Acclimatization on washington

[Jim lombard]

It's amazing how with time people can get used to the affects of altitude. In Rocky Mt National park there's a road called Trail ridge rd that goes up to a point over 12,000 feet. Many tourists climb what's called Turkey hill, maybe a 1/4 mile or so to an overlook with a sign, where like on Mt Washington people wait in line to have their picture taken. We saw many on the way up who were only able to take a few steps before stopping to gasp for breath. We'd only been there for three days but we were easily walking rather fast.

Grays peak in Colorado at over 14K affected about half the group including me. My wife had terrible AMS at 18K on Kili and I was just fine. You never know. I wonder how big a factor fatique and diet are?

 

[DougPaul]

I have read a good bit on the topic of acclimatization, and yes you will adapt to 5Kft. Not much adaptation is required for a healthy individual, however. Many will not notice any effects unless they try to break athletic records.

Charles S Huston M.D. has written some good books on the topic "Going High" and "Going Higher".

BTW, my earlier comments on the effects of altitude assumed that the individual had no problems with his oxygen delivery system. Someone who already has, for instance, emphysema, could be at risk at rather low altitudes. Mt. Washinton (or any other mechanical ascent peak) would tend to cause problems for these people. Pressurized passenger aircraft typically fly with a cabin air pressure altitude of about 7Kft--low enough that most people don't notice it (it helps to keep them mildly sedated...) but high enough that the susceptable may have to use bottled oxygen.

In fact, healthy mountain climbers on expeditions have been studied as a model for emphysema etc patients. (Emphysema etc patients are effectively at altitude all of the time.)

Most healthy people do not have to worry about altitude-induced illness at or below about 8kft.

Doug

 

[Pete_Hickey]

I personaly have had problems at different elevations on different climbs. Your tolerance can change not only with acclimitization but also because of several other factors including overall health and fitness at the time, nutrition and hydration, and stress levels.

Four times, I was over 14K feet,and had no problems whatsoever (aside from a little shortness of breath), but one time, after spending 3 days at 7K feet, I got a real bad case of something at 12K feet. The worst headache I ever had. I HAD to get down.

 

[WalksWithBlackflies]

"Pressure in pulmonary capillaries is increased, 'forcing' blood into parts of the lung which are not normally used when breathing at sea level" ----

Last year, I spent a week above 11,000 ft. The biggest physiological adaptation I noticed was that my lungs felt twice as big as normal.

 

[DougPaul]

I wonder how big a factor fatique and diet are?

Effect on acclimatization (IIRC):
* fitness: not much. Allows you to do more, but not much effect on altitude induced illness.
* Fatigue: not much. But effects can begin or are more severe during sleep due to the normally reduced respiration. See also Cheyne-Stokes breathing.
* Diet: some. Digesting food consumes oxygen, fats more than protein and carbs. Above ~17Kft, fats are ineffective as a fuel source (eat carbs). Taste may be altered and appetite may vanish. Some high altitude climbers have to force-feed themselves carbs... The also frequently come back down from the big peaks looking like starvation victims (which they are--high workloads on little fuel for an extended period*).
* Hydration: VERY important. Maintaining adequate water intake (which can be 8 liters, 2 gallons at altitude) is essential. You need more output than normal at lower altitudes (there are PH changes going on in your blood and you have to excrete excess ions etc).

* A Don Williams story: on the walk into Everest Basecamp (back when it was a 2 week walk in), someone needled Williams about how fat and out of shape he looked (his favorite training location was the pub...). His response was "Wait you see what we look like when we come back" (or words to that effect).

Doug

 

[DougPaul]

after spending 3 days at 7K feet, I got a real bad case of something at 12K feet. The worst headache I ever had. I HAD to get down.

There are 3 basic treatments for altitude problems:
1. Get down.
2. Get down.
3. Get down.

Doug

 

[SAR-EMT40]

There are 3 basic treatments for altitude problems:
1. Get down.
2. Get down.
3. Get down.

Doug

Those are the treatments for all altitude problems AMS, HAPE or, HACE.

The most important thing is to diagnose it early so that the person is able to get themselves down before they are incapacitated. Also not having a problem in the past is no guarantee that you won't have a problem another time.

Keith

 

[blacknblue]

Here's another good article: http://www.princeton.edu/~oa/safety/altitude.html

I've been living in CO for 4 years and have plenty of altitude-related stories. When I moved from the East Coast, I was running a lot and knew could predict my time within a few seconds/mile. My first few runs out here were a good 20 seconds/mile slower despite the same effort. My brother can attest to that, too. During his visit last fall, I took him to an 11,900' pass the day after he arrived, and he nearly passed out on the descent. Three days later we went above 13,000 with no problems (other than usual breathlessness. By the way, it's fun to wrestle with people who aren't acclimated!)
My resting pulse at 5300' (where I live) is about 42/min. If I go up tonight and sleep at 11,500' (treeline, roughly), my resting pulse will be 84/min. I've got a great graph that shows your % of oxygen at particular altitudes, based on your altitude of acclimation. It's in a Word doc, though, and not sure how to post it here. I guess email me if interested.
I never have much difficulty below 8000', but once above about 12,000' there are some serious consequences. I can tell you that hiking above 12,000' with 45 pounds on your back is absolutely exhausting (even after 4 days above 10,000 to acclimate!)

 

[Jim lombard]

Effect on acclimatization (IIRC):
* Diet: some. Digesting food consumes oxygen, fats more than protein and carbs. Above ~17Kft, fats are ineffective as a fuel source (eat carbs). Taste may be altered and appetite may vanish. Some high altitude climbers have to force-feed themselves carbs... The also frequently come back down from the big peaks looking like starvation victims (which they are--high workloads on little fuel for an extended period*).

Doug

I know one thing, stay away from nuts if you go to high altitude. Eating alot of nuts takes tons of energy to digest and this makes the effects of elevation much worse. I agree, food has no taste at all above 15,000 feet, you really have to force it.

 

[dr_wu002]

One of the nicest things about Washington, I've always thought, is that the air (when yer not smelling the cog!) is so nice and thin. I start to notice slight changes around 3500-4000' up until the Washington Summit. What a great feeling. Then to come down low is so disappointing. The air is so oppressive, especially around Boston! It's not a funtion of pollution necessarily, either... I just like that slightly 'thinner' air on Washington. I know when I hiked Washington for years with my dad he always complained about it but I think he liked it too.

-Dr. Wu

 

[DougPaul]

I know one thing, stay away from nuts if you go to high altitude. Eating alot of nuts takes tons of energy to digest and this makes the effects of elevation much worse. I agree, food has no taste at all above 15,000 feet, you really have to force it.

Nuts contain a significant amount of fat.

Doug

 

[Mad Townie]

This is just anecdotal evidence, but a friend who has spent a fair amount of time on the Himalayan trek routes says that altitude sickness (NOT shortness of breath) seems to be inversely related to conditioning: people who are in really good shape seem to get it more than people who are not in such good shape.

 

[giggy]

along those lines - I hear that smokers do well at altitude. A few of them british climbers like doug scott and joe simpson were smokers.

never noticed it on washington - but have also never been up there for extended preriod of time. I did notice it at 10k - shovleling snow and then above 12k - nothing huge - just kind of noticed it, tire a bit quiker, etc...

 

[David Metsky]

This is just anecdotal evidence, but a friend who has spent a fair amount of time on the Himalayan trek routes says that altitude sickness (NOT shortness of breath) seems to be inversely related to conditioning: people who are in really good shape seem to get it more than people who are not in such good shape.

I don't think it's that clear. I saw people in good shape doing just fine, and some in good shape having problems. Same with folks in bad shape. He may have just noticed the people in good shape more or they stuck in his memory more.

Once they dealt with AMS, those in good shape pretty much all functioned better than those in bad shape. AMS is the headache/nausea/sleeping problems that can occur to anyone at altitude. If they were able to go lower, take it slower, hydrate, etc the ones in good shape did pretty darn well.

I probably have much less Himalayan experience than your friend but the doctors at HRA were pretty clear that being in shape didn't factor into AMS.

-dave-

 

[DougPaul]

I probably have much less Himalayan experience than your friend but the doctors at HRA were pretty clear that being in shape didn't factor into AMS.

The sources that I have read state that being in shape (or not) has little effect on acclimatiation.

Doug

 

[Bluethroatedone]

When we were in Nepal, our guide explained that the problem was that people who are in shape push harder than those out of shape. He explained that ideally you should do a moderate amount of exercise and sleep a little higher every night. People who tend to get HAPE or HACE the most are fit people who push ahead skipping a rest day, hike for hours and hours, and rise too fast etc.

The deal is its tough to do a monster hike/climb if you're fat and out of shape....