The Latest Re: High Altitude Illness
Fwank Lichtenklitz
Review Articles
High Altitude Illness, Peter Hackett, MD and Robert C. Roach, Ph.D.
New England Journal of Medicine, July 12, 2001
Highlights:
1991 Colorado study: acute mountain sickness (AMS) in 22% @ 7000-9000ft;
42% @ 10,000ft. Risk factors include previous bouts of AMS, residence
below 2800ft, exertion, and preexisting cardiopulmonary conditions.
Persons over 50 years of age are somewhat less susceptible to AMS
whereas children are about as susceptible as adults. Women are less
susceptible than men to HAPE (High Altitude Pulmonary Edema) but equally
prone to AMS. Physical fitness is not protective against high-altitude
sickness. Genetic factors and the environment probably explain varying
individual susceptibilities. Descent of only 1500 to 3000ft usually
leads to resolution of AMS (HACE--high altitude cerebral edema--may
require greater descent).
New evidence suggests that ALL people have swelling of the brain at high
altitudes. One hypothesis is that those with a higher cerebrospinal
fluid volume to brain volume experience AMS less often, since they have
more skull space with which to accommodate brain swelling.
400mg to 600mg of ibuprofen decreased or resolved high-altitude headache.
Gradual ascent is still the best strategy for AMS avoidance.
In two controlled trials, Ginkgo biloba (80mg-120mg orally
twice daily) prevented AMS during a gradual ascent to 15,000ft and was
50% effective in an abrupt ascent to 12,500ft. Prophylactic aspirin
(325mg every four hours totaling three doses) reduced the incidence of
headache from 50% to 7%.
The notion that overhydration prevents AMS has no scientific basis. (!)
---------------------------------------------------
PETER HACKETT, MD: Associate Professor, University of Washington School
of Medicine; Director, Denali Altitude Research Project; Medical
Control, Denali National Park Mountaineering Rangers; Emergency
Medicine, Grand Junction, Colorado.
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rick++
> altitudes. One hypothesis is that those with a higher cerebrospinal
> fluid volume to brain volume experience AMS less often, since they have
> more skull space with which to accommodate brain swelling.
I do above treeline (12K'+) hikes 20+ days a year. I always get what I
call a "hiking hangover", a blah or tired feeling. I almost never get
headaches or dizziness.
>
> Gradual ascent is still the best strategy for AMS avoidance.
>
Unfortunately I dont have the patience. I hike class I at about 3 mph and
class II at 2.3 mph by myself. More leisurely with others.
Jim Morris
from AMS at as low as 7000-9000ft. As a flatland Scouter, I will keep a
better eye on my charges when in the mountains. THX.
Bob Gross
high altitude symptoms of the mild kind whenever I went up the Colorado
peaks. Once I moved to California, I still had occasional symptoms of the
mildest kind. But the more that I went in and out of the mountains (the more
practice my body had at the short-term adaptation), the better it became at
doing that short-term adaptation without any symptoms at all.
I have led probably many hundreds of Californians into the mountains for X-C
skiing and backpacking, and I am not surprised to see at least 10% having
some kind of mild symptoms. However, that incidence is the highest among
those who are not keeping properly hydrated, and it is lowest among those
who are hydrated properly.
However, I know some strong outdoors people who will get mild-to-moderate
symptoms almost every time that they go above 10,000 feet, regardless of
hydration.
So, the only rule is that there are no rules.
I've been up to about 80% of the height of Mount Everest without symptoms,
but that does not mean that I cannot get very sick someplace at 12,000 feet.
---Bob Gross---
"Jim Morris" <jim.m...@nospam.boeing.com> wrote in message
news:3BBCB24E...@nospam.boeing.com...
Anonymouse
tiny bit lightheaded, but mostly felt great. Made a very steep, slippery
ascent up Boundary Peak, the highest peak in Nevada. Ironically, I got an
altitude headache AFTER the descent while sleeping at the 9,000' level. Oh
yeah, I always get acid stomach above 10,000 ft. and carry Pepto Bismol tabs
for that purpose. I carry ibuprofen for headache but have never tried
aspirin prophylactically. Left an American flag on the peak!
"rick++" <ric...@hotmail.com> wrote in message
news:f7422d8e.01100...@posting.google.com...
Rick Courtright
> for that purpose. I carry ibuprofen for headache but have never tried
> aspirin prophylactically. Left an American flag on the peak!
Hi, 'mouse!
I've never tried non-aspirin tablets for altitude problems, but find a
couple of aspirin taken before starting the hike help me avoid most
altitude discomfort. First heard about this almost 30 years ago after an
unpleasant episode on Mt. Whitney, but only started doing it about 10
years ago when my body started complaining louder about discomforts in
general than it used to do! If aspirin doesn't disagree with you, it's
worth a try.
BTW, how was your trip to San G last month?
Rick
Anonymouse
>
Hi Rick! Gorgonio was great! The camping spot at Vivian Creek was gorgeous
and there was plenty enough water. Had a bear toss our can around at night
but didn't come near us humans. Made the peak easily. Saw 3-4 female
bighorn sheep right up top. Met a real nice Pakistani up there. Of course,
this was before 9/11/01. How was your trip?
'mouse
Rick Courtright
> Hi Rick! Gorgonio was great! The camping spot at Vivian Creek was gorgeous
Hi, 'mouse!
Sounds like you had at least one "trip of a lifetime" experience with
the bighorns! Things have been so dry this year, I haven't seen too much
game, but have heard of numerous deer sightings mid-day at Dry Lake
which is somewhat unusual, and the bears always get pesky when it's dry.
In 35 years up there, I still haven't seen a bighorn, so that had to be
a thrill. Plenty of water at Vivian must have been a big relief after
the worries we put you through!
Our trip was good--billed as a "deer hunting" trip it quickly turned
into more of a getaway and relax trip. We saw plenty of deer, but never
really got serious about hunting them: we spent the first 4 days near a
creek that was full of feisty smallmouth bass, but we were tripping over
the rattlesnakes to get to where we could fish. Felt a little like
Indiana Jones with his snakes!
Our first camp was full of quail each morning, a flock of turkeys came
out to visit in the late afternoons, and a couple of "developmentally
challenged" grey squirrels provided comic relief as they scampered up
and down an almost vertical cliff across the creek for two days doing
everything they could to avoid climbing a tree. The second camp was in
an area where there was enough bear scat to put the age old question to
rest forever, but we didn't run into Yogi at all. (Just the way I like
it! Got between a mom and her cubs once on San G and have had an even
healthier respect for bears than I used to ever since.) We didn't see
any people until one fellow came in on Wednesday, the 12th. He asked if
we'd been in contact with civilization in the last couple of days--we
hadn't since Sunday, so it was shock when he filled us in on the WTC
events. That changed the tone for the rest of the week, not only because
of events in general, but because my buddy, who works for Raytheon, was
supposed to have some people back there at the same time.
When we got back to civilization, we found his guys were safely grounded
in LA, but the company had lost 8 people between the two planes that hit
the towers (four of their own, four from another company and the
government who worked with them.) He knew and had worked with three of
them, so there was a somber tone on the way home. We stopped for gas in
a little redneck kinda town where the clerk was a nice gentleman of
Middle Eastern heritage--I've never seen anyone quite as nervous as that
poor fellow! Meeting him kinda drove home a serious sentiment, hoping
people would remain calm and not react in the wrong way.
That notwithstanding, we had a wonderful time. Glad to hear your trip
was a good one and the water worries were overblown! Took the GF a
little ways up Vivian last week, but it was still a bit warm for her
taste, so guess we'll wait a couple more weeks and try it again! Are you
gonna add San G to you list of "good spots?" If so, a trip up the north
side in the late spring is usually really pretty!
Rick
Verd...@webtv.net
sickness may begin to
do so at 3,ooo feet.
There's plenty of gorgeous hiking, climbing
and just sitting and viewing the scenery,
all to be done at or below that altitutde.
Unless you lke being a swelled head,
or have something to prove, why not enjoy
yourself? Why be sick?
Bob Gross
OK, Mister Anonymous of Web TV. Can you support any of the incredible
statements that you made?
In my experience, virtually nobody gets major symptoms of high altitude
below 10,000 feet. Most of the severe symptoms I see above 15,000 feet, but
those are unusual.
There is plenty of scenery below 3,000 feet, but most of the scenery that I
prefer is above 10,000 feet, and some really fantastic scenery is above
15,000 feet. Above 20,000, it just gets kind of awesome.
"Swelled head"? I assume that you refer to high altitude cerebral edema. The
only time I witnessed that was above 22,000 feet. The only times that high
altitude pulmonary edema was suspected were between 10,000 feet and 16,000
feet, at least in my presence. Most of us who are well-prepared can go to
very high elevations, have a good time, enjoy the scenery, and return home
to tell about it with no negative symptoms of altitude.
<troll alert off>
---Bob Gross---
<Verd...@webtv.net> wrote in message
news:21208-3BC...@storefull-264.iap.bryant.webtv.net...
Jeff Wilson
sickness at 8000.
Verd...@webtv.net wrote:
--
Jeff Wilson
jrwi...@thegrid.net (yes, a real address!)
"And now these three remain; faith, hope and love. But the greatest of
these is love."
...... Seek harmony and balance in the mountains.
Find harmony and balance within.....