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#27480 - 09/05/12 03:45 PM Altitude Sickness Trip Report and Re-Attempt Questions
Chicagocwright Offline


Registered: 09/05/12
Posts: 172
Loc: Alaska
Yesterday my father and I set out for a "day" hike of Whitney. We stopped at Lone Pine Lake to nap and hopefully further acclimate before our Midnight permit became active.

Both of us felt great as we began our trek. At some point I began to complain of a very mild head ache. I was being careful to hydrate, had hiked a ton this summer and am in very good shape and I hoped the nights stay at about 8,000 feet after my flight from Alaska would be enough to acclimate. My dad and I also hiked Dana last year and had no effects.

Well at some point my headache worsened and I felt a little nauseous. We made it to Trail Camp under a gorgeous Full Moon that was literally blinding in its brightness. At this point, 12,000 ft. I knew my summit effort was in jeopardy. I took some aspirin, we rested a bit, and then headed up the 97 swithbacks. Not long after (maybe 200 ft. Elevation) I made the call. The nausea was scaring me and I had never experienced altitude sickness. About 10-15 minutes and heading down the nausea overcame me and I violently vomited including dry heaves (sorry to be so graphic but I am hoping others can learn or give advice). At this point the headache was massive and to be frank I was VERY scared. Thoughts of rescue were dancing through my head and it was still dark. All I could think of at this point was advice I've read to get down! So I rushed down as much as I could. Several times the headache, fatigue and nausea would overcome me and I would find a place to almost lay down on the trail. I was also cold and stopping too long I would tremble with shivers. I never did vomit again but I believe I fell asleep a few minutes several times on the way down. I was also doing my best to stay hydrated but the taste of water digusted me, it tasted bitter but I forced myaelf to drink.

By the way, my 67 year old father was doing great. Disappointing him and ending his summit attempt was the toughest part of my decision.

Since I am writing this you know I am okay. I am at 8,000 ft again and feeling great after resting all day today. I hate we didn't make it but am happy to be safe and healthy. My thoughts are about all the maximum 7-8,000 ft mountains there are in Alaska where I never had to experience this again. It was a very scary experience and I've never felt that type of sickness before.

I posted the above trip report at a Yosemite Site but am hoping you all can help with some advice. I am contemplating a return trip to Whitney at the end of September. The trip will have to be on a tight schedule but based on everything I read here I think it is doable:

Wednesday: Fly from Alaska to Ontario arriving 10 am
Wednesday: Acclimate somewhere
Thursday: Acclimate somewhere
Friday Night: Begin Hike
Saturday: Complete Hike
Sunday: Fly from Ontario to Alaska at 6 am

Questions:
1. Any advice based on the schedule above on where the best place to acclimate is? Drive all the way to Mammoth and stay there?

2. I believe based on everything I have read that our chances for last minute permits are fairly good. We would need to get permits at 2:00 pm on Friday correct?

3. I am planning to go to doctor and get Diamox. Planned dosage on Thursday, Friday before hike and during hike as needed. Any suggestions here?

Any other suggestions? Prolonging the schedule won't work so I have to make it fit in the above schedule or just not do the trip. I need to buy plane tickets very soon so I am hoping for quick comments. Thanks so much.

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#27484 - 09/05/12 04:54 PM Re: Altitude Sickness Trip Report and Re-Attempt Questions [Re: Chicagocwright]
Bob West Offline


Registered: 11/13/09
Posts: 780
Loc: Bishop, CA, USA
We're glad to hear that you made the right decision and descended.

Diamox might help, but you ought to try at in a less challenging altitude before using it at Whitney...just in case you don't like the side-affects. Perhaps try it on some high-altitude hikes in Alaska; you've got some big mountains up there.

You might consider camping at the Whitney Portal camp ground for several nights (more than two) before starting up the trail.

Also...and this is very important...watch the local weather forecasts very carefully. Major storms can and have occured at the end of September. Storms at Whitney can prove to be deadly. The Sierra Nevada isn't always "gentle" in the Fall and Winter.

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#27485 - 09/05/12 05:04 PM Re: Altitude Sickness Trip Report and Re-Attempt Questions [Re: Bob West]
Chicagocwright Offline


Registered: 09/05/12
Posts: 172
Loc: Alaska
Thanks for your comments.

My dad and I hiked Mt. Dana together last year and had no problem. There really are no accessible high altitude hikes near me in Alaska (if accessible at all other than a full scale mountaineering treks.) I routinely hit snow at even 3,500 ft. in some places and other places climb 4-5,000 ft. but starting at sea level.

I know I'll be taking a risk booking a flight with such a tight timeframe but that is what I have to work with. Weather with have to play in our favor as well as actually landing the permits.

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#27486 - 09/05/12 05:08 PM Re: Altitude Sickness Trip Report and Re-Attempt Questions [Re: Chicagocwright]
wagga Offline


Registered: 10/07/09
Posts: 2213
Loc: Humbug Reach (Pop. 3)
1) If you can get to 12k somewhere in Alaska in the next week or two, that will carry forward. Good job you don't live in Florida, where the highest point is in MouseWorld. Also, Horseshoe meadows for your acclimatization days.

3) Diamox makes beer taste weird. Do pay attention to experienced summitters who use a fraction of the glaucoma dosage. YMMV.
_________________________
Verum audaces non gerunt indusia alba. - Ipsi dixit MCMLXXII

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#27487 - 09/05/12 05:44 PM Re: Altitude Sickness Trip Report and Re-Attempt Questions [Re: wagga]
Chicagocwright Offline


Registered: 09/05/12
Posts: 172
Loc: Alaska
I am new to Alaska and I know this sounds strange but I am pretty sure there is no accesible elevation. The mountains are huge but they all start at zero elevation and become snow bound very quickly. Just across the Turnagain Arm from Anchorage are mountains where the snow is at sea level still. I've heard that Denali (Mt. McKinley) may be "bigger" than Everest because Everest starts at a much higher elevation.

So as far as elevation I may as well be in Florida.

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#27491 - 09/05/12 06:20 PM Re: Altitude Sickness Trip Report and Re-Attempt Questions [Re: Chicagocwright]
Ken Offline


Registered: 10/29/09
Posts: 742
Loc: Los Angeles
Your proposed schedule should work.

Agree with Horseshoe Meadows (10k), with day hikes higher that will not wear you out. Onion Valley would be an alternative. Mammoth is too far, and too low.

This is exactly the scenario that I like the use of Diamox.
By the way, you can simple take a dose or three at sea level to evaluate your tolerance....the side effects are identical at all elevations. I recommend this.
1/2 tab before bed, two nites before your hike.

One other thing. Every hour, take a 10 minute break, sitting down. This allows the body to "catch up" somewhat, and gives your leg muscles a break. It pays off for some people many hours later.

Make SURE you pee within the first three hours. A good habit is to down a quart of gatoraide at the trailhead before heading out. (I'd give up the coffee, as it is a mild diuretic you don't need that morning) Most people are dehydrated, and it doesn't help.

Best of luck!

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#27492 - 09/05/12 07:09 PM Re: Altitude Sickness Trip Report and Re-Attempt Questions [Re: Ken]
Chicagocwright Offline


Registered: 09/05/12
Posts: 172
Loc: Alaska
For those recommending Horseshoe Meadows, what do you recommend we do while there? I don't know anything about that location. What kind of dayhikes are available?

By the way, I booked the tickets so I am in. Now on to the final hurdle---getting the actual permits. Any special strategy besides everything written on the #6 of the other page?

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#27493 - 09/05/12 07:45 PM Re: Altitude Sickness Trip Report and Re-Attempt Questions [Re: Chicagocwright]
Bulldog34 Offline


Registered: 11/12/09
Posts: 1254
Loc: Atlanta
Horseshoe Meadows is the trailhead for both the Cottonwood Lakes trail and the Cottonwood Pass trail. Either make a nice warm-up hike for Whitney. Neither are very strenuous, and Cottonwood Pass is close to 12K'. If you're feeling adventurous, the Cottonwood Lakes trail will take you to Army and New Army passes, as well as to Mt. Langley. That would be overkill though - you don't want to burn out on gain right before your second shot at Whitney.

No matter which trail you take, be prepared to slog through some beach sand at the outset. A real PITA the first mile heading up to the lakes.

Good luck with round two!

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#27494 - 09/05/12 07:47 PM Re: Altitude Sickness Trip Report and Re-Attempt Questionsa [Re: Chicagocwright]
ChrisInLongBeach Offline


Registered: 02/05/12
Posts: 44
Loc: Long Beach, California
You need a plan. Without one, you'll conk out.

I "trained" in HM for two days prior to my ascent.

Day 1: from the parking lot, Mulkey Pass to Trail Peak to Cottonwood Pass and back to parking lot.
Day 2: parking lot to Cottonwood Pass to Cirque peak round trip.

Both days, I had bkfast and lunch followed by a nap and a hour listening to my audiobook at HM. Pretty sure this greatly helped in acclimatization.

My ascent was on 8/14. Other than the expected fatigue, it was a breeze.

Never even considered taking Diamox. And I am a 47 y/o guy with a desk job.

I prepared a year ago running 5K and 10K three times per week. Lost 20+ pounds in the process.

Again, have a plan. Do NOT just show up thinkIng you'll show the mountain who's boss. Wrong attitude.

You're smart. You can do it. But don't overdo it befor your big day. Save your strengh.


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#27498 - 09/05/12 08:58 PM Re: Altitude Sickness Trip Report and Re-Attempt Questions [Re: Chicagocwright]
Akichow Offline


Registered: 04/07/10
Posts: 659
Loc: SF Bay Area
1. Where to acclimatize

For camping, I agree with Horseshoe Meadows (10,000') or Onion Valley (9,600'). Onion Valley gives you a wonderful opportunity to acclimatize by climbing up to Kearsarge Pass (11,760') or just hanging out at one of the lakes between the trailhead and the pass. Personally, I think it would be a bit aggressive, if staying at Horseshoe Meadows, to go for Langley or Cirque; if it were me, I'd go hang out in the Cottonwood Lakes Basin, maybe even get a fishing permit.... (For photos of the area, see the trip report I posted yesterday). I stayed at OV for two nights before my first Whitney Climb in 2010.

If you don't want to camp, consider high altitude lodging like the Rock Creek Lodge, which is near 10,000 feet. Really fantastic acclimatizing hikes nearby out of Mosquito Flat trailhead. They have relatively reasonably priced cabins (the cheaper ones being more rustic but at least having a kitchen, though shared bath). I stayed at Rock Creek Lodge for two nights before my second Whitney Climb in 2011.

2. Diamox

This can help, but like others said, test it out at home first. And avoid the glaucoma dose of, what, 250mg 2x a day, that some doctors ignorantly prescribe for altitude. Caveat: I am no doctor (others here are), but generally, the recommendation seems to be no more than 125 mg twice a day for a male. I am female and, when I take Diamox (which is increasingly rarely now), I take just 62.5mg before bed (Diamox does some of its best work when you are sleeping and not consciously breathing or working).

3. Other

Hydration is important, and flying can dehydrate you. While you don't want to overdo the water intake, you do want to arrive in California well-hydrated, which is especially important because of your flying. For myself, I try to drink at least 1 gallon of water the day before I go to altitude, and I lay off the diuretics at altitude (which means no caffeine).

Also, I take electrolyte supplements at altitude. I find that, for the first few days I am at altitude, I tend to pee more, with or without Diamox in my system. Electrolytes can be very important.

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#27503 - 09/05/12 11:37 PM Re: Altitude Sickness Trip Report and Re-Attempt Questions [Re: Chicagocwright]
VersatileFred Offline


Registered: 09/22/09
Posts: 130
Loc: SoCal
Originally Posted By: Chicagocwright
2. I believe based on everything I have read that our chances for last minute permits are fairly good. We would need to get permits at 2:00 pm on Friday correct?

There is a chance that day hike spaces will become available before 2pm from group size reductions, if you show up early. Yes, 2pm is the time when day hike no show spaces become available.

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#27507 - 09/06/12 08:44 AM Re: Altitude Sickness Trip Report and Re-Attempt Questions [Re: VersatileFred]
Chicagocwright Offline


Registered: 09/05/12
Posts: 172
Loc: Alaska
Wonderful info from all who have posted. Thank you so much for your help.

As I noted I have my tickets now and arrive on Wednesday morning in Ontario at roughly 10. We are now discussing whether or not we should try for permits on both Friday and Saturday.

This would increase our chances of getting a permit. But if we get the one for Friday it also means one less day of acclimizing.

As it is, my plan is to get from Ontario to Horseshoe Meadows as quick as possible and either hike around some or just read a book.

I'm also setting up a doctors appointment to get some Diamox.

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#27509 - 09/06/12 09:00 AM Re: Altitude Sickness Trip Report and Re-Attempt Questions [Re: Chicagocwright]
John Sims Offline


Registered: 04/20/12
Posts: 524
Loc: Sunnyvale, California
Originally Posted By: Chicagocwright
Wonderful info from all who have posted. Thank you so much for your help.

As I noted I have my tickets now and arrive on Wednesday morning in Ontario at roughly 10. We are now discussing whether or not we should try for permits on both Friday and Saturday.

This would increase our chances of getting a permit. But if we get the one for Friday it also means one less day of acclimizing.

As it is, my plan is to get from Ontario to Horseshoe Meadows as quick as possible and either hike around some or just read a book.

I'm also setting up a doctors appointment to get some Diamox.


Hi Chicagowright,

I cannot tell from your post if you are seeking Overnight Permits, or Day Use Permits. The reason I ask is because the issue/release date is different for the two permits. For Day Use, you need to pick up the permit the day prior to entry. I "think" for Overnight, you can pick up the permit the day of entry. For Day Use permits you should enter and exit the zone on the same day, so in your earlier post you mentioned starting on Friday, and completing on Sat. This would not be "legal" using a day pass. In your most recent post you are considering a Sat. hike, which I think would have to be a Day User Permit, which would mean picking it up on Friday. Also, to do the Friday Day Hike, you would need to pick up the permit on Thursday.

I "think" I have this correct.

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#27510 - 09/06/12 09:21 AM Re: Altitude Sickness Trip Report and Re-Attempt Questions [Re: John Sims]
Chicagocwright Offline


Registered: 09/05/12
Posts: 172
Loc: Alaska
I'm looking at day permits. By a Friday start I mean basically Friday night-Midnight Saturday.

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#27511 - 09/06/12 09:31 AM Re: Altitude Sickness Trip Report and Re-Attempt Questions [Re: Chicagocwright]
bobpickering Offline


Registered: 02/07/10
Posts: 311
Loc: Reno, Nevada
You have done fine on Dana (13K) and had trouble at Trail Camp (only 12K). Possibly the excitement and lack of sleep contributed to your troubles. I would consider starting later.

Altitude sickness tends to show up when people are resting and especially if they are sleeping. This is because an un-acclimatized person doesn't breathe enough while resting at altitude.

Ken isn't the first person I've heard recommending a 10-minute break every hour. I just don't buy it. It is better to go slower but KEEP MOVING. Yes, you should stop frequently for a byte or two of food. Drink, pee, and take pictures as often as you like. But don't spend one sixth of the day sitting on your butt letting your legs stiffen up and your breathing slow down until you get AMS again. The tortoise beats the hare every time.

Diamox may help. Remember that the correct dosage of any medication is the smallest does that is effective. 250mg is the most common tablet, but I don't think anybody needs that much for AMS. It's common to take it for a few days before going to altitude, but half a tablet when you start up will probably get you to the summit and back down low enough that you won't need any more.

The more time you can spend at 8K - 12K before you head up Whitney, the better. Moderate exercise at altitude is key.

Good luck!

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#27514 - 09/06/12 10:32 AM Re: Altitude Sickness Trip Report and Re-Attempt Questions [Re: bobpickering]
Chicagocwright Offline


Registered: 09/05/12
Posts: 172
Loc: Alaska
Based on everything I've read I have a couple theories:

1. I was not well enough rested. I didn't sleep much on the plane ride and didn't sleep enough the night before the hike.

2. I did not breath deeply enough. The Alaskan hiking I've done all summer has been steep and strenuous. Somehow, switchbacks have not yet been introduced on Alaskan trails!

So I am in very good shape. My theory is that I was not exerted on the Whitney hike and simply was not breathing hard enough---I don't ever remember being out of breath and certainly didn't work up a sweat on the entire hike.

One solution would be to hike faster which would cause you to breath heavier and deeper. Most would probably not advise that. So my intent is to create a purposeful deep breathing routine throughout the hike.

3. Water--I am normally a heavy drinker on the trail (and frequent peeer) and that didn't change on my Whitney hike. But I am going to be even more careful on this hike. Instead of using my 3-Liter Camelback I am going to carry bottles so I can easily monitor exactly how much I am drinking.

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#27516 - 09/06/12 11:05 AM Re: Altitude Sickness Trip Report and Re-Attempt Questions [Re: Chicagocwright]
Ken Offline


Registered: 10/29/09
Posts: 742
Loc: Los Angeles
Quote:
One solution would be to hike faster which would cause you to breath heavier and deeper. Most would probably not advise that.


Agree. The best correlate with development of AMS is rate of ascent. Those who go faster are at greater risk.

You may want to look up "pressure breathing" a mountaineer technique.

However, I'm not sure I buy that "not breathing deeply enough" had anything to do with it.

Good quality sleep prior to the hike may or may not have had to do with the AMS, but it sure didn't help.

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#27523 - 09/06/12 01:10 PM Re: Altitude Sickness Trip Report and Re-Attempt Questions [Re: Ken]
Chicagocwright Offline


Registered: 09/05/12
Posts: 172
Loc: Alaska
As additional information my dad suggested I emphasize how good of shape I am in. Perhaps it will show that it really doesn't matter how good of shape you are in, altitude sickness can still get you. If nothing else a word of warning to those who also think they are in great shape.

Anyway I am a marathon runner with a PR of 3:40. Even though I didn't run this summer at all because I was too busy hiking a couple weeks ago I did run a half marathon, at the last minute a few days after major hikes, in 2:05.

I'm not sure I buy the "not breathing deep" enough excuse either, but I am looking for any excuse possible! I am looking for those "excuses" in order to purposefully identify things I can change for this second attempt.

So I am left with rest, breathing technique, water intake, and diamox.

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#27533 - 09/06/12 08:56 PM Re: Altitude Sickness Trip Report and Re-Attempt Questions [Re: Chicagocwright]
Ken Offline


Registered: 10/29/09
Posts: 742
Loc: Los Angeles
Quote:
So I am left with rest, breathing technique, water intake, and diamox.


Well, acclimatization. Diamox is really an adjunct to that.

But with your history you should not be under any illusion that anything but acclimatization is remotely as important.

Diamox is not a substitute, nor are any of the other things.

But I've never heard of breathing technique being important in a person who is not short of breath at all, and it is not one of the problems routinely identified that I've heard of.

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#27535 - 09/06/12 11:18 PM Re: Altitude Sickness Trip Report and Re-Attempt Questions [Re: Ken]
Lynne Offline


Registered: 08/31/12
Posts: 1
Loc: calif
Hi everybody;

Just some FYI about Diamox;

I am an Emergency Department and Procedural Nurse. I have used DIAMOX after having extreme nausea on the switchbacks on my first day hike. NO FUN! And yes, I slept @ 10,000ft=Horseshoe Meadow

My next climb I was free of symptoms! Thank GOD for DIAMOX! Yes, a true GOD-SEND!

The dose being mentioned in prior comments (of 125mg and 62mg, 2x a day) is NOT an effective dose for "acclimatizing". What is perscribed per the doctor fallowed pharmicopia and very effective, is 500mg 2x a day. Drink as much water as possible while taking. Start 3 days prior to your hike. Stop after descent. Diamox is a diuretic, so hydration is key! You need to be drinking as much as possible, to keep your urine clear. Electrolyte replacement is just as key!

In good health!

Moderator edit: THIS dosage is very high, what may have been prescribed for its original use for glaucoma sufferers. Please see comments on the next page

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