Any issues with altitude sickness? Water problems? Acclimatization to altitude?

[Spirit Walker]

Diamox can help, but it will make you pee every hour. Don't drink alcohol just before your hike (or while you're hiking). Drink a lot of water. Acclimate ahead of time if possible and sleep low if you can. Hiking in the San Juans the year before our CDT hike, we first spent 3 or 4 days visiting Durango and Mesa Verde. I had a horrible headache the whole time, but by the time we started our hike, I was okay.

Getting sick on one hike doesn't necessarily mean you will always have issues with altitude either. Our first time in CO, my husband had the flu just before we started our hike. He got pretty dehydrated. About 7 days in, he ended up with pulmonary edema and we had to bail. Carry enough maps that you can find a trail out if you need to. When Jim was coughing up froth, we knew we needed to get down quickly and the map showed a trail to the south that would lead to a road. What we didn't realize was that it was a 600' climb up to get over the pass. I wasn't sure he was going to make it. His cough lasted for about a month. A year later, we thruhiked the CDT and he had no issues whatever. We also did the PCT without any problems, but when we did the CDT a second time, in Colorado he ended up with aphasia where he actually passed out briefly. He said he felt like he was drunk. But we finished the hike. I could always tell when we reached 10,000', because I would slow down and feel like it was so much harder than it should be, but I never got anything more serious than a headache for the first few days.

[colorado_rob]

Diamox can help, but it will make you pee every hour.

Yes, Diamox works absolute wonders. And you don't have to take the kind of dosages that make you pee every hour. Doctors, because they generally don't know anything about high altitude medicine, tend to prescribe 250mg twice a day, which is what older ladies typically take for their Glaucoma. Turns our research was done by a couple of climbing doctors and about 1/4 of this dosage is still effective for staving off AMS. So, when my wife and I climb really high stuff, we take along 125mg tablets, break them in half and take 62mg twice a day starting a couple days before we go high, and have never been altitude sick up to 23,000 feet (highest I've been). This stuff works. But it is also a sulfa drug, some people have a reaction to sulfa drugs, so it is highly recommended that if you go this route, try a couple tablets at home first.

But, all this being said, I really don't think Diamox is necessary for sea-level folks coming to CO for the CT. Just be smart, hydrate, go gradually up, all good!

[Paddlefoot]

I hiked the CT in 2013. I live at 1100' in Wisconsin, flew to Denver in the afternoon, stayed overnight and was on the trail the next morning.

As other posters have noted, I think altitude sickness has a lot to do with individual physiology.

I was careful to drink plenty of water and I avoided alcohol the whole hike - which was difficult, but made the free beer at Carver's in Durango all the more delicious.

When I hit Breckenridge, I felt like I could not drink too much water. I just kept guzzling it down. I think the effects of hiking and high elevation made me the thirstiest I think I have ever been. Other than that, I did not have any problems with altitude sickness, other than very vivid dreams.

[Dogwood]

"The only way to know how well you are at high altitude is to experience high altitude."

Saying that seems like your ignoring what Ted suggested to consider to avoid altitude related issues.

It isn't possible to know, in advance.

I don't know where there is disagreement: you would have to point that out.

I apologize if I jumped at you Connie. As commentary is indicating it is possible to know in advance that which often triggers altitude sickness. It is possible to offset the likelyhood of altitude sickness. However, that does not mean that those who never have had altitude sickness even when regularly ascending to higher elev above 16k+ will absolutely never experience it. Likewise, someone who has had it doesn't necessarily mean they will always get it. Does that help?

[Dogwood]

Thanks CR for sharing the Diamox dosage info.

[Highway Man]

I got pretty sick when the trail first hits 9,000'. The AMS effect had lingered on me for more than a week that almost led me quit the trail at Brekenridge. I took one whole day off there trying to get more rest and seek for some medical advises. Drinking more water and more often is one of key things to help reduce AMS risk. Staying in towns or camp sites near the trail for a few days before starting hiking can give you some time to adapt the altitude, if possible.

[Cookerhiker]

I drove out to Denver, figuring I'd be gradually acclimating from 1,000' to 5,300'. Stayed with a friend in Evergreen the night before - at 7,800', I noticed I was breathing heavily. Took me 3 days of hiking to acclimate. Day 1 - short miles but I struggled. Day 2 seemed fine but hit a wall on Day 3 even though we hadn't hit 8,000' yet. At that point, I had doubts about Day 4's ascent to 10K' but overnight, my body adjusted and I was fine for the rest of the trip.

Water: Segment 2 is totally dry but quite manageable because you have water at both ends. As mentioned, Indian Trail Ridge is a dry stretch but you also have to manage your water wisely in Segments 16-18. Each year will vary depending on the winter snowpack. Always ask hikers you meet coming in the opposite direction how the water is.

[Nooga]

I drove out to Denver, figuring I'd be gradually acclimating from 1,000' to 5,300'.

Same here. Even though I have a ton of frequent flyer miles, I drove out and spent about a week in Northern NM and Colorado to adjust to the elevation. I carried Diamox, but did not need it. Starting in Denver, sets up nicely to acclimate. As others have mentioned, stay hydrated.

[Wülfgang]

I know this thread is pretty old, but I wanted to bump it with another take on altitude.

I was born in Colorado and have lived here for about 2/3 of my life. Ever since I was a kid I have had intermittent and unpredictable issues with altitude. It is a very individual thing, and the "why" isnt very well understood from a medical perspective. It does not correlate with fitness level, either. I am a provider and have read a lot of literature on AMS and mountain medicine.

I've hiked 14ers uneventfully, and I've had trips at 10,700 where I felt sick. For me, it feels like I have an awful hangover. Nausea/sea-sickness feeling, weak, sweaty, even panicky. It is an awful feeling. I do find it is correlated with both exertion level and of course hydration status.

There are several drugs out there that have off-label indications for AMS---acetazolamide, dexamethasone, and ibuprofen at higher doses. I have not yet tried them.

In my observations, it doesnt seem to affect most people coming from sea level. Well it does, but not to the extent of true AMS. Everyone feels the lower partial pressure of oxygen. But I would estimate only 10-15% get AMS.

For would-be CT thru hikers, start from Denver and spend a night or two there. The climb to 10k+ is gradual. Hydrate copiously. If you feel sick or have a splitting headache, you probably have AMS and need to descend immediately, or at the very least do not ascend further. Mind the climbing mantra "sleep low, climb high".

Most serious, life-threatening cases of AMS (HAPE or HACE) happen on the peaks. And by the time you get to the high peaks on the CT, you'll know if you are handling the altitude or not.

Again, it's a very individual thing. If you feel sick, you feel sick. Dont try to keep pace with others if you feel this way; hydrate and rest, hike slower, and if that doesn't help, descend.