Some days, however, even the mountains can’t purge these thoughts. Don’t feel bad if you miss a summit because of a heavy heart; it happens to the best of us.
For some people, the mental side of hiking isn’t an issue. For other more sensitive souls, a bad experience can make the prospect of returning to altitude an intimidating invitation. Take this into consideration when assessing why a hiking partner feels bad: sometimes a good joke or an encouraging comment can take the edge off and make reaching the summit that much easier.
Fitness and Altitude
Research on fitness and altitude is a mixed bag. Some sources insist that fitness has nothing to do with altitude sickness, though all agree obesity seems to be a catalyst for AMS. Fitness levels seem to have no impact on involuntary adjustments, so in a technical sense, it may be genetics or nutrition (or both) that determine the rate of acclimatization. That being said, stronger legs and lungs are undoubtedly a boon at altitude. Powerful muscles and leaner bodies will exert themselves less, thereby decelerating the effects brought on by tough physical efforts. Add in the psychological edge of knowing your body is mountain ready, and it’s safe to say that fitness does play a part in adapting to altitude. The key for a newcomer to altitude is to keep a moderate pace, hydrate properly, and don’t be a hero. Once you are adjusted, you can try all the pushups you want on the top of your favorite 14er. In the meantime, give your body the time it needs to adjust—no matter if you exercise infrequently or are an Olympic marathon runner.
Sleeping at Altitude
Oh, sweet sleep, how elusive you can be for those who seek slumber on high! A person’s body continues to adjust to altitude, even if they’re completely tuckered out. Even the most worn-out backcountry traveler may find sleep hard to come by. An increased rate of respiration inhibits deep sleep and promotes snoring—just ask your beleaguered tentmate. Also, having to urinate more will wake you from a sound sleep, often several times a night. In addition, you may feel your heart pounding for no good reason; other times you may feel as though you are suffocating for no reason. The strange, sometimes scary, irregular patterns of a companion’s breathing may also keep you awake. An odd breathing cadence, known as periodic breathing, is normal at high altitudes and in most cases is nothing to worry about.
“Camp low, and climb high” is a good motto when acclimating.
It is my experience not to rely on prescription drugs—your body will naturally adjust and, perhaps, as is the case with muscle memory, get the knack of acclimating for the next time you visit high altitudes (this is a common belief among Russian mountaineers).
The key to good sleep: Climb high, and sleep low. Don’t attempt to sleep at elevations over 10,000 feet if you have just arrived from low elevation. Only increase sleeping elevation by 1,000 feet per night, once over 10,000 feet. Avoid caffeine and sugars before bed. As tempting as they may be, do not take sleeping pills. Over-the-counter pills decrease the rate of respiration and are detrimental to proper acclimatization. When you do fall asleep, you may have what the Sherpas of the Himalaya call the “sleep of the dead,” a dreamless passing of time. More common are brief, incredibly vivid or erotic dreams, thought to be a result of rapid eye movement sleep while your body stays in a near-waking condition. Remember, a good night’s sleep is essential to good performance in the mountains. You can get away with a day or two of bad sleep, but once your body is more comfortable at altitude, make the time to get a good night’s rest.
Prevention and Treatment of Altitude Sickness
The golden rule for treatment of altitude-related illnesses: descend, descend, descend! In Colorado, a difference of 1,500–2,500 feet will usually alleviate any symptoms of AMS. If HAPE or HACE is present, descend as low as you possibly can. (For people living in high-altitude places such as Leadville—elevation, 10,000 feet—this may require leaving town.)
For mild cases, ibuprofen, acetaminophen, and aspirin can help relieve discomfort without having to descend. Antacids and Pepto-Bismol can help settle queasy and gassy stomachs. Energy drinks such as Gatorade and Cytomax can help prevent dehydration and restore sugars and electrolytes to the body.
Preventing altitude sickness is easier said than done. Ascend slowly and don’t overexert yourself. Out-of-towners should spend at least one to two full days above 8,000 feet before heading out to the peaks in this book. Locals in Colorado may be able to ascend and descend quickly enough to avoid any ill effects of altitude. Day hikes taken at a reasonable pace are often easier on the body than forcing a night’s sleep at altitude. And one last axiom: Never take a headache higher.
It is my experience not to rely on prescription drugs—your body will naturally adjust and, perhaps, as is the case with muscle memory, get the knack of acclimating for the next time you visit high altitudes (this is a common belief among Russian mountaineers). However, for those pressed for time or hoping to bag that one special summit, there are some doctor-prescribed options.
Drugs for Altitude Adaptation
Always consult your doctor before trying prescription drugs. The medicines used for altitude adjustments affect the heart, blood vessels, and respiratory systems. Never “borrow” a friend’s prescription unless the situation is life or death (HAPE or HACE, for example).
Acetazolamide is more commonly known by the brand name Diamox. It is taken to ward off mild to moderate AMS and to help facilitate sleep at altitude. Basically, this medicine helps the body balance pH levels in the blood that can help regulate respiration and aid in acclimatization. Acetazolamide is taken in advance of heading to altitude as well as while one is there; it may also be taken if AMS becomes apparent. In that sense, it is both a preventative and a cure. While it may not be useful in cases of severe AMS, it should be taken nonetheless to reduce the work the body has to do to get back to normal. For those coming to Colorado from lower elevations, acetazolamide is a good option that has proven to work well, especially at elevations of 12,000–14,000 feet.
Dexamethasone is a steroid that is usually reserved for severe cases of AMS and HACE. It is often carried by mountain guides for use in emergency situations. If you are heading to the remote backcountry for a number of days with unproven or weaker companions, it may be wise to take along “dex” (available by prescription only) in case of extreme emergencies.
If the thin air doesn’t take your breath away, the cold water might!
Nifedipine is used specifically to curb the affects of HAPE. This drug is rarely seen in Colorado, though it may be advised for hikers who have had previous bouts of HAPE at altitudes up to 14,000 feet.
Use of narcotics of any kind should absolutely be avoided. Speaking frankly, marijuana should never be used at altitude—besides impairing judgment, marijuana decreases respiration and can actually promote or worsen AMS.
There are other drugs prescribed for those with specific conditions, including issues with vision, digestion, or prior illnesses. The scope of this book does not cover individual cases—consult your doctor.
What the Locals Know: Eight Tips for You and Your Out-of-Town Friends
1) Even if your friend is a superman or superwoman back home, don’t push them too hard at altitude. Chances are they won’t let on how tired they are. Be tactful and make it seem like
