How long do the benefits of acclimatisation last?

[monique]

I shall soon be 72 and still going strong . My husband will soon be 70 and very fit. Four years ago we and a couple of friends obtained excellent information and advice from this site . In particular, we followed Yakshaver’s advice to go to Gokyo instead of Everest base camp. We trekked for 21 days returning from Gokyo via the left bank of the Dudh Khosi ,as far as Dingboche. We are still very grateful for the information we received on this site which enabled us to feel confident that we could achieve this wonderful journey.
Soon after we left Gokyo, having climbed Gokyo Ri the previous day, my husband developed double vision . This lasted for a few months during which he was fitted with special lenses and the problem gradually cured itself . ( By the way he was given excellent care in Kathmandu where he underwent specialist examinations and tests).
No definite diagnosis was given but it was thought that the double vision might have been caused by a small clot which had developed and was pressing on an optic nerve.
My opinion about the likely reason for this (although my husband denies this . He would!) is that he went up Gokyo Ri far too fast and he did not drink enough during the whole trek in spite of my nagging about both these things.
We are now planning to return to Nepal for more trekking . We plan to do one high altitude trek followed by a week in the valley and then a second trek at high altitude.
Now my question:
Would the benefits of acclimatisation which we would have acquired on the first trek last long enough to see us through more easily on the second trek or after a week in the valley would we need to acclimatise slowly again ?

Monique

[Lars]

At the talk on AMS given at the "clinic" in Manang, a few months ago,
someone asked a similar question. IIRC the doctor replied that
acclimatisation may last up to three weeks. She also stressed that there are
variations between individuals, and maybe also that it could vary from one
occasion to another.

[monique]

Thanks Lars this is very useful
monique

[Spaceman347]

I don't want to be negative here, just cautious........

I would seek some medical advice prior to undertaking any additional visits to altitude. If the reason for the double vision really was a blod clot caused by AMS or some light cerebral edema (essentially swelling of the brain caused by the lack of oxygen) it would be advisable to be very careful in future.

Age also seems to play a significant part in altitude acclimatisation, the older we get, the less our bodies are able to adapt to the environment presented at altitude.

Having said that, I doubt whether many GPs have much idea about AMS or altitude related medicine...............

The benefits of acclimatisation 'normally' last several weeks in 'most' people as Lars has indicated

[monique]

Thank you spaceman, this is very interesting . I am wondering whether there is an reasonable upper altitude limit below which there is much less likelyhood of being seriously affected.
I add that I personally had no unexpected or very unpleasant reaction to altitude BUT I followed very strictly all the advice I was given. The male half of the couple with whom we trekked tried several times to tempt us to go faster and to skip the odd stay overnight . Having foreseen this we had decided to hire two guides and two porters for the four of us so that we could remain independent. This was a very good decision as it is easy to be pressurised by the feeling that you are holding someone back.
monique

[Spaceman347]

Maybe I'm overly cautious, but developing double vision whilst at altitude and having it stay for an extended period of time like you mention would have me a bit concerned about the implications of further high altitude visits.

If you read any modern mountaineering biography or book you will come across a lot of stories of people (some who had summited multiple 8000m mountains previously) collapsing with cerebral edema or other altitude related problems and dying within hours. Now I know that sounds quite alarmist but altitude can (and does) kill, and it can do it quickly. The story goes that the Nepali helicopter pilots refer to Gokyo valley as "death valley" due to the number of emergency evacuations of trekkers suffering some form of AMS.

Maybe your husband's vision problems were from completely 'natural' causes and just a coincidence that it occurred at the same time as you were at altitude. I'd personally be concerned about any health problems (particularly vision, balance, fine motor skills etc) which developed whilst at altitude. Maybe I've just read too many books.....

As an interesting anecdote Sir Edmund Hillary lost his ability to acclimatise to altitude later in life and couldn't go above Namche (~3400m) without suffering from altitude induced problems (I never read exactly what his issue was, but I suspect the standard AMS symptoms). I believe later still he found that he couldn't even go to Namche. This coming from a guy who summited Everest.

I think the official altitude at which AMS can be a factor is as low as 3000m in some cases.

[kegarne]

Yes well Sir Edmund often said " Altitude is not very good for the brain you know...." or words to that effect.

To be honest from what i know, he never recovered from nearly dying trying to climb Makalu. He suffered many problems for a while afterwards.

In saying that to add my two cents worth I would have to agree with spaceman and his words. I would be very concerned with any previous problems at altitude( maybe I am just paranoid when I get to altitude) and as he said there are many examples of great climbers dying quite low on mountains of oedema after previously suffering altitude related illnesses eg Gary Ball partner of Rob Hall died @6000m approx on Dhauligiri.

Anyway, if you are even contemplating going to altitude at 70+ you are absolute legends in my mind and I hope you have a great time if you decide to go.

Take it easy
Tony

[yakshaver]

Monique,

Great to hear you want to go again. It is difficult to say if you husband's problems were caused by altitude, climibing too fast etc. Or they were just "added" or triggered by altitude. Double vision etc, could come from any number of reasons, and I am sure your doctor explored those with you/him.

Altitude does have a bigger effect on childred and, dare I say it... the "elderly". However I we've had the privilede of witnessing a 72 year old American lady on crutches back in 1999. She was always about one hour late coming to the lodge in the afternoon but enjoyed herself tremendously. She want all the way to EBC.

And yes, Sir Ed, who in his youth was envied and admired by the Sherpas for how quickly he acclimatized, "like a Sherpa" they said to him - after his 79th birthday, indeed he found it difficult to go much beyond Namche.

My suggestion is like last time around... just take it very easily. Please do sleep 2 nights in Namche Bazaar (doing short day trips, maybe on to Everst view hote, and another one up the vally to Thame, but not all the way there...). Then a third night of acclimatisation could happen in Kumjung (3790m), a bit higher than Namche. You'll get there in 2 hours from Namche, so you can spend the afternoon going to Kunde hospital, and to the Gompa.

We did this a couple of months ago with our group of 8 people, and none of us had any major altitude problems. One person had constant mild headaches for about 2 hours every early evening all the way to Fifth Lake Hill near Cho Oyu base camp... But she was ok, and the rest of us were much better.

I would also suggest you spend an extra night somewhere around 4200m altitude if you can.

I suppose it is a matter of taking it easy. It is a major cliche by now. But a useful one when on trek. And drink lots. Pee must be clear, like clear water. But you know all this by now, you are a veteran!!!

[monique]

Many thanks to all for your answers . It has been most helpful . We have indeed, since receiving them, started to question the wisdom of putting our plan into practice . Yakshaver it’s good to see that you are still there helping and encouraging us all .
I too feel that if we take it very slowly we would probably be OK .One of the advantages of being “very old” is that we have all the time in the world . (A bit of a contradiction isn’t it?) . And after all people live up there .
The bits about Edmund Hilary are very interesting and surprising.

Aging has been and continues to be very different from my expectations. People are so often surprised at the things we do and express their envy .We can’t really understand why . I feel it’s very much a matter of motivation providing us with enough determination at least to try it . I don’t feel much different when walking/trekking than I did when I was 20; but then I was inexperienced and did not realise that I could even contemplate doing such things. My fascination with mountains started when from school in France we were taken to a film and lecture, in a small and intimate venue, by Maurice Herzog who had just conquered Annapurna and gone through hell. I was spell bound by the scenery and off course his dramatic descent and missing fingers . On a sort of pilgrimage to theAnnapurna Sanctuary ( although I know he went from a different side), in our mid- sixties, we met a 75 year old man who had just trekked around the Annapurna circuit accompanied by his two adult grandchildren. He seemed very relaxed , happy and unphased about the whole thing. He definitely inspired and encouraged us to plan other treks.
Another inspiring example which still amazes me : Last year as we were ”doing” the Tour du Mont Blanc in the French Alps we were made aware that that the annual North Face Ultra Trail race around this path was about to pass us . This race includes 163 kms of mountain paths and 8,900 metres of positive “denivellée” . We found out a day later that the winner for the second time was an Italian :Marco Olmo aged 59 who took 21h 32 m and arrived well ahead of the second . We had seen so many young runners pass us . I have reservation about this sort of race but it does not diminish this impressive performance by a man almost 60 !

[critter2722]

Great Topic, Great Questions and Great Responses. I am in Neurosurgery and I don't have a concrete answer to these topics. I basically think that everyone is right in some way and wrong in some way. It is correct to say that the elderly (although I would never consider Monique elderly) are more likely to develop AMS due to the thickening of the membranes in their lungs decreasing the O2/CO2 exchange. But studies actually show that you are at an increase risk of developing AMS if you are UNDER the age of 60. Who would have thought!!!?

I would have to agree that the double vision was in some way caused by the altitude (it is too coincidental for anyone to say it is not) but I don't think it was symptomatic of AMS. Crazy concept but I can’t put the two together. I even am having a hard time putting the double vision with the altitude. As everyone has seemed to have decided, your acclimation lasts several weeks but his problem lasted several months. Usually AMS or other altitude related symptoms resolve almost as soon as you descend. Also, most CNS problems that are non-traumatic are unilateral and that is basically what double vision is; it is a problem with one eye, not two. The CNS symptoms for AMS are global in nature (hydrocephalus).

Enough babble: Monique, go for it, have a great time. I wouldn’t let this stop your husband. And always listen to Yakshaver, he knows his stuff!!!

[monique]

Thank you Critter. Irrespective of our personal concern the subject is extremely interesting in its own right.
monique