Mt. Whitney Portal Store & Hostel Forums General Mt. Whitney Portal Store Message Board altitude sickness trial?

Me a bunch of friends/siblings are probably going to attempt of summit of Whitney next year, as a warmup/test run of our altitude abilities for Kilimanjaro. None of us have been up to this height before, although we all have some experience camping/hiking smaller mountains. I was thinking day 1, arrive and camp at the portal, day 2 go up to the trail camp and day three summit attempt and descend. My main concern is the night at trail camp, climbing all that way to sleep. Since I want to find out our abilities but also summit, I was thinking of bringing diamox but hopefully not using it. Contigency plan if someone is feeling unwell on the way up, is to stop at outpost camp, have them use diamox, and then attempt a longer summit day if they feel better?


Seem reasonable?


Thanks

Not reasonable. Diamox should be taken for 48 hours before you ascend to altitude. Taking it after you start feeling ill does not help much.

If you hike to trail camp, (12,000) on day 2, most of you will be feeling bad after the night at that elev. AMS often sneaks up on you -- it is likely nobody will feel badly by the time you get to Outpost. But after that second night at Trail Camp, look out!

I would drive to Horseshoe Meadows at 10,000' and camp two nights, maybe hike to Cottonwood Lakes during the day (day 2). Then on the third morning, drive to Whitney Portal and pack to Trail Camp. On the fourth day, bag the summit, then pack all the way out.

...this is based on my personal experience: I KNOW I would have AMS symptoms if I followed your plan. But then I think I am a little more susceptible than average.

Proper pre-trip conditioning, pace, hydration, and pressure breathing help alot with regards to preventing AMS.

Spending a night at Horseshoe Meadows will help also.

Well, I actually think it is fairly reasonable, considering what you are evaluating. Some people can really be hit by altitude lower than one might think, and you are testing what happens to you. Smart.

The only part I'd perhaps modify, is that if one is getting a clear headache (required for the technical definition of actual altitude illness) at Outpost, I would take the diamox myself, and I would sit at Outpost for several hours, until one felt a lot better. The diamox would not be the reason that one would feel better, it would be because of the natural acclimatization that would be occuring by the stop. However, you would already have proved that person's suseptibility, and it is somewhat predictive that they will have other issues higher up. So taking the diamox will help what happens in the following two days.

So, I'd take the diamox at that point, for it's effect to speed up the acclimatization....although, as Steve pointed out correctly, one cannot get the full effect of the Diamox unless one started a couple of days before.....but you are doing an experiment. It is likely that this person will have a very poor sleep that nite, as well, and the diamox will certainly help that.

I could see others saying the other option would be simply to spend a couple of hours at Outpost, then travel up more slowly, stopping every hour for 1-15 minutes, and skipping the Diamox. Most people get to Trail camp in 6 hours or less, so you have a LOT of time to play with.
And they'd be right! That is totally reasonable.

I'd also say that you might want to take a hike up to Lone Pine Lake on day 1, that will help, too.

But, I'd say that if the situation suggests diamox, then the hiking plan should change, primarily in the speed department.

And if any of this is happening, I'd definitely plan a much earlier summit day, with a plan of travelling much slower, with frequent breaks.

Best of luck!

Matt,

I see from your posting that you're a New Englander. I'm guessing that the rest of your party are low landers as well. Most folks in reasonably good health who are training at altitude and employ pressure breathing and good hydration are going to be OK. i think the number 1 piece is getting to the Sierras early and spending some time at altitude enjoying the surroundings and getting up and down a few trails to get used to being 'in the groove' for getting up the Whitney trail. So long as you're coming this far might as well make the best of it. I see far to many people just wanting to bag the peak and missing out on the beauty of the Sierras and being disappointed if they don't get to the top. Good luck!
Jerry

"I would drive to Horseshoe Meadows at 10,000' and camp two nights, maybe hike to Cottonwood Lakes during the day (day 2). Then on the third morning, drive to Whitney Portal and pack to Trail Camp. On the fourth day, bag the summit, then pack all the way out."


I think i might do that. Would you expect any significant altitude affects on day 1 at 10kft, given that most of my group would be coming straight from sea level?

That, of course, depends on the people in your group.

Fatigue from backpacking bring on the AMS symptoms with me, while driving to altitude and taking it easy has never been a problem. Dayhiking to Cottonwood Lakes climbs less than 1000 ft, so it is quite a bit easier than any backpacking.

Edit: Reading the posts below about going to White Mountains: Sure, that is a good place to acclimate. But... It is a loooong drive to the end of the road at 12000' elev. 45 minutes north of Lone Pine on 395, half an hour on 168 (one-lane, steep), then another hour driving that last 16 miles of washboard.

On the other hand, Horseshoe Meadows is 45 minutes from Whitney Portal, and the road is not that bad. Which place you go to acclimate depends on how much time you have.

The first time I tried Mt. Whitney a long time ago, I drove to Portal from my home at low altitude in the San Fernando Valley, then hiked that day to 10,000' and stayed the night. I had altitude sickness: a headache and nausea. Miserable.

The next year I drove from SFV to Portal (8,000') and stayed the night, hiked to Trail Camp (12,000') and stayed the night, and summitted the next day, hiked out and drove home. No altitude sickness. (However, I can't remember what training hikes I might have done in the smaller local mountains.)

So your plan of sleep at Portal, then sleep at Trail Camp seems reasonable to me. But from reading this board, I wouldn't be surprised if someone in your group had altitude sickness. But then that's what you want to find out! Better here than Africa.

BTW, what's the schedule for increasing altitude in Africa after you get off the plane?

Maybe try camping a night or two over in the White Mountains. They are the mountains on the east side of the Owens Valley (across From the Sierra Nevada Mtns) and are accessed by a good paved road out of the town of Big Pine. There's a car campground at over 10,000 ft, and you could hike up some on the smaller hills in that area (12,000 ft Sheep Mountain or Barcroft Peak, maybe even 14,242 ft White Mountain) or even just spend the day wandering around the Bristlecone Pine forest.

Matt:

Being from a very low elevation area, I second the suggestion for White Mtn. No permit hassle, no quotas, just go. Easy to get to, 45 minutes north of Lone Pine, east on hwy 168 out of Big Pine. Check any Calif. map. Go 13 miles east of hwy 395 on 168 amd you'll see the White Mountain signs. It's 16 miles on rough dirt after you pass the Bristlecone Forest Center, no water, gas or cell phone reception.
Some tire poppin' rocky road near the end which ends at the Barcroft Lab gate where you can car camp overnight in the high 11,000's. Just 3 miles up you'll come to the ancient space observatory which is apparently up and running again. This will put you into the low to mid-13,000's elevation. It's a road all the way. You can walk it or bike it all the way to the summit.It's a fast trail and you'll probably get sick, so slow it down.

To see the topography of the area (spectacular) see Barcroft Lab's website www.wmrs.edu

I'm with the Horseshoe Meadow vote as it's easy to get to and close to the portal. With a group, someone will probably get a little sick or even more so so be prepared for that person to go back. We've all done that and it's just part of the game. The more time you have at altitude, the better your chances are.

I'm a Diamox fan if I don't have time which is usually the case. I only take it 48 hours prior to going up and the first night and then I seem fine. But, we're all different and I'm not a doctor.

Thought people might be interested in this short article, published in the journal of the UIAA, the technical organization that sets all kinds of standards for climbing gear, and safety for climbing, generally:
=====================================

http://www.uiaa.ch/article.aspx?c=338&a=920

Viagra and Other Drugs at high altitude

When we talk about useful drugs at altitude, we have to start with the most tried and tested drug, diamox (acetazolamide), which clearly does not have the romantic appeal of viagra (sildenafil). Both for the prevention and treatment of acute mountain sickness (AMS), diamox is second to none. Acute mountain sickness is like a “hangover” (headache, nausea, fatigue) caused by ascending too high too fast. If you disregard the symptoms and continue to ascend you may suffer from the life threatening forms of AMS, namely water in the head, high altitude cerebral oedema (HACE) or water in the lungs, high altitude pulmonary oedema (HAPE).

Usually it is a good idea to ascend to high altitude in stages without any drugs so that the body has a chance to slowly acclimatize i.e. get used to the low oxygen levels of high altitude (> 2500 m).

However for various reasons there may be no time for acclimatization. For example if you fly to La Paz, Bolivia or Lhasa Tibet which are at high altitude from airports situated at lower altitude, it is advisable to take diamox (125 mg two times per day) starting a day before or even on the day of departure (diamox works within hours) for up to about 3 days in Lhasa or La Paz. Side effects are some tingling sensation in the fingers and toes, and those who have sulphur allergy should not take diamox; otherwise this is a reliable drug for the prevention of AMS. Diamox is also very effective for the treatment of AMS although guide books like the latest edition of the Lonely Planet, Tibet says diamox will just “mask” the symptoms. This is scientifically incorrect. Diamox treats the problem and does not just cover it up!!

There is yet another useful function of diamox. Have you had problems sleeping at altitude especially due to “periodic breathing”? You think you are falling asleep, but you suddenly wake up feeling suffocated or choked at high altitude. If this happens many times during the night, it is not unnatural to have a panic attack at high altitude. Interestingly this is a common problem at altitude; and diamox taken before dinner seems to help alleviate this distressing problem. So if you are going up to high altitude, don't leave home without good old diamox!!

The other commonly used drug at altitude are corticosteroids. This is not the same group of steroids that the Canadian Ben Johnson took to win the 100 meters in the 1980-s. This is a completely different group of drug. This drug is life saving for people who have HACE (see above) and are unable to promptly descend from high altitude (bad weather, nightfall, no helicopters etc.). In the Himalayas more and more, we are seeing mountain climbers take this drug as a performance enhancing drug in climbing Everest. For example on the final summit day, it is not unusual for climbers to take this drug so that their brain “remains dry”. The New York socialite in the book “Into Thin Air” used this in injection form. This may be helpful, but please do not forget that this drug can have extremely dangerous side effects, one of which is euphoria (exaggerated feeling of well being) which you can probably do without on an icy jagged slope. There may also be ethical issues.

Finally we come to viagra. Viagra relaxes smooth muscles in various parts of our anatomy. A less known place where this action takes place is in the lungs, the pulmonary artery smooth muscles to be exact. This relaxation of the smooth muscles in the lungs may both prevent and treat HAPE (see above); and some people claim viagra also helps with high altitude climbing. Adequate studies have certainly not been performed to definitely say all of this, and any claims of this nature are premature at present. In addition, an important side effect of viagra is headache,
and remember headache is a well known, common problem at high altitude. You don’t want to enhance your headache at high altitude!! As to the enhancement of that other part of your male anatomy, the hypothermic setting and bodily hygiene at high altitude are usually not ideal, and this may all be for naught, as they say! Your best bet at present for improving high altitude climbing and enjoyment is proper acclimatization.

Happy climbing, as far as possible without drugs!

Buddha Basnyat
MD, MSc, FACP President of
UIAA Medical Commission

Thanks Ken.
Maybe Cialis would be better than Viagra. It is same class of drug but lasts longer according to the ads on TV.

Just to stir the pot, a corticosteroid (dexamethansone) was used by one recent summiteer who was allergic to Diamox, reported here:

http://www.whitneyportalstore.com/forum/ubbthreads.php/ubb/showflat/Number/38250/page/1#Post38250
Harvey

Don't you think medical ethics require disclosure of the risks and adverse event profile of the drugs you are describing as well as advising that an individual consult a physician knowledgeable with the climbers medical history, concomitant meds and medications? I wouldn't think that you would want people taking Diamox and/or corticosteroids without proper informed decision making and medical supervision.

Sam, that is why magazine ads for prescription drugs are followed by three pages of fine print listing all the possible risks and adverse effects.

This is a public message board. People talk about the drugs, but cannot possibly include all the legal-speak warnings after each mention of a drug. (In fact, magazine articles like the one above cannot, either.)

When someone here goes to a doctor to request a prescription for any of the above named drugs, it is up to the doctor to discuss the drug's effects and decide whether they will or should prescribe it. My doctor did exactly that when I asked for a Diamox prescription.

It seems to me that the process is working ok.

...And that reminds me of a situation I encountered last fall: I had a hernia operation, and had serious problems with the Vicodin causing constipation. So the surgeon prescribe Torridol (I think). Next morning I woke up with my eyelids badly swollen. Looking through the drug-store provided warnings with the drug, it said "If you experience swollen eyelids, call your physician". So I called the doctor and explained the situation, thinking this might be an indication of pending disaster.

His exasperated response was, "Well stop taking it!" He calmed down after I explained what we had read.

Uhhhhh.....no, to answer your question. I am not providing medical advice, which requires a direct, personal interaction, an appropriate medical examination, which must be recorded, including documentation of consent to hold that discussion and exam. I am providing information about a drug, as an expert (defined, not by me, but by courts) in use and prescribing of prescription drugs, along with my personal experience prescribing, supervising, and using those drugs. To actually obtain and use either drug, one would need to access a physician to obtain a prescription, which WOULD require those things that you mention.

God, if I had to go through those kinds of disclosure and advice to just discuss anything medical, I'd never be able to talk about anything, and no doctor could ever write anything at all, in non-technical publications.

Ken-

While it sounds like it was not your intent to provide medical advice, many inexperienced people on this board read something like your post, see lots of letters after a name, and perhaps take a different meaning than you intend. You sound like a knowledgeable guy and can certainly do as you wish, but my suggestion is that you post a more balanced perspective when talking about drugs so that less knowledgeable people can be better informed about the risks and benefits. I spend too much of my time seeing some of the negative consequences to get comfortable with people hearing that it is ok to just get a few pills of drug X to address a minor medical issue which can then turn into a major issue. Every drug has toxicities. It is a good thing for people to factor that into their thinking before popping a few pills to help them climb Whitney. You don't need pages of cautionary language to tell people that there are known risks with a drug just as there are known benefits. Don't get me wrong, I am not a purist about taking medications to help you, just don't want people thinking they are taking something perfectly safe to make the trip more enjoyable.

putting soapbox away now.

Hey, that's why we keep you around!

But you might find that if you have something to say, you don't really need to couch it in oblique terms of ethical processes.

It *sounds* as though you don't want people with expertise posting their opinions. If that is the case, well, it's a free country.

I am under no obligation to post a "fair and balanced" (HA!) perspective, when I am posting my opinions. They are my points of view. There are others who have different opinons, and they are free to post them, as you have done. I certainly go out of my way to respect other's opinions, even when I disagree with them. Do you think you need a minder? I'm rather sure that I do not.

Now, are we done with your objections to what I post, and the way that I post? Flaming other posters seems to be a boring activity for all..........

Sorry folks.

Your plan is a good one, but forget the diamox. I have climbed Whitney twice - in September 1973 and in October 2005. Both times I did exactly what you propose: sleep one night at altitude on day 1, climb to Trail Camp (or near there) on day 2, then summit and descend on day 3. I'm going again in a couple of weeks, but this time I may take it easy and stay near Trail Camp (at Lake Consultation) a second night on the way down. I never had any significant problems related to altitude other than a minor headache. Although I have stayed in pretty good physical condition, I've never been super athletic. For me personally, the key is to walk up the mountain slowly but steadily. People may pass me but I often catch up to them as they're leaning against a big rock gasping for air. It's my opinion that some people are susceptible to altitude sickness and some much less so, and it doesn't appear to be directly related to low elevation fitness. Whitney should be a good opportunity to see how suited you and your companions are to high altitudes. If you can do Whitney, give Kili a shot. If you can't do Whitney without ill effects, you'd better avoid the big hills in the future.

I ditto RichP's response. I did the climb with a bunch of friends a few years back, staying at Trail Camp before and after summiting. None of us were ready to head back down so soon. Some of us felt AMS and some of us didn't. All of us were in pretty good shape and all from sea level. The person who felt the worse was the person who sped all the way to the summit. Take it slow and enjoy the views.