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Altitude sickness death

How do you prepare for the rigorous physical requirements of high elevation adventure? Strength and endurance are key, but are only part of a more complex equation. How do you prepare for changes in altitude, exposure, diet, etc.? How do you mentally prepare? Learn from others and share what you know about training in advance for outdoor adventures.
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Re: Altitude sickness death

Postby kpeter » Thu Aug 16, 2012 6:29 pm

A great tragedy. Hopefully we can all learn from it and maybe one of us will have the occasion to help someone avoid a similar tragedy in the future.

Question: I know that gradual acclimatization certainly helps general energy and comfort levels, but is there any evidence as to whether gradual acclimatization helps to avoid HAPE?



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Re: Altitude sickness death

Postby ucangler » Fri Aug 17, 2012 9:50 am

Everytime I go out to the Sierra's I do take Ibuprofen to relieve inflammation. So far, I believe it has reduced the headaches. From the Institute from Altitude Medicin, everyone's brain swells at least slightly and the anti-inflammatory properties of IBUP work like a charm.
http://www.altitudemedicine.org/index.p ... e-sickness

I usually take 600mg every 5 hours or so on the 1st day. To get a good rest, I take a benadryl to knock me out and quell any allergies I have from the natural antigens in the wilderness along with Ibuprofen for the prevention of further inflammation. The next day, I'm good to go fly fishing at 6am!
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Re: Altitude sickness death

Postby Mradford » Fri Aug 17, 2012 10:14 am

WOW, this is very sad to here and very scary. I have backpacked with kids before and they were suffering form AMS and we kind of overlooked it. Now i know better but back then i was very new to all of this.
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Re: Altitude sickness death

Postby DonDeadman » Fri Aug 17, 2012 10:37 am

Terrible news.

Now, this is one thing that I've questioned, and hope that this isn't the improper time to ask...

For those of you that have fallen victim to this: where (roughly) do you live? I come from a place that's all ready higher than most (5500 ft), so on my trip, I wasn't hit so hard (I think).
Do you think it's worse for people coming from places like LA or the Bay Area, where the elevation is significantly lower?
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Re: Altitude sickness death

Postby mbear » Fri Aug 17, 2012 10:50 am

DonDeadman wrote:Terrible news.

Now, this is one thing that I've questioned, and hope that this isn't the improper time to ask...

For those of you that have fallen victim to this: where (roughly) do you live? I come from a place that's all ready higher than most (5500 ft), so on my trip, I wasn't hit so hard (I think).
Do you think it's worse for people coming from places like LA or the Bay Area, where the elevation is significantly lower?


I come from San Antonio, Texas (~800 feet)
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Re: Altitude sickness death

Postby jfelectron » Fri Aug 17, 2012 1:18 pm

I recently bailed from a 10 day trip on day 3 due to what I think ultimately started as AMS but became severe dehydration due to inability to keep liquids down. I've never had problems with altitude sickness, which just goes to show that it can happen to anyone even if you think you are 'immune'. I camped my first night at the lakes on the East Side of Kearsarge Pass at ~10k. I slept OK and felt reasonable in the morning. However, I had little appetite and gagged on my coffee and vomited a little. I felt OK going over the pass, and my route had me descending down toward Road's End so I thought I'd be OK. Over the course of the very hot day (>90F), I had increasing trouble keeping fluids and food down. I descended all the way down to Road's End and bivyed next to the permit station. In the morning, I attempted to hike back toward Onion Valley but felt pretty awful. I continued to have limited success in keeping liquids down. I ultimately had to hitch out of the park to receive IV liquids in Fresno. I always force liquids the first days at altitude and this was no exception. I think with vommiting due to AMS and the heat I just couldn't keep up and woud up dehydrated. So the moral is that even upon descending, sometimes the effects of AMS can still prove perilous and force evacuation.
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Re: Altitude sickness death

Postby zorobabel » Fri Aug 17, 2012 2:29 pm

How about this scenario?
Let's say you wake up with HAPE or HACE. Your car and fastest descent lie over a pass that is about 500 ft higher than your campsite; let's say 7 miles to the car - called the E route. You can also descent right away at a more moderate pace in the direction opposite of your car (called the W route) with the nearest human/trailhead in that direction being about 35 miles, that's if you have a map of that area. You have only 1 day of food left. What would some of you that have thought more (than me) about AMS do?
What if the pass is 1000 ft higher?

My thoughts - for short term, taking the W route offers the fastest cure for HAPE/HACE, but you end up walking a lot more, possibly X-country, while being at the least of your abilities. Food is not important yet, as you don't want to eat because of the sickness. By the second/3rd day of the W descent (if you don't brake a leg - XC and with no map) you will end up very hungry and possibly lost. SAR has no idea where you are. If you manage not to get hurt descending (which might be hard with HACE), chances of getting out OK are high.

The E route, might kill you in the beginning - ascent to pass, then descend to original camping elevation which might add 2 hours. In these 2 hours you would have descended to a safe elevation already by taking the W route. If this was your intended route (shared with rangers/family) SAR knows where to look for you. If you have to go XC, chances of injury are higher than the E route (we are talking about E Sierra right?)

If there's a trail for only one route I would choose the trail.
If there are trails on both routes I would choose the E route, over the pass, especially if I catch HAPE/HACE early.
If HAPE/HACE is advanced, I would crawl on the W route.
Note to myself, I should start to carry an extra map - for the route I don't intend to take :).

PS. There's also a 3rd possibility, descending W for one (or half) day, than going back E after feeling better. This could be the worst choice of the 3.

Thanks for reading the long post...
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Re: Altitude sickness death

Postby Cross Country » Fri Aug 17, 2012 8:31 pm

First a little background.
At 45 years of age I never noticed any altitude sickness on my part and had no recollection of being in the presence of it with someone else.
My sons (6yo to 16yo) reveled in being backpacking tough guys more that I ever did and actually liked "death marches". I never did.
On our 3rd trip ever (6 and 11yo) I took them over Kersarge Pass, their first time above 11K. They seemed to do fine hiking over the pass. Upon arrival at the lakes they both laid down in the tent and after a while informed me that neither of them wanted to eat dinner. They only wanted gatorade. They each slept about 11 hours that night and didn't eat until a light breakfast the next day. Although unplanned, that day was to be a layover day. The following day they were fine and we hiked down the short distance to Charlotte Lake.

That was pretty scary to me and from then on I monitored them very closely. It came up a few other times but because I was sensitive to it, it never caused a problem but was always a cause for alarm and caution.

One should always be willing to change plans when prudent.
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Re: Altitude sickness death

Postby giantbrookie » Fri Aug 17, 2012 9:26 pm

I think back to my hiking days as a kid and try to figure out whether if I was in the position of my dad I might have pulled the plug on a trip. Although the 2nd strongest hiker in the family after my dad, I was the most prone to altitude sickness of anyone in the family. I had some miserable day 1's, but I think, as noted by others, the telltale signs are the deterioration in later days such as day 3 plus and my day 2's and beyond were nearly all very strong. I almost never had much of an appetite at all on hiking trips in those days (say age 7 to 20). I'd hydrate OK, but I simply didn't eat much, whether I felt good or not (little wonder that I would lose lots of weight on those trips in those days--since the mid 90's I've eaten so well on trips that I seldom lose weight on them anymore). I had one trip where I didn't feel so hot on day 3--I threw up on the summit of Whitney on day 3 of a Mountaineers route family outing (age 11). In spite of that I believe I had altitude sickness but wasn't deteriorating otherwise as a result of something more serious such as HAPE--of course there wasn't a really good test given that my sickness climaxed at the summit and we descended reasonably fast after that (although our camp that night was still fairly high--est 12k somewhere below Iceberg L bivouacked among talus). Other than that I can't recall me or someone in my group having issues with altitude past day 1 or 2 on any trip I've been on over the 45 years I've been backpacking, thankfully. I have become sick in the backcountry beyond day 2, but these have been cases of the common cold, perhaps flu, and perhaps bacterial infections, rather than altitude sickness related (almost all of those examples are as an adult on trips taken aged 32-40). I guess I am partly thinking out loud to distinguish physical/health difficulties me or my hiking groups have had in the past from genuine symptoms that may have been the onset of HAPE--I sure hope I will be able to recognize the symptoms if indeed anyone in my group is suffering from them.
Since my fishing (etc.) website is still down, you can be distracted by geology stuff at: http://www.fresnostate.edu/csm/ees/facu ... ayshi.html
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Altitude sickness death

Postby Fishstick » Fri Aug 17, 2012 11:03 pm

A few years ago, we hiked up Whitney from the west on day 7 of a trip out of Mineral King. A 17 year old in our group was in great shape and had outpaced our group all week, even shuttling some packs up the passes for others who were exhausted. When we dropped packs on the ridge to hike the final mile to Whitney, he decided to show off by running. Ten minutes later, he was doubled up in cramped agony along the side of the trail. Several passers by told us "descend, descend, descend", so with an arm draped over two of our shoulders, he limped down the east side to the first base camp. An hour later, he was fine. A good reminder not to play fast and loose with the Mountains.

I'm not sure if this is anecdotal or scientific, but the times I have experienced altitude sickness symptoms (often after several days of acclamation) have been when I was in a hurry and didn't stop to eat or drink. It takes some conscious discipline, but if I intentionally slow the pace above 11k and routinely stop to drink and eat before I feel like it, I have not experienced the nausea and other effects. I may be mixing up routine fatigue with the more serious AMS and HEPE, but the practice has served me well in any event.
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Re: Altitude sickness death

Postby orbweaver » Sat Aug 18, 2012 3:48 pm

I'm thinking about AMS with respect to my forthcoming trip - in about 3 weeks. I'm planning to go North Lake to South Lake, over Piute Pass, down Piute Creek and up Evolution Valley, exiting through Bishop Pass - solo.

Some background - I'm a 69 year old hiker living in Florida. I'm in good health - not the strongest hiker but experienced and careful. I've just completed a week's hike between huts in Norway. I've been over Piute Pass twice for two day trips, the last time was last year, and I've had no AMS symptoms. I've acclimated at about approx. 9500 ft for two nights before these hikes and plan to do the same this year. I move slowly, drink a lot of water and eat snacks frequently.

What makes me nervous is going over Piute Pass and getting down to 8000 or 9000 feet, then developing symptoms as I go up to Muir Pass, say. I could go back down but wouldn't be able to get back to the eastern side of the Sierra without going up again.

I hadn't heard the idea of symptoms developing on the second night, then worsening a lot on the third day. This is new information for me. If I stay at 9500 for two nights, taking day hikes, then go over Piute Pass for a third night, and then wake up without symptoms (as I've done before), do you think I'm good to continue the rest of the loop?

Like others said, I don't want to hijack this thread, but I'm listening to the important message to be very careful of AMS.
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Re: Altitude sickness death

Postby rlown » Sat Aug 18, 2012 4:18 pm

To everyone with questions here especially about symptoms about AMS/HAPE/HACE and appropriate meds or approaches: We're not Doctors and I think most of you have one. Talk to them about past experience and appropriate approaches if the symptoms kick in.

WebMD is a fun site for background approaches, but it should still be a discussion with your doctor and you.
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