cottonwood lakes (sierra) report - fighting AMS

MattCav · Post by **MattCav** » Mon May 27, 2013 3:42 pm

Wife and I set out to overnight it up to Cottonwood Lakes from Horseshoe Meadows. The adventure did not go as one would plan, however.

The trip started out pretty tyipcal. We departed the 10,000′ trailhead around 3pm, a late start to our hike. Wife had her Gregory Jade 28 pack on, loaded up with water, a couple layers, and her sleeping bag. I had my Gregory Z65 pack on, loaded with the remainder of our stuff. This will come into play later.

The trail itself is absolutely beautiful, well marked, and just a lot of fun. The first two miles are relatively straight and slightly rolling. Around 2 miles in, you will come across one of the most beautiful meadows you will ever see, with a winding creek through the middle of it. If i could build a house here, I would.

After 2.5 miles or so, just past the New Army Trial cut-off, the trail starts to pick up a bit of elevation, but never really surpasses a 500′ gain/mile grade. Finally, after 5 miles, we reached 11,000′ and entered into the Cottonwood Lakes Basin. We hiked over towards Cottonwood Lake #3 and were greeted by a family of 6 deer. I tell you, beautiful.

We set up the tent, bear vault placement, etc… as the sun was setting. Mount Langley and its surrounding comrades glowed pink in the dwindling daylight and created an ambiance that would be hard to put into words. However, something else began to happen as well. The accuweather forecast (and the forecast in the Lone Pine Visitor Center) called for a low of 34 in this area. However, even before the sun had set, the temps had dropped below 30. The wind had begun to pick up and I was guessing temps would most likely bottom out into the teens, something we had not banked on. Lessons learned. We decided to pack up camp and actually head back to the car, something that paid off drastically.

Up to this point, I had not been hungry. It happens with elevation sometimes and usually isn’t an issue. I usually force myself to drink a lot of water, eat electrolyte stuff and “reguarly food” and I monitor my body’s condition. However, this time around, it must have slipped away from me. As we began our headlamp-led descent back to the car 5.8 miles away, I began to feel dizzy and my speech started to slur. I had a feeling that AMS might be onsetting. Typically in this situation, the most important thing is to get to lower elevation. However, because this trail is all above 10,000,’ it’s a little bit trickier. I told myself “just get back to the car.” 2 miles into our descent, Laura (who was ahead of me) turned around and saw me dizzily hiking, struggling to stand. At this point, I felt my stomach doing flips, I could hear my pulse in my aching head, I was not talking much, and I was coughing up some sort of substance. Oh yeah, and I was still bearing that full pack and exhaustion was hitting. However, up in the mountains, there is no time or benefit to making excuses. Whenever Laura would ask me how I was doing, I would say either “more electrolytes,” “more water,” or “just get to the car.” I was doing my best to focus on my steps so we could get off the mountain asap.

We got back to the car after 2 hours of focused hiking. I don’t remember tons of the descent but I do remember almost instant relief upon reaching Lone Pine’s 3000′ elevation. This trip was quite the unexpected adventure and served as a reminder that the mountains always win when war is being waged.

I've thrown some pics and specs up on the hiking site if anyone is interested.
http://summitascents.com/2013/05/27/5-2 ... ms-episode

Phil B · Post by **Phil B** » Mon May 27, 2013 6:41 pm

Hi MattCav,
Glad you made it back to the car OK, sorry that your trip did not work out as planned, but I'm glad you had the good sense to make the right decision, and that, you should feel good about.
I had a similar experience once when I drove all night to get to the Sierras and started hiking without any acclamation time, needless to say, my legs turned to jelly after about an hour on the trail and I had to turn back, I guess sometimes the combination of the long drive, excitement and altitude all takes its toll. The beautiful Cottonwood lakes are still there waiting for you to go back, I know you will, good luck, and thanks for the honest report.
Phil

MattCav · Post by **MattCav** » Mon May 27, 2013 9:12 pm

Thanks Phil. I appreciate knowing that someone else has gone through something similar in the past.

DukeJH · Post by **DukeJH** » Tue May 28, 2013 12:14 pm

My family of 4 did the same backpack last Memorial Day weekend with gorgeous weather. My wife had symptoms of AMS (nausea, headache, fatigue) but Diamox, lots of fluids, and some food got her over it.

It sounds like you were sliding beyond AMS into something worse and I'm glad you made it back down safely.

Post by **tekewin** » Tue May 28, 2013 12:56 pm

You held it together under duress and made the right decisions. You should find solace in that and know that you live to climb another day. It was also courageous to share. Thanks.

Post by **JeffH** » Tue May 28, 2013 4:32 pm

At least you had the sense to turn back, AMS can make people act pretty stupid or at least make bad decisions.

cougarmagic · Post by **cougarmagic** » Tue May 28, 2013 5:12 pm

Cottonwood Lakes clobbered me as well. About two years ago. I felt like my legs were made of lead heading up, then had a mostly sleepless night with a stabbing headache. Somehow in the morning, after chugging a bunch of water and moving around, I felt well enough to hike. My friend who was with me at the time, was watching me, and said she was prepared to hike down during the night if she thought it was necessary.

Thanks for sharing the story. It is a beautiful place. I'd like to go back, but with a bit more acclimatizing.

MattCav · Post by **MattCav** » Tue May 28, 2013 11:17 pm

thanks everyone. i appreciate knowing that people way more hardcore than i have had to deal with this frustration in the past.

Post by **Taco** » Fri May 31, 2013 10:25 pm

It would appear you were starting to have fun.

I got AMS pretty bad before the summit of Langely once. Felt terrible from about 3pm to 10pm, when we got back to Lone Pine and Jack in the Crack.

Had it yesterday, too. Your story brings back memories of not having fun.

Is this your first time with AMS?

MattCav · Post by **MattCav** » Fri May 31, 2013 10:28 pm

Nah, I've had it up on Whitney and towards the top of San G before, but never to this extent. I've gotten dizzy and headaches in the past, but this time I was also coughing blood, having trouble standing, and seeing hallucinations (not the cool ones either

). Does this sound like what you had at Langley Taco?

Post by **tekewin** » Sat Jun 01, 2013 7:13 am

I am not a doctor, but the coughing up blood part sounds like HAPE. Here are a couple of articles on it:

http://www.scientificamerican.com/artic ... ain-high-a

http://en.wikipedia.org/wiki/High_altit ... nary_edema

http://www.basecampmd.com/expguide/hape.shtml

Post by **Taco** » Sat Jun 01, 2013 12:46 pm

Yeah the blood part sounds pretty gnarly. Whenever I get it, I just get nauseous or dry heaves, a headache, lack of appetite, minor hallucinations, that kinda stuff that you can easily assess and fix.

MattCav · Post by **MattCav** » Sat Jun 01, 2013 6:44 pm

Taco (or anyone else) - have you used diamox for this? I just got a prescription and I'm hoping to get out again soon in order to test this stuff out.

Post by **Taco** » Sat Jun 01, 2013 10:11 pm

Aspirin is all I've had, maybe Aleve once or twice? I just kinda accept it if I haven't been at elevation much in the weeks prior.

DukeJH · Post by **DukeJH** » Mon Jun 03, 2013 11:41 am

I have not personally taken Diamox (Acetazolamide is the generic version) but I carry it and have administered it to my wife (at Cottonwood Lakes). It aids in the acclimitization process and reduces the symptoms of AMS. Diamox is not steroidal and will not treat HACE or HAPE. Diamox allowed her to acclimatize more comfortably without progressing into more serious altitude illness.

My wife said she had some tingling of extremities and her taste was affected a little. I encouraged her to increase her fluid intake beyond that required to normally stay hydrated since Diamox can act as a diuretic.

MattCav · Post by **MattCav** » Mon Jun 03, 2013 11:03 pm

thx duke!

palmeredhackle · Post by **palmeredhackle** » Tue Jun 04, 2013 9:08 am

Yikes! I hope it wasn't HAPE, if it is be very careful at altitude! A buddy of mine is retired ski patrol from steamboat springs and he's had to help peple with HAPE before.

I know it's not always easy to do, but I almost always spend one night at the backpackers camp at horseshoe before going over any of the passes in that area. The one time I didn't was the one time I had a mild case of AMS. Did you have a chance to acclimate overnight before you hiked up?

Post by **Sean** » Tue Jun 04, 2013 10:31 am

MattCav wrote: ↑I usually force myself to drink a lot of water, eat electrolyte stuff and “reguarly food” and I monitor my body’s condition. However, this time around, it must have slipped away from me. As we began our headlamp-led descent back to the car 5.8 miles away, I began to feel dizzy and my speech started to slur. I had a feeling that AMS might be onsetting. Typically in this situation, the most important thing is to get to lower elevation.

I'm not an expert or doctor in such matters. But I have hiked several 10k+ peaks including Whitney, Gorgonio, Jacinto, Baldy, etc., and experienced some of the problems discussed here, including dizziness, tingling in extremities, mild headache, lack of appetite. With that in mind I think some people make a mistake addressing such issues. Sometimes hikers experience initial symptoms of dehydration, starvation, or electrolyte imbalance coupled with a lack of appetite due to being at altitude. Then they become immediately concerned about AMS and make descending priority number one. In my view this is usually a mistake. The first priority should be to sit down for a few minutes, force yourself to eat your food and drink your electrolytes, especially if you know that you have not been doing that enough, and rest your body so it can focus on digestion. After fifteen minutes, if you don't start feeling better, then it's probably best to descend. Unless you have some genetic issue, it's probably safe to spare a few minutes addressing your body's fundamental nutritional requirements. At least that has been my experience, and I've always resolved these problems simply by eating and drinking.

MattCav · Post by **MattCav** » Tue Jun 04, 2013 11:05 am

I know it's not always easy to do, but I almost always spend one night at the backpackers camp at horseshoe before going over any of the passes in that area. The one time I didn't was the one time I had a mild case of AMS. Did you have a chance to acclimate overnight before you hiked up?

nope, we drove up from the beach to horseshoe in 4.5 hours and then just started hiking. lessons learned.

DukeJH · Post by **DukeJH** » Tue Jun 04, 2013 1:04 pm

Good point Sean. Although it's good to err on the side of safety, rehydration is critical to preventing AMS. Dehydration and AMS do share some common symptoms.

I used to get AMS every time I got above 10k and exerted myself. I lost a ton of weight, try to stay super hydrated, and get a good nights sleep beforehand and I've found this keeps AMS at bay.

In my experience, electrolyte imbalance and lack of adequate energy supplies (food) presents itself differently, generally with malaise and fatigue.

I am not a doctor but have spent quite a bit of time at elevation.