A Balanced Life

Head in the Clouds High Altitude Skiing Requires Time, Attention

By DIANE RICHARD

Going to the mountains for the weekend, flatlander?

Great. Just be prepared and take your time, because skiing in high altitudes requires more than a plane ticket.

I'm speaking from experience here. A couple years ago, I grabbed a weekender cyber fare from Minneapolis (elev. 815 ft.) to Calgary (elev. 3,557 ft.) where my best pal lives. In no time flat, we borrowed a pair of skis from a friend and piled into her Subaru wagon, loaded down with water, Gore-Tex and gorp. And up to Lake Louise went we.

Things weren't so easy once we hit the trail. The borrowed skis required wax, and we hadn't brought any. So I slipped around the snow like a dog on ice, which didn't add much to the occasion.

But the bigger problem was that I simply couldn't breathe. A couple months of sedentary behavior, a sudden change in altitude from the plains to the Canadian peaks, and lack of time to adjust to the less-oxygenated air left me sitting in a snow bank, headachey and gasping.

Once I could breathe normally again, I consoled myself by sucking on orange slices and inhaling the smell of cypress. Still, it wasn't exactly the cross country ski experience I was after. Deterred and depressed, we loaded up the car and went to buy Roots boots in Banff.

It was a classic case of Skius Interruptus. And one that could have been prevented had I given myself more time to acclimate to the altitude, says Robert Mazzeo, a professor of kinesiology and applied physiology at the University of Colorado, Boulder.

Mazzeo works with other researchers at the crest of Pikes Peak (elev. 14,110 ft.), studying the effects of high altitude. He includes tourists among his subjects.

"Obviously, you're at higher altitude, so there's less oxygen per liter of air," he explains. "That has a number of consequences. One, it affects your well-being and, the other, your performance." Acute mountain sickness is the most common problem related to what he calls well-being. Caused by a change in the rate of available oxygen, it typically affects people who rapidly ascend to a height of 2,743 meters (9,000 ft.) or more, and it affects them in varying degrees, according to their sensitivity. Its symptoms, much like a hangover, include headaches, shortness of breath and nausea.

A trip down hill is the best remedy, though it's also possible to take a prescription medicine called Diamox, or a hit of oxygen, and stay up in the clouds.

"A number of our sea-level investigators take it for two days before they come up to Pikes Peak," Mazzeo says of the medication. He adds that, with Diamox, skiers can continue to ski. "Exercise is not counter-indicated," he says.

Rarer and much more dangerous are two high-altitude diseases that require immediate medical attention. One is high-altitude pulmonary edema (HAPE), a potentially fatal condition that causes headaches, disrupted ventilation and, eventually, fluid-filled lungs.

It can occur with the other, HACE, or high-altitude cerebral edema. Also potentially lethal, HACE describes a condition in which the brain gets engorged with fluids. Symptoms include a severe headache, lethargy and disorientation. The true test of HACE is that victims cannot walk a straight line, toe to heal.

Hypobaric bags, carried by emergency technicians and alpine medical staff, were invented to handle such cases by simulating the oxygen levels at sea level for victims

Hypobaric bags, carried by emergency technicians and alpine medical staff, were invented to handle such cases by simulating the oxygen levels at sea level for victims until they can be moved to lower altitudes for emergency medical treatment.

Thse edemas are relatively rare, according to Mazzeo. They make up perhaps 5 percent of all reported cases of high-altitude sickness.

No one is sure what predisposes people to get high-altitude diseases, and there are no tests to predict whether someone is susceptible to altitude illness. Experience is the most reliable guide; an illness can affect those in even peak physical shape. "We've been looking at signs, potential markers to detect it in advance, and there's nothing known yet," Mazzeo says.

Other than those mentioned above, symptoms of high altitude illness include loss of appetite and sleeplessness. Mountain climbers who spend weeks at a time above the tree line know to eat plenty, whether hungry or not, because a serious loss of weight and muscle mass can occur within a week.

As for performance, mountain air forces athletes to work far harder, making them do with less oxygen in blood and muscles. Most competitors give themselves a week to acclimate, which improves the oxygen-carrying capacity of the blood, Mazzeo says.

"We usually relate [the effects on performance] to VO2max -- or the amount ofoxygen your body consumes at maximum exertion, in liters of oxygen per minute," Mazzeo says. "At altitude, your VO2max is lower, [so] you're working harder, your heart rate is higher, you're producing more lactic acid."

A precipitous drop in performance and a more rapid rate of fatigue often result. That is serious for competitors but only a nuisance for those skiing recreationally.

"If you tried to cross-country ski at sea level and then at high altitude, all those physiological and metabolic responses would be accelerated," Mazzeo says. "It's tougher, particularly for a sea-level resident."

Of course, the difficulties of going from lowlands to altitude was a rare problem until air travel became so popular. Now, it only takes a day to get from Kalamazoo (elev. 755 ft.) to Katmandu (elev. 4,500 ft.), and from there on to K2 (elev. 28,250 ft.).

"People can pay a lot of money to go to the summit of Everest, making it more accessible and problematic," Mazzeo says. "But I've never seen anyone ski on Mount Everest." (elev. 29,500 ft.) Yet.

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