We Don't Talk About Altitude Sickness Enough

[Chris Walker]

Blaming the flu, poor conditioning, too much skiing...

What would account for a highly conditioned soccer player who skied 2 runs getting a flu bug that suddenly and completely disappeared when he got to say, Idaho Springs? Sure sometimes other issues compound or are confused with altitude sickness, but it is real, and not just in the death zone.

 

[Core2]

What would account for a highly conditioned soccer player who skied 2 runs getting a flu bug that suddenly and completely disappeared when he got to say, Idaho Springs? Sure sometimes other issues compound or are confused with altitude sickness, but it is real, and not just in the death zone.

The sickness can get even in shape people. Here in AZ we get altitude sickness mixed with heat exhaustion.

 

[Eleeski]

Except that the article initiating this thread was about a person who died hiking at an elevation lower than the top of the lifts at Breckenridge. So yes, pay attention, even if you're "just" at a ski resort or doing some other high alpine activity.

The article referenced merely speculated about altitude sickness diagnosed by her mother (who was not identified as a doctor). The severe altitude issues of HAPE and HACE (high altitude pulmonary edema and high altitude cerebral edema) are clearly indicated and would show in an autopsy.

There are sensitive people. They are outliers, not normal skiers. My friend is diagnosed with sickle cell (he's an avid skier who lives and works in Mammoth). He struggled a bit with altitude changes. He got an aircraft oxygen mask and tank. If he woke up in the middle of the night short of breath, he would take some oxygen for a couple minutes. He slept fine after this. Skied well regardless. Living at altitude has cured him. Note that he has a real and severe medical issue.

To be sure, altitude is an issue for some healthy people. But it's not a hidden epidemic destroying skiers. Fear mongering may be good for internet traffic but is not good for our sport. Please note that I'm not saying this thread has crossed into that. In fact, the advice here has been pretty reasonable.

Of course, altitude sickness strikes hardest on powder days. People MUST stay indoors on big powder days. Stay out of the KT line for your own safety!!!

Eric

 

[Monique]

The article referenced merely speculated about altitude sickness diagnosed by her mother (who was not identified as a doctor). The severe altitude issues of HAPE and HACE (high altitude pulmonary edema and high altitude cerebral edema) are clearly indicated and would show in an autopsy.

Ah. Okay, rereading, you're right that "mother says" does not necessarily equate to a fact. I don't know how all the details of a coroner's report work - if we'll know later or not.

In any case, though, it's important to monitor your own situation and take care. Pushing through the pain/discomfort isn't the right answer for everything. People who turn out to have extreme sensitivity or a medical condition may not know about that issue until they're put into a physically stressful scenario, such as high altitude.

 

[Jully]

Ah. Okay, rereading, you're right that "mother says" does not necessarily equate to a fact. I don't know how all the details of a coroner's report work - if we'll know later or not.

In any case, though, it's important to monitor your own situation and take care. Pushing through the pain/discomfort isn't the right answer for everything. People who turn out to have extreme sensitivity or a medical condition may not know about that issue until they're put into a physically stressful scenario, such as high altitude.

Agreed. While the altitude sickness in the article is not formally diagnoses by autopsy (as far as I know), it is not outside the realm of comprehension that it was indeed a proper 'diagnosis' by the mother. You don't want to mess around with altitude sickness, or any kind of sickness at altitude. That has been the advice of this thread, and it is excellent advice to give.

It may be rare, but it is still important for people skiing and exerting themselves at 10,000' to be aware of it. Bear attacks are rare too and it is still important to be well informed on what to do in that emergency situation too.

 

[Doug Briggs]

I once went on a tour up Breck after the season to ski 4th of July Bowl. One guy was feeling poorly and getting worse as we continued up. Eventually he stopped, we continued and then we resumed our descent with him. Eventually he couldn't proceed so we got a car up to the base of E-chair to evac him. He thought it was flu. Turns out it was altitude sickness. I was a newbie to the area so not well educated, but the locals we were with didn't recognize it for what it was.

Another problem that has been pointed out is trying to convince someone that it really IS altitude, not illness, complicates the problem. Symptoms can be very similar. In this day and age of high deductibles and 'diagnosis by Google' it is tempting to think one knows what it is when we really don't. Know that I'm not criticizing people here for misdiagnosis of anything; I nearly died from acute appendicitis because I didn't think I could afford the MRI to confirm a diagnosis. Well, I in reality I couldn't afford it, but the alternative was nearly fatal.

 

[dlague]

I can attest that AMS can sneak up on you if you don't respect it. It has happened to me a few times, with symptoms of fatigue, periods of dizziness and headache. Each time I got the clue and headed for lower altitude. It's so unpredictable. Most ski days I can head up to the mountain and take the chairs up to ~9000ft 1st thing. But every once in a blue moon my body can't tolerate the change - even though I'm feeling great getting on the lift for the ride up.

Also, when folks come to visit during the ski season, they'll sometimes stay at a condo/lodge nearer the resort - which is at 4000-5000ft. It's pretty common for one or more of the folks to go through the fatigue phase the first couple days or so, which puts a bit of a damper on things for them.

So, this does touch on a little discussed reality for ski vacation planning: it's wise to include some degree of elevation acclimatization time in the schedule and your skiing strategy.

Elevation acclimation is hard to do if you are in Colorado for 5 days and the place you are staying is already at 9100 ft. We were on vacation in Summit County and drove straight to Dillon which is at 9100 ft. In Denver, we were fine, however in Dillon bringing suit cases up two flights of steps was exhausting. While we slept, we also found ourselves gasping for air. As a result, we researched altitude issues and water water water is key. We ate bananas before skiing for energy and potassium. We also took Altitude Adapt (nitric oxide) which we found to be helpful. However, when we skied A Basin we bought oxygen and would go in and take a few breaths from the can. It took me about 2-3 days to adapt to Dillon's elevation.

Do not be fooled by acclimating in Denver. Altitude is not really felt there a whole lot unless doing something strenuous. It may cause people to think that they feel fine there but remember Denver is around 5280 ft but it is not until after the human body reaches around 2,100 m (7,000 feet) above sea level that the saturation of oxyhemoglobin begins to plummet. After we vacationed here, we moved to Colorado and now live at nearly 7000 ft and have found that it does not bother us too much, however, when we ski and are starting at elevations above 9000 ft and often above 10000 ft, we still get short winded. To this day, we continue to drink water and eat bananas before we ski.

When ever anyone comes to visit, we have then take Ginkgo Biloba and Ginseng daily for a week or two before arriving. We did this before moving here and from to visitors who took it vs those who did not, the results have been great.

Blog post about Altitude Adapt

http://briangreen.net/2013/08/altitude-adapt-reader-testimonial.html

Summit County Elevations

Arapaho Basin Base Elevation - 10,780 Feet

Breckenridge Base Elevation - 9,603 Feet

Copper Mountain Base Elevation - 9,712 Feet

Keystone Base Elevation - 9,280 Feet

Loveland Ski Area Base Elevation - 10,800 Feet

Dillon Elevation - 9,111 Feet

Frisco Elevation - 9,075 Feet

Silverthorne Elevation - 8,730 Feet

 

[Jeff N]

I actually don't know that I've ever experienced altitude sickness. I am shocked at the idea that somebody could be so severely affected that they could die- on a trail that maxes out at 11,200 feet. Has the autopsy confirmed this as a cause of death? It is possible to die from vomiting/dehydration, but I would also wonder about exposure overnight.

I've spent the vast majority of my life over 6,000 feet. Currently I live at 8,400. At Colorado altitude, I've never experienced something I recognize as altitude sickness, just the typical issue of being more winded at higher elevations. I expect acclimation is the reason- when I travel to sea level I feel buried in air...

 

[Core2]

I actually don't know that I've ever experienced altitude sickness. I am shocked at the idea that somebody could be so severely affected that they could die- on a trail that maxes out at 11,200 feet. Has the autopsy confirmed this as a cause of death? It is possible to die from vomiting/dehydration, but I would also wonder about exposure overnight.

I've spent the vast majority of my life over 6,000 feet. Currently I live at 8,400. At Colorado altitude, I've never experienced something I recognize as altitude sickness, just the typical issue of being more winded at higher elevations. I expect acclimation is the reason- when I travel to sea level I feel buried in air...

I grew up at 7k feet and never felt any altitude effects until I moved to Phoenix. It was a rude awakening when I started getting back into skiing. I eventually get acclimated every ski season but I have to start new every November. Low elevation really does put you at a disadvantage.

 

[graham418]

Being a sea dweller, when I go into the mountains for a week, I experience the dizziness and lightheaded feelings when I do something like going up a flight or two of stairs, but that usually goes quite quickly.
A long time ago, an old timer from Colorado told my dad to give blood 2 weeks before going away. I've been doing it for years now. The theory is that you make new fresh red blood cells, which are much better at absorbing oxygen than the old tired ones.
It may just be placebo effect, but I haven't had any real problems with altitude.

 

[Pat AKA mustski]

Another thought that isn't one I like to dwell on ... things change as we *cough* mature. A friend of mine who lived in Big Sky developed sleep apnea and had a heart attack. Her O2 levels are excellent at sea level but at altitude she needs O2 twenty four-seven. Her skiing days are over as she has been medically ordered to stay at sea level. She's in her early 70's and, other than this, she is in excellent shape. She is not a happy camper!

 

[Core2]

Do they sell an oxygen tank/mask you can wear while you ski? I feel like people would buy the crap out of that.

 

[graham418]

Do they sell an oxygen tank/mask you can wear while you ski? I feel like people would buy the crap out of that.

In Jackson , in the cafe at the top of the gondola, I saw some little canisters, like an aerosol, $9.95 or something for 18 whiffs of O2. I don't know how effective it would be. Definitely not cost effective!!

 

[luliski]

I used to suffer terribly. Try skiing with a pounding headache and no sleep. Awful.

Then I discovered . . . sugar. No really, for me, in addition to paying attention to hydration, keeping up with sugar. Sugar before bed. Sugar if I wake up and can't get back to sleep. Sugar every few hours on the slopes. Its really not about getting a lot of sugar. Its about getting it regularly. If I am sure to get a little sugar every few hours thos first few days, no trouble at all.

I think there might be a scientific basis for this. My brother gave me a book on High Altitude Physiology a few years ago (wish I could find it) and there was something about sugar( glucose). It makes sense, with the metabolic changes happening at altitude.

 

[Olesya C]

From Dr. D. M. Polaner's article-
There is some evidence that a high carbohydrate diet beginning about 3 days before ascent may speed acclimatization.

From Dr. Polaner's article that Tricia posted. So yes, sugar and carbs will help. It's interesting I love carbs in general, but at high altitude I really crave them, could be also that I ski pretty hard most of the day, every day of the trip.
@Tricia Thank you for starting this thread and posting Dr. Polaner's article.

 

[Tricia]

From Dr. Polaner's article that Tricia posted. So yes, sugar and carbs will help. It's interesting I love carbs in general, but at high altitude I really crave them, could be also that I ski pretty hard most of the day, every day of the trip.
@Tricia Thank you for starting this thread and posting Dr. Polaner's article.

Thank you Olesya. Its always good to hear form someone like you.
I hope you don't mind, I edited your post to reflect that the quote credited to me was in fact Dr Polaner, even though you did give him credit in your post, I like to be safe in respect to giving proper credit.(measure twice, cut once )

 

[Olesya C]

Thank you Olesya. Its always good to hear form someone like you.
I hope you don't mind, I edited your post to reflect that the quote credited to me was in fact Dr Polaner, even though you did give him credit in your post, I like to be safe in respect to giving proper credit.(measure twice, cut once )

You are welcome! Yes, thank you for editing it, I agree, it's better to make sure it's quoted properly.

 

[eok]

Dried red beet juice concentrate powder can also be helpful & supplement endurance as It increases your nitric oxide levels as well. Just mix with water (or whatever). It doesn't taste like beets. Actually mildly sweet with a malty after taste. I like it & often add a little cranberry juice to give it a sharper taste. I usually drink a glass before heading to the mountain & take a water bottle full of it so I can drink it mid day. Makes a difference for me. YMMV.

 

[Olesya C]

Well, I now have an excuse, khm, I mean a reson, to have desert after every dinner on ski trips!

 

[Monique]

Do they sell an oxygen tank/mask you can wear while you ski? I feel like people would buy the crap out of that.

I've seen people (crusty old farts, er, mountain men) skiing with oxygen cannulas.