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