Wild Altitude & the effects of altitude

TRAINING | by DI WESTAWAY | 04 May '18

Wild Altitude

Trekking at altitude is at best pure heaven, and at worst, sheer hell.  Depending on how your body reacts to altitude, how fit you are, how fast you’re walking, how high you are and how much you’re carrying, amongst other things, walking at altitude is never boring, often quite challenging and always memorable. 

On an organised trek, with an expert adventure travel company, your guides will assist you with managing the altitude. Your itinerary should be devised to provide the best possible acclimatisation program within a given time frame for most people. On a high altitude mountain such as Mt Kilimanjaro, this will require you to ‘climb high, sleep low’. This means during the day you climb into a new altitude, allow your body to experience the effects and make adaptations, then sleep at a lower altitude. However, we’re all unique and individual and it’s difficult to know how your body will respond to altitude until you try. I’ve had two experiences where I was on an itinerary that did not allow me sufficient time to acclimatise. One was on Mt Aconcagua, and the other on the North Col of Mt Everest. When you’re inexperienced, its difficult to know whether the itinerary will work for you, but the more research you do, and the more carefully you choose your travel company, the greater your chances of success.

I’ve heard of many stories where people book in to a 4 day Kilimanjaro climb and wonder why they fail to summit. We often add a couple of extra days for acclimatisation, but if you’re with an organised group this may not be possible. Think carefully about your goals. If you’re not concerned about summiting, you won’t mind turning back if you need to. But if you’re keen on getting to the top of a high pass or a mountain, give some thought to how long this might take and what your options are if you take longer to acclimatise than the rest of the team. 

Anecdotal evidence suggests that older moderately fit female trekkers do best at altitude, because they’re patient and not competitive. It is often the youngest fittest male trekkers that get altitude sickness because they don’t modify their pace. They are used to walking at a certain pace and they don’t make allowances for the reduced oxygen and reduced pressure at altitude. 

Training For Altitude

If you plan to trek or climb above 3,000m, it is a good idea to learn as much as you can about altitude and to prepare your body and mind for this “thin air” challenge. The fitter you are, the better – provided you’re prepared to take it slowly. 

Increasing your cardiovascular fitness will increase your body’s ability tolerate sustained hard effort and to use the available oxygen efficiently. The best way to train for this is through interval training. (See Chapter 1). The high intensity phase of interval training will force your heart rate up so that you’re really puffing for short bursts. This is called ‘anaerobic’ training, meaning ‘without oxygen’. It is these bursts that help prepare your body for altitude. 

You can also prepare for altitude by ensuring that you are in good health. There is some evidence that suggests that antioxidants can help prevent AMS. Many of our clients focused on having an antioxidant rich diet during and in the lead up to their high altitude treks. This includes consuming foods such as goji berries, blue berries, and dark chocolate! It is best to obtain these antioxidants through eating nutritious whole foods, rather than with artificial supplements which are often not absorbed and can have other harmful side effects.

Depending on where you live, you might also be able to access an altitude chamber. An altitude chamber is a facility that reduces the amount of oxygen in the air while you perform cardiovascular effort. Some elite sports training facilities have these and they have been shown to provide time efficien training environments for altitude preparation. 

Altitude on Your Trek

I most treasure being with a team of women who will look after each other when I am at altitude. Having experienced climbs in mixed teams, and all female teams, I am left in no doubt about which I prefer. Women nurture and look after each other in the wilderness. This becomes particularly evident at altitude where you may not be aware that you need a helping hand until it’s too late. 

It is not unusual to begin to experience the effects of altitude at around 2,500m. Often you will first notice a headache or nausea. You might wake up with puffy eyes feeling generally yuck, tired and miserable. The morning after we arrived in Cusco, Peru, 3,310m, Flo got out of bed and staggered to breakfast cursing and extremely grumpy. “Why did you bring me here,” she said. “This is hideous. I’m staying in bed, and I’m not coming on the trek!” She turned and went back to bed. I admit, she didn’t look well. Her eyes were extremely puffy and swollen and she looked a little grey. But two days later, she was fine, and of course she joined us on the most awesome adventure imaginable. In fact, as we trudged slowly up the 4,600m high pass on a remote Inca Trail, Flo was perfectly acclimatised. She was one of the strongest girls and she managed the challenge like a local: with ease and confidence So, the body adapts to altitude, which is essentially lack of oxygen in the air, over time. And it effects each and every one of us differently, regardless of age or sex. The best way to acclimatise to altitude is to take it slowly and rest lots. It is often the fittest members of the team who struggle the most at altitude because they’re used to going fast and find it difficult to slow down. 

So, whether you’re planning to trek to Everest Base Camp, climb Mt Kilimanjaro or trek the Inca Trails to Machu Pichu, an understanding of the effects of altitude will be helpful.

Effects of Altitude

Mountain or altitude sickness can range from a bad headache and tiredness to life-threatening pulmonary or cerebral edema, which is fluid on the lungs or brain. It is caused by climbing up too quickly. At high altitudes, the atmospheric pressure is lower and the air thinner than at ground level, so less oxygen gets into the blood stream. The body can adjust to this but it takes time. The first notable symptoms are usually breathlessness and a need to slow down. But more severe symptoms of altitude sickness may include headaches, chest discomfort, loss of appetite, nausea, vomiting, disorientation, confusion, difficulty with balance and a dry cough.

The various stages of altitude sickness generally affect climbers at different heights. 

Acute Mountain Sickness (AMS) comes on quickly and includes headache, nausea, dizziness and shortness of breath. High Altitude Pulmonary Edema (HAPE) includes fatigue, dry cough, headache, fever, rapid heartbeat and blue lips and is generally preceded by Acute Mountain Sickness. High Altitude Cerebral Edema (HACE) includes severe headache, noise in the chest, lack of coordination, loss of vision and/or hallucination. HACE is generally preceded by Acute Mountain Sickness. 

Your guides will make decisions regarding treatment, but anybody with HAPE or HACE, must descend immediately. 

I had an interesting experience at Advance Base Camp 6,400m, on Mt Everest. After acclimatising well trekking around the Kanghsung Face of Everest in Tibet I arrived at Everest Base Camp, 5,200m feeling fantastic, healthy and strong. I’d stuffed myself full of garlic, ginger, anti oxidants, fis and lots of green vegetables. I ascended to Interim Camp, 5,600m. The pace was good and I was eating and drinking well. Without a break, we continued up to Changtse Camp, 6,150m the next night. During the night I had difficulty sleeping and woke often, unable to breath. We continued up again the next day to Advance Base Camp. That night my breathing got worse and I became a little concerned that I might have gone up too fast. 

The next day I had no appetite, but I forced food and liquid in to assist with acclimatisation. I felt ok during the day, but the night was frightening. I couldn’t breath properly lying down, so I made myself a sitting up bed and tried to doze. I had to force air into my lungs, constantly hyperventilating to keep enough oxygen in my system. I had a condition called Chyanne Stroke Breathing where you stop breathing in your sleep and wake up gasping for air. I spent a whole night gasping in this way, too afraid to lie down in case I stopped breathing again. It was the most scary experience I’ve ever had. 

The next morning the Base Camp doctor checked my O2 saturation and told me I had early signs of High Altitude Pulmonary Edema. She recommended I descend in case it got worse. It was a very tough decision because I was very healthy and felt well, but my responsibilities as a mother were weighing heavily on my mind. I had no desire to become a liability to the rest of the team or to tie up resources in a rescue. So I decided to descend while I was well enough to get myself down independently and safely. I covered the 3 day ascent in 8 hours, feeling fantastic once I got to the oxygen rich air of Base Camp! 

The next day I witnessed the effects of Pulmonary Edema in two climbers who had allowed their symptoms to get worse, and had needed yaks and porters to help them down. They were so sick it took weeks to recover. I still torture myself over this decision, but I have chosen not to regret it. I’ve learned many lessons from this failure and continue to look for ways of turning this obstacle into an opportunity. I spent the next 5 days at Base Camp talking to the media and the result of this has been that the Wild Women On Top Sydney Coastrek will be a booked out event, raising nearly $1million for The Fred Hollows Foundation. I met some really interesting people at Base Camp, and spent time with a South African Summit team. One of their team members also had High Altitude Pulmonary Edema, which was cured when he returned to Base Camp. He returned to the climb and summitted Mt Everest two weeks later Unfortunately he got Cerebral Edema on the summit, took his gloves off and is now missing 6 fingers. Mmmmmmmmmmm…. The lessons are clear.


Want tips on preventing Altitude Sickness? READ HERE


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