Acclimatization - Rates and Advice?

[erikwilker]

Any one have any advice for acclimatizing. I am planning a trip up Huascaran 22,000+ and am hoping to do it in a 2 week schedule. I live at sea level and have been spoiled by training in all this oxygen. Any feelings if 2 weeks is enough time (weather, route conditions and all other variables being favorable)? Any tricks to it?

Thanks in advance,

Erik

[Rodchester]

There are SOOOOO many factors that go into it. Two weeks can be enough assuming a little luck, good conditioning, good diet, constant hydration plan, and a good climbing plan on the mountain. If the weather does not cooperate it will not be enough time.

Diamox can help, but it is not a cure-all. It is more benefical to some than others. It does have some drawbacks, it is a mild-diruetic.

Are you doing any smaller peaks first? This always helps. Do Nevado Pisco, easy and great views.

Also, that peak is REALLY avalanche prone...be careful and be prepared to go to other peaks if it is crappy. Avalanche conditions there take a long time to settle, dry soft snow with low water saturation means that the snow takes a long time to consolidate.

Lots to do in the area. Huarez is a party.

good luck

[erik]

so does ginsing.....

i have new converts to my weedacology studies....more proof that hard climbing and hard drinking can coexist in a state of disconnected bliss......

[mtngrrrl]

Sorry, but I cannot comment on Huascaran specifically, just your altitude questions.

Drink looooooooooooots of water. Pee loooooots. I've carried diamox on high altitude trips, but I've never used it. I've seen people using it who claim it helps. I believe, though, that diamox is basically a diuretic so it's forcing the water through your body and draining you to flush the toxins out. As a result you get thirsty and drink lots. Keep in mind that diamox is NOT a panacea. Some people have no positive effects from it and others have negative effects such as numbness and strange tingling. Read up before deciding if diamox is for you.

I've been successful by just forcing lots of water in all day long, and eating full meals, even when I didn't really feel like it. Truly, I cannot overstate how much drinking will help. I've seen people wallowing in pain who refuse to drink. I've seen people stumbling up mountains who refuse food and water. You'll piss like mad, but it helps!

Rodchester is correct in that a lot of factors go into how each of us reacts at altitude. The effects are not fully understood from a scientific perspective, though you'll find plenty of anecdotal evidence. Some people may suffer at 2500 meters. Other people will have no trouble at 4000 meters on one trip, then feel horrible the next. That said, pay attention to your body. Mild AMS should be expected. If you can plan a couple of floater days in your schedule, that will help you if you feel you need to acclimatize more at some point. You and your partners should watch each other daily and note changes in behavior. You may not realize you're getting listless and not eating, but a partner might. I've seen more than enough people vomiting on mountains who refuse to accept that they need to go down. Knowing that AMS leads to HACE and HAPE should be enough to let you know that a summit isn't worth it. Descend if your body can't handle it.

If you have a chance to get out of your oxygen rich environment in the weeks leading up to your trip, do it! Go as high as you can and sleep out. If you can start doing this a month ahead for each weekend before your trip, it will certainly have a more positive effect than sleeping at sea level will. Acclimatization wears off quickly though, I think in two weeks you'll lose nearly everything.

One last thing about altitude. Watch out for HAFE. No amount of training can prepare you for High Altitude Fart Emissions. Most likely you or your tentmate will come down with a case of HAFE. It's unpleasant but not cause for immediate evacuation, except maybe from the tent.

[mr._happy]

good advice here, everybody's pretty much right on. it's true that different people respond differently to high altitude, and there's no good predictor of how any one particular person will do, other than past experience. what i mean is, what is your altitude history, particularly what is the highest altitude at which you've spent the night? if you've been to 14k before and had no problems, then odds are that you'll do fine up to 14k on huascaran. higher than that you can't really know until you try.

having said that, some will advocate a conservative ascent rate of no more than 300m a day, with a rest day every 1000m of total elevation gain, to prevent the onset of AMS(acute mountain sickness). this is probably too slow for a lot of parties, so the best thing to do is to listen to what your body is telling you. the earliest symptom of AMS is headache, others include nausea, vomiting, dizziness. if you begin to experience any of these during ascent, the best advice for you would be to look for the next available bivy site and spend at least one night out at that altitude in order to acclimatize. most people wake up the following morning feeling better and can resume vertical gain.

warning signs to watch for include confusion, incoordination, disorientation, stupor--all evidence of HACE(high altitude cerebral edema). HACE is ALWAYS preceded by AMS. other warning signs are persistent dry cough, coughing up bloody sputum, extreme shortness of breath--evidence of HAPE(high altitude pulmonary edema). if you have a healthcare professional on your team(always a good idea) they may hear fluid in your lungs when listening with a stethoscope. HAPE AND HACE REQUIRE DESCENT. further ascent in the face of either is NOT AN OPTION. both can be rapidly fatal, and likewise both can be easily treated--with descent. there are some medicines that can be given, like dexamethasone and nifedipine, but you should leave these up to the team physician, if you have one. another useful adjunct to descent in the treatment of HAPE/HACE is a portable pressure chamber, the most popular being the Gamow bag, but there's also one called the Certec bag which is a little lighter(10 lbs as opposed to 15 lbs). i have the address of the Gamow company in new york if anybody is interested.

about Diamox(acetazolamide): yes, it is a mild diuretic, but that's not really how it's useful in AMS. it's actually a carbonic anhydrase inhibitor, and to make a long story short, make your kidneys excrete(piss) out bicarbonate. this induces a mild metabolic acidosis in your system, which serves to stimulate your brain's respiratory drive. this prolongs the body's hypoxic ventilatory response and keeps your lungs working to oxygenate your blood. diamox can be taken prophylactically, though i personally don't advocate this unless you have a prior history of AMS. diamox contains sulfa, so DON'T TAKE IT if you are allergic to sulfa. and yes, it may give you tingling in the hands and feet and make you pee a little more. it will also make carbonated drinks taste flat(carbonic anhydrase inhibition).

DRINK LOTS OF FLUIDS. dehydration is more prevalent at high altiudes--your body loses lots of moisture in the form of insensate losses, like in your breath, with perspiration, with diuresis. so DRINK. dehydrated bodies are more prone to AMS. so DRINK. not but water or electrolyte solutions(better).

hope this helps. it's also always a good idea to have along an expedition physician(or some kind of healthcare person with experience) on the team, whether he/she is a climber or not, cause lots of nasty things can happen overseas on a mountain....

good luck and good climbing!

[rayborbon]

Advice,

Smoke cigarrettes at low elevation. Stop smoking when you climb higher.

[Happy-Go-Lucky]

I hear ginkgo helps. Check out the website below.

http://www.ismmed.org/np_altitude_tutorial.htm

[Terminal_Gravity]

I am going to have to be the contrarian here. Good advise above, particularly about drinking water. 4 liters a day minimum on rest days above 14k + more on movement days. Mr Happy is right on about Diamox.

I think that unless you absolutly know how you perform at this altitude; 17 days is the absolute minimum. That being said; altitude can even bite someone in the butt that did fine at similar hights on a prior trip.

Here is my rational:

States to Lima - day 1

Lima to Huarez ( 10,500) - day 2

2 days in Huarez ( and yes it is a fun town, but you need that much time to acclimate and get the logistics taken care of) - day 4

1000 ft a day to high camp ( I like 3000 ft in one day and rest 2, this seems to let me skip the extra rest day) even this schedule may be too fast but you almost certainly can't go faster. - that puts you to day 12

one rest day at High camp - day 13

summit day - day 14

two days to get back to Huarez - day 16

one day to Lima and catch a red eye back to the states - day 17 (more likely 18 'cause I doubt you'll find a red eye)

I think this is a very optomistic schedule for some one coming from sea level and does not allow any room for any problems, conditions, weather, aclimitization or logistics. It also assumes that every member of the party is able to acclimitize fast.

The Cordillara Blanca are wonderful mountains. I spent 5 1/2 weeks on my trip to them, climbed several peaks and wished I had more time. I think it would be a shame to rush a trip and most likely fail because you left no margin for error.

I do recommend having Dexamethazone (4mg pills) in your kit, and I would consider taking 200mg diamox before bed from Huarez on. And absolutely know how to recognize early HAPE & HACE symptoms. When in doubt go down, even at night draging your sick buddy if that's what it takes.

[erikwilker]

Gracias for all the good input. I may add a day or so to give me a better chance. Most of what I read is pretty consistent with what I've experienced (been up to 19+, but I was younger then and less likely to complain).

Thanks again,

Erik

[oo9]

After cruising Av. Raimondi in Huaraz for the most enjoyable cuy (sixty million guinea pigs are eaten annually in Peru.)or perhaps the Chicharrones yum! deep fried pork fat.Enjoy some Picarones from the street corner on the way to TOMBA for a few Pisco sours or some good ol'fashion cerveza then dance the night away, but be sure to get a good nights rest, of course after drinking plenty agua.Hopefully you would have already packed for your climb.While waiting for your truck ride enjoy a banana pancake, some coffee and more water.Your truck has arrived have a great time 12 days should be just fine.I hope you remembered your coca leaves and llipta powder from the local market. yum yum!(prolonged use may be damaging to you gums.)drink tea!Good Luck

oo9

[ruddersbox]

Mountain grrrl offers great advice, as do all the other offerrees. The most crucial..."forcing lots of water in all day long, and eating full meals, even when I (you) didn't really feel like it." That is the key to best thwart the ill effects of high altitude. But what about ladies hanging out their chunkers at 22,000 when it's 30 below, what is the best method for ensuring (HAWC) happy and warm chunker.