FYI - Altitude Sickness Primer

AMS is serious and can lead to life threatening situations. If you are doing higher altitude hikes (or climbs), and sometimes for the older/younger/less healthy, how to identify it via its symptoms is essential. Head to lower altitudes immediately when you see them.

Thanks. Zipping up to the Jungfraujoch my first day in the mountains gave me a screaming headache, which is rare for me. Now I sleep overnight in the mountains before doing any hiking at altitude.

RE: "AMS is serious and can lead to life threatening situations. "

AMS (Acute Mountain Sickness) is actually the lowest threat mountain sickness and while could progress to a threat, is addressed by not ascending higher.

High Altitude Pulmonary Edema (HAPE) is the more dangerous (life threatening) condition where fluids build up in the lungs. Evacuation to lower elevations is the usual treatment. That said, it usually takes several days at high altitude to develop HAPE.

High Altitude Cerebral Edema (HACE) is the most life threatening of the forms of altitude sickness where fluids build up in the brain. Immediate action is required.

Interesting article. But the percentage of people getting acute mountain sickness in Colorado seems too high (25-30 % ??). Elevation where most people get it (7 to 8 thousand feet) seems too low. When people get it it's usually when they sleep in elevation, not just when they get there for short time. It is very individual and hard to predict who gets it. My friend got AMS at the elevation of 4500 meters (14500 feet) and had to be taken down (in Nepal Himalaya). I did not have the slightest symptoms on Kala Patar (5545 meters or 18200 feet). I talked to doctors in Kunde and Pheriche hospitals and they said if people get it it's usually around 4500 meters (that's why hospitals are there).
On the trip to China and Tibet we landed in Lhasa 3600 meters or 11800 feet and slept there without any acclimatization. Only one traveler (out of 15) got AMS and doctor had to be called. That's why I think that the numbers of people who get it are exaggerated and elevation where they get it is quoted too low in the article.
Basic physiology of AMS: because of low oxygen people hyperventilate and get rid of CO2. If kidneys are not quickly getting rid of HCO3, pH of blood gets into alkalosis which triggers the problem. Some people are using Diamox (diuretic) to help kidneys to work harder. You have to start taking it before you get AMS. After you get it, it's too late.

I currently live at ~ 6,000 ft. Moved here 12 years ago from sea level. Never had any real issues. I do get slightly short winded after visiting sea level relatives for extended periods on my return (it might be the sprint through the airport that does it), but that clears in an hour or two.

With all that said, I did have problem in Switzerland on the RS GAS Tour. Nothing that put me out of commission, but when we went up to the Schilthorn in Mürren I found it impossible to move more than a few steps without having to stop and breath hard. Went back to Mürren and all was well in a few hours.

So, who knows when or where AMS might hit or how intense it might be.

I never thought much about altitude sickness until this year. But then we went to Mesa Verde and spent a night in the lodge at 8500 feet. I developed a headache after a couple of hours but ignored it. By evening, when we went to the lodge restaurant for dinner, the headache was quite pronounced. By about 8pm, I was extremely agitated and my head was pounding. We threw our stuff in the car and drove down to 5000 feet. I started feeling better immediately. My headache was gone by morning. It was something - I've taken high altitude travel off my list - I have no desire to repeat that.

RE: But the percentage of people getting acute mountain sickness in Colorado seems too high (25-30 % ??). Elevation where most people get it (7 to 8 thousand feet) seems too low.

Mayo Clinic paper: http://www.mayoclinicproceedings.org/article/S0025-6196(11)63396-X/fulltext

Altitude-Related Illnesses
David L. Klocke, M.D., Wyatt W. Decker, M.D., Jan Stepanek, M.D

An estimated 30 million people are at risk for altitude related
illnesses in the western United States annually. Many cases are
unrecognized by the victims and by their physicians who may attribute
symptoms to viral illness, “hangover,” or fatigue. In addition,
commercial airline travel exposes passengers to a cabin pressure
equivalent of 2,500 m and allows them to travel rapidly to high
altitude destinations such as Aspen or Steamboat Springs, Colorado,
where they may be exposed to even greater altitudes. Approximately 20%
of tourists to Colorado ski resorts (elevation about 3,000 m) will
experience acute mountain sickness (AMS) in comparison with 67% of
climbers on Mount Rainier (elevation about 4,500 m). Approximately
0.01 % of tourists to Colorado ski resorts will experience the serious symptoms of high-altitude pulmonary edema (HAPE) or high-altitude
cerebral edema (HACE). In addition to AMS, HAPE, and HACE, other
medical problems may occur in low landers who ascend to high
altitudes, including peripheral edema, retinopathy, thromboembolism,
disordered sleep, high-altitude bronchitis,6 snowblindness
(ultraviolet keratitis), and exacerbation of chronic illnesses.

Thanks everyone for the perspectives. I just thought it would be helpful for those who may need to be aware of the issues, which are usually quite manageable, if one is aware of the altitude factors. I just want to help everyone enjoy the vistas and experiences comfortably. The high places are wonderful places to see and enjoy. The risks are really low, but one needs to understand what is going on and how to acclimate and when something may be outside the normal.

Coping with altitude:
http://www.active.com/running/articles/the-effects-of-high-altitude-training

Randy Eichner, M.D., suggests the following tips for handling high
altitude:

Take it easy on day one.

Take a walk or nap. Give your body time to adjust before taking on a
full workout.

Altitude is very dehydrating. Drink lots of water and juices,
beginning during travel to high altitude.

Avoid alcohol. It's a diuretic and depresses the normal breathing
response to altitude.

Limit caffeine. It's also a diuretic.

Eat pasta. The carbs are good for athletes in general and at altitude
there's another benefit-the extra CO2 they produce spurs the breathing
response.

Avoid sleeping pills but do get a good night's sleep.

If all these fail, you can consider Diamox, a prescription drug used
to control altitude sickness symptoms. Try a low dose of about 125mg
twice a day for the first two days. During that time, take it easy,
exercising with walks. Then stop the Diamox and jog on day three.
Build speed from day four with some running. Know that you won't be
able to run as hard or as fast as at sea level.

Edgar, thank you for clarification from Mayo Clinic. Indeed if we consider even mild symptoms as AMS (like mild headache, cough, sleep disturbance etc.) then percentage of affected people and elevation where it happens is probably right. But symptoms like severe headache, nausea, vomiting, dizziness occurs in much smaller number of people and in higher elevation (what was the case of my friend). For those who are more interested in this topic I could recommend these books:
Charles Houston, M.D.: High Altitude Illness and Wellness
Medicine for Mountaineering edited by James A. Wilkerson, M.D., chapter Medical Problems of High Altitude written by Herbert N. Hultgren, M.D.
I am sure there are many more books about this topic.

Unfortunately I cannot find the article now, but...

After the timetable changeover in December, the round trip to the Jungfraujoch will become shorter by half an hour. Why? Travel time will shorten thanks to faster trains and now only one stop in the tunnel.

Worth considering if you have had issues in the past.

Thanks for the article. My daughter was affected when we went up to Schitlhorn at 9744 feet. It was remedied when we came down. I will keep these articles for future reference.

Edgar, "AMS is serious and can lead to life threatening situations. "

AMS, if not dealt with, can lead to HAPE and HACE, two life threatening conditions that I take very seriously. I have experienced all three in my time, one in Italy and the other two in the Swiss Alps. The common treatment for AMS is rest and, if symptoms persist, descent to a lower altitude.

These things can be funny, but not HAHA funny. I have had exactly three problems in all of my years, the rest of the time I have been fine. Usually it can be determined that I ascended too quickly. One time a group of 70-80 year olds bullied me into ascending Weissmiess. Coming back down was bad and I was lucky there were two doctors in the group.

I did some research on altitude sickness prior to visiting some of the high altitude locations in Europe, so was aware of the two main conditions that Edgar described earlier (HACE & HAPE). This affects everyone differently, but my experiences have been.....

• Schilthorn - I've made multiple visits to Piz Gloria and never had a problem, even after spending several hours up there.
• Jungfraujoch - no serious problems but I did find that I was moving more slowly than usual and things like climbing stairs were more of an effort and had to be done slowly.
• Aguille du Midi - that was a problem, possibly because I spent too much time at the top between the Auguille and Pointe Helbronner. After several hours it became apparent that I'd need to head down in a hurry, as I was becoming very short of breath (I felt fine until that point). The symptoms dissipated quickly after I reached Chamonix.

While the advice to acclimatize slowly over several days is sound, that's hardly practical for someone that's only visiting a high altitude sight for one day.