fitness and AMS prevention

[iceaxe23]

Here is the deal I get AMS real easy and not sure if I should get a Acetazolamide prescription. I'm not a big fan of prescription drugs.

 

I have climbed hood a few times this year and feel pretty crappy by the time I get to the hogsback but I know it's not much longer before I start going down and then feel better. I tried Rainer a few times this year and both times just crapped out at around the 9k level and then just got wonky at 10k. With work I can normally only get one night on the mountain. The one time spent two nights and acclimated well I got hammered with weather at 14k (but I felt ok)

 

I'm 35, in great shape, I run, I lift, and I crossfit. But unless I make a climbing trip more than 2 days I can't do a single push or 24hour climb over 10k.

 

Any over the counter stuff? Any tips? Any tricks?

 

I get it worse than ANY of my friends and it kinda sucks

[akhalteke]

Some people are more succeptable than others. Acetazolamide will likely make your forays into the mountains more enjoyable and likely safer at higher altitudes.

 

If you decide to use it, take some while at home to understand how it affects you. Lots of people get peri-oral tingling and some other side effects like increased urination. Very few have an allergic reaction (usually those with sulphonamide allergy).

 

I work a lot at altitude and some people are just plain miserable above altitude x without meds.

[Maine-iac]

I notice a big difference in how I feel with the diet and how well hydrated I am prior to any climb. Being dehydrated mimics AMS quite well, so making sure to be hydrated before the climb always helped me, and then having regular intervals where I stop and grab a sip seem to help. Also being well rested clearly makes a big difference. One thing all my coaches said was it is not the night before the event that matters, it is the night before the night of the event that matters. So if you are climbing on saturday thursday is the key night.

 

Another tip is pressure breathing. Every few minutes, typically when I am going hard, just take a few deep breaths and force the air out through pursed lips to really empty your lungs. Altitude sickness of any sort is all about hypoxia (which is what the drugs work against by stimulating you to breath faster), so really working on your air exchange will help.

 

Obviously, the longer you are at some sort of altitude the better you will feel, so on Hood try to get to the carpark as early as you can and just relax in T-line before you go to sleep. e.g. if you get out of work at 4pm on a friday and you are going to climb at 2am, aim to be in the lot by 6pm and just hang out.

 

For some of those bigger climbs like Rainier I would suggest the same thing- spend a night in the carpark before even going to Muir (Don't spend it in Ashford though as the elevation there is only 1k). But the single largest thing I have found to be helpful is being hydrated and fueled to go.

[catbirdseat]

Get over your aversion to pharmaceuticals and take the Diamox (acetazolamide). It works.

[iluka]

Acetazolamide and dexamethasone are both safe, well-tolerated medications for preventing altitude illness in those known to be susceptible or pushing a faster than recommended ascent rate. They also have pretty good data from randomized trials not only demonstrating their safety, but more importantly, demonstrating their usefulness for preventing altitude illness. I think CBS is right... it might be time to put your reluctance to use prescription meds to rest on this one and use them to decrease your risk of getting sick and help you enjoy the climbs more. If you still don't want to use them... the primary option will be to lengthen your ascents and give your body enough time to acclimatize.

 

There are no good over the counter products that will prevent altitude illness. Gingko has been studied and, although there are a few positive trials, there are several negative trials as well and it should not be relied on for this purpose. There is no evidence to support using Vitamin E, TUMS or a variety of other things you might hear people argue works for them at altitude.

 

Unfortunately, the response to altitude and the ability to acclimatize varies a lot from person to person which explains why your friends do better than you do in this respect. That's hard to change as there's a strong genetic component to this (although no one has found the exact genes yet) Being in good physical shape also does not protect against altitude illness, but it does at least make it easier to perform physical work at altitude.

 

As for "pressure breathing"... it's often mentioned as a tool to help the body adjust to the altitude but is not worth much. There are actually a few different breathing techniques that get labeled as "pressure breathing" when you talk to people out on the trail. The notion of exhaling really hard to clear your lungs is one of them... that concept makes no sense physiologically and only serves to expend energy on the forceful exhalation that you should conserve for other things while climbing. The other type is when someone purses their lips (brings their lips together) and breathes out against them. This creates back pressure in the airways that stents open the small airways and alveoli (air sacs) in the lungs. This can help improve oxygen levels (if you measured them using a finger pulse oximeter while doing it at altitude for example) but is hard to keep up for the long periods of time that might be necessary for it to make a difference and would be extremely hard to do while actually climbing when your body wants to be ventilating to a much greater extent than if you were sitting at rest.

[iceaxe23]

thanks all for the great information! I will go get a prescription