High Altitude Sickness

I’ve been making my preparations to travel to Machu Picchu, Peru, with Sol Fitness Adventures this coming May. The plan is to spend three days in Cuzco at the beginning of the trip to acclimate. At an elevation of over 11,000 feet, the city has a reputation for vibrant culture, friendly locals - and skull-splitting headaches.

The highest peak I’ve ever hiked was Utah's King's Peak at 13,500 feet, where each foot felt heavy as a brick. Machu Picchu rests on a mountaintop at 7,784 feet and is the culminating highlight of hiking the four-day Inca Trail. Warmiwanusca is the highest point on the trail, measuring a sky scraping 13,780 feet above sea level.

All this talk of elevation has me thinking, what is high altitude sickness, and what can I do to treat, if not avoid, the illness altogether?

According to The International Society for Mountain Medicine (ISMM), there are three categories of high altitude sickness: Acute Mountain Sickness (AMS), High Altitude Cerebral Edema (HACE), and High Altitude Pulmonary Edema (HAPE).

A diagnosis of AMS can be made when a headache and any one other symptom is present at over 8,000 feet.Medline Plus, a service of the US Library of Medicine, describes the symptoms of Acute Mountain Sickness as:

Symptoms of mild to moderate altitude sickness:
*Difficulty sleeping
*Dizziness or light-headedness
*Fatigue
*Headache
*Loss of appetite
*Nausea or vomiting
*Rapid Pulse
*Shortness of breath with exertion

HACE can range from mild to life-threatening, when the brain is so swollen that it fails to function properly. The classic symptoms of HACE are changes in the ability to think and walk. The sick person will stagger like a drunk, and when tested, cannot walk with one foot in front of the other in a straight line. The person is very ill at this point, and must be taken to a lower elevation immediately to recover.

HAPE, also potentially fatal, occurs when there is fluid in the lungs and can occur along with AMS or separately. Signs of HAPE include:
*Extreme fatigue
*Breathlessness at rest
*Fast, shallow breathing
*Cough, possibly producing frothy or pink sputum
*Gurgling or rattling breaths
*Chest tightness, fullness, or congestion
*Blue or gray lips or fingernails
*Drowsiness

Hikers suffering from mild symptoms of AMS are encourage to rest and drink plenty of water. The symptoms typically improve. The recommended treatment for both HACE and HAPE is immediate descent to the last elevation where the person felt well. After a few days of rest and recovery, a slow and cautious climb back up the mountain is possible.

The bottom line when hiking at high elevations is to educate yourself on the signs and symptoms of altitude sickness, and then be honest with yourself and stay tuned-in to your body. Keep an eye on those you are traveling with and agree on protocols before you begin your hike. The International Society for Mountain Medicine (ISMM) has a great online altitude tutorial for anyone wanting more information.

Have you had experience with altitude sickness? Tell us your story here.

Add Gear Tester to the Qualifications

Attractive as far as river sandals go, the Ahnu Tilden II retails for $89.95. I made the switch to a covered toe sandal in preparation for my four-day hike through Utah’s Virgin River narrows. While the Tilden II did hide my chipping pedicure, the cute shoe was no match for the challenging terrain.

The covered toe did prevent the lurking-under-the-water-dead-tree-branch-toe-stab; however, the mesh upper stretches when it’s wet, allowing the foot to slide side to side in the shoe. The last thing you want when you’re stepping across slick rocks in a swiftly flowing river is your foot sliding around inside the shoe.

The sandal has a soft waffle sole with little arch. I’m no Princess and the Pea, but the flexible sole had too much give, and I could feel every rock. The mesh upper felt soft on my skin and includes a padded heal strap to prevent chaffing; but the thin rubber straps on the sides cut holes in my ankles that even duct tape couldn’t prevent.

I recommend the Tilden II as a fun shoe that’s perfect for playing with the kids in the backyard sprinkler, but keep looking if strenuous river hiking is on the agenda.

Training for High Altitude

This May I'm traveling to Peru to hike the Inca Trail to Machu Picchu. Naturally, I want to know how I should be training to prepare for the challenges of high altitude.

Much research has been done to show the physiological benefits of training at altitude. However, short of blood doping, it is difficult to prepare the body for the actual changes that will take place immediately upon arrival at high altitude. What is necessary is a dedicated effort to the most practical aspects of training the body, paying attention to physical training and dietary guidelines.

Physical Training Guidelines:

1. Cardiovascular. Train the body for the stress of decreased oxygen by doing bouts of cardio for up to one hour, six days a week. It's best to exercise outside, on a hilly, uneven surface. While the majority of cardio bouts should be performed at 65% of your maximum heart rate, don't forget interval training. Short intervals that cause a rapid increase in the heart rate and deprive the muscles of oxygen will result in the production of lactic acid. Lactic acid can cause muscle soreness, which won't be fun to experience for the first time on the mountain. Start including intervals in your training routine now to train the body to metabolize lactic acid and speed muscle recovery time.

2. Strength. A significant loss of body mass is observed during long-term exposure to high altitude. It's best to go into the situation with strong, well developed muscles that have been exposed to various forms of training. Train for muscular endurance (high reps) and don't forget to vary your routine to stimulate continuous muscle development.

Dietary Guidelines:

1. Food. Eating complex carbs and low salt foods has been shown to be beneficial in decreasing the risk of mountain sickness. In addition, women and vegetarians should consider iron supplementation. Iron enhances the rate of hematocrit increase at altitude, allowing the body to sustain an increase in red blood cell production to deliver oxygen to working muscles.

2. Drinking fluids. Thin air at high altitude contains less water, causing an increase in urine production and respiration. Increased water consumption prior to arriving at altitude and during the acclimatization process is a must.

3. Avoid alcohol. Alcohol has been shown to increase the risk of mountain sickness, so it's best to start cutting out the substance before arriving at altitude and avoid it altogether during the acclimatization process.

Dedicating the time to prepare for your trip to the mountains is important, and so is doing it the right way. Sol Fitness Adventures has developed training programs for the recreation hiker to prepare for these adventures. Click here to see our list of programs.

Hike the Inca Trail to Machu Picchu, Peru

Sol has worked closely with native Peruvian travel experts to develop our next adventure: Inca Trail Trek, Machu Picchu, Peru. Sol Adventurers aren't content to merely take the train. We'll reach the ancient city the way the natives did, walking the Inca Trail in the High Andes with our Quechuan porters, exploring ancient ruins, eating Peruvian cuisine, and sleeping under the starry skies.

Tune in during the next 2 months for training tips, cultural highlights, and more as we prepare for this EPIC trek. Beginning May 23, track us in live time with SPOT GPS technology and Google Maps.