Ed has led numerous trips to altitude with clients and first learnt about altitude sickness and poor preparation the hard way, he doesn't recommend it!
Ed is also the Development Officer for the Association of Mountaineering Instructors (AMI) and works regularly for Jagged Globe, the mountaineering expedition specialist.
More about Ed on his website: www.edchard.co.uk
So you've hiked up Helvellyn, tramped up Tryfan and done the Ring of Steall. What next? How about going higher and further than you've ever been before. Hopefully the next few minutes of reading will help you on your first journey into the unknown!
Let's start at the beginning, what is high?
Well, the UK isn't! In fact it's pretty low compared to the Himalayas and even the European Alps. Our problem is that we live here and our bodies are adjusted to living here: 'high' for us Brits is anything above 2500m. If we are going to head higher than Ben Nevis, we need to prepare.
Slow yourself down
Preparing for walking at altitude shouldn't happen on the bus to the airport – give yourself lots of time and think clearly about your objectives well before you go. Don't be too cocky about how young, fit and strong you are: stats show that the younger and fitter you are, the more susceptible you are to getting Acute Mountain Sickness (AMS). One of the reasons for that is younger people find it harder to slow down and not walk so fast. Older folk normally don't have so many issues with taking it that bit slower. Walking at altitude is all about taking your time: slowly and steadily wins the day.
"...stats show that the younger and fitter you are, the more susceptible you are to getting Acute Mountain Sickness (AMS)..."
Get yourself fit
Bad news for you though if you think it is all about taking it easy, before you rush off to Mrs Miggins pie shop and fill up, fitness is a big factor, too; a good standard of cardiovascular fitness is the basis of all good health. Before you go on your big trip, aim for 30 minutes of hard exercise three times a week for at least 6 weeks. This should help you maintain fitness but not build it: if you haven't exercised recently then you'll need to do a bit more. Cycling, fast walking and front crawl swimming are all good ways of getting there.
Once you get going on your trip get drinking as you acclimatise. Your body will need more water to adjust its fluid levels; you also exhale more moisture as you breathe dry mountain air. Add this to the fact that you'll be working harder due to the reduced levels of oxygen in the atmosphere and you start to see a real need. As a guide you should be drinking about four litres of fluid a day, the majority of this being water. The average adult in the UK drinks about two litres a day, the majority of this being tea, coffee and pop. The other way to see if you are drinking enough is to take note of the colour of your urine. If it's clear and copious that's good. Have a practice at drinking large amounts before you go (no, not down the pub) to get used to it.
"...If you rush the acclimatisation phase, then you have some great symptoms waiting for you..."
Any other health tips?
Other areas of preparation are rather more obvious. Food needs careful consideration. The average adult requires 2000-2700 calories a day to work effectively, but at altitude the body doesn't deal too well with fats and proteins. Your normal diet will have to change; a diet rich in carbohydrates is the way to go. Getting clean water can also be an issue in some places. I always try to purify my water and not buy bottled water that has been carried, dragged or helicoptered in. I find 'Drop in' tablets work best and don't require lots of pipes and filters to keep clean.
5 Suggested Starter Peaks
Toubkal, Morocco, 4167m
Trekking in Morocco has to be one of the best ways to discover hill walking at altitude. Exploring The Atlas Mountains and visiting traditional Berber villages along the way is an amazing experience.
Kilimanjaro, Tanzania, 5895m
The extinct volcano of Kilimanjaro is one of the world's most recognisable peaks. It rises dramatically above the dusty East African plains with an impressive snow-capped summit. Give yourself time to acclimatise on this one and don't rush it. Try climbing the nearby Mount Meru beforehand.
Cotopaxi, Ecuador, 5,897m
The volcanoes of Ecuador are well photographed and popular with western tourists. Cotopaxi is the world's highest active volcano and offers some of the most breathtaking scenery in the world. You can even climb this from a mountain hut!
Stok Kangri, Northern India, 6121m
Stok is considered to be a suitable 'starter expedition' for fit trekkers. It is an excellent first Himalayan peak and no previous experience of high altitude or mountaineering is required.
Mera Peak, Nepal, 6476m
Mera Peak is the highest trekking peak in Nepal. It is situated on the edge of the famous Khumbu region, which is dominated by Mount Everest. Although very high, Mera is a straightforward peak; with a little hard work it's very achievable.
Another idea... El Pico de Orizaba is Mexico's answer to Cotopaxi. See this article by Dan Bailey:
Mexican Volcanoes - High Altitude Hillwalks
Preparation will give you a better chance of enjoying walking at altitude, but the real key is proper acclimatisation. It's normal above 3000m for the reduced levels of oxygen to cause slight headaches, lethargy, sleeplessness and a lack of appetite. But after being at a similar altitude for a day or so the body adjusts to this new altitude and goes back to normal - it's acclimatised. Different people adjust at different rates so don't worry if you don't acclimatise in a day. But if any of the symptoms get worse you shouldn't go any higher – they will only increase. Wait two or three days to see improvement, and remember, in all cases of altitude related illness, going down 500-1000m can improve things or even cure you.
If you decide that you're superhuman and rush the acclimatisation phase, then you have some great symptoms waiting for you. At altitude the fine tissues in your lungs and head that normally act as barriers start to get leaky. If you acclimatise slowly then this fluid, called oedema is managed by your body and carted off. If not, then it builds up. If the oedema builds up in the head, it's called cerebral oedema; if it's in the lungs it's called pulmonary oedema. High Altitude Cerebral Oedema (HACE) and High Altitude Pulmonary Oedema (HAPE) is the killing end of AMS. The symptoms of HACE are varied but can include massive headaches, lack of balance and dizziness as the pressure builds up in your head. The symptoms of HAPE are an increasingly bad cough, breathlessness at rest and blood stained mucus as your lungs fill with fluids.
- For more on AMS check out: www.theuiaa.org/kilimanjaro.html
What to wear?
I could write several pages of advice about Pertex, fleece and how to look good on your trip! Essentially, I'd suggest you think about the differences in temperature you will experience and how you can deal with them. One of the great misconceptions about walking at altitude is that it is always cold - not so. You will often experience a huge temperature range from sub zero to plus twenty degrees in a matter of hours. Dry air, dust and wind will make that range seem even greater especially as you ascend.
I tend to concentrate most on three areas of clothing: head, hands and feet. These are always the bits of the body that will suffer first. A good sun hat and sunglasses should be matched with a close fitting fleece hat and wrap around high strength ski goggles. You will often sleep in a hat as well so make sure it's comfortable. Don't ever skimp on gloves - when your hands don't work due to cold or sun burn you are totally dependant on others, not great for going to the toilet! I go with three pairs of gloves to cover the very cold, coldish and chilly scale. Mitts are warmer but you won't be able to do much with them on. Out of these three clothing areas feet are the most important.
Get the right boots and socks for the right trip
It might sound simple but you will need time and patience with an experienced boot fitter to get it right: don't go into the shop at 4.30pm on a Saturday and expect to walk out half an hour later. It could take a couple of visits, and you'll need to take the time to wear them in over several days and weeks.
So in conclusion, it's all about preparation. There is lots of information around on all of the subjects I've mentioned, these days easily accessible on the web. Walking at altitude can be safe and fun. But don't forget to take it slowly, and if in any doubt about AMS remember there is a simple cure: go down, go down now, and go down again!
Get the right socks
Bridgedale Endurance Summit Knee
Knee length sock designed for high altitude and winter expeditions. Tough WoolFusion construction provides durable performance. Dense cushioning throughout provides extra warmth, impact resistance and comfort.
For more information visit www.bridgedale.com