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#50440 - 07/14/08 04:15 PM MT TR from 7-9 -- 7-11 with notes and q's on AMS
Brent N Offline
Member

Registered: 04/21/08
Posts: 193
Loc: Orange County
First, let me thank all of you for the tremendous amount of help that your information provided. I will try to contribute my own lessons learned in hopes that I make the trail a safer place for others as so many of you have done for me.

Taking the MT, my sister and I summited and descended on the 11th, camping first at Outpost on the 9th, and then at Trail Camp on the 10th.

This mountain is truly a very special place. I fell in love with each new vista and never lost of sight of something to take my breath away--sometimes literally.

I studied this message board intensely, but still learned a few things on my own that I will pass on.

Lessons from Trail Camp. I have two pieces of advice for trying to get a good night's sleep at trail camp. Because of the fierce winds (including before the massive storm), trail camp gets incredibly windy. Bring and wear ear plugs. Otherwise, in your semi-dream state, you will be constantly jostled through the night wondering whether a bear is knocking your tent. Also, point your lowest portion of your tent toward the wind. During the day, the wind may come from a different direction, but during the night, the wind will come from the mountain. I oriented my tent according to the direction of the daytime winds which didn't work out as well during the night when they were nearly reversed.

Acclimatization: I really got knocked over by altitude sickness, notwithstanding a pretty good plan to acclimatize. First, I have been on summits near 12,000 feet before with no problem, but that was no indication of how I would do at 14,500. Also, we camped from mid-day till early morning at Outpost and then again from mid-morning to early morning at Trail Crest. I did not experience any symptoms that I thought indicated altitude sickness at Trail Camp. I also tried the aspirin regimen recommended by several on this board (two aspirin every 4 hours starting 24 hours before the trip and then continuing through the trip). I also stayed extremely well hydrated. Not that I think it matters, but I'm also in very good shape.

At about 13,600, I started to experience symptoms: loss of appetite, headache, and I could hear my blood pressure in my head. Lethargy and slow thoughts also settled in, albeit slowly. I tried resting until the headache and audible blood pressure went away, which they always did in a matter of a few minutes. In hindsight, I didn't rest long enough. I continued on until I got the summit. I got there, signed the log and then puked out everything I had ever eaten all the way back to childhood. I descended as quickly as I could, which was not quick at all during the uphill portion along the backside of the needles. I cannot express to anyone else who decides to ascend like I did just how precarious a position I put myself and my hiking partner in. The advice about how to cure altitude sickness is to descend quickly. I didn't find descending too difficult on the downward portions, but there are some long and tough upward portions before you get back to Trail Crest. Some of those upwards portions contain the few places where the trail narrows considerably as well, meaning this becomes dangerous territory for someone who has little strength or mental faculties. I was so lethargic and exhausted that I didn't know how I was going to make it.

This was complicated by the fact that I was now malnourished because I kept vomiting up everything I tried to put down myself (Gatorade to replace electrolytes, small amounts of Chex mix, water--I threw up everything). My older sister heroically agreed to carry my wag bag so that I wouldn't have that constant smell force me to wretch even more. (In all seriousness--what a gal. A guy couldn't ask for a better big sister.) When we got back to trail camp, she also carried more of my weight just to get me down to lower altitude. By the time we reached trail camp, I was still miserable. The slightest effort was more than I could take and I couldn't get or keep anything down me.

Here's the mind-blowing part. When we got down to about 11,000 feet, all symptoms lifted and I suddenly felt like Superman when he finally gets away from kryptonite. (Just what do they keep up in that shack on the peak anyway? Hmmm.) I could have leapt the mountain in a single bound. I had full energy restored and could have (and practically did) run the rest of the way down to the portal. I have never had such an intense illness with such an abrupt ending before.

They say that a wise man learns from the mistakes of other fools. Actually, I think a fool can learn from his own mistakes. A wise man learns from the mistakes of other fools. Please let me be your fool and learn from my mistakes. The two hardest pieces of advice dealing with altitude sickness that I found to follow are: Never take altitude symptoms higher, and descend quickly. I found it difficult to take the former advice because my judgment was impaired and because I was so darned close to the top that I just couldn't see myself not finishing. The latter piece of advice was so difficult to take because my physical ability was so impaired. That is not an easy trail to retreat from when you feel absolutely miserable.

Now, I would like to get your advice. I do plan on summiting again--probably in October. My plan for next time is as follows, and I would love to get any comments from the pros about whether I am setting myself up for failure.

Acclimatizing for a lengthy period of time is just not an option for me, although I know that is the best advice you could give me. Not being able to do that, I plan on taking Diamox next time. I will also camp at Trail Camp the first day and on that first day, I plan on hiking up to Trail Crest and hanging out there for as long as daylight allows. I will then hike back down and sleep at Trail Camp. On the second day, I will summit, although if I experience these same symptoms, I will retreat until the symptoms are good and gone before attempting to go up again. I won't carry these symptoms to the top again.

Regarding Water--A big thanks to Bob R. I carried a very light pack because of your great posts on water sources. I picked up GPS coordinates for almost all of your MT sources and will try to send you the file later. If you think it is worth adding to your list (which I carried in my pocket and found invaluable), I'll let you do that.

One last note: A very special kudos to my dear sister. She has an illness that previously made it difficult for her to walk the dog. Through perseverance and a great deal of effort, she has now gotten to the point where she has now done Half Dome and Whitney with me. She's so fit, she can carry my poo;-) I am as proud of her as a brother can be and am honored to have her as my hiking partner.

Brent N.

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#50442 - 07/14/08 04:41 PM Re: MT TR from 7-9 -- 7-11 with notes and q's on A [Re: Brent N]
DocRodneydog Offline
Member

Registered: 01/13/07
Posts: 612
Loc: Santa Clarita
Wow great TR.You indeed have a fantastic sister. Too bad about the AS. Lets us know how the diamox works for you. It is great for some, others have mixed results.

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#50446 - 07/14/08 05:20 PM Re: MT TR from 7-9 -- 7-11 with notes and q's on A [Re: Brent N]
Anonymous
Unregistered


Quote:
I had full energy restored and could have (and practically did) run the rest of the way down to the portal.
That's because you were trying to outrun sis, since she was trying to get you to carry the poop again. laugh

You're an excellent candidate for Diamox. I take three 250 mg tablets over three days, half a pill in the morning, half in the evening. For your trip, I would time them so the last half was taken the morning of your summit attempt.

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#50464 - 07/14/08 08:24 PM Re: MT TR from 7-9 -- 7-11 with notes and q's on A [Re: ]
Brent N Offline
Member

Registered: 04/21/08
Posts: 193
Loc: Orange County
Steve and DocRodneyDog, thanks for the Diamox tips. Do either of you know whether the side effects show up at sea level? I would like to experiment to see if the side effects are bad enough to avoid the stuff before I get at altitude next time.

Brent N.

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#50466 - 07/14/08 08:29 PM Re: MT TR from 7-9 -- 7-11 with notes and q's on A [Re: Brent N]
Ken Offline
Member

Registered: 01/29/03
Posts: 2446
Loc: Studio City, Ca
Originally Posted By: Brent N
Steve and DocRodneyDog, thanks for the Diamox tips. Do either of you know whether the side effects show up at sea level? I would like to experiment to see if the side effects are bad enough to avoid the stuff before I get at altitude next time.

Brent N.


Side effects are independent of location, and that is a good idea.

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#50468 - 07/14/08 08:39 PM Re: MT TR from 7-9 -- 7-11 with notes and q's on A [Re: Ken]
Brent N Offline
Member

Registered: 04/21/08
Posts: 193
Loc: Orange County
Thanks, Ken. BTW, thanks for all of your help. My sister attended your class at A16 and your tips were invaluable.

Brent

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#50473 - 07/14/08 09:41 PM Re: MT TR from 7-9 -- 7-11 with notes and q's on A [Re: Brent N]
Steve Peacock Offline
Member

Registered: 05/27/08
Posts: 112
Loc: Alhambra CA USA
I'm sure the doc you will get the prescription from will ask, but Diamox is a antiepileptic drug. If you are, it could be a drug interaction problem.

This is the drug of choice of many. It is not a routine or safe drug for some.

http://www.healthsquare.com/newrx/dia1131.htm

Aspirin is good for localized temporal problems with head aches (Ibuprofen better), and not normally suggested as a precaution.

Here are suggested dosages.

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

Since you have first hand experience with it, won't be long before you can be an expert on treatment as well. You might want to spend some time googling for what you can and can't expect with it. There is a good chance you will not be affected the same way the next time you get up there. But you should plan as if you will.

It fairly successfully treats periodic breathing (Cheyne-Stokes) which I have. Insures I get a good nights rest for the first few days.

The more recent studies seem to show there is no added benefit from taking Diamox for many hours before the ascent. Save a few $$ or trips to the bushes. The major drawback taking Diamox is that you will have to make sure you will be drinking sufficient to take on the added burden of the diuretic.

You won't sleep through the night smile

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#50486 - 07/15/08 06:59 AM Re: MT TR from 7-9 -- 7-11 with notes and q's on A [Re: Brent N]
LonePalm Offline
Member

Registered: 06/30/07
Posts: 37
Loc: Key Largo, FL
Brent,

The approved method of acclimatizing above 10,000 feet is to limit your gain to 1,000 feet daily with a complete day off every three days. Using these guidelines it would take five days to summit Whitney. I would guess that it has rarely (never?) been climbed so cautiously. Most people "push" those limits until something starts to break.

Your idea to hike to Trail Crest and descend to Trail Camp for overnight is sound. You are exposing yourself to a 13K+ altitude, which in theory will give you a greater edge the next day.

Quote:
Do either of you know whether the side effects show up at sea level? I would like to experiment to see if the side effects are bad enough to avoid the stuff before I get at altitude next time.


By all means experiment before you head for the mountains. My doc recommended a 250mg dosage, however, lots of studies show a 125mg dosage is equally effective.

I found the 250mg gave a noticeable "tingling" to my head/ears (like that old shampoo commercial). Nothing drastic, but a little distracting. I cut the dosage to 125 and had the same effect. I ended up cutting the dosage again in half (1/4 of a tablet) and that ended the problem. I know this is far from scientific, but that's how I attacked the problem.

The other side effect, frequent urination, had little effect on me. Even at the highest dosage it was no great concern, and yes, I drink plenty of fluids. This is something you will want to learn for yourself.

The real mystery is how/if Diamox works for each individual. I had spent over a week at the 10-12K range and took the drug before climbing Whitney. Did I achieve good acclimatization results from the extra exposure, the drug, or both? Is it best to start days in advance or wait until the day of the climb? It is impossible to really know without a controlled experiment which is difficult at best. What you want to find is what works best for you.

One of the best ways to measure your body's reaction to altitude is with a pulse oximeter. But they are expensive and experimentation on your part should provide a good alternative.

Good Luck

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#50488 - 07/15/08 08:29 AM Re: MT TR from 7-9 -- 7-11 with notes and q's on A [Re: LonePalm]
Anonymous
Unregistered


Originally Posted By: LonePalm
Is it best to start days in advance or wait until the day of the climb? It is impossible to really know without a controlled experiment which is difficult at best. What you want to find is what works best for you.

I believe medical studies have shown that it takes about 24 hours to have full effect, so taking it only on the day of your climb is contrary to that. My doctor as well as a friend who is a doctor both recommended starting at least a day before the climb.

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#50492 - 07/15/08 08:54 AM Re: MT TR from 7-9 -- 7-11 with notes and q's on A [Re: LonePalm]
Brent N Offline
Member

Registered: 04/21/08
Posts: 193
Loc: Orange County
Lone Palm wrote, "The other side effect, frequent urination, had little effect on me."

That is actually better news than I thought. Am I correct that the elimination effects cause more frequent urination, but not more frequent defecation? The thought of having to wag more often on purpose would be a little discouraging.

Thank you Steve and all for your posts.

Brent

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#50496 - 07/15/08 09:57 AM Re: MT TR from 7-9 -- 7-11 with notes and q's on A [Re: ]
LonePalm Offline
Member

Registered: 06/30/07
Posts: 37
Loc: Key Largo, FL
Quote:
I believe medical studies have shown that it takes about 24 hours to have full effect, so taking it only on the day of your climb is contrary to that.


My doc also recommended starting early (48 hours) and I did just that. But I hear from some climbers who insist on waiting until symptoms show up.



Quote:
Lone Palm wrote, "The other side effect, frequent urination, had little effect on me."

That is actually better news than I thought. Am I correct that the elimination effects cause more frequent urination, but not more frequent defecation?


Yes, the drug works on the kidneys to eliminate bicarbonate. But it may react very different to you than me so you may not dodge this bullet. I suggest you experiment before you head up to altitude and just see what happens.

The link by Steve Peacock above on acetazolamide (generic form of Diamox) has some excellent info.


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#50499 - 07/15/08 10:17 AM Re: MT TR from 7-9 -- 7-11 with notes and q's on A [Re: LonePalm]
Brent N Offline
Member

Registered: 04/21/08
Posts: 193
Loc: Orange County
Thanks again. I carefully reviewed Steve Peacock's links and noted also that it warns against using Diamox with high doses of aspirin. The take away from that warning is not to try the aspirin regimen and Diamox at the same time.

As always, I know more than I started thanks to all of you.

Brent

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