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#54351 - 09/28/18 02:39 PM Altitude Acclimatization takes too damn long!
jaym Offline

Registered: 09/10/18
Posts: 16
Loc: San Pedro
I having been trying to understand my AMS problems (mostly nausea/vomiting). This summer:

White Mountain Peak (Whitney Dry Run)(Success):
  • Slept 10k (Horseshoe Meadows Campground)
  • Slept 12.7k (Barcroft Observatory)
  • --> Peak 14.25k (Success!)

Mount Whitney:
  • Slept 10k (Horseshoe),
  • Slept 11.3k (Chicken Spring Lake),
  • Slept 3.7k (Lone Pine)
  • --> Puked once at 14k. (But summited).

Matterhorn Peak (Mountaineering Course)
  • 11.7k dayhike (on Mt Dana).
  • Ate Dinner 6.7k.
  • Slept 9.6k (Tioga Lake Campground)
  • Ate Breakfast 6.7k
  • 7.1K --> Puked at 9k on approach to Matterhorn Peak Base Camp. (Game Over for Moutaineering course).

Mount Whitney:
  • Slept 10.3k (Outpost Camp)
  • Slept 12k (Trail Camp)
  • Slept 12k (Trail Camp 2nd Night) Started hike a bit after 1:30am.
  • --> Nausea near Trail Crest (13.6k). Puking while rushing down from Trail Crest (Whitney Summit aborted).

I am starting to understand go high sleep low now. In the Matterhorn Peak
fiasco, I drove from ~0 to 10k and then strolled up to 11.7k in a
short time (to see the views). Got mild altitude sickness, slept at 9.7k (I usually have
trouble sleeping at a higher altitude initially) and then started the
Matterhorn Peak hike 14 hours later and I believe I had
lingering AMS as I actually puked at a lower altitude than I had slept at!
Instead of doing altitude acclimitization, I instead preloaded myself
with AMS. The sleep low part gets your body out of an (mild) AMS state quicker.

I thought with my first Mt Whitney hiking sleeping down in
Lone Pine for the last night was the problem (there was
a heat wave, my air mattress was popped/leaking, car problems and
needed the Whitney permit (the Rangers wouldn't issue the Whitney
permit 3 days ahead)). But actually, it may have helped lower
my "AMS level" before the dayhike.

In my final Whitney failure ("overnight" (3 nights) permit). I kept pushing
higher getting mild AMS (0-->10.3k, 10.3k-->12k, 12k->13.7k), recovering
a bit and then pushing higher again. I was disappointed
that my final ~1.66 days at 12k did not prepare me to go up
another 1.6k feet. 3+ days at Trail Camp?

To add insult to injury, I saw a guy run up Mt Whitney
almost butt-naked with just a tiny little pack (saw him going
up, passed me going down).

I have now given up avoiding Diamox. In fact, I took a full dose
at Trail Camp after my failure to try it out. My body just
takes too damn long to acclimitize. One reason I have
been avoiding Diamox is that I hike with my dog and I am
afraid my dog would not be properly acclimitized if I was
"turbo charged for acclimitization" with Diamox
(put dog on Diamox too?)

One reason I dislike go high, sleep low, is that I am "lazy".
It seems lame to say instead of sleeping at Trail Camp (12k),
to hike say to the Switchback Cables and then retreat down
to Outpost Camp to sleep and then repeating the same path
the next day. Kind of like doing "laps" on the same trail.

Another problem is forcing myself to do little
during car camping acclimitization when surrounded by a
beautiful area to explore (see above fiasco). Even if you don't
burn your legs out (right before dayhiking Whitney),
you could slip into AMS. Also, car camping in the Sierras is
limited to around 10k elevation, unless you brave the White Mountain
Road to get to 11.7k (maybe walkin camping to 12.7k).

Of course, taking so many days off work is also a problem...

#54352 - 09/28/18 03:31 PM Re: Altitude Acclimatization takes too damn long! [Re: jaym]
Dave F Offline

Registered: 06/24/14
Posts: 17
Loc: Northern California
The "climb high-sleep low" issue has been discussed here before. Harvey Lankford, our forum's resident alpine doctor,
weighs in helpfully here:

It looks to me like your problems might be caused by gaining altitude from unacclimated condition too quickly, mixed with sometimes sleeping too low (i.e., Lone Pine). In every case, you slept night one at over 10,000 ft. I've had great success sleeping multiple nights (3 or more) in the 8-9,000 range, then sleeping higher at elevations like Trail Camp (12k). I've never had any altitude issues using this approach on Whitney in my various summit attempts. Not everyone has the luxury of that many nights to acclimate, but it really helps.

Edited by Dave F (09/28/18 03:55 PM)

#54353 - 09/28/18 04:32 PM Re: Altitude Acclimatization takes too damn long! [Re: Dave F]
bruce Offline

Registered: 09/27/13
Posts: 130
Loc: Novato, CA
What really works for me is acclimating for 2 days/nights. On the way in from the Bay Area I stop at Mammoth Mountain Inn. At 9000 feet, it's just the right elevation for spending the first night at altitude. Just as important it is a full service hotel with comfortable beds so I can still get a good night's sleep, which is key two days from the hike. Then the next morning I just drive the 2 hours to the Portal campground at 8000 feet and hang out all day. I only sleep a few hours in the tent as I like to start around 2am and don't sleep very good in a tent. But...I got a good night sleep the night before so I don't feel tired or run down from sacrificing sleep for acclimization.

I don't think more than two nights are necessary, but each person is different. Also it makes a difference on how well conditioned or prepared you are as hiking with an elevated heart rate will accelerate altitude sickness issues. Hike slow to keep heart rate low (as reasonably possible). I use a HR monitor to make sure I'm not going too fast as it's very easy to do so in the exitement and it's easy to misjudge your cardiovascular load at altitude.

Edited by bruce (09/28/18 04:34 PM)

#54358 - 09/29/18 06:43 PM Re: Altitude Acclimatization takes too damn long! [Re: bruce]
Harvey Lankford Offline

Registered: 11/10/09
Posts: 1029
Loc: Richmond, Virginia
Three caveats

Each person has their own acclimatization rate, although with repeat experience some but not all people may improve. On the flip side, most commom is that people with prior history of AMS, HAPE or HACE are the ones most likely to get it again, especially if they continue to repeat the same circumstances.

Next, and most important to the OP is that 8000 ft is the official threshold of altitude illnesses. Going directly to 10,000 or even higher to sleep the first might can be done by some people, both others need an “intermediate” night or two or three at this level.

Diamox is not a slam dunk. It is not a magic bullet. It can help, sometimes. Best solution for OP is more time, time to properly acclimatize as he appears to need it.

#54376 - 10/03/18 02:16 PM Re: Altitude Acclimatization takes too damn long! [Re: jaym]
pcieluch Offline

Registered: 08/29/16
Posts: 54
Loc: duluth,mn
I've been out there twice and Diamox both times. first night was spent at about 9K and the second one I went over 11k before going lower to camp. Luckily both time I had no real issues except a slight headache the second day. Both time I had 5 days or more up there prior to going over Trail Crest. In 16 I came in via Onion Valley and did Forrester the 3rd day. This year the entry was Piute Pass and Muir, Mather, Pinchott, Glenn, and Forrester were climbed prior to Whitney. So I had plenty of time up high prior to summit day.

#54378 - 10/04/18 08:24 AM Re: Altitude Acclimatization takes too damn long! [Re: jaym]
KaraKyrgyz Offline

Registered: 07/10/15
Posts: 11
Loc: California, USA
I strongly agree with the points others have made about how much acclimatization rates can vary person to person, but wanted to share/echo a couple of things that have helped me. I used to get severe headaches and puke fairly consistently above 13K, and still tend to feel rough my first day above 10K or so.

Taking more time really is the best solution (more on that below), but I get that it isn't always realistic. When I don't have time to properly acclimatize (I live in the Bay Area, sea level, but frequently do weekend trips to the Sierra), I've found that eating and drinking regularly, even when I don't feel hungry/thirsty, help keep the nausea at bay. Putting Gatorade or other drink mix in my water so that I'm getting calories even if I'm not able to eat quite enough also help tremendously. Finally, slowing WAAAY down is important. I love trail running and hiking fast, so this was/is a challenge, but I've learned that for me a pounding heart leads to a pounding head if I'm above 10K or so and haven't properly acclimatized. I try to set a goal of hiking smart rather than hiking fast -- like, instead of getting to X waypoint in Y hours, my goal is to get to X elevation still feeling good, then Y elevation still feeling good, etc.

I've used Diamox for especially challenging trips, and have found that it helps, but I still have to be careful about my exertion and nutrition/hydration. As others have noted, it's not magic, just something that can tip the scales a little more in your favor. I've found that the ONLY thing that allows me to get sloppy on nutrition or aggressive on pacing is spending several days at elevation. One other thing about Diamox -- it can actually dehydrate you, especially your first day on it, so make sure you're extra careful about hydration if you take it.

Spending several days at altitude can work wonders if you have the time, though. A couple of years ago I day-hiked the Whitney main trail twice a few weeks apart, no Diamox either time. First time was with a group of friends with only a night at Horseshoe Meadows before the hike. I summited, but had to go slower than most folks, and had a mild headache at the summit. The second trip came at the end of a week of backpacking and car camping/trail running ranging from 8,000 - 12,000 feet. I was over an hour faster on the ascent while feeling less tired, and didn't notice the altitude at all.

Hope at least some of this is helpful!

Edited by KaraKyrgyz (10/04/18 08:33 AM)