Mountain Medicine: Expert Advice for High Altitude Climbers with Physician Tracee Metcalfe

I recently had the pleasure of interviewing my friend Dr. Tracee Metcalfe on my podcast, Finding Elevation. As an experienced climber and physician, Tracee had invaluable insights to share about staying healthy and avoiding altitude sickness while mountaineering.

Acclimatizing to High Altitude

When traveling to high-altitude locations, our bodies go through a complex physiological adaptation process. As Tracee explained, the first 24-48 hours typically involve increased breathing rates and urine output as the body tries to balance oxygen and carbon dioxide levels. This can leave you dehydrated, so it's important to drink lots of fluids.

After a few days, your body starts producing more red blood cells to transport oxygen more efficiently. Proper acclimatization takes 1-2 weeks, so be patient and listen to warning signs like headaches or nausea. Pushing yourself too quickly can lead to serious illnesses like high-altitude pulmonary or cerebral edema.

Strategies for Prevention and Treatment

Tracee is a strong believer in using acetazolamide (Diamox) to aid acclimatization. By making your blood more acidic, it drives increased breathing rates and oxygen saturation. She recommends 125mg before bed to reduce periodic breathing and improve sleep at altitude.

Staying well hydrated, using protective face coverings, and managing blisters early are other important preventative measures. However, even experienced climbers can sometimes develop pulmonary or cerebral edema. Warning signs include unusual fatigue, confusion, and difficulty breathing at rest. Immediate descent and supplemental oxygen are the main treatments.

Empowering Women Climbers

I'm excited to support Tracee's upcoming climbs in Pakistan, Nepal and Tibet while she raises money for Ascend Athletics' leadership program. By teaching young women in Pakistan and Afghanistan critical mountaineering skills, they are working to increase women's participation in the sport and provide tools for confidence and self-sufficiency.

Preparing for Mount Everest: Tips from a Pro

Climbing Mount Everest, the highest mountain in the world, is an incredible feat that requires extensive planning and preparation. In my recent recording, I shared invaluable advice for getting ready to attempt this epic summit.

Develop a Strong Fitness Foundation

I emphasize the importance of being in the best physical shape possible before embarking on Everest. This includes building cardiovascular endurance through months of zone 2 cardio training, followed by strength training focused on the lower body and core. I recommend trying to summit another 8,000-meter peak first to gauge your abilities at high altitude.

Master the Mental Game

While fitness is critical, the climb above 23,000 feet is largely mental. I advise climbers to build resilience through visualization, mantras, and overcoming challenges on smaller peaks. Knowing your "why" and setting a clear intention to summit also set the right mindset.

Prepare for the Unexpected

Even with extensive training, things can happen on Everest that you don't anticipate. That's why I suggest brainstorming potential worries ahead of time, from getting cold to falling ill. Developing a plan to address each concern makes them less daunting if they occur. I also emphasize knowing your limits and being ready to turn around if needed.

Gear Up Properly

From trying on your oxygen mask with all your other headgear to adding a pee zipper to your base layers, I provide numerous gear tips. I also recommend testing products like heated gloves and foot warmers to ensure the batteries and user interface will actually work with your bulky mittens on.

Support Your Summit

Finally, I share great ideas for extra motivation like voice memos from loved ones and writing yourself an empowering letter. Taking a triumphant but scary post-summit selfie also captures what you endured to achieve your goal.

With my guidance, you'll be prepared for a successful Everest expedition. Just remember, no mountain is worth sacrificing your health or safety. Listen to your mind and body so you can return home successfully with an incredible sense of accomplishment.

Finding My Why on the Trail

I recently recorded an episode on my podcast, Finding Elevation, about discovering your deeper purpose and motivations for outdoor adventure. As an avid mountaineer and climber, it's a topic very close to my own journey.

I explain how I wasn't inherently "outdoorsy" growing up in the flat cornfields of Illinois. When I later moved to mountainous Seattle for a corporate job, I felt compelled to start climbing to fit in with my athletic male coworkers. My why initially stemmed from insecurity and wanting to prove myself. 

It took the devastating blow of a cancer diagnosis threatening my identity as a climber to really inspect my why at a more profound level. I realized I climbed not out of defiance, but to understand my capabilities and grow through overcoming challenges. My motivations evolved to focus on female empowerment and giving back to the generous mountain communities who had taught me so much.

I offer advice in the episode for getting clarity on your why so you can harness it during difficult situations on the trail. I suggest journaling, continually asking "why" to get at core motivations, and distilling it down to a mantra or anchor phrase.

I share a story of putting this into practice during a fundraising climb in Nepal that stretched me mentally and physically. By tapping into why I was climbing for those specific girls I aimed to send to school, it fueled me to not give up when it got painfully tough.

What I've learned is getting underneath surface reasons for venturing outdoors, and aligning activities more meaningfully with who you are, leads to more fulfilled, purpose-driven time outside. I encourage you to carve out space for self-reflection too - what motivates you to escape into nature and challenge your limits? Defining your why sets the stage for deeper transformation waiting out there on the trails.

Aconcagua: Summiting the Stone Sentinel of South America

Aconcagua, the highest peak in both the southern and Western Hemisphere, boasts a fascinating history and thrilling climbing routes while demanding the utmost skills and preparation. So, let's gear up and embark on this awe-inspiring journey!

History and First Ascents of Aconcagua

Aconcagua's story dates back to 1883, when it was first attempted to be climbed. However, it wasn't until 1911 that the first successful summit took place. The name "Aconcagua" originates from the Quechua language, meaning "stone sentinel" or "snowy peak". Having climbed Aconcagua in 2011, it’s much more stone sentinel than snowy peak. If you're headed to Aconcagua, be prepared to encounter every type and size of rock!

The first ascent of Aconcagua was made by Swiss climber Matthias Zurbriggen in 1908. His entire party turned back due to treacherous weather conditions and he had the fortune of standing on the summit alone. Another remarkable achievement was made by Annie Smith Peck, an exceptional woman ahead of her time. In 1908, at the age of 58, she became the first female to conquer the peak. Despite facing criticism for wearing pants during her climb, she left an indelible mark on mountaineering history. Can you imagine climbing a 22,000 foot / 6,000 meter peak while wearing a dress?? I’m in Annie’s camp!

Most Popular Routes and Terrain on Aconcagua

Aconcagua offers various routes, but two particularly popular ones are the Normal route and the 360-degree route. The Normal route commences in the Horrcones Valley and typically takes around three weeks to complete. Spanning 42 miles and gaining 13,500ft of elevation, this route is a formidable challenge. In contrast, the 360-degree route starts in the Vacas Valley and intersects the Normal route. It covers 64 miles and gains a staggering 15,000ft elevation. While both routes do not require technical climbing skills, climbers must be well-prepared physically and mentally.

The Terrain on Aconcagua is a spectacular tapestry of diverse landscapes. From steep, loose rock and scree to sand, pebbles, stones, talus, scree, and boulders – I told you it was rocky! Crampons and ice axes are often necessary near the summit, and ropes may be employed for sections of the climb.

Skills and Training for Summiting Aconcagua

Conquering Aconcagua requires a unique blend of skills, experience, and training. Climbers must possess a robust physical fitness level, be adept at handling steep, rocky terrain, and have prior experience in high-altitude climbing. Building endurance, strength, and resilience is crucial, and achieved through long hikes, runs, or bike rides. Training should be commenced at least six months before the climb, with a focus on cardiovascular fitness and lower body and core exercises. It's also essential to gradually accustom oneself to high altitudes and harsh weather conditions during your training sessions. Plan a winter camping weekend or venture out in windy (but safe) conditions if you can. Mimicking conditions on the mountain during your training program will pay off when it matters.

Challenges and Common Mistakes

Scaling Aconcagua is no easy feat, and many inexperienced climbers underestimate its difficulties and the effects of high altitude. With a success rate ranging from 35% to 60%, Aconcagua poses formidable challenges. Despite its reputation for being a challenging mountain, about 3500 people attempt to conquer it each year.

One common mistake made while climbing Aconcagua is the failure to adequately prepare for the harsh weather conditions. The summit can experience temperatures as low as -20 degrees Celsius or Fahrenheit, accompanied by strong winds that can reach over 100 miles per hour. Monitoring mountain forecasts regularly and equipping oneself with appropriate clothing and gear is imperative. To begin to mentally prepare for the conditions on the mountain, listen to prior-season blog posts from expedition companies and monitor weather websites like mountainforecast.com

Conclusion

Aconcagua, South America's no-nonsense rock giant, stands there like it's saying, "Yeah, I've seen it all." It's a symbol of human grit and stubbornness. With its interesting backstory, tough routes, and no-nonsense weather, it’s in the top 3 of the most challenging of the Seven Summits.

So, if you're into pushing your limits and want to see if you've got the chops, why not take a crack at Aconcagua? Get yourself in shape, both physically and mental - hire Alpine Athletics to help you prepare - train like your life depends on it, and soak in the beauty of the peak. Don’t forget to respect the mountain, play it safe, and remember, it's not a race.

Train Smart. Climb Prepared.

Mental Fitness in Climbing and Mountaineering: Why It Matters and How to Prepare

When it comes to climbing and mountaineering, we often focus on physical fitness, technical skills, and equipment. However, one aspect that is not commonly discussed but can make a significant difference in performance is mental fitness. Being mentally tough can be the differentiating factor that helps climbers and mountaineers achieve their goals and overcome challenges in the mountains.

The Importance of Mental Preparation

While physical strength and technical skills are undoubtedly important in climbing and mountaineering, mental preparation plays a crucial role in the success and safety of these endeavors. The ability to maintain focus, manage fear and stress, and stay positive in the face of adversity is essential when climbing challenging routes or tackling high-altitude expeditions.

Tips for Mental Preparation

There are several strategies that climbers and mountaineers can employ to enhance their mental fitness:

1. Visualization: Visualizing success and mentally rehearsing the climb can help build confidence and alleviate anxiety. Imagine each step of the route, the feel of the rock or ice, and the movements required. Visualize yourself moving smoothly and confidently, overcoming any obstacles that may arise.

2. Positive Self-Talk: Use positive affirmations and self-talk to bolster confidence and maintain a positive mindset. Remind yourself of past successes and strengths. Replace negative thoughts with encouraging and empowering statements.

3. Goal-Setting: Set clear, realistic, and achievable goals for each climb or expedition. Breaking down larger goals into smaller, manageable tasks can provide a sense of accomplishment and build confidence along the way.

4. Managing Fear and Stress: Fear, stress, and anxiety are natural responses in challenging situations. Acknowledge these emotions, but don't let them overpower you. Develop strategies to manage fear, such as deep breathing exercises, mindfulness techniques, and having a plan for different scenarios.

Building a Support Network

Building a support network is crucial for developing and maintaining mental fitness in climbing and mountaineering. Find trusted friends, mentors, or fellow climbers who understand the challenges and can provide emotional support and motivation. Share your concerns, fears, and failures with this network, as well as your successes. Having a support system that holds you accountable and provides guidance can make a significant difference in building your mental fitness.

Overcoming Challenges in the Mountains

Climbing and mountaineering present various challenges and potential breakdowns. Fear, fatigue, altitude sickness, and objective hazards are all common obstacles that climbers may face. Here are some strategies and techniques for overcoming these challenges:

1. Focus on Small Tasks: Break down larger goals into smaller, manageable tasks. By focusing on one step at a time, you can alleviate overwhelm and build confidence as you progress.

2. Stay Positive: Embrace a positive mindset and cultivate resilience. Remember that challenges are an inherent part of the climbing experience, and they present valuable opportunities for growth and learning.

3. Embrace Discomfort: Climbing and mountaineering often involve discomfort, whether physical or mental. Embrace these moments as part of the journey and use them to strengthen your mental toughness.

Addressing Post-Climb Challenges

It's not just during the climb or expedition that mental fitness is important; post-climb challenges also deserve attention. Many climbers experience a post-expedition letdown, where they may feel a lack of purpose or direction after accomplishing a significant goal. It's essential to acknowledge these emotions and to take the time to reflect on and process the experience.

Sharing Strategies and Experiences

Finally, sharing strategies and experiences with others can help build their mental fitness and create a supportive climbing community. By openly discussing mental challenges, fears, and strategies for overcoming them, climbers can help each other grow and succeed.

In conclusion, mental fitness is a crucial aspect of climbing and mountaineering that should not be overlooked. By incorporating mental preparation strategies, building a support network, and developing techniques to overcome challenges, climbers and mountaineers can enhance their performance, achieve their goals, and stay safe in the mountains. Remember, mental strength is just as important as physical fitness and requires consistent effort and practice. So, keep climbing, keep pushing your boundaries, and always focus on building your mental toughness.

The Mental Game: Training Your Mind for Adventure Sports

As climbers and outdoor enthusiasts, we spend countless hours physically preparing for big adventures in the mountains. But what about our mental preparation? In my recent webinar , I shared the mental training strategies I've learned through decades of mountaineering, strategies that have helped me summit the highest mountain on each continent as well as K2. In this blog post, I'll expand on these key tips for strengthening your mindset and overcoming challenges on your next big climb.

Know Your Deep "Why"

It's crucial to identify the core motivation driving your goal. Dig deep by continually asking yourself "Why?" until you uncover the most meaningful answer. Is it to prove your capabilities? To inspire your kids? To honor a lost loved one? Pinpointing this deeper why gives you an emotional anchor to cling to during difficult moments.

Take time to really immerse yourself in your why. Write it down, make it your phone background, tell friends about it. Visualize it fueling you through uncomfortable training and up the final summit push.

Cultivate Positivity and Resilience

Mountaineering will test your resilience. Things rarely go perfectly. Storms roll in, gear breaks, bodies ache. Maintaining a positive mindset enables you to accept setbacks and pivot to solutions quickly. How do you build positivity? By practicing it now.

Next time your training run feels miserable, reframe the narrative. "I'm strengthening my mental stamina to power through adversity." Adopt mantras like "I got this." Share positive progress with your community, not just complaints. Celebrate small wins. Positivity and resilience snowball when consistently nurtured.

Mentally Prepare for Specific Challenges

Identify your biggest mental hurdles, like exposure to steep heights or managing team conflicts. Watch climbing footage to spot potential issues. Learn techniques to overcome them and mentally rehearse.

For example, if you'll need to cross ladders over crevasses, set one up in your backyard. Practice while visualizing an open glacier chasm below you. The more you successfully conquer fears in low-risk settings, the more confident you'll feel on the real mountain.

Stock Your Mental Toolkit

Having the right mental "gear" can help you stay focused and motivated during physically and mentally grueling summit pushes. Here are some of my go-to items:

- Inspiring mantras like "I am resilient"

- Notes from loved ones

- A summit visualization routine

- An enriching podcast or audiobook

- A letter from my future summit-self

The more tools you have to redirect your thinking and boost spirits, the better. Try them out while training to see what works best for you.

Care for Your Body and Mind

Climbing performance relies heavily on nutrition, hydration, rest, and protection from the elements. Don't ignore basic self-care needs. Hunger, dehydration, and exposure rapidly degrade both physical and cognitive abilities.

Listen to your body's cues and communicate openly with your team. Voice your needs like, "I'm feeling fatigued and need to replenish." Take proactive breaks to eat, drink, and add layers BEFORE you reach your physical edge. Keeping your body fueled and warm will help you stay mentally sharp.

Surround Yourself with Support

It's vital to have people who believe in you, understand the climbing mindset, and can offer perspective when needed. Ideally this support network includes family, friends, mentors, coaches, and fellow climbers.

Share your big goal with your inner circle early on. Openly discuss fears and challenges with them. Ask for advice training through nerves on exposure. Celebrate when you crush a tough workout. Vent when you're exhausted. Let them remind you of your capable, strong self on tough days.

Mental preparation is just as important as physical training to succeed in adventure sports. Start integrating cognitive training into your regimen early on. Commit to building resilience, tuning your self-awareness, collecting mental tools, and being vocal about support needs. With consistent practice, you'll develop the mental fitness to tackle major mountain objectives safely, efficiently, and joyfully.

What other mental training do you prioritize? Share any tips in the comments!

What’s Next: Choosing your next Mountain Adventure

There’s a lot of strategy involved in choosing your next mountain adventure. That’s true regardless if you’ve been scrambling for years of if you just bought your first pair of trail runners.

So, let's talk about picking your next mountain adventure. Start by envisioning your long-term goals as an adventurer. Do you dream of climbing the Seven Summits? Or maybe you want to gain confidence climbing with your friends closer to home? Do you want to lead 5.9? Set those goals and work backward to determine the steps and adventures you need to take to achieve them.

If your goal is to climb Denali and you’ve just stood on the summit of Mt. Rainier, plan some longer expedition-style climbs on mountains like Kilimanjaro or the volcanoes in Ecuador or Mexico. On your first expedition, you will learn a lot about what’s it’s like live on a mountain for weeks with a diverse team. Your body will also endure the demands of climbing day after day. You will also experience the stress of strategizing about mountain conditions and weather. As you plan for Denali, you’ll also want to climb in challenging weather conditions and, if you can, practice pulling a sled or tire. These experiences allow you to test your body's reaction to altitude, acclimatize, and adapt to the rigors of multi-day expeditions. Remember, these mountains are not only an opportunity for physical growth but also a chance to embrace the little things, like not showering for 15 days straight!

As you build your skill and confidence in the mountains, it's also essential to align yourself with like-minded individuals or organizations that can guide you on your journey. Look for reputable climbing organizations or join national programs focused on mountain education. Building a supportive network of friends and mentors who can share their experiences and help you grow is invaluable.

When it comes to training for your mountain adventure, I can't stress enough the importance of building a solid cardiovascular base. Whether you're running an ultra-marathon or climbing Denali, you need to think of yourself as an endurance athlete. This means dedicating months to low to moderate intensity, high volume cardio workouts. It may not be glamorous, but it's the only way to build that essential reservoir of cardiovascular ability.

Remember that your journey to the top of your dream mountain begins with an idea and the desire to challenge yourself beyond your current boundaries. Set your goals, find your tribe, and train hard. Whether you're starting with a local peak or aiming for the highest summits, always remember to embrace the challenges and cherish the experiences along the way. The mountains are waiting for you, so go out there and experience them with all your might! Happy climbing!

What is Aerobic Threshold and how can I use it to improve fitness?

So, what is aerobic threshold and why - as an endurance athlete - do I care?

The range of beats per minute that your heart can sustain is organized into zones. There are as many ways to calculate heart rate (HR) zones as there are training plans, but they are all based on a percentage of your maximum heart rate. For simplicity, we’ll consider a four zone range. Keep in mind that your heart rate can be affected by many factors like stress, hormones, sleep, and medication. Heart rate zones are are also highly personalized, they’re dependent on your genetics, age, and fitness. Your lowest intensity zone is about 50 - 60% of your maximum heart rate and should be reserved for recovery. Your body will feel at ease in this zone and you are able to breathe easily through your nose. In this range, about 85% of the calories that you burn come from fat. Since we all, no matter how fit you are, have ample fat stores, athletes are able to maintain work in this low intensity zone for hours. In part, this is because your body is using oxygen to break down, or oxidize, the fat that it needs for fuel.

As the intensity of work increases, either because workload or pace increases or the terrain steepens, your heart beats faster to meet the demand for oxygen from your muscles. You are now in your second heart rate zone, and working at about 60 - 75% of your maximum heart rate. As the demand on your body increases, less oxygen is available to oxidize fat for fuel and your body produces excess lactate. So, as your HR increases your body responds by looking for other sources of fuel, which it readily find in the form of glycogen (sugar), also known as carbohydrates. Lactate production will continue to rise, causing symptoms like muscle weakness, rapid breathing and nausea. Climbers will often say that they’re “bonking” when they reach this stage. The HR at which your body predominately uses glycogen for fuel and the amount of lactate in your blood rises above it’s baseline level, is your aerobic threshold (AeT). Because we don’t have an endless supply of carbohydrates, you are only able to sustain work above aerobic threshold for two hours or less.

Determining your aerobic threshold allows you to maximize your training time. The goal of an endurance athletes is to improve your speed and power at your AeT. This is accomplished by training for many, many hours at, or just below your AeT. This type of work often feels easy, especially to athletes that have ascribed to the “no pain, no gain” training motto. Stick with it and over time your AeT will increase.

Why do endurance athletes care? A higher aerobic threshold allows you to work at higher intensities for longer.

There are many methods to determine your AeT, competing a blood lactate test or gas analysis test at a metabolic testing lab is the most accurate. You can also estimate your AeT by gradually increasing your exercise intensity on a run or cycle until you notice that it becomes more difficult to breathe through your nose. To do this, warm up for 15 minutes with easy running or cycling on flat terrain. Gradually increase your effort by increasing speed or incline until you notice that you begin breathing through your mouth. Note the HR at which this breathing transition occurs, it is approximately your AeT. It’s usually helpful to repeat this assessment several times.

Like HR zones, AeT is a personal number. Having a higher AeT than your climbing partner doesn’t mean that you are more fit than them.

Now that you know your AeT, it should become the foundation upon which you build your cardiovascular training. Plan to spend several training sessions per week, especially early in your training regimen, at this heart rate. If trail running is your preferred mode of cardio, begin with three forty-five minute runs per week and build up to one two-hour run and two one-hour runs weekly.

This type of training isn’t glamorous. But, it is the proven method to build your cardiovascular capacity. Over time, your aerobic threshold will increase which will allow you to work at higher intensities for longer periods of time.

Incorporating Technology into Endurance Training

There are many gadgets and apps available to record your workouts and track your training progress.

Most athletes already have a smart watch that records workouts and measures heart rate, pace, speed, elevation, power, distance, etc. If you don’t yet have one or in the market for a new one, i’ve had the best luck with Garmin devices. I personally have used the Fenix since its third iteration. Though it’s a sizable investment, I’ve not regretted the purchase once I started using the watch. On newer models I especially like the acclimatization and pulse oximeter features. Though I’m not a fan of it rating every run against the last one. There’s nothing more defeating than being a mile into a run, feeling great, hearing a ding! come from your wrist, looking down and Garmin telling you that you’re unproductive.

When you begin a training regimen, record all of your training sessions with your smart watch. There are arguments against recording strength sessions because they will skew your overall fitness calculation since your HR will be much lower than during a cardio session., so if you’re a HR zone purist, omit don’t record strength.. I strongly recommend uploading all of your workouts to an application that analyzes fitness, fatigue, training load, and heart rate zones. I, and every athlete I have coached, have used Training Peaks for many years. I like that it is geared toward endurance athletes, and has solid analytical data. The UI could be improved IMO but the analytics outweigh the some-times clunky interface. I especially like the ability to measure an athletes fitness, fatigue, and training load. And, I like that an athlete has access to all of the data and analytics that I do as a coach, it empowers the athlete and is another way to keep them engaged in their progress.

A word of caution: don’t let the data be the only measure of your progress. I’ve worked with several athletes that question whether they should complete a workout because their Oura ring told them to take a rest day. Data is great, it can be powerful. But, also thoughtfully consider how your body is feeling. If you’re not sore or fatigued, you probably don’t need a rest day.

In the end, I encourage athletes to test all of the gadgets and technology that the can, find one that works for you and your coach, and use it in a thoughtful way that enhances training, it shouldn’t be burdensome.

The Hypoxia Hurt Game

Your head hurts, you’re slight­ly nau­seous, each step you take injects pain into every cell of your body, and you have a hard time wran­gling the moti­va­tion to eat. Hun­gover? No. Just climb­ing at ele­va­tion. Wel­come to the hypox­ia hurt game.

As moun­tain ath­letes, the ele­va­tions that we play in affect our bod­ies and minds in many ways. If you’re like us, you want get the most out of your time trekking or climb­ing in the moun­tains, it’s impor­tant to under­stand the phys­i­o­log­i­cal changes that your body is endur­ing at ele­va­tion, and how they man­i­fest for you. 

How well you do at high alti­tudes depends on many vari­ables to be sure. You can train for months in advance of your trip and be in the best shape of your life, but if you ignore the poten­tial impacts of high alti­tude ill­ness your hard work may all be for naught. Prepar­ing for a high alti­tude trek or climb includes train­ing, get­ting the essen­tial equip­ment, some men­tal work, and under­stand­ing what your nutri­tion­al needs will be. But, the first and fore­most way to pre­vent ill­ness up high on your climb is knowledge.

How high is high?

Alti­tudes over 9,000 feet (2,743 M) are con­sid­ered high. This means whether you are on Mount Bak­er, Kil­i­man­jaro, or Aconcagua, you will be impact­ed no mat­ter who you are and how well you do up high. As ele­va­tion increas­es, atmos­pher­ic pres­sure decreas­es. Low­er pres­sure allows the oxy­gen mol­e­cules in air to spread out. This means that each of your inhala­tions at alti­tude con­tain few­er oxy­gen mol­e­cules. At the top of Ever­est (29,035 ft / 8848 M) the par­tial pres­sure of oxy­gen is one-third that of sea-lev­el. If you were mag­i­cal­ly deposit­ed at the top of Ever­est with­out pri­or acclima­ti­za­tion you would lose con­scious­ness with­in min­utes and you would die.

Adap­ta­tion

There soon becomes a lot of activ­i­ty in your body as you arrive at high­er alti­tudes. The first reac­tion is your body accli­mates to low­er pres­sure and less oxy­gen with both acute and longer-term changes. Ini­tial­ly, your body, won­der­ing where all the oxy­gen has gone, responds by increas­ing your res­pi­ra­to­ry and heart rates to increase oxy­gen deliv­ery to tis­sues. Then, your kid­neys start pro­duc­ing bicar­bon­ate and increas­ing urine pro­duc­tion to keep your pH neu­tral. After a cou­ple of days at a new ele­va­tion your heart and res­pi­ra­to­ry rates start to slow down as your pH returns clos­er to nor­mal. Your body also responds by increas­ing a hor­mone called ery­thro­poi­etin which in turn increas­es the pro­duc­tion of oxy­gen-car­ry­ing red blood cells. Increased ery­thro­poi­etin pro­duc­tion starts with­in min­utes of arriv­ing at high alti­tude but takes 2 – 3 weeks to complete.

How to pre­vent illness

If you’ve ever rushed the acclima­ti­za­tion process, like a two-day ascent of Mount Rainier, or dri­ven to the top of Pike’s Peak, you’re famil­iar with the headache that marks the onset of Acute Moun­tain Sick­ness (AMS). Oth­er alti­tude-relat­ed ill­ness such as High Alti­tude Pul­monary Ede­ma (HAPE), High Alti­tude Cere­bral Ede­ma (HACE) and High-Alti­tude Flat­u­lence Expul­sions (HAFE) can also occur; the for­mer two can be dead­ly, while the lat­ter only threat­ens the wel­fare of your tent mate and lead you to end up sleep­ing out­side. These risks can be min­i­mized by fol­low­ing a prop­er acclima­ti­za­tion strat­e­gy, chang­ing dietary habits, and in some cas­es by using medications.

If you are com­ing from low­er ele­va­tions, or even sea lev­el, those aren’t points against you in the game of high alti­tude moun­taineer­ing or trekking, it’s just some­thing that needs to be strate­gi­cal­ly han­dled with each new ele­va­tion reached. You don’t need the cen­turies old genet­ic adap­ta­tions to alti­tude of a Sher­pa or the Andean Quechua, just some basic things will go a long ways in help­ing you reach your goal.

As moun­tain ath­letes who endeav­or to climb high and feel as strong as pos­si­ble, the best way to work with the changes that alti­tude caus­es is to accli­ma­tize. Prac­ti­cal­ly, this means ascend­ing to a new high point then return­ing the same day to sleep at a low­er ele­va­tion. This climb high, sleep low approach allows your body to slow­ly adapt to the stress of per­form­ing in an oxy­gen deprived environment.

So, what’s a moun­tain ath­lete to do?

• If you’re join­ing a Moun­tain Mad­ness trip, please read the sec­tion of high alti­tude ill­ness in your depar­ture info we send you; otherwise,

• Plan acclima­ti­za­tion into your schedule

• Reduce as much stress on your body as pos­si­ble. Stay hydrat­ed, rest, eat well

• Com­mu­ni­cate how you’re feel­ing to your guide or teammates

• Lis­ten to your body — there are times when you have to push through the hurt and oth­ers when it’s bet­ter to take a time out; it’s ok to take a break now and then

Some sol­id resources

Train­ing by your­self or with a part­ner is fine, get a pro­gram dialed and stick to it. But, if you hire a train­er it’s worth con­sid­er­ing find­ing some­one that has some knowl­edge of high alti­tude climb­ing and trekking and what your body goes through. Alpine Ath­let­ics own­er Lisa Thomp­son, who has climbed the Sev­en Sum­mits and K2, has pro­grams that train you, gives you advice on equip­ment and nutri­tion, and that pro­vide invalu­able insights from some­one that has played the hurt game and over­came the chal­lenges of high altitude.

A go-to books to get you schooled and intrigued at the same time include is  Going High­er.

Con­trib­u­tors: Dr. Tracee Met­calfe, Lisa Thomp­son / Alpine Ath­let­ics, and Mark Gunlogson / Mountain Madness