Experience with acute mountain sickness (and preventing in the future)

This weekend I climbed Mt. Shasta (west face gully, highly recommend just for camping in hidden valley which is magical!) and ended up getting really sick on the way down. I had pretty significant shortness of breath, multiple episodes of vomiting, and severe fatigue. I had been a tired and had some nausea above 11,000 ft but nothing significant. I tend to deal with some mild nausea on climbs- especially with alpine starts (happened on Rainier and Adams but nothing like what happened on Shasta). Thankfully I was with a really strong team and was able to descend safely and am almost recovered with some leftover fatigue.

My question is- what can I do to try and prevent this in the future. I’m really trying to figure out what I might have done better- I am a pretty fit, moderately experienced climber. I’ve heard mixed things about using medication? I think I was decently hydrated. I would appreciate anyone’s experience with having AMS and what you did after to recover/prevent it happening again.

Thanks so much!

in Mountaineeringby Lost-Copy867

75%

13d

NorthRemove7167

13d

Acclimate?

14ercooper

13d

Going to second this - acclimating to the elevation is needed, even if you're otherwise "fit".

pawntofantasy

13d

Whenever I start to get high altitude headaches, I make sure to amp up my Wim Hof breathing. I hate to say it works every time, but for me it works every time.

helpfulhikerdave

13d

That’s an interesting idea & I like it! I’ll definitely try this!!

Lost-Copy867

11d

Great tip, thank you!

EffortStandard3047

13d

Yup

well_its_a_secret

13d

https://www.airforcemedicine.af.mil/News/Display/Article/3233346/how-the-us-military-acclimates-units-to-high-altitude-operations/

PNW-er

13d

I am also susceptible to altitude issues. I had AMS a step below yours on Rainier (didn’t throw up, but not far from it). On Rainier the hose on my camelback and also my water bottle froze at 11.5k, which I think was a big part of it. Another part: there were a few nervy times when we had to move very fast for potential icefall issues. So speed/breathing too hard and water were two controllable-ish factors.

A month ago I hiked up to nearly 14k (started at sea level the same day, so no acclimation) without symptoms. Could have just gotten lucky on the day, but I also made sure I was drinking plenty of water and also that I moved at 1/2 my normal hiking speed (zone 1 nearly the whole time), even though it felt annoyingly slow.

junglecommand

13d

Three things: slow ascent for prevention/descent is the best treatment. Hydration is second best, and probably the reason you had trouble. Carbohydrates are third. Lots of sugar. Also I take diamox.

DannyStarbucks

13d

Interesting. Isn’t Diamox a diuretic? Wouldn’t that make the dehydration worse?

junglecommand

13d

Definitely. So I chug extra water

Lost-Copy867

11d

Good tips, thank you! I was really hydrated the day before but probably could have drank more water on the way up from our camp. I started the day feeling really good.

power0818

11d

Diamox or acetazolamide as others have mentioned is the one medication that is recommended for preventing acute mountain sickness. Yes, it’s a diuretic, but it works through creating a slightly lower pH in your blood that counteracts the altitude which raises the pH of your blood to give a very simplified explanation. You take it twice a day starting a day before you intend to go to altitude and continue while you are on the mountain. It’s very effective. This is unlike dexamethasone which only treats the symptoms of AMS but does not help you acclimate.

DannyStarbucks

13d

Curious about the views on anti nausea meds like Zofran. I’ve seen some studies that indicate it works to reduce nausea from mountain sickness (no surprise). But is that more risky? I get headaches and fatigue when I’m not acclimatized, so I imagine I’d be able to tell from those symptoms?

Summer-1995

13d

I've used Zofran and ibuprofen to curb headaches and nausea, and it's worked fine for me, but it was also in a group/work setting where I was there with other people and it was my job to keep people safe, so if I had become disoriented it would have been noticed.

I think it's fine to use those things if you're with someone else who can guide you to descend if you become disoriented. And you would still notice shortness of breath, Zofran wouldn't mask a symptom like that.

matt800

12d

I find what I eat before increasing in altitude matters. Anything gassy like burritos can make me feel terrible. Maybe not relevant but its something to consider.

Appropriate_Ad7858

11d

The vomiting and the fact you were coming down. Are you sure it was AMS?

Lost-Copy867

11d

It started right after coming down from the summit so we were still about 14,000 ft. I’ve talked to a couple of physician friends who are also climbers who think it was AMS, but without someone being there it is hard to know for sure- honestly the rapid breathing/inability to slow my breathing was worse. While I wasn’t disoriented I felt mentally slow if that makes sense? And I did feel better after lowering down to our camp and sleeping. To be honest I don’t care what it was as long as I can be prevent it from happening again.