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  1. #1

    Default "High" Altitude Sickness

    Just thought I would share a "lesson learned" moment with y'all. This will be long but I hope you read it and learn something. I certainly did.

    I drove out to Pine Springs Campground in the Guadalupe Mountains National Park on Monday. The plan was to stay and hike Tue, Wed and Thu. On Thu I was going to do a short hike and go to Carlsbad Caverns to watch the bats take flight, spend a night in a local RV place to get a shower and drive home on Monday. That was the plan.

    In preparation I looked through guidebooks and made a tentative plan for hikes and then got some advice from this site to do McKittrick Canyon and make sure I stopped by Carlsbad (not part of the original plan) but decided instead of trying to hike 3 peaks, I subbed in McKittrick on day 2 and a short hike on day 3 to make sure I could see Carlsbad (and get that shower).

    I also made sure I was getting properly hydrated every day leading up to my trip, especially the last 3 days and the day I was driving. Because "proper hydration" is often short circuited a little at a time over many days.

    I had a little navigational error and got to the campground a little later than planned. I was tired. Not surprising after 11.5 hours driving. I was not hungry, which isn't surprising as I usually only eat 1 meal a day for the past 4 months. I had actually eaten a couple of small snacks while driving. A small handful of nuts and a small piece of 85% dark chocolate that I COULDN'T leave behind. But usually once I start eating, I EAT. But that night I ended up throwing out about half my salad. I NEVER DO THIS. I chalked it up to being tired. So by 7:30 pm I was sending my husband a text that I was going to sleep. After all, the plan for the next day was to get an early start and climb Guad Peak. And, I hadn't even sorted my gear for that hike and I hadn't filled my water bladders either. Both tasks I normally would have done the night before.

    I awoke at 1:30 am with a headache and need for the Ladies Room. Ok. Tried to go back to sleep but decided to take some pain med for my headache. Now, because y'all aren't all that familiar with me I will just say that I NEVER have had a headache in the front of my head. Never. I do get headaches from the back from muscle spasms but this was not one of them. I also NEVER take pain meds, not even OTC stuff. But I had these from when I had some body part stitched up (ok, I take pain meds for a day or 2 after getting stitched up) and I thought it would be good to take as part of my first aid kit in case I seriously hurt myself.

    At 5:30 am I woke up again and took ANOTHER pain med, decided to sleep in, and see what the day would bring. At this point I probably should have realized there was a problem.

    I woke about 8:30 am, started moving about, wasn't feeling great but got cleaned up and dressed. I sat outside, texted my husband that I hadn't "slept well" and was looking for a short route to hike. Oh yeah, at this point I thought maybe my hydration hadn't been as good as it could be while I was driving. So I focused on hydrating and making sure I had my electrolytes, etc. I started feeling good. I found a shorter hike than the one I had planned that also looked quite level. I had decided on Devil's Hall Trail, just 4.2 miles. Since it was 10:30 when I took off, I figured this was good enough as 4 miles usually only takes about 2 hours without doing much stopping. I had packed up 5.5L water in addition to the 2+L I had already taken in. And I was feeling rather good.

    I texted my husband with my plan, told him it would likely take me 2-3 hours (after all, I was planning on stopping for pics and taking an easy hike).

    I felt GREAT hiking the trail. I took my time, took some pics, talked with other hikers, got some pictures of 2 deer, etc. I was getting back to my start point and was determined that since I was so close to the trailhead where others may encounter me that I would make it back to the bathrooms vs. "popping a squat" amongst the "thorny things." I had taken in at least 3L of water at this point.

    I made it to the Ladies room just in time. (I thought y'all would want to know that detail). But while I was sitting there taking care of business I got "suddenly nauseous." Just a little bit where you get a "little reflux" and a bitter taste in your mouth. But it also passed right away. I headed to the van, we have converted the back of it as our own mini RV. I got out of my sweaty clothes, turned on the portable fan and laid back to let the sweat dry off. I was also really happy with how cool the inside of the can stayed but that's a different story.

    Well, my ears started ringing. My head was hurting, not pounding but just painful like it had been when I was sleeping. I tried adjusting how I was lying down. Then the nausea started and I knew I needed to get out of the van. I threw on some clothes and made it into the ladies room and to a toilet before I threw up. I cleaned up and went back to the van to lie down. But my GUT told me I needed to leave. That whatever was wrong, wasn't going to straighten itself out right there. In the back of my mind I knew it had to be related to the altitude. BUT I WAS ONLY AT 5700 FEET! Yeah, I reminded myself. But you feel like crap. And EVERY TIME I have ever ignored my gut, I have regretted it. So my gut/instinct was screaming at me to lose some altitude even though the last thing I wanted to do was start a drive home at 2:30 in the afternoon feeling like crap with a headache and who knew what else would happen. But I started off.

    As soon as I got to lower elevation I started to SLOWLY feel a LITTLE BETTER. I drove for about 4 hours. I was making my 2nd stop, no make that the 3rd stop of the trip. At the second stop I had tried to get gas but the card reader wasn't working so I decided to go a bit longer and get gas. It was about 5:30 pm when I stopped for gas. I decided to get a room for the night as I still had a headache and I knew I just needed to rest. By this time, my back was also starting to spasm, likely from the stress, which leads to another type of headache which induces vomiting because of it's intensity. And even though it bothered me to stop driving while it was daylight I knew I needed to. So I did, and made myself eat dinner, which wasn't hard at all. I actually made myself stop in case I did get nauseous again that night. But I was fine once I fell asleep (around 8pm) and woke up "fit as a fiddle!"

    So I did a little research and found out that YES, you can get High Altitude Sickness at 5000 feet. Perhaps even less. I live at about 500 feet above sea level. The campground, where I slept was at 5700 feet. Quite a difference.

    The next lesson I learned is that the FIRST symptom was likely my lack of appetite the night before. My Second symptom was the night time headache that wouldn't go away. Since I woke up to pee (and that was normal), it likely was hydration related, but I went to "hydration" because I know how important that is.

    The third and fourth symptoms were two sides of the same coin you might say. When I was moving I felt fine, even just a little movement like getting cleaned up and dressed in the morning. When I stopped moving and laid down, I felt MUCH worse. I didn't know this, but that's a common sign of HAS. When you are moving your heart beats a little faster and thus your oxygen intake increases. Your body compensates naturally. When you stop moving, your heart rate slows and now you aren't getting enough oxygen. This explains why my easy hike felt good. Obviously in extreme cases, even moving about won't cause your lungs to work hard enough to compensate for "thinner air."

    Now, some of y'all might suggest I stay there, enjoy the beauty and try to acclimate. However, when I decided to leave, I didn't know how bad it would get, whatever was my problem, and I was "alone." If my husband had been with me we may have made a different choice and see if I would improve. I also had a time restraint in that I needed to be home on Friday anyway, so I likely couldn't "wait it out." If he were with me he could have done the research that I wasn't able to do at that point and frankly, I don't know that I was clear headed enough to do anything other than trust my instincts. If I got worse, being alone, I knew I would have that much harder a time completing a "self rescue."

    So I left. I know I made the right choice for me at the time.

    I also know that I will approach my next trip to an area with "elevation" differently.

    My son, when I told him what happened, couldn't believe it as we had lived in, and I backpacked in NH for years. I never really thought about it, but my guess would be that most, if not all, of my campsites over the years were well below whatever my personal "altitude tolerance threshold" is.

    Thanks for reading. It was very "enlightening" to me personally. I hope someone learns from my experience.
    https://tinyurl.com/MyFDresults

    A vigorous five-mile walk will do more good for an unhappy but otherwise healthy adult than all the medicine and psychology in the world. ~Paul Dudley White

  2. #2
    Registered User scope's Avatar
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    Interesting. Affects everyone a bit different I think, no matter how much you plan. I remember going to RMNP and spending a day in Lyons to prep. Raging, debilitating headache that night at about 7000', but camped and hiked next 3 days around 10-11,000' without issue. I live in ATL, about 1000', but routinely hike and camp in the 5-6Ks in NC without issue.
    "I wonder if anyone else has an ear so tuned and sharpened as I have, to detect the music, not of the spheres, but of earth, subtleties of major and minor chord that the wind strikes upon the tree branches. Have you ever heard the earth breathe... ?"
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  3. #3

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    Quote Originally Posted by scope View Post
    Interesting. Affects everyone a bit different I think, no matter how much you plan. I remember going to RMNP and spending a day in Lyons to prep. Raging, debilitating headache that night at about 7000', but camped and hiked next 3 days around 10-11,000' without issue. I live in ATL, about 1000', but routinely hike and camp in the 5-6Ks in NC without issue.
    I have hiked at those heights but after looking through a few sites and other resources today I realized that I usually sleep at about 3000 feet. And let's face it, most of New England isn't even at 5700 feet!
    https://tinyurl.com/MyFDresults

    A vigorous five-mile walk will do more good for an unhappy but otherwise healthy adult than all the medicine and psychology in the world. ~Paul Dudley White

  4. #4
    Registered User kestral's Avatar
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    Thank you for taking the time to post this trip review. Most folks don’t like to admit their “failures”.

    I had to cut a trip short in Rocky Mountain national park due to same problems, hadn’t had any issues 2 years previously. It sucks to cut a well anticipated journey short, but sometimes it is the absolute correct decision.

    Happy future trails

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    I had a similar experience last year. Slept around 6700 feet, felt fine all night, but became quite dizzy as I packed up. I cancelled the trip, hiked down to my car at 5400 feet and felt fine. One more thing to be aware of as I get older.
    "It's fun to have fun, but you have to know how." ---Dr. Seuss

  6. #6

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    I used to be able to climb a 9,000 foot peak and smoke a cigarette at the top. Maybe that's why I can't do that anymore

    When I went out to try some of the Colorado trail, I didn't have any trouble until about 9,000 feet and that was just because I couldn't get enough O2. Other then just having to go slow, no other problems. Georgia pass at 11,784 feet really slowed me down. Take 2 steps, take 10 breaths, take another 2 steps, repeat.

    According to WebMD, symptoms don't start until above 8,000 feet and are dizziness, headache, nausea, lack of appetite. Typically it takes a few days to acclimate. If you get too high (in elevation) too fast, you can get fluid build up in the lungs which is not good. In extreme cases, the brain case can fill with water and that's really bad.

    Getting altitude sickness much below 8,000 feet is rare. I suspect there was more going on then just the elevation. The long drive, lack of sleep, too much hydration and assorted other stress factors or possible undiagnosed medical problems probably had a bigger roll then being at 5700 feet.

    1,000's of people drive from the Boston area at or near sea level and climb Mt Washington (or drive up) the same day without any problems. Same for Clingmans dome in the Smokies.
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    Registered User colorado_rob's Avatar
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    With due respect, after reading your post a couple times, it sounds like you were hyponatremic. When you figured out you hadn't hydrated enough, you might have overdone the hydration without enough electrolytes.

    The extreme dryness of the area makes matters worse. Next time, pre-hydrate more, don't over-hydrate on the hikes and make sure to take electrolyte supplements.

    I do not think you actually had AMS. Maybe just a touch. It is extremely rare at those paltry altitudes.

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    Quote Originally Posted by colorado_rob View Post
    I do not think you actually had AMS. Maybe just a touch. It is extremely rare at those paltry altitudes.
    Perhaps the only way to find out would be to try it again; maybe with a partner, so you don't have the added stress of being alone.
    Big Bend has elevation that you can quickly get down from, and you'd still be in a pretty cool place. Well, maybe not literally cool right now ...

  9. #9

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    Quote Originally Posted by colorado_rob View Post
    With due respect, after reading your post a couple times, it sounds like you were hyponatremic. When you figured out you hadn't hydrated enough, you might have overdone the hydration without enough electrolytes.

    The extreme dryness of the area makes matters worse. Next time, pre-hydrate more, don't over-hydrate on the hikes and make sure to take electrolyte supplements.

    I do not think you actually had AMS. Maybe just a touch. It is extremely rare at those paltry altitudes.
    With all due respect I doubt I went from dehydrated to over hydrating. I DID use electrolytes. I certainly wasn't sweating or urinating excessively. I drank a TOTAL of maybe 5 to 6L (I did re read my OP and I would say it may have seemed like I drank more than that) from the time I woke up until I finished my hike. This is not an unusual amount of water for me given the elevation, hiking, etc. I usually will drink 2.5L just doing a 4 mile hike near home and keep drinking water throughout the day.

    While HAS is not usually thought of as occurring at elevations under 8000 feet, it isn't that unusual. Also, I h ave suffered dehydration and heat exhaustion in the past so I know what those feel like for me. As soon as I lost the elevation, my symptoms improved.

    However, the symptoms ARE similar between hyponutremia and HAS. But I do know how much my water intake was and it certainly was NOT excessive with the heat and driving. I may have been under hydrated for the altitude which actually would have contributed to altitude sickness.
    https://tinyurl.com/MyFDresults

    A vigorous five-mile walk will do more good for an unhappy but otherwise healthy adult than all the medicine and psychology in the world. ~Paul Dudley White

  10. #10

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    One of the other major symptoms of HAS is shortness of breath. People who suffer from COPD can have symptoms as low as 5000 feet as they already have reduced oxygen absorbing abilities.

    Since you didn't mention any problems with breathing or shortness of breath, that leads me to think your headache and nausea came from other causes, maybe food related? The heat might have been a factor too. But as we like to say around here "hard telling, not knowing".
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    Registered User colorado_rob's Avatar
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    Quote Originally Posted by PennyPincher View Post
    With all due respect I doubt I went from dehydrated to over hydrating. I DID use electrolytes. I certainly wasn't sweating or urinating excessively. I drank a TOTAL of maybe 5 to 6L ss.
    Yeah, who knows, your body, your guess is as good as anyone's.

    One more comment: you say you were not sweating excessively, but in those higher, dry climates, sweat basically instantly evaporates from your skin, making it seem like you're not sweating much.

    One reason I'm sticking with the electrolyte imbalance idea is the Occam's Razor concept, meaning generally the simplest answer is the most likely correct answer, and as we all keep saying, AMS (I thyink what you call "HAS") hardly ever occurs at such altitudes. Slo also makes a good point about simply being GI/food related... I know when I do road trips, I eat horribly and have made my system upset because of my laziness.

    And I've had both Hyponatremia (mild case, on a long Grand Canyon hike) and AMS (also mild, at 23,000' altitude) and your symptoms sound more like the former than the latter, hence my original post, but really, just an outside opinion. I hate to see anyone shy away from hiking at altitude because of a possible misconception, and I'm also sad that your trip didn't go as well as planned.

  12. #12

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    Slo and Rob,

    Thanks for your input. I will take it all under advisement. And I will not be deterred from going back out there and other places from 1 bad trip. And yes Rob, I know it's less usual to have AMS/HAS at these lower elevations but it is definitely a possibility.

    As for being food related - nope. Never. I'm kind of a stickler (some would say anal) about what I eat ALWAYS. I eat a very specific "diet" and no, I don't stray even when traveling. I had packed all my food including "fresh" foods (like my salad the first night in a cooler) and my own home made freeze dried meals and nuts. I DID "stray" by buying a package of "roasted" peanuts while at a gas station which is roasted in oils I avoid. But I know well enough that the oils would not have done to me what I experienced. LOL. Yes, for me, that's "straying."

    But next trip, hopefully, I will have my BFF with me (my husband of 25 years), and we can adjust our "campsite" height, and he can "watch over" me and we will hopefully have more time to acclimate IF it is indeed altitude related.
    https://tinyurl.com/MyFDresults

    A vigorous five-mile walk will do more good for an unhappy but otherwise healthy adult than all the medicine and psychology in the world. ~Paul Dudley White

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    I've felt the cumulative effects of altitude on my thru hike in the Smokies. Each day and night was above 5000 ft, some in the 6000's. What I noticed is I did't recover as well as I normally do. Each day I felt more weak, like the sleep was not restorative. When I finally came down and spent a night at a much lower altitude I felt much better.

    Additionally from my later Ridgerunning the smokies I have met people with altitude problems, one I had to escort down the mountain which caused me to miss a night out as it was too late to go back up. Once they get down they really start to feel better. It seems like those who get themselves in trouble live at very low altitudes and suddenly ascend using a lot of energy with out much acclimation. It is very similar to pushing oneself past the point of exhaustion.
    Last edited by Starchild; 09-27-2019 at 11:49.

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    Well, those sound like "Mountain Sickness" symptoms to me and it's certainly not unheard of at that altitude. Even at 5,000 feet there's 16% less oxygen than at sea level so yeah, it's a real thing. It's not easy to predict how people will react to altitude though and the same person may have different reactions at different times. We're all unique after all

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    Next time I go to a place in the 600 foot range, I'll bring an blood oxygen meter. They are light and I have one. Won't be until next summer, though.
    "It's fun to have fun, but you have to know how." ---Dr. Seuss

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