Climber standing high on a mountain to show altitude sickness

All You Need to Know About Altitude Sickness as a Climber

The first time I had altitude sickness, I didn’t even realize it. I’d flown to Denver for a business meeting, years before I’d ever gotten into climbing. I had a headache and felt randomly fatigued. I assumed I’d just come down with something thanks to the coughing guy a few rows back on my plane.

Once I got into climbing though, I realized that Denver trip was my first introduction into altitude sickness. It can happen to anyone when they travel to a place that’s a higher altitude, though it can affect climbers on a more regular basis because we’re not happy until we get way up on that crag.

Understanding altitude sickness and how it can affect you is important as a climber. Being prepared in every facet of a climb is something I stress often, and this is one of those things you should be ready for as you start taking on more challenging routes and going for multi-pitch climbs. I hope my guide here can help you stay aware and prepared so you can love every minute of your ascents.

What is altitude sickness?

Altitude sickness, which is sometimes called mountain sickness, comes on with several symptoms at once when you’re suddenly in a higher elevation. Like it did to me when I went to Denver that time, I had never before been in such a high elevation. But in climbs, you can get up higher than your body can adjust, which is why it’s so important to take things slow.

It happens because as you get higher up, the air pressure and oxygen levels get lower. Our bodies were not designed for a sudden change in this. It takes our bodies some time to make the adjustment. For those that are from lower altitudes that haven’t ever been up very high before getting into climbing, it’s very important to pay attention to the signs of altitude sickness and act accordingly as well as quickly to prevent complications.

There are three extremes of altitude sickness, and the more extreme, the more dangerous it can be. Knowing what symptoms and threats each poses can save your life or that of another climber that you happen to be out with.

What are the different types of altitude sickness?

As I said, there are three types of altitude sickness. Here’s what you need to know about them.

Acute Mountain Sickness (AMS):

If you’re up on a climb and you suddenly find yourself with a throbbing headache, or even one that remains steadily painful, it’s the first sign of acute mountain sickness. But a headache alone isn’t cause for panic. I’ve had headaches come on while climbing at lower altitudes and it was just that, a headache. But I kept my guard up and watched for any of the other symptoms that come with AMS.

Symptoms of AMS:

  • Fatigue
  • Nausea or vomiting
  • Loss of appetite
  • Feeling lethargic
  • Trouble sleeping

Treatment of AMS:

With AMS, your body can generally cure itself but you’ll need to allow it to adapt to your new higher altitude. The best way is to get down to the last elevation you were at that you could sleep at without any symptoms and get some rest. I talk about more treatment for specific symptoms further down so keep reading!

High Altitude Cerebral Edema (HACE):

The key difference between this type of altitude sickness and the milder version are in the added symptoms which are much more dangerous. What happens here is that your brain starts swelling. That’s scary enough, but as a climber you need your focus and your balance and with HACE, it’s compromising those things. If you see the symptoms of AMS plus the symptoms for HACE, it’s major that you act immediately.

Symptoms of HACE:

  • Unable to walk in a straight line with heel-to-toe action
  • Unable to stand on one foot and balance

Treatment of HACE:

If you have HACE, it’s extremely unlikely that you’ll know it before your team does. That’s why keeping everyone with you informed if you start feeling those beginning signs of AMS creeping in is so important. We all have to watch out for each other. Anyone displaying the symptoms of HACE need to be taken down to a lower altitude immediately where medical help should be contacted without delay. Again, I have more tips on what you can do further down.

High Altitude Pulmonary Edema (HAPE):

HAPE is scariest of all because it may not have any of the symptoms you’d see in AMS or HACE. Instead, what you’ll experience is shortness of breath with a dry cough. When I was on a multi-pitch after having plenty of experience, one of the intermediate climbers along with us displayed the symptoms of HAPE. Because we were all educated and aware of this type of altitude sickness, we were able to get him the help he needed immediately. He needed some time to recover and rest in the hospital but was much better not long after and has been much more careful on his climbs.

Symptoms of HAPE:

  • Worsening of the shortness of breath
  • Sudden onset of fatigue
  • Unable to exert any energy
  • Wet, gurgling cough

Treatment of HAPE:

If someone with you has the symptoms of HAPE, drop everything and carry them down to a lower elevation. Contact emergency services immediately.

How can I prevent altitude sickness?

Look, I know it sounds frightening, but remember G.I. Joe said, “Knowing is half the battle.” If you truly want to enjoy climbing, you also need to be realistic about the dangers you face. Part of that is solved by having quality gear and checking it. But altitude sickness can’t be secured with gear.

The good news though is that if you take a few precautions, you can usually prevent it and avoid anything really serious from happening, but you’ll have to do it before climbing. Here’s what to do before a climb to prevent altitude sickness.

– Use ibuprofen

Nope, not Tylenol or Aleve but Ibuprofen. It was proven in studies conducted to directly assess its merit for reducing altitude sickness. For it to be effective, you should take 400mg of it in the morning before you begin climbing and follow up with another 400mg every 6 hours while you’re on an elevation.

– Stay hydrated

Hopefully, you already drink lots of water. If not, time to start training yourself. Work your way up so you drink 2 to 3 liters of water a day by the time you go for your multi-pitch. If you’re even slightly dehydrated, it can make it more difficult for your body to get used to the change in altitude.

– Try caffeine

On any day of the week, could we find you with a cup of coffee in your hand each morning? Then you’re like me! I love coffee, so this tip was one that was very easy for me. If you have been a caffeine person before climbing, then don’t stop. Have caffeine before your climbs and bring something along with caffeine to help give you a boost.

– Cancel your plans if you’re sick

I know it’s a total bummer to have to bail on a climb you were looking forward to, but it’s for the best, believe me. Even if you just have the sniffles or are feeling just a little blah, once you get up higher, it could turn into something serious. Your lungs have to work extra hard at higher heights and when you’re sick, you’re going to compromise your health, big time. You can always take a rain check until you’re well. Don’t push it or you could find yourself being sent by helicopter to the nearest hospital.

– Ask your doctor about acetazolamide

This is a medication that your doctor can give you to help prevent altitude sickness and reduce the symptoms. But the problem is that the side effects can be almost as bad as altitude sickness itself which is why it might not be a good option for everyone. Still, you can talk to your doctor about possible options and the risks associated with them. Don’t ever give this medication to children.

– Much a bunch

During any climb, bringing along sustenance is always a must, but when you’re hitting those higher altitudes, you can’t afford to go without it. Simple flavors and simple snacks are all you need. I personally love pretzels, but it’s all up to you. Just make it portable and easy to tolerate.

How to prevent getting altitude sickness by what you do

We’ve covered those things you can ingest or take before you get out on your climb. But now, I want to address the actions you can take to keep from having altitude sickness get you while you’re climbing.

– Take it slow

The technical term is acclimatization, and it’s one of the most important ways you can avoid getting altitude sickness altogether. If you avoid going too high too quickly, you should be fine. A good rule of thumb is to stay a night or even two at 8,000 feet and keep from climbing more than 1,600 feet up each day.

– Sleep at lower altitudes

It’s an old climber’s adage for sure, but it’s very true. During the day, get up there and acclimatize, then as night gets closer, get down to lower levels for that oxygen. If you feel the symptoms of any stage of altitude sickness even when you descend to a lower altitude, do not sleep there. Instead, get off the mountain and get to where the air is richer with oxygen.

– Keep drinking that water

Nope, not repeating myself here. My last tip was about getting hydrated before embarking on your multi-pitch. While you’re there, you must keep drinking plenty of water. In higher altitudes, your body needs that extra fluid. It’s not enough to go buck wild on water drinking before you venture out. You must maintain it!

– Dress accordingly

Something interesting about altitude sickness is that it can occur from sun exposure. Not only that, but you should protect yourself from the sun even in lower altitudes. Sunburns are the worst, and you can even get them when there’s snow. Ouch! Keep your head covered, use SPF lip balm, and always wear sunblock. Don’t forget your sunglasses either. Even in warmer weather, you’ll find snow way up on those elevations and it can totally blind you from the sun’s evil reflection.

What to do if you get sick

Sometimes no matter how much effort you put in, you might start to feel AMS coming on. If you start feeling this way, you can try to chase it off by stopping for more hydration. Drink more water or even better, Gatorade, which will help you get those electrolytes. Wash down your ibuprofen with that water or Gatorade. Then walk slowly.

I took a class once on introduction to mountaineering and one of the things I learned about dealing with altitude sickness was to step, step, breathe, and keep repeating. I remember we even had to get up and practice this around the room. I felt stupid at the time but I’m really glad I learned this. Now I’m passing it along to you.

Now, again, I don’t want to scare you but if you try these tactics and you still feel that headache and it’s getting harder to breathe, get down. Don’t try sleeping it off. Tell your fellow climbers. They won’t be angry. The safety of everyone you’re with is so much more important.

Mild cases of AMS can be treated with ibuprofen and rest. But if you develop HACE or HAPE, you should get down about 3,300 feet. For HACE, you may be given Dexamethasone, Prednisolone, or Acetazolamide. For HAPE, you may be given Nifedipine. It’s probably wise to breathe in oxygen too which is why you should contact medical professionals at once. It may even be necessary to be evacuated via helicopter.

While a helicopter ride over the mountains sounds super-cool, I’d like a tour, not a medical emergency, to be the reason for my helicopter ride, how about you?

Conclusion on altitude sickness when climbing

Honestly, it’s best to heed this advice and avoid a situation like this altogether. Prevention is the best way to keep from getting altitude sickness, as is taking a slow approach to ascent. But no matter how well you prepare, knowing the signs and spotting them could be the thing that saves someone else you know. That’s climbing… we’ve all got to look out for each other together!

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