Hiking at High Elevations

Stephen, I live in the Atlanta area also, and have done a few trips to high altitude. A couple of times with groups. I have found that the altitude sickness varies with the individual and is not necessarily dictated by fitness level (although healthy lungs and heart can improve your oxygen transfer). So what works for one person may not work for another. Similar to sea-sickness. We have traveled to Bolivia for the last couple of years and the airport in La Paz is at 13,000 feet, so you start off pretty high and get higher if you go into the mountains. The general rule is to "chill out" for the first 24 hours, try not to lift anything heavy or exert too much energy, as your body adjusts to the change in oxygen. Some folks take prescription Diamox to help with the altitude sickness. In any case, rest,lots of fluids and perhaps some ibuprofen will help your body to adjust. The advantage you have in Colorado is that if you feel sick, you can usually go down to a lower altitude to recover (not the case in Bolivia). I have been with 25 different people on these trips and no one got true altitude sickness, usually just a dull headache until your body can adjust.
Good luck with your trip!
Bert Blanchard

I live at 500 feet near the coast. Typically head out to the Sierras and what I do is spend the first night camping somewhere near the trailhead. This is usually around 7-9000 feet. Usually by the next day I am starting to acclimate. Some are better than others at this and some aren't. I camp at altitude and spend the next day hiking at a slower pace than usual just to get in the swing of things.

Your body will let you know. Just take it easy. No need for an oxygen cannister

Portable oxygen tanks are not practical unless you are on a Himalayan expedition above 20,000 feet, or unless you have a serious chronic disease.

For your first trip to high elevation, you really need to be a little cautious. After that is successful, you can push it a little more each time. I know people at both extremes. One guy (geophysicist) knows that he will get a splitting headache as soon as he has been above 11,000 feet for an hour. It gets him every time no matter what he does. Some of us have a more normal response. That is, the first time up it will slow you down tremendously, and you may need aspirin for headache. Little by little, time after time, your body learns how to respond to that, and you will learn to drink more water. You can learn what your own body requires.

The old axiom for expeditions is to keep pushing your camps up higher and higher daily, but not to try to gain a net of more than 1000 vertical feet per day. My personal opinion is that the axiom is overly conservative, but it is OK if you don't know any better.

My personal opinion is that 80% of the high altitude symptoms that people have can be traced back to simple dehydration. So, maybe drink more water and add in a bit of Gatorade. The other thing is that it helps to be somewhat in shape. You don't need to be an Olympic marathoner, but your legs have to be ready for a workout.

Every year I hike up Mount Whitney. I can almost guarantee you that if I simply drive up to the 8000 foot trailhead and start, the altitude will catch up to me before I am halfway up the trail. Instead, I go "hang out" at some high car campground (maybe 8000-9000 feet) for a few days, and I take dayhikes up from there. That gets my body more tuned in to what it needs to do. Basically, my respiration gets deeper but not much faster, and my rest heart rate increases slightly. Once I see that my own body is functioning normally, then I head to the Whitney trailhead and start.

If you want to make a guess about your own high altitude ceiling, then try this. At sea level, record your rest heart rate and your maximal heart rate. Now go up to 5000 feet, for example, and repeat those recordings. Now go up to 10,000 feet, for example, and repeat those recordings again. What normally happens is that your rest heart rate keeps increasing as you go higher, and your maximal heart rate keeps decreasing as you go higher. Plot that out on graph paper, and you will see that the two lines will converge at some point. It may be 11,000 feet, or it may be 16,000, or something else. That is your ceiling, and you are unlikely to make it far beyond that. If you hang out at high altitude for a week or more, your body will begin an adaptation process that involves blood chemistry. Then the two lines will begin to shift a little, and you may get a better ceiling.

–B.G.–

I live at sea level. Your home altitude doesn't really matter. If you take people who grew up at 15000 feet and make them live at sea level for a while, they'll have as much altitude problems as anybody else. How people react to altitude doesn't seem to have anything to do with your fitness, but fitness helps because you'll be working a lot harder at altitude. Staying well-hydrated helps. Spending a night at 7 or 8000 before heading into the mountains helps. Climb high, sleep low helps. Gradual net elevation gain helps. That's what they forced us to do when I trekked in Nepal.

If you end up with bad symptoms–a headache and nausea–you need to go down. You'll want to stop and rest or sleep or something but really you're not going to get any better until you go down. You could get worse. So make a contract with yourself that if you get really sick, no matter how awful you feel, you'll head down.

Different folks, different strokes.

We live near sea level. We regularly walk in the mountains at 2,000 m (6,500') without any effects. 3,000 m does not seem to worry us either. But it does worry others. As others have said, go slow the first time and 'calibrate' yourself.

Cheers

3000m doesn't worry me either, but my legs start to feel leaden at around 3300m on steep ground.

Just take your time and move at the pace your body dictates. Allow for longer rest periods and a slower pace in your planning.

I agree with bert and would add that it is important to sleep high. Just because you've spent time at altitude in the past, after being away for 2 weeks your body readjusts. They say in best case scenarios give yourself 2 weeks to adapt, but it is generally accepted to just give yourself a few days if you're not doing anything too intense.

The other benefit of giving your body time to adjust is that it becomes way easier just hiking.

I live in Bolivia and go up to the small hills 15 minutes from my house (3600 meters) and besides a bit of shortness of breath, hiking 7 k is no problem.

Just yesterday I drove up to 5300M with my family and trying to climb up a fairly steep but otherwise short trek to the top of the peak (chacaltaya) was incredibly painful… especially caring my 3 year old!). My point is that you'd think that it wouldn't make much difference, but even after 2 years living at altitudes of 32-4200 meters a bit more still is tough.

Finally, there is a trick to help. Take a deep breath and release it quickly through pursed lips. This should force more air into your lungs and make it easier!

+1 on going up early and just doing day hikes.
Even then- last year we camped for 2 nights at 10000 feet and then hiked up with a 2000 foot gain over just a few miles. When we got up to 12000 feet a third of us ( large group of scouts) developed headaches. Two of us got nauseated and uncoordinated. Fortunately, at that point the trail was pretty easy to follow so we kept going.
Staying well hydrated helps. Motrin or Tylenol for the headache. Several of us found that a liter of the camelback elixir (the orange flavored one with caffeine) really helped. The combination of all three (hydrated, Motrin and electrolyte/caffeine drink) worked for the two kids and one adult who were really miserable.

Bolivia certainly deserves a place in any discussion about high altitude! I just returned from Bolivia last Tuesday. It is an amazing country!

I decided to take Diamox because we were walking on Isla del Sol in Lake Titicaca on my second day there (the average elevation is around 3800 meters). I was definitely out of breath on any climbs but was generally ok, although my appetite was lowered for several days (probably a mix of altitude and travel). We then started the Choro Trek on day three. I live in Portland (elevation 15 meters). I had no noticeable side affects. I feel it was probably worth it taking the Diamox for that specific trip.

Here in the U.S., I occasionally get a few symptoms of altitude sickness (headaches or a little nausea) even around 6000+ feet in WA or OR, but I generally feel better the next day. There are not many places in the U.S. where I think Diomox would be all that necessary (depending on the individual, of course).

Drink large amounts of fluid, with electrolytes, consider adding gatorade powder to your drink. Drink even when you are not thirsty because you do not realize how much water you have lost. The same goes with eating.

If possible, drive to a trailhead at a high as possible elevation and sleep there, that's basically free acclimation. If you're visiting an area and hiking later, consider camping out at these high elevation trailheads.

It's not just the altitude thats important. Lifting massive loads or doing heavy work at high altitude will greatly increase your symptoms. Take the days easy.

Re: “Two of us got nauseated and uncoordinated.” I’m no expert, but I’ve heard that being “uncoordinated” is a symptom of HACE (high altitude cerebral edema), which can kill within hours, and those people should have gone down, not continued on.

I forgot to mention, here in Bolivia they offer a cheap alternative to diamox. They give you pills that are a mixture of caffeine and aspirin. Basically thinning the blood and then speeding up cells. Pretty clever and pretty simple.

It would definitely be the simplest antidote for NA!

HACE is uncommon except at very high elevations. I saw one victim that was stricken at over 22,000 feet. Others are stricken above 15,000 feet. It isn't seen so much at normal backpacker elevations (8000-14,000 feet). Think of it kind of like a stroke.

HAPE is more common at normal backpacker elevations. Even then, full-blown HAPE isn't that common. Acute Mountain Sickness is more common and less lethal. Think of it kind of like pneumonia.

Some statistics were gathered on downhill skiers visiting resorts in California, and it was noted that there was a higher incidence of HAPE in those at Mammoth and less incidence of HAPE in those at Squaw Valley. What is the difference? The sleeping elevation at the base in Squaw is about 6200 feet. The sleeping elevation at the base at Mammoth is about 8000 feet. There is some kind of imaginary boundary there for many people. The good news is that the physicians in both places are tuned-in for symptoms. It shows up the most in people who sort of rush in from sea level and push too hard on the first day.

–B.G.–

A couple of years ago, we spent a few weeks in Peru. After surfing Punta Rocas (south of Lima), we flew up to Cusco, and then off to the requisite tour of Machu Picchu. I gotta tell you, as I stepped off the plane, my legs buckled a little bit. LOL

It took us around 24 hrs to properly acclimate – I guess having a little coca 'tea' in Ollantaytambo probably helped a smidge. LOL2

After a few days @ elevation, we were back in Cusco ready to fly home. While we toured one of the Inca sites, we could see some professional looking locals, who had flown up for a getaway weekend from Lima, looking like drunken sailors as they held on to each other for support. LOL3

I typically don't have issues up to 10k. I can get to Whitney area THs in 4 hrs from the OC – I get out of the car and get going. Sure, you might get a little bit lightheaded, but there's things to do and places to go.

As others have said, it depends on the person, and can even affect an individual much differently from one trip to the next.

In general I think it's smart to pay attention to how you're feeling and act accordingly, descending if you're getting symptoms. "Climb high, sleep low" is a good rule of thumb.

http://en.wikipedia.org/wiki/Altitude_sickness

If you take your time acclimatising you are unlikely to have any serious problems.

"In general I think it's smart to pay attention to how you're feeling and act accordingly"

The problem comes for a person on the very first visit to high elevation. They have heard that they will feel different or a little "off," but they have no frame of reference. Then, as they make progress upward on some trail, they can't tell the difference between feeling tired versus feeling a high altitude problem.

It has often been said (although not proven) that the most serious high altitude symptoms take 24-36 hours to set in. The problem there is that sometimes the victim won't know that they have a serious problem until they are incapacitated. That makes for a terrible problem in evacuation.

I was on a Kilimanjaro trek one time, and two out of twelve people had to be evacuated from the rest of the group. I could tell 24 hours in advance for the first one, but the second one was a complete surprise. Both recovered completely once they had descended a few thousand feet.

–B.G.–

I have made a few trips from Ky to high altitudes. Reactions seem to vary a LOT from person to person. I don't know any way to know except to go and see. Turn back if you have problems.

"I currently live at ~1100ft above sea level and am wanting to do a hike in Colorado at just above 14,000ft."

Are you coming out to do 14er's, hike trails, or sit naked for a week on some peak?

If the former, then long high output up to elevation could be a problem.
If the latter two, then not so much of a problem.

Edit: Age, weight, conditioning, history, etc. might more elicit specific responses.
Guys doing the Leadville 100, run and/or bike are of 2 camps. 1) Come out early and see how the body responds, or 2) fly out the day before and just do it.

Hemoglobin changes take about 2 weeks. Getting your brain to learn and honor how you body responds takes about 2 days. If you are on your own schedule, it is usually not to much of an issue.

Years ago, a bunch of us had climbed a nearly-7000 meter peak, and the trip report was posted on the net. Within the year, I was contacted by a stranger from Columbus Georgia who was looking for information on the same peak, and he asked if I would mind answering a few questions. Before I answered much, I asked him to tell me his level of experience for what he was planning.

He told me that he was a Lt. Colonel of the U.S. Army Green Berets at Fort Benning, and he had a Green Beret team all ready to go climb the peak in a few months. He mentioned that they parachute and scuba dive, they hump through the swamps with huge packs, yada, yada… so, in his view they were ready to go climb the peak. The team consisted of some Army plus a couple of Marines, plus one guy from Chile.

I told him that their activities seemed good, but that I didn't see anywhere in there that they had any high altitude experience other than jumping out of a perfectly good airplane. The officer went back over their activities list, but there was no high altitude anything… not even downhill skiing. I told him that they needed to get a few 4000 or 5000-meter notches on their belts before they tried to do 6000 or almost 7000.

I told them to fly out to Fort Carson Colorado and hike up the first 14,000 foot peak they could find, sleep there one or two nights, then come back and report in on how it went. The immediate response came back to me, sort of "Grrr!"

A few months later they went to climb the peak. As you might guess, they got to around 6000 meters, and the Army guys had to bail. The Marines kept going higher and then had to bail also. The only success was the guy from Chile, who apparently had some high altitude experience. I hate to think of this, but that was probably my federal tax dollars at work.

–B.G.–

Bob,
I thought I add another post so you could add another story…

"Hemoglobin changes take about 2 weeks. Getting your brain to learn and honor how you body responds takes about 2 days."

Yes, short term adaptation begins happening almost immediately, and you can get a lot of good out of a couple of days at a moderate elevation. In the short term, little gas pressure receptors in your circulatory system sense that oxygen is beginning to dip a little, so you begin breathing deeper or sometimes quicker (deeper is more efficient). Your rest heart rate increases slightly. All this occurs subconsciously.

After a couple of days of that, your system will _begin_ creating more red blood cells, but that will take a week to make much difference, and it may take two to three weeks to make a lot of difference. This may have the effect of increasing the solid part of your blood, the hematocrit, so it is a good idea to increase your hydration to make sure that your blood doesn't get too viscous (which leads to other problems). This is the long term adaptation process.

However, that long term stuff takes so long that it is impractical to consider except for a Himalayan expedition or something. So, just focus on letting the short term adaptation happen. For me, it takes two nights, minimum. Three nights is excellent. After that, I get little extra help out of four or more nights. However, the muscles get some good out of moderate exercise during that period. Some people do this much faster, and some do not adapt well at all.

–B.G.–

Greg, your turn.

–B.G.–

Got another story?

I am laughing out loud at this moment….this exchange is tooo funny!