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excerpts.
Altitude Sicknesses
and Hazards
High Altitude Sicknesses and Hunting Hazards
Note: I culled the literature to present an inclusive overview of altitude hazards, including the lesser known ones.
The articles by Christine Paige, Ty Stockton, postings on the Center for Disease Control, and on the High Altitude
Research website were notably helpful. I am not a physician and do not make medical recommendations.
Consult your doctor if you have medical complications or concerns.
Altitude sickness is a real and extremely dangerous condition. Clearly understand the symptoms and the
necessary responses. Do not recklessly assume altitude sickness will go away. It conceivably might, but it also
may develop to disability or even fatality. Just do not mess with it. The best thing to do is to prepare for and
maintain fitness WELL IN ADVANCE of the hunt. The Flat Tops Wilderness is at an altitude of 10,000 to 11, 000
feet. You are going to need extra lung capacity and stamina if you are a lowlander. You simply cannot get that by
exercising just a couple of weeks before hunting. You must begin and continually train months in advance if you
live at a low elevation.
Pulmonologists say that any conditioning for high altitude breathing and lung oxygen absorption rapidly declines
in a few days. Therefore, in addition to pre-conditioning, you should gradually readjust to altitude immediately
before the hunt. Most medical people say you should come to Denver’s 5,200 ft. altitude for a minimum of three
days before proceeding to the high country. Additional conditioning without extreme exertion should occur
during another three days at increased altitude before going as high as the Flat Tops (9 -11,00) feet.
Altitude sickness can merely be a headache, but more commonly it includes fatigue, nausea, sleeplessness,
vomiting and confusion. Some people just shut down. Then there is the strain placed on the heart, a buildup of
lactic acid in the muscles resulting in cramps, and eventually delirium that can result in getting disoriented ( i.e.,
lost).
It is possible to take a prescription medicine several days prior to going up to altitude. The medicine is Diamox
(generic name is Acetazolamide). It has no effect after altitude sickness occurs. This medicine causes allergic
reactions; a trial dose taken before travel might be a good idea.
Acetazolamide should not be used by people allergic to sulfa drugs. If you
are concerned because of your physical conditions or medical reasons, see
your doctor before coming to Colorado. This is not a commonly stocked
medicine and it will probably have to be specially ordered, so plan way
ahead.
A High Altitude Sickness Story: Let me relate a story to convince you to
take altitude sickness very seriously. A dedicated hunter friend in fine
shape brought his neighbor and the neighbor’s teenage hunting daughter
to the Flat Tops. He also brought his horse. I warned my friend that driving
straight from Michigan to the Flat Tops would be extremely unwise. He did
it anyway. Arriving late, we bunked with other friends in the trailhead camp
because of coming darkness and windy, snowy weather. The young woman
became reclusive and disoriented, but determinedly in good spirits. After
we were all sleeping in our sacks, we heard an anguished cry for the dish
towels followed by violent vomiting.
The next morning my friend loaded his horse and started up the trail. From
my vehicle I observed the horse frequently stopping. In an hour the horse was only one third of the way up the
trail. I knew the horse was experiencing altitude problems. Eventually, everybody was up the trail and into their
tent, but the girl was not eating or drinking. Early the next morning my friend rode over in now deep snow and
described the girl’s condition, asking “what should we do?” “Immediately get her off the mountain and to lower
elevation”, I yelled at him rather impolitely. We had to get her out before she developed pulmonary embolism
and died. I rolled my camp into the tent rain fly, tied it like a string of sausages, and dragged out my hunting
camp/trip for the year. We got her down to lower altitude and she recovered. That was the only year of 45 that I
missed opening morning, but people come first.
Types, Symptoms, Remedies for Altitude Sickness: There are several levels of altitude sickness, and each type
can progress to a more severe and eventually fatal stage. The level of inspired oxygen at 10,000 feet is only 69%
of sea level values. Since you will be hunting at 10,000-12,000 ft. (well above the recommended 8,000 ft.
“concern” threshold), read the following sections carefully. Remember, even physically fit individuals get altitude
sickness when ascending more than 1,500 feet per day.
Acute Mountain Sickness (AMS) is quite similar to a hangover – headaches, nausea, malaise, fatigue, appetite
loss, insomnia, and shortness of breath. So, catch my drift. Do not use alcohol shortly before or during your
hunting trip, or you may think you are groggy because of drinking, and dismiss the possibility of altitude
sickness. Maintain good hydration and regular (normal) good nutrition. Avoid caffeine drinks and “power drinks”
because they dehydrate the body. AMS usually resolves 24-72 hours after onset in normally healthy individuals.
If symptoms increase in severity, descend to lower elevation in 2,000 ft. steps. Use oxygen if it is available- not a
likely possibility in this remote location.
High Altitude Cerebral Edema (HACE) is a severe form of altitude sickness. It is swelling of the brain. Symptoms
are confusion, clumsiness, and stumbling. People with HACE find it difficult to walk heel-to-toe in a straight line.
First signs are laziness, excessive emotion or violence, severe headaches which show no response to medications
or rest, seizures, bizarre behavior, hallucinations, and loss of consciousness. DESCEND AS FAST AS CAN SAFELY
BE DONE, at least 2,000-4,000 feet. Death can occur within 24 hours of developing ataxia. SEEK MEDICAL
ATTENTION. Administer Dexamethasone and Acetazolamide, and oxygen if possible.
High Altitude Pulmonary Edema (HAPE) is the third mountain sickness. HAPE casually develops 2-3 days after
reaching 8,000 ft. or more. Pulmonary lung arteries constrict and fluid accumulates in the lungs. The heart will
stress itself trying to pump de-oxygenated blood through increasingly water-flooded, non-oxygenating lungs and
then to body organs. Body organ and muscular fatigue occurs. Ventricular heart failure can lead to an immediate
fatality. The patient succumbs as the lungs continue filling with fluid and cannot supply oxygen to the body.
Symptoms are shortness of breath, frequent coughing with pink, frothy sputum, harsh breathing sounds, blue
lips, fever, disorientation, seizures, and unconsciousness. HAPE can be more life threatening and bring death
more rapidly than HACE. DESCEND IMMEDIATELY 2,000 to 4,000 feet. Use oxygen and administer Nifedipine
(which opens lung blood vessels).
Probability of getting altitude sickness can be reduced best by ascending to hunting elevations in 1,500 feet/day
intervals. Skiers flying to Colorado have a 1 in 10,000 chance of developing HAPE. Flying from sea level and then
hiking into the wilderness in one or two days is asking for misery and maybe serious medical trouble.
Interestingly, older people get HAPE/HACE less frequently. They seem to have developed more common sense
with age, and they have and take more time to progressively reach higher altitudes.
HAPE
Fells
Another
Victim:
A
woman
died
of
high
altitude
pulmonary
and
cerebral
edema
even
after
trying
to
acclimate
to
altitude.
She
spent
an
August
day
Golden
(6,000
feet)
and
then
three
days
at
Dillon
(9,111
feet)
before
hiking
and
camping
near
Aspen
at
10,367
feet,
there
she
died
in
her
sleep.
University
of
Colorado
professor
of
emergency
medicine
Dr.
Benjamin
Honigman
researches
defects
of
high
altitudes
on
humans
said
the
victim
may
have
thought
she
had
low
sodium
symptoms,
which
are
similar,
and
failed
to
comprehends her dire situation.
Denver Post September 8, 2017 p10A