Mt. Whitney Portal Store & Hostel Forums General Mt. Whitney Portal Store Message Board is this a good idea?

My brother and I were negotiating on how we could improve our chances of making it up to the summit in one day. We were thinking that we will hike to lone pine lake two days straight before the day of the summit and sleep at whitney portal the day before we attack the summit. Does this sound like a good idea to help us make it up to the summit? And this will be the first attempt for us on Mt. Whitney.And our first try in one day too.

Miguel

Get a permit and overnight at Lone Pine Lake. Cuts a couple miles of a very long day.
We did it a few years ago. Pretty good fishing also.

We did the hike to Meysan Lakes from the portal as training.
Its a very beautiful walk in its own right and goes up to around 11500 which will be better aclimatisation than lone pine lake and no permit required.
We did take a rest day between this and our Whitney hike.

I'd opt for the Meysan Lake Trail option. You can go further and high.

If you haven't hiked these elevations on a regular basis I go up about a month before and say in Horsehose Meadow and day hike both the Cottonwood Pass and New Army Pass trails that weekend. This way you'll figure out if you are going to have AMS problems and if you do you can deal with them before hand.

I'm assuming you are a day hiker based on your post.

Bill

There is really no substitute for being in the best shape possible before your hike.Real physiological changes do not happen for about 3 weeks,so unless you get to altitude 3 weeks ahead any improvement you feel is psychological.
I am always surpised when sedentary people try to hike up a mountain in one day.Whitney in one day is at least equivalent to a marathon.

Robert,

Can you please site the (scientific) source for the three-week period?

Well for the weeks leading up to mt. whitney. We were thinking of probably doing mt. san gorgonio, cucamonga peak, and mt. san jacinto. One for each week. leading to mt. whitney

Your plan is very reasonable. A few good hikes to Cucamonga, San Antonio, San Jacinto and the like to help with the Altitude adjustment....followed by 2 nights at the portal and some day hiking.

It will still be a long hard hike but certainly a workable one. Best wishes and good luck. The Mountain won't dissapoint you.

Two other very good training hikes in Southern California are Mt Baden Powell and Saddleback Mtn.

Baden Powell is a bit of a drive from most of the L.A. area but well worth the time. 8.2 miles round trip, TH @ 7903 w/ 1900 ft of elevation gain.

Saddleback Mtn in Orange County is only 5800 ft in elevation but the Holy Jim trail from Trabuco Canyon is 16 miles round trip with 4000 ft of elevation gain.

You don't get the elevation training on these but they are a good test of your endurance.

San Gorgonio from the north side is similar in slope to Whitney below Trail Camp.

Most of the research is rather old but there is no reason to repeat it since it is already settled. sources

1.Balke,B.Nagle,F.and Daniels,J.Altitude and Maximum performance in work and sports activity.
Jama,194:646-649,1965
2.American Psysiological Society:High Altitude and Man.Washington D.C. American Psysiological society,1984

multiple other sources.what is your research on
acclimatization in the typical two or three days?

Robert,

I don't have any sources for the acclimatization that can be achieved in two to three days, but I usually state that an opinion is mine when I make any ridiculous statements. According to your statement that "real" physiological changes do not happen until after three weeks at altitude, 99.99% of us ought to stay home (my guestimate).

And, the topic of acclimitization reasearch is far from settled. My opinion is that it's still in it's infancy.

Time again to post one of the best references on this subject on the Web:
http://www.ismmed.org/np_altitude_tutorial.htm

There are certainly acclimatization processes that occur in a matter of hours, and this, in fact, is what we depend upon in climbing mountains the height of the Sierra. There are longer term issues in altitudes that are greater.

In "The High Sierra" by Secor, 1999, he repeats the standard advice of increasing sleeping altitude by 1,000 feet per day over 10k (p17), and certainly, if it took weeks for changes to occur, this would be useless. In fact, it has proven very effective in very high altitudes.

As I've discussed before, if you are concerned about the altitude issue, and have the time to spend, I'd spend the time at Cottonwood Lakes campground (10k), and do dayhikes to get higher.
Particularly if you have not been to higher altitudes, you will gain some familiarity with your body's response to the situation.

In fact, the best thing I can think of doing would be to climb Mt. Langley a week before, as a dayhike. No permit needed, the trail is a bit harder, the altitude is similar, and an easy drive from LA.

Yes the body has some adaptations.the oxygen-hemoglobin dissociation curve is shifted in order to accomodate more oxygen.By increasing respiration which reduces the co2 and therefore the carbonic acid.This is how Diamox works by increasing the effectiveness of the shift of the curve. Besides these changes no physical change happens until weeks out.People don't make it up these mountains because of acclimitization but because they have a reserve.If you were to for example land on the top of Everest without several weeks of preparation you die within 5 minutes,despite the fact that several people make it up there without oxygen.It takes about 4-6 weeks for this process.Please site peer reviewed medical journals(as i did) as your source not a climbing book.RR

Whatever or however insubstantial the body's short-term altitude adjustments may be, they sure as heck seem to work, and very effectively at that. On this topic I have to invoke the old Army maxim: "If it's stupid but it works, it's not stupid."

As for the trail for pre-Whitney warmup, I definitely recommend Meysan Lakes.

Dr. RR,

Not being a doctor, as your response leads me to believe you are, maybe you can answer a question for me? If quick a decent seems to be the universal cure to altitude sickness, why wouldn't short-term acclimatization provide any benefit? It doesn't make sense to me?

BJ

Robert, I'm not sure where you're coming from. I'm not really interested in getting involved in a debate. I cannot really see the point of citing (I'm surprised that you used the word site: not the kind of mistake that a literature-savy person would make) a bunch of literature that the people reading this forum do not have access to read. However, I'll attach some. I do think that is is reasonable to point people to some online references from reputable sources, that they can access for themselves. I'm surprised that you don't recognize the International Society for Mountain Medicine as an authority, certainly the mountaineering and medical communities do, Peter Hackett, the President, is probably the foremost authority on altitude illness alive, having devoted his professional life to it's study and treatment. Perhaps you consider Princeton University reputable?
http://www.princeton.edu/~oa/safety/altitude.html
Most people would think the Himalayan Rescue Association, of which Peter Hackett was the first medical director, knows what they are talking about:
http://www.himalayanrescue.com/

I will say that I dispute your assertion that the two articles you cite are the end-all and be-all, and that there has basically been no research since, since there is no need. You will seen in my references, I will cite a whole lot, but a tiny bit of what has been published in peer-reviewed jounals, like the one for which I am an editor. A comprehensive bibliography can be accessed at: http://annie.cv.nrao.edu/habibqbe.htm, and includes 8600 references published through 2001. There is a lot published since then.

Here's a few:
Barry PW: Altitude Related Cough, Does It Exist? ISMM News, 7: 3, 8-10 (Summer 1997)
Bircher HP, Eichenberger U, Maggiorini M, et al.: Relationship of mountain sickness to physical fitness and exercise intensity during ascent. J Wilderness Med 1994; 5:302-11.
Dubowitz G: The Effect of Temazepam on Arterial Oxygen Saturation During Sleep at High Altitude. British Mount Everest Medical Expedition 1994. (This appeared as an abstract on their web page, which no longer exists. I am not sure it was ever published in a journal)
Hackett PH, Hornbein TF: Disorders of High Altitude. In: Murry & Nadel (eds): Textbook of Respiratory Medicine; Saunders, Philadelphia 1988; 2:1646-63.
Hackett PH, Oelz O: The Lake Louise Consensus on the Definition and Quantification of Altitude Illness. In: Sutton JR, Coates G, Houston CS: Hypoxia and Mountain Medicine; Queen City Printers 1992; 327-330.
Hackett PH, Roach RC: High-Altitude Medicine. In: Auerbach PS (ed): Wilderness Medicine, 3rd edition; Mosby, St. Louis, MO 1995; 1-37.
Hutchison S, and Litch JA: Acute myocardial infarction at high altitude. JAMA 1997; 278: 1661-2.
Litch JA: Safety at extreme altitude. Wilderness and Environ Med 1996; 7(3): 259-60.
Litch JA: Drug-induced hypoglycemia presenting as acute mountain sickness. Wilderness and Environ Med 1996; 7(3): 232-5.
Maggiorini M, Buhler B, Walter M, et al.: Prevalence of acute mountain sickness in the Swiss Alps. BMJ 1990; 301(6756):853-855.
Montgomery AB, Mills J, Luce JM: Incidence of Acute Mountain Sickness at Intermediate Altitude. JAMA 1989; 261:732-734.
Parker SJ, Hollingshead KF, Dietz TE, Hackett PH: Preliminary prospective randomized trial of hyperbaria versus dexamethasone. (Abstract) Proc. Ninth International Hypoxia Symposium (1995).
Singh I, Khanna PK, Srivastava MC, et al.:
Taber R: Protocols for the use of a portable hyperbaric chamber for the treatment of high altitude disorders. J Wilderness Med 1990; 1:181-92.
Ward MP, Milledge JS, West JB: Acute and subacute mountain sickness. In: Ward et al., High Altitude Medicine and Physiology, 2nd edition; Chapman & Hall Medical, London 1995; 366-87.

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High Altitude Cerebral Edema & Other Neurological Problems at Altitude
Bärtsch P, Maggi S, Kleger G, Ballmer P, Baumgartner R: Sumatriptan for high-altitude headache. The Lancet, 344:1445 (November 19, 1994).
Jenzer G, Bärtsch P: Migraine with aura at high altitude. J Wilderness Med 1993; 4:412-15.
Litch JA, Basnyat B, Zimmerman M: Subarachnoid hemorrhage at high altitude. Western J of Med 1997; 167(3): 180-1.
Shlim DR, Cohen MT: Guillain-Barre Syndrome presenting as High Altitude Cerebral Edema. N Engl J Med 1989; 321:321:545.
Shlim DR, Meijer HJ: Suddenly symptomatic brain tumors at altitude. Ann Emerg Med 1991; 20:315-316.
Song S-Y, Asaji T, Tanizaki Y, et al.: Cerebral thrombosis at altitude: its pathogenisis and the problems of prevention and treatment. Aviat Space Environ Med 1986; 57:71-76.
Ward MP, Milledge JS, West JB: High-altitude cerebral edema and retinal heaemorrhage. In: Ward et al., High Altitude Medicine and Physiology; 2nd edition, Chapman & Hall Medical, London 1995; 412-18, 552.
Wohns RN: Transient ischemic attacks at high altitude. Crit Care Med 14(5):517, 1986

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High Altitude Pulmonary Edema
Bärtsch P, Maggiorini M, Ritter M, et al.: Prevention of high altitude pulmonary edema by nifedipine.
N Engl J Med 1991; 325:1284-89.
Hackett PH, Roach RC: High altitude pulmonary edema. J Wilderness Med 1990; 1:3-26.
Nakagawa S, Kubo K, Koizumi T, et al.: High-altitude pulmonary edema with pulmonary thromboembolism. Chest 1993; 103:948-50.
Schoene RB, Hackett PH, Henderson WR, et al.: High-altitude pulmonary edema: characteristics of lung lavage fluid. JAMA 1986; 256:63-69.
Schoene RB: High-altitude pulmonary edema: Pathophysiology and clinical review. Ann Emerg Med 1987; 16:987-92.
Shlim DR, Papenfus K: Pulmonary embolism presenting as high-altitude pulmonary edema. Wilderness Environ Med 1995; 6:220-24.
Ward MP, Milledge JS, West JB: High-altitude pulmonary edema. In: Ward et al.: High Altitude Medicine and Physiology, 2nd edition; Chapman & Hall Medical, London 1995; 388-411.
West JB, Colice GL, Lee Y-J, et al.: Pathogenesis of high-altitude pulmonary oedema: direct evidence of stress failure of pulmonary capillaries. Eur Respir J 1995; 8:523-529.
Zafren K, Reeves JT, Schoene R: Treatment of high-altitude pulmonary edema by bed rest and supplemental oxygen. Wilderness Environ Med 1996; 2:127-32.

Hmmm ... I normally just hang around and lurk, but I guess I'll weigh in on this one with my measly opinion. Ignore this if you want - really, the following may be quite boring for most.

There ARE physiologic changes that occur almost immediately as part of acclimating at altitude. The primary problem at altitude is the hypobaric hypoxia that ensues as the atmospheric pressure drops, thereby decreasing the oxygen content of inhaled air.

This, in turn, will decrease the alveolar pressure of oxygen (PiO2). Typically, respiration is primarily governed by the hypercarbic response of the carotid bodies, but there is a component of respiratory regulation driven by hypoxia. When the arterial PO2 falls below approximately 60 mm Hg, there is an exponential increase in the minute ventilation to account for this - hence, a hypobaric (low pressure) hyperventilatory (increased ventilation) response - aka HVR.

The HVR is limited physiologically by the ensuing respiratory alkalosis. However, all this can happen within a minute or two in response to a low PiO2.

The body can compensate to a certain degree by dumping bicarbonate in response to the respiratory alkalosis. This is where diamox comes in handy as it inhibits carbonic anhydrase and therefore promotes the urinary dumping of bicarbonate, thereby decreasing the effect of the respiratory alkalosis, and thereby allowing for a greater hyperventilation in response to hypoxia. This typically maximally occurs over 4-7 days and is what most people refer to as acclimitization.

While diamox will cause a metabolic alkalosis, it will not in and of itself cause a shift in the hemaglobin saturation curve - because the HVR has already provided the maximal alkalosis from a respiratory standpoint. It is true, the curve will be shifted, but not because of diamox - it will be because of the hypoxic ventilatory response. Semantics? Perhaps, but a very important distinction from a physiologic perspective.

There are number of other physiologic responses, including things such as elevated epo levels seen in chronic altitude dwellers - and the lack of these responses can be seen in chronic altitude dwellers who do not respond appropriately (Monge's disease).

Anyway, just my $0.02 ... and yes, for the record, I can cite all my sources ... but chances are, you might not want to spend hours reading journals ...

I think that the disconnect in this discussion is that Robert appears to be describing the peak athletic performance at altitude vs. the others here are describing the start of physiologic changes in response to altitude. Since a big part of peak athletic performance at altitude is due to production of red blood cells, which takes about 3 weeks to reach peak levels, Roberts references are correct for peak altitude performance, but not for just improving altitude performance quickly. In the context of the question originally asked, how to improve short term adaptation to altitude, the answers by Ken and others here are correct. Your body begins adapting immediately (some faster than others). A few days at altitude is sufficient for most, though not all, to acclimitize to a degree sufficient to enable a climb to 14,500 without bad AMS. In addition to acclimitization, the two pharmacologic approaches shown in clinical trials to reduce AMS (which is what usually prohibits otherwise fit people from reaching the summit) are Diamox and Ginkgo Biloba. In addition, most climbers find that drinking large amounts of water also helps. Hope that helps to clear up the confusion.

Thanks, Sam. Yes, my point.

To elaborate, though, I don't want people to think mistakenly that because acclimatization is not complete for several weeks, that there is no point to try for a few days, at all. The literature is replete with information about how helpful it is, and some adaptations are so fast, that simply hiking at a moderate slow rate can make a big difference, as Bob R has mentioned with people he was leading up.

There is no doubt that the most consistant problems that occur are altitude and hydration, generally because people don't appreciate the issues.

Thanks, you guys!

I'll have something to keep me busy for the next few days (delving into all the research...I have to admit that I haven't read anything serious on the subject in years).

Sam, when I read Robert's post I was thinking the same thing, but didn't want to be long winded...just wanted to stir it up...