Trip cut short due to altitude sickness

[cshire]

Would taking iron supplements for a period of time prior to trip help to increase red blood cell count and hemoglobin?
How much iron per day,? how many days before trip?
Would this be better than the meds?

 

[RLGrats]

It’s not just hemoglobin. It has to do with different reasons our bodies regulate our respiratory rate and secondary ways our bodies regulate our pH. If you want a deep dive, here’s a good link to what happens in AMS: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3678789/
Why some get it and some don’t probably has more to do with subtle variations in our physiology that either keep us in balance at altitude...or not.


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[Farmingdale's Finest]

So what would the expectations be for us next year if we drive into the town at 6600 feet and stay there the first two days? Then camp at the 8400 feet we did this year. I realize this is a hypothetical that no one can answer with certainty but some of you clearly have a good understanding of AMS and it’s effects.


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[ColeyG]

There has been some research done on iron supplements and altitude. My basic understanding is that you don't want to be iron deficient when you are trying to acclimatize, but that trying to bolster your iron levels shortly before trying to acclimatize does very little to help if you were already at or close to normal iron levels. Our bodies dump extra iron and red blood cells as waste if they aren't needed. Conversely, we ramp up production when they are needed for additional O2 carrying capacity.

There is only one "med" that has been proven to aid with the acclimatization process and that is Diamox aka Acetazolamide. It makes you breath more, thus addressing the lack of O2 in the blood problem and hopefully staving off AMS. Diamox most commonly comes in 250mg tablets. Many studies have shown that the benefits are about the same for a half or even quarter dose as the whole 250. There are some detrimental side effects to Diamox with regard to physical performance and health, mainly it is a diuretic and can dehydrate you fairly quickly.

The other "meds," Dexamethasone and Nifedipine, are emergency interventions for HACE and HAPE respectively. Neither aid with acclimatization, but rather are meant to address life threatening conditions in order to facilitate a hasty descent.

Why do some people get sick while others don't and/or why is it different every time for a given individual? Those are the million dollar questions. Everyone is different and our bodies respond differently to altitude and the acclimatization process every time based on a wide variety of physiological and environmental factors. These unknowns and this uncertainty is why it is best to follow a formula for proper acclimatization every time, trying to stack the odds in your favor. You might get away with rushing it a few times, but it only takes getting hammered by altitude once to potentially ruin things forever.

 

[ColeyG]

So what would the expectations be for us next year if we drive into the town at 6600 feet and stay there the first two days? Then camp at the 8400 feet we did this year. I realize this is a hypothetical that no one can answer with certainty but some of you clearly have a good understanding of AMS and it’s effects.


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Try spending a day and a night at 5000, then move up to town at 6600 for two nights. Then, if everyone is AMS symptom free, move to 8400. Again on these acclimatization days, make sure you stay lightly active and moving, but avoid over exertion.

Don't move higher until everyone is feeling good at the elevation you are currently at. You mentioned your heart rate earlier. Your resting heart rate is a decent indicator of how your body is acclimating. Take your resting HR when you arrive at a new altitude and then check it once or twice a day to see how it changes for the first few days. As you build more red blood cells and increase your carrying capacity for O2, your HR should drop. It will always be higher than at sea level, but it should start decrease after a day or two at a new elevation.

Another thing you might consider is a pulse oximeter. Several companies make small, portable versions that are cheap, fairly reliable, and backpacker friendly. These devices measure your SpO2 aka O2 saturation in your blood. I hesitate to recommend these because many people put waaaaaay too much stock in the numbers and don't pay attention to how they are feeling first and foremost. That having been said, they are a good diagnostic tool that can help you figure out what is going on. As a caveat, I have seen sick people with great O2 sats, and healthy people with horrible O2 sats, so again if you use one of these, take the number as one piece of a big complex puzzle.

https://www.nonin.com/products/9590/

 

[Farmingdale's Finest]

Try spending a day and a night at 5000, then move up to town at 6600 for two nights. Then, if everyone is AMS symptom free, move to 8400. Again on these acclimatization days, make sure you stay lightly active and moving, but avoid over exertion.

Don't move higher until everyone is feeling good at the elevation you are currently at. You mentioned your heart rate earlier. Your resting heart rate is a decent indicator of how your body is acclimating. Take your resting HR when you arrive at a new altitude and then check it once or twice a day to see how it changes for the first few days. As you build more red blood cells and increase your carrying capacity for O2, your HR should drop. It will always be higher than at sea level, but it should start decrease after a day or two at a new elevation.

Another thing you might consider is a pulse oximeter. Several companies make small, portable versions that are cheap, fairly reliable, and backpacker friendly. These devices measure your SpO2 aka O2 saturation in your blood. I hesitate to recommend these because many people put waaaaaay too much stock in the numbers and don't pay attention to how they are feeling first and foremost. That having been said, they are a good diagnostic tool that can help you figure out what is going on. As a caveat, I have seen sick people with great O2 sats, and healthy people with horrible O2 sats, so again if you use one of these, take the number as one piece of a big complex puzzle.

https://www.nonin.com/products/9590/

Coley are you a doctor you seem extremely knowledgeable on the subject?

Based upon your first paragraph I am reading this as taking 3-4 days before we even scout let alone start hunting? We would be driving almost 2000 miles going west on Route 80 before even getting there.

We left NJ the Wednesday before the archery opener and got to where we were hunting 36 hours later. I drove all but 4 of those hours. It seems that the change in altitude on the drive at least the way you are writing it doesn't count toward acclimatization? If that's the case we get there Thursday we don't hunt before Monday and would have to drive home Friday morning. That would at best give us 4 days hunting on a 12 day trip?

 

[ColeyG]

Not a doc, but an EMT that worked on Denali for 14 years dealing with, among other things, climbers with altitude illness.

All time a higher altitude counts, or rather helps with acclimatization, but the altitude that you sleep at is most significant. This approach seems slow and I understand the limitations of work and family schedules. The itinerary I suggested would have you sleeping at 8400' on your fourth day in the area.

Another possibility to consider would be sleeping lower (5-6K) for those first 2-3 nights but then scouting/hunting up high during the days. Shorter exposure to the higher altitude while you are fairly active during the daytime shouldn't be enough to get sick if you guys continue sleeping low for the first few days.

 

[Farmingdale's Finest]

Another possibility to consider would be sleeping lower (5-6K) for those first 2-3 nights but then scouting/hunting up high during the days. Shorter exposure to the higher altitude while you are fairly active during the daytime shouldn't be enough to get sick if you guys continue sleeping low for the first few days.

So if we drive 36 hours like we did this year and then stay down in town for the next two days we would probably be ok or maybe drive a different route and stay in Denver and then drive the final few hours the next day and stay in town at 6600 the next night and then hunt and camp from the 8400 after that?

 

[ColeyG]

Most people would be just fine with that itinerary, but then again most people don’t get sick going from sea level to 8400’. If in doubt I’d say spend two nights at 6600’ before sleeping any higher. A night in Denver on the way wouldn’t be a bad thing either.

 

[Pramo]

I go from the east coast at sea level and up to 10K to hunt, camp and sleep in the same day. With that said I spend about two weeks a year above 8K hiking, biking and snowboarding for the last 10 years so I acclimate pretty quick now.

My biggest recommendation is sleep a night or two between 5 and 7K and fly don't drive, on my way out west I drink so many fluids I'm floating on the plane. Driving 36 hours it would be very hard to physically prep for a trip and cut into to many hunting days.

 

[LaHunter]

So if we drive 36 hours like we did this year and then stay down in town for the next two days we would probably be ok or maybe drive a different route and stay in Denver and then drive the final few hours the next day and stay in town at 6600 the next night and then hunt and camp from the 8400 after that?

Driving 36 hours straight through is rough. Lack of quality sleep could possibly contribute or increase the risk of AMS. I used to drive 24-26 hours straight through, but was never able to recover at altitude, especially when covering miles. I would arrive drained and feel like I was in a fog most of my hunt. Now I split my trip up and make sure I get good sleep. This seems to have made a huge difference for me.

 

[Farmingdale's Finest]

Driving 36 hours straight through is rough. Lack of quality sleep could possibly contribute or increase the risk of AMS. I used to drive 24-26 hours straight through, but was never able to recover at altitude, especially when covering miles. I would arrive drained and feel like I was in a fog most of my hunt. Now I split my trip up and make sure I get good sleep. This seems to have made a huge difference for me.

I was the one up most of the 36 hours my son took many naps on the way and he was the one who got sick. We were more worried about me before we got there. In 2010 I had a Widow Maker Heart attack at the age of 43. Seven months after winning the Pan Ams for Brazilian Jiu Jitsu. I have had surgery on my right knee 3 times from college football. I also had a construction accident after Hurricane Sandy where I fell through the steps between my first and second floors of my home due to rusted nails from the flooding we experienced. In the fall I herniated 3 discs in my neck and 3 in the lumbar region. I was in PT for 7 months and had an epidural and could barely walk around the block for a year.

 

[Fatcamp]

Holy shit, talk about hard to kill.

 

[tim tarras]

Does he have sleep apnea or possibly have it? That can also be a factor if he didn't bring his machine or not having one.

That's what happened to me when I went out. I bought a portable battery operated machine to take with me this year.

 

[Farmingdale's Finest]

Does he have sleep apnea or possibly have it? That can also be a factor if he didn't bring his machine or not having one.

That's what happened to me when I went out. I bought a portable battery operated machine to take with me this year.

It's possible that he has sleep apnea but I am unsure. I have a mild case of it and don't use a Cpap but am going to start shortly.

 

[Pre1032]

Talk to a sports medicine doctor before your next trip. They will likely send a a few meds with you. Diamox, Steroids if symptoms develop, or Dex if diamox doesn't work. doesn't work. The main downside of diamox is the tingling fingers, and strange taste. As stated earlier, the biggest concern is altitude gain per day. 5-6k is the number I keep hearing. I've climbed dozens of mountains, and my climbing partner is a high altitude trained emergency care physician. High altitude problems strike at random, and I would not think having it once would predispose you to it a second time. New here, and just wanted to add my thoughts.

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[Gatorgrizz27]

Being from FL, I was worried about it last year also. I spent one night in Denver at 5,300’, the second night at 5,800’, and then the rest of the trip we camped around 9,000’ and hunted over 10,000’ most days.

I’ve heard the same, stay hydrated, don’t drink alcohol before, and it can hit anybody totally randomly.

Not really understanding what you’re saying about the scouting + hunting time. For the month long Colorado archery season, you’re more limited by the amount of time you can take off than the season length.

I’d much rather start the 8 days I have to hunt of a 12 day trip (with travel) opening day than spend 4 days before it scouting and only hunt 4.

 

[Jeff Martin]

One of the most overlooked points regarding altitude sickness is dehydration. Dehydration can bring on AS. I have a friend that was similiar to your son and could not seem to shake it. Until, he met a doctor that told him just breathing in 9,000 feet, he needed 2 liters of water to keep him hydrated (just for breathing). You add a diamox which is a diuretic and the boy is dehydrated. Add, exercise and most are drastically dehydrated. This is greatly overlooked. Next time, get him where he is pissing every 5 minutes and I bet he feels totally different.

 

[Jeff Martin]

We camped at 8400 feet and he had no issues for 5 days between 7500 and 9300 feet. On Monday we hunted up to 9750 roughly and Tuesday he woke up sick. Like I said I drove him into town and it was at 6600 and he got no relief. So we bailed on the trip.

About 6 weeks ago I was in Lake Tahoe with my wife on a business/pleasure trip and she got altitude sickness at 6200 feet. According to what I read on Wikipedia 20% get it at 8000 feet and 40% get it at 10,000 plus and some get it as low as 6200. She had a mild case of it with a headache, dry mouth some stomach cramping. The day after we got home she lost 7 pounds of retained fluid. Maybe it’s genetics. I don’t know.

We plan on going again and just going to hope it works out.


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Your family needs to drink drink drink. I take my girls snow skiing at 10K feet. I force them to drink to where it is almost stupid. It works ! I think the tell tell sign is they are ok, and then they are not. Thats dehydration. AS 'usually" comes on early...not after a couple of days. Dehydration will bring it on after time.

 

[Mike 338]

For years I've been nagged by altitude sickness. When I was young, I just called it a headache and nausea. Took me a while to figure it out. Most guys pull into camp at higher altitudes and charge hard the next morning. Not real good if your susceptible. Your far better showing up two or three days early and loafing around camp. You'll still feel bad but you can lay down and ride it out. You'll eventually feel better after a couple days of puking. I've noticed that it isn't as bad if I can get around some altitude for a day or two, a week or two before I hunt. I almost am never bothered by it now. Not sure why not. Not doing anything different other than heading up a little early just in case and not going from zero to full speed the second I arrive.