CTR Altitude

[ltlquail]

Hi all,

A while back a friend of mine planted this idea in my head about the Colorado Trail Race. It has been plaguing me for some time now and seeing I will be in the USA next year from Mid July to early September next year an attempt at this ride is a genuine possibility. To tell the truth I have become slightly obsessed by this and have planned our trip to keep 2 weeks around the CTR free just in case I decide to have a go.

I have almost everything working in my favour including a very supportive spouse who tells me I am stupid if I don’t do it. I am a little nervous about the climbing and how tough it is going to be but that is not really a concern as I can somewhat prepare for these things. My goal is only to complete the ride under 10 days but I have one rather large reservation regarding the Altitude. Due to family commitments I wont be able to get to the start until the day prior to the start. I live in Australia at about 600m (2000ft) and will be down at sea level for the week before. I know it’s hard to predict who will suffer altitude sickness but before I get too carried away I would like to hear from or know of any lowlanders who have attempted and hopefully successfully completed the ride who did not have time to acclimatise beforehand. What was your experience? Is it doable?

Thanks

[ImAFred]

It is a real possibility since you travel over 12,000' multiple times, however you can usually get it to subside quickly just by dropping down a thousand or two feet in elevation ...ie just camp lower, it'll be warmer too.

[bartspedden]

Seeing as I do suffer from altitude related issues, I can't wait to hear about folks experiences. As I'm getting older, the problems seem to be showing themselves less and less.  I've learned that age can sometimes be a good thing for acclimatization. While individual experiences will be helpful, in the end, the only thing that will matter is how you respond during the race.  Do you know how you respond when going higher? If not, maybe you can do some hiking/mountaineering trips to 13,000'.  Not sure where you live, so that may be harder then it sounds.  Since dealing with altitude is something you are interested in, you might find books like "Going Higher: Oxygen, Man, and Mountains" by Charles Houston M.D. and published by The Mountaineers to be a helpful read. Being able to quickly and accurately identify altitude related symptoms in myself has been critical over the years.  Before I read this book I would often mis-read my body's responses to the thinning air and end up hurting badly.  Once, while on a 14'er here in Colorado, I was unknowingly dealing with HAPE, coughing up blood, etc... and my partner had to almost drag me down the mountain. Big mistake! So I started reading as much as I could on the topic. And it has proved invaluable and has helped me become more successful on my adventures.

It seems like some people have issues, and some don't.  There are some physiological predictors that help to determine which camp you fall into, but I've never had any of the tests done.  I'm not sure it really matters though, because sometimes even folks that rarely have issues succumb, so I think it is really important when traveling in the high country to be knowledgeable of HACE and HAPE symptoms, and what to do when/if they appear.  Lots of folks will say, "Go for it!" because they want to encourage. I say "Go for it, but be prepared!"  Like the Czech mountaineers on Mt. Whitney recently found out, folks can and do become afflicted with HACE even at 12,000', and die.  It's a sad thing for family's and those involved that have to deal with these situations.  

So arm yourself with some knowledge, and better yet go on some biking/hiking/mountaineering trips to elevation if you can.  The CTR bug is a tough one shake. Once it got in me, it was all I could think about too!

[tonymason]

Itlquail,

I have a fair amount of experience with altitude related illness both personally and professionally. I am a family physician in Colorado and have spent a lot of time hiking and biking at altitude (including a 2 week mt bike tour of the CT)

Knowledge is vital. Like Bart said: learn all you can about AMS, HAPE and HACE. Houston's book is a good resource. While most every racer will suffer a little AMS, HAPE or HACE will take you out- possibly permanently. You need to be able to differentiate between these to race the CT safely.

Personal experience is very important. Have you been over 10000 feet? Doing strenuous activity? If not try to get up to high altitude before the race to see how you respond. A history of AMS is the second most common predictor for recurrent altitude illness. The first most common predictor you will all ready have- ascending to over 8000 feet rapidly.

Prevention is the key. The most important preventive measure is to ascend gradually. If at all possible spend 3 days at altitude before the start of the race. This allow your body to complete much of the important, initial acclimation before you start to max it out racing. Like Fred said: bike high but camp low. Sleeping below 10000 feet will help tremendously. Hydration is essential. Drink enough that you are peeing every 2 hours while racing. This is tough to do because you will be losing tons of water due to the exertion and the dry air. Eat loads of carbs. They should be you main source of calories.  Take preventive medication. Studies have shown Acetazolamide 125-250mg 2x a day and Dexamethasone 2-4mg 2x a day prevent AMS. You need to see your doctor for that. They both require a prescription and can have serious side effects. Over the counter Ginko might help too- the jury is still out on that.

Treatment is to get to lower altitude. Mild AMS you may be able to get through using the above preventive measures but severe AMS (or god forbid HAPE or HACE) is a game ender. I don't want to be discouraging. Echoing Bart "Go for it, but be prepared!" Prepared includes being willing to bail if the altitude really gets you.

Tony

[ltlquail]

Thanks everyone this is really great stuff. Unfortunately here in Australia there is no such thing as "real" altitude. Our highest peak Mt Kosciusko is 2228 meters so not much more than 7000 feet. I did used to XC ski competitively and spent much time racing at around 1500 meters with no issues but this is not what you would call altitude. I have spent time in the USA hiking around Mt Rainier and the Grand Tetons which has been much higher but I have never been more than 24hrs above 10000 feet. I noticed no ill effects these times but definitely could notice the the thin air.

I will definitely check out that book it looks like very interesting reading. Not knowing how I will react is my biggest fear but knowing what to do if I have problems is what I am after. It would be nice to leave with all the others but attempting the trail several days after the grand depart might be a more sensible option.

Thanks again for the advice it gives me lots to think about. Please keep the info coming! 

[tonymason]

Having been on Rainier and the Tetons without getting AMS is a good sign. It doesn't sound to me that you are particularly susceptible to altitude illness. Stick with those preventive measures as much as possible and I bet you'll do fine.
Tony

[Foster]

You could sleep in a hypoxic tent!  You'll get acclimated and loopy from hypoxia at the same time, fun.  My buddy has one for his high altitude mountaineering training.  I've used it before for a couple weeks sleeping at the equivalent of just under 17000 feet, for CC training.  It helped tremendously, especially racing at sea level.  17000 feet is about the maximum altitude that the human body can adapt to.  This is definitely excessive for mountain bike training IMO but just thought I would throw it out there.  There is also a lot of debate about sleeping high training low or sleeping low training high, and which is the best way to optimize acclimatization and body repair. 

[bartspedden]

Just out of curiousity, what is "CC"?

[Foster]

Cross Country-CC

[sanjuanrider]

I battle High Altitude sickness about once every year and try to watch out for the signs of it.  I live very near the start of the CTR (Aprrox. 5600' above sea level) and ride the trail a lot.  When I did the CTR in knew the main things to keep me healthy from getting AMS where to stay very hydrated, and be in the best shape of my life. With several days of acclimatization at higher elevations 7000' or above close to the race start and staying hydrated you should be good.  As Bart mentioned as you get older you have less problems with AMS.  From the research I have done on it - it appears the mid 30's age tends to have more problems than other years (not sure why). Having said that I never got AMS when I did the CTR at age 38 but got it 5 months later on a very simple hike at 9000 ft.  I relate it more to hydration more than anything.

[stevage]

I've been to altitude twice: once, a few weeks in Bolivia/Peru, where I suffered moderate symptoms. More recently I went cycling in India, 8 days ranging from around 2200m to 4500m (mostly 3000ish). Very few symptoms other than expected shortness of breath, general feeling of unfitness. I think the big difference was taking "altitude pills" religiously throughout. On our second day we rode from around 2200 to 3300m, which was a bit of a shock but not terrible. That wasn't a race though

I agree with the advice that it's very sensible to have plan B's worked out - losing altitude is the only solution to severe altitude problems.