loss of energy, which eventually met with summit failure. In 1953, the Brits had along the NZ beekeeper by the name of Ed Hillary. They remembered that he would eat everything left when everybody's appetites waned. Somehow, he had that extra energy, and then (with Tenzing) they were the first ones to summit. Since then, many climbers report disruption of their normal appetite. Up high, your body is starting to run with something lower than full oxygen saturation in the blood, so your body can't fully metabolize food quite the same way as it would normally. As a result, Everest climbers nearly always report a weight loss.

Rather than trying to set up a system of food laws, I follow only one. When I'm hungry, I eat.
–B.G.–

[EndoftheTrail]

Makes sense, Bob.

Last year, I went up to Everest Base Camp (EBC – Chinese side). I've never experienced A.S. before (my highest up to that point was Mt. Whitney) but A.S. is also one of those things that is very unpredictable. Luckily for me, I was fine at EBC (17,200').

While I was told to eat less, I simply did what you suggested — eat when hungry — and suffered no ill effect whatsoever. But who really knows?

Methinks taking things slow and easy is by far the best way to cope. I took the train to Lhasa, Tibet and did 2 days of sightseeing before heading up to EBC (jeep) — which took another day and a half. So that was 3.5 days' worth of ascent. I got off the jeep and hiked up the last 4km — and it felt only marginally more demanding than a normal walk in the park.

[Bob Gross]

I guess you know that riding a vehicle up to high elevation does not really qualify as proper acclimatization. I guess it is semi-OK if you are not going to be exerting yourself much. To avoid altitude problems best, you need to be hiking and sleeping at progressively higher elevations.

The thing about EBC-Chinese side is that they want to rush you in there, let you snap your photos, and then rush you out. That's why they built the road.

EBC-Nepal side is quite different. The first time I went, we were on the trail for 25 days. We hiked up and down over five river drainages and passes before we got to EBC. That allows the traveler to toughen up a bit before the thin air gets too much.

I saw hikers who had already hit their ceiling at 14,000 feet and had turned back. In most cases, they had been "pushing" just a little too fast.
–B.G.–

[EndoftheTrail]

"The thing about EBC-Chinese side is that they want to rush you in there, let you snap your photos, and then rush you out. That's why they built the road."

Actually, for those willing to hire their own local transport, you can stay multiple days at EBC, Tibet. But for foreigners, yeah, the authority will insist that you travel as a group — although most will actually stay the night — to catch both sunrise and sunset.

I haven't been to the Nepali side, but my LP Guide mentions that the view on the Chinese side is far better. Regardless, I do hope to travel to Nepal though.

[Bob Gross]

I hear that the view doesn't get really good until you get a little above 28,500'.
–B.G.–

[EndoftheTrail]

It better be!! But then, who really knows — if I'm there and my heart's pounding and my head is hurting and I'm struggling to give it my all with every half step up — maybe the thrill will mostly be psychic by then?

[Bob Gross]

That's where the trouble is. Too many climbers will go far higher than their normal limit, and they are spurred on by the thrill and all that. They pass their safe ceiling and their body starts to degrade, but they try to keep going just on emotional energy. That lasts for only a short time, and then they are in serious trouble. That's why it is absolutely vital to bail out before you've hit your limit and before you are incapacitated. To do that, it is a good idea to record your rest pulse rate, and you can start to predict when the limit is coming.

That's why prior training is important. Each person can find out how they do at high elevation before they get into the really serious stuff.

–B.G.–

[Roger Caffin]

> Up high, your body is starting to run with something lower than full oxygen saturation
> in the blood, so your body can't fully metabolize food quite the same way
> as it would normally

But you still need the energy! A partial solution is to switch your diet to less complex carbohydrates. Avoid any fats at all, and eat sugars and simple carbos like biscuits. These digest and metabolise more easily.

There were some local-brand plain semi-sweet biscuits for sale in many places. These, with jam or honey, were good.

And drink lots of water. You are dehydrating fast in that air.

Cheers

[Bob Gross]

When you get up high, like 16,000+ feet, and if your appetite starts to wane, you have to keep eating something. The local "biscuits" work fine. They are not as sweet as cookies.

In Nepal, the Sherpa mountain guides found that when you can't eat anything else, at least you can eat biscuits and drink tea.

In Nepal at about 16,000 feet, one trekker was getting hungry, and the usual camp food wasn't filling him up. So, he found this micro-store built out of rocks and looked inside. They had a small can of Pringles Potato Chips ("crisps" to you blokes) that he bought for $8.00. That appealed to his brain. Unfortunately, they did not appeal to his stomach, and after the first few he was giving them away. Nothing functions quite normally up there.
–B.G.–

[Anonymous]

"But you still need the energy! A partial solution is to switch your diet to less complex carbohydrates. Avoid any fats at all, and eat sugars and simple carbos like biscuits. These digest and metabolise more easily."

+ 100!!! Absolutely critical. Simple carbs. 1 mole of glucose is oxidized by 1 mole of O2. C6H12O6 + 6 O2 = 6 CO2 + 6 H2O + energy. The oxygen requirements to oxidize a mole of a medium chain fatty acid or a simple protein are astronomically higher. Given the reduced availability of O2 at high altitude, the conclusion is pretty clear. The advantage of glucose is that it carries 1/2 of the oxygen required for its complete oxidation as part of the glucose molecule.

[Anonymous]

How many carbohydrates are in a mole?

[EndoftheTrail]

"When you get up high, like 16,000+ feet, and if your appetite starts to wane, "

That night at 17,200', I was super hungry for some reason. The Chinese style soup noodles weren't that great — but I ordered two bowls (double portion) anyway and wolved it all down. In other words, I completely ignored the guide's advice.

I felt no negative effect whatsoever, but posted the question because I could have just been lucky…

The suggestion to switch to simpler carbo makes sense!

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