Mt Whitney Zone Forums General Discussion AMS on White Mountain Peak: looking for advice for Whitney

I'm usually off it after a 2 to 3 days at elevation. I will come of the the trail after a long weekend being able to enjoy a beer.

WAGNER, D. R., K. D'ZATKO, K. TATSUGAWA, K. MURRAY, D. PARKER, T. STREEPER, and K. WILLARD. Mt. Whitney:
Determinants of Summit Success and Acute Mountain Sickness. Med. Sci. Sports Exerc., Vol. 40, No. 10, pp. 1820-1827, 2008.

Purpose:
The aim of this study was to determine the prevalence of summit success and acute mountain sickness (AMS) on Mt. Whitney (4419 m)
and to identify variables that contribute to both.

Methods: Hikers (N = 886) attempting the summit were interviewed at the trailhead upon their descent. Questionnaires included demographic and descriptive data, acclimatization and altitude history, and information specific to the ascent.
The Lake Louise Self-Assessment Score was used to make a determination about the occurrence of AMS.
Logistic regression techniques were used to calculate odds ratios (OR) for AMS and summit success.

Results: Forty-three percent of the
sample met the criteria for AMS, and 81% reached the summit.

The odds of experiencing AMS were reduced with increases in age
(adjusted 10-yr OR = 0.78; P G 0.001), number of hours spent above 3000 m in the 2 wk preceding the ascent (adjusted 24-h OR =
0.71; P G 0.001), and for females (OR = 0.68; P = 0.02).

Climbers who had a history of AMS (OR = 1.41; P = 0.02) and those taking analgesics (OR = 2.39; P G 0.001) were more likely to experience AMS. As climber age increased, the odds of reaching the summit decreased (adjusted 10-yr OR = 0.75; P G 0.001).

However, increases in the number of hours per week spent training (adjusted 5-h OR = 1.24; P = 0.05), rate of ascent (adjusted 50 mIhj1 OR = 1.13; P = 0.04), and previous high-altitude record (adjusted 500 m OR = 1.26; P G 0.001) were all associated with increased odds for summit success.

Conclusions: A high percentage of trekkers reached the
summit despite having symptoms of AMS.

Thanks, Steve!

Lambecc,

I live in Studio City, and get bad AMS (yearly!), so I know your pain.

Although you don't mention urination, the volume of water you are discussing should be sufficient, and I wouldn't adjust that particularly. You might consider some sort of electrolyte addition, although the literature is mixed on that. I personally prefer to use 1/2 strength "whatever" you might choose. I drink more when it is flavored.

Diamox is definitely something to look towards. A small dose, (1/2 of a 125 mg tab) taken at bedtime, starting 2 days before going to altitude, is what I usually prescribe. If you've never taken it before, I recommend using it at home once, just to make sure you won't have a very unusual reaction that messes up your trip.

The diarrhea is an enigma. It does not technically fit the Lake Louise criteria:

http://www.high-altitude-medicine.com/AMS-LakeLouise.html

Which is restricted to N & V, or anorexia. However, it is part of the same system, and the criteria were developed in 1991, and there are clearly some things that are recognized as being altitude related outside of the criteria. Personally, I'd treat is as altitude related, and you lose nothing by doing so.

Fixed. All dashes need to be re-typed. I know that was one of the problems. I didn't check for any others, just used my "bigger hammer" tool.

Ken, thanks for revisiting the LL study. I read it once a few years ago, but I must have missed the part about analgesics contributing to AMS. Any conclusions as to why?

Gary, I did not re-read where you are quoting from, but association does not prove cause and effect.

For example. Those taking analgesics before hiking may have had prior headache or AMS history, other medical issues, age, etc. In other words, were they are fair comparison to the control group? (assuming their was an accurate control group.) A good study would try to take that into account. OTOH, did those taking analgesics start pills not chronically before the hike, but at the start or early into it? If so, maybe they knew from past history that they might benefit from it (for what little good it does). Again, a well designed study would take this into account.

Ken can better answer this as he has been part of an AMS study on Whitney.

Actually, that was my study. I was the fourth author (always the most important!)

There was no control group, this was an observational study. Needless to say, there was no money to fund a controlled study.

That said, this merely documented whether a person took an analgesic, but not why. So my conclusion is that the most likely reason for them taking it, was that they were having pain, and in this setting, most likely a headache.

Measured that way, it would be fairly amazing if the people with AMS did not have a higher rate of analgesics.

Got it. More a case of being associated with AMS during an event, as a response to the altitude headache, than a contributing cause. Makes sense when viewed in that light. I just wasn't connecting the dots. Thanks.

Wanted to say thanks to all for the advice.

#1 - I'm looking into the Mosquito Flats to Mono, but haven't done it yet. Had the opportunity to do a back country hike I've been long looking forward too which was: (see #2)

#2 - Did Aspendell (Lake Sabrina) to Hungry Packer Lake for an over nighter. (Beautiful, great fishing, and my #1 fave place in the Sierra Nevadas so far). Peaked at just a touch over 11,000 feet. No major issues. Just a tiny barely fuzzy headache while sleeping. I drank more water and popped some aspirin and it vanished.

#3 - I have added Nuun to my pack and on my first trial, to the hike above, I took about 2-3 complete tablets. I'm not sure if it helped, but I didn't have any side effects that I was aware of (and that was my primary test).

#4 - I have a local hike this week here at home in the L.A. area, and then the following week I'm doing the exact same Hungry Packer Lake hike. Then Whitney starting Sept 2nd.

So, again, thanks for the pointers!