Full disclaimer here: Everything I’ve learned about altitude, acclimatization and mountain sickness comes from NOLS, the Altitude Org & my own experience. I’m not a doctor or a scientist but I do live at 7,200 feet, regularly climb mountains above 12,000 feet and take out of town guests from low areas into the wilderness. This post is just a few thoughts on altitude and how to adapt. 

Recently the awesome Sara asked a great question on our facebook page:

“Higher elevation pals, advice please! I’m coming from a low elevation, just a little over 1000 feet, and will be going to Manitou Springs, CO and hiking the Barr Trail to the top of Pikes Peak (14,115ft). I had already planned to do it in two days but my salesperson at REI was from CO and she said that was aggressive. Then a former student of mine who lives out there was freaking out on me talking about the tourists who come out and die from HACE and such. I already planned an lazing about for two days to try and acclimate a bit. I am now going to stretch my hike to 3 days. I know to stay hydrated. I also know that you cannot predict how someone reacts to elevation. I know to turn around if I start feeling ill. But now so much doubt had been planted in me, and this journey is important to me for some symbolic reasons. Any advice is appreciated!!!”

What advice would you give Sara? Let’s discuss this topic in the comments below and on our facebook page.

I think Sara is on the right track. She understands the importance of adapting to the altitude and hydration but I would say that people who are planting seeds of altitude fear should replace that fear with education.

So what’s the big deal about altitude illness? Before we get into the details of Sara’s trip we first need to understand altitude illness.

Altitude illness occurs when there is insufficient oxygen in our blood. It has a lot to do with decreased barometric pressure at altitude and a bunch of other stuff but we’ll keep it simple here.

Acute Mountain Sickness (AMS) is typically what happens when those who are unacclimatized ascend too rapidly.

People with AMS tend to feel pretty crappy–think bad hangover here. They’ll have a headache with some fatigue and general weakness. They might also have some nausea or vomiting, they might not feel like eating or sleeping. Symptoms typically start 6-36 hours after arriving at altitude.

To avoid AMS it’s best to acclimate slowly, Many mountaineers recommend climbing just 1,000-1,500 feet/day above 10,000 feet. It’s also good to climb high but sleep low–so set up camp 1,500-2,000 feet lower.

If you’re at high altitude and feeling some minor effects it’s best to stop climbing right where you are without going any higher. Sometimes you can wait a day or so to see how you feel but if you feel really terrible head down immediately. If you wait it out but don’t feel better after 24-48 hours then head on down.

A few things can help such as paying close attention to nutrition and hydration, getting some light exercise, and even taking ibuprofen if you’re experiencing a bit of a headache.

It’s also important to be aware of the pressure that things like schedules, hiking companions and even our ego can put on us–there’s temptation to ascend too high, too fast when you know your plane is leaving in two days. When in doubt pay attention to your body and know when to stop, rest and give it a little bit of extra time.

Here’s where mountain sickness gets dangerous. If you’re climbing and you experience shortness of breath, altered mental status, or lose responsiveness (ie pass out) it’s medical emergency and not good, at all.

We’ve all read horror stories from Everest about High Altitude Cerebral Edema (HACE) and High Altitude Pulmonary Edema (HAPE) but it’s not just a problem for badass mountaineers.

Without going into a lot of detail here’s a little bit of information about HACE & HAPE.

HACE is when your brain starts to swell at altitude, it typically occurs above 12,000 feet. Often someone suffering from HACE has an altered mental status–meaning they just aren’t thinking or acting like themselves. They might act kind of like someone who is suffering from a head injury. They might be experiencing changes in vision, hallucinating and they might act disoriented, irritable, and even combative.  HACE can be fatal and rapid evacuation to a lower altitude is essential.

HAPE on the other hand is when fluid accumulates in the lungs at altitude, it rarely occurs less than 8,000 feet. It’s sudden onset can make it very dangerous. Symptoms such as a cough (dry evolving into a wet cough), shortness of breath, increased respiration rate and heart rate, weakness and fatigue typically occur 24-96 hours after an ascent. HAPE is also a medical emergency and rapid evacuation to lower altitude is vital.

So let’s get back to Sara’s question…

Coming from low altitude to Pikes Peak (over 14,000 feet) in just 3 days. I’d say the key to a successful visit to Colorado is to get lots of rest, eat well, hydrate, avoid alcohol and learn about the effects of altitude on the body so you’re prepared. At the end of the day the most important thing is to take care of yourself not to bag a peak. But, thousands of tourists from low altitude areas visit Pikes Peak each year so it can be done and done safely. Check back with us at the end of your trip Sara and let us know how it goes! Good luck, you’re gonna have a blast!

Do you have a question about hiking? We’d love to answer it. Just drop a comment below.








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