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Note 44.373 MOUNT-L 373 of 517 CUPIDO::STRITAR "Andrej Stritar,IJS,(61)-371-321" 67 lines 18-MAY-1994 13:24
CUPIDO::STRITAR "Andrej Stritar,IJS,(61)-371-321" 67 lines 18-MAY-1994 13:24
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Subj: Re: Altitude acclimatization

Date: 18-May-1994
Posted-date: 18-May-1994

On Mon, 16 May 1994, Franz Jahoda wrote:

> I am interested in your practical advice and experience for avoiding
> the high altitude discomforts of headache, nausea, etc. as well as
> the dangers of pulmonary or cerebral edema that go beyond the
> obvious caution to allow time for acclimatization and gradual
> ascent. I live at 7000 ft and am talking about trekking at 14000 to
> 17000. Any suggestions?
>
The responses you have received so far show you how much individual
variation there is to high altitude. There aren't many fixed rules. Some
people rarely have symptoms eve if they go to 14,000 feet rapidly. Others
begin to get symptoms even if they take two days to get to 9000 feet. The
half dozen people who have summited Everest or K-2 in ONE day from base
camp have all trained for weeks at 16-18,000 feet. By contrast, some
world class climbers always get symptoms above a 'ceiling' no matter how
long they take.

For a long time we've preached that hydration helps prevent AMS; recent
studies suggest this isn't true. But dehydration impedes performance at
any altitude - so drinking more than usual is desirable at altitude.
Resting pulse rates vary and are only a weak indicator of
acclimatization. Recently there's been a lot of stuff about diet - high
carbo being thought to prevent altitude problems. We've done some work on
this and reviewed the literature. Fact is that unless you take almost 95%
CHO, and raise the metabolic exchange (RQ) to almost 1.0, you don't get
the benefit hypothesized fifty years ago, and theoretically helpful, and
that much CHO is hard to get for more than a day or two. On all my trips,
and from what others say, eating small frequent mealks, easily
digestible, and quickly absorbable is best. (But back along when I was
doing my highest climbing, we relied on pemmican! and chocolate and got
along fine).

If you are going to be above 20-22,000 feet for long, then breathing low
flow (one liter) oxygen at night definitely improves performance next
day and appears, repeat appears, to enhance acclimatization. And in this
connection note that when a huge party of Chinese summited Everest years
ago they had only enough oxygen for a third of the party or so, and they
took turns using it. This shouldn't help, but it apparently got all 12 or 15
of them to the top.

Some things are NOT good to do. Don't take nifedipine unless you have had
HAPE before, and in that case you will be at risk with or without it.
Don't count on diamox to help acclimatize you; what it will do is to
smooth out breathing during sleep and that lets you sleep better.
Almitrine does increase breathing, but it also makes periodic breathing
worse during sleep and is probably not good to take. Compazine also
increases ventilation and suppresses nausea. ibuprophen has recently been
shown to suppress altituyde headache. "grunt breathing" is no better than
milf hyperventilation and neither is helpful for more than a few minutes,
and occasionally can do harm. Nitric Oxide is just now being tested and
might possibly be helpful but it's much too early to say.

I could ramble on for longer about what we know for sure (not much), what
we think we know (more) and what is still individual and conjectural (a
lot). I believe your own body will tell you how safe you are. BUT OVER
22-23,000 FEET YOU CAN'T RELY ON YOUR HEAD.

Enough pontificating from an old man.

charlie houston

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