High Altitudes

Altitude Sickness

IMG 1975The Machame Route begins at 1800 meters (5900 ft) above mean sea level. On the first day you hike up to an altitude of around 3000 meters (9800 ft). This continues over the next few days as you hike up to an altitude of nearly 5900 meters (approx. 19,000 ft). At this altitude every breath you take supplies only 50% of the oxygen contained at near sea level altitudes (that's really not very much). Not only is there markedly less oxygen available, but the efficiency with which your body assimilates the oxygen has decreased also... "the double whammy". This can have very serious health consequences if proper (i.e. gradual-) acclimatization has not occurred.


Conventional recommendations

According to nearly every piece of information I dug up you can't train for altitude. You basically have only the following options: (see the Links-page for detailed information)

  • acclimatize gradually according to recognized standards
    (this is only conditionally feasible on the Kilimanjaro routes)
  • Drink lots and lots of water while on the hike.
    (The high level of exertion and dry air make this a very sound idea.
    Getting supplied with sufficient quantities of water on a Kilimanjaro trek is not an issue.)
  • Hope that you're not one of those poor souls that is particularly susceptible to altitude sickness.
  • Consider taking Diamox.
    (Due to the reported side effects and possible serious allergic reactions I categorically refused to take Diamox.)

After reading many Kilimanjaro journals, which quite often, sometimes proudly recounting numerous episodes of severe headaches, vomiting and other symptoms of altitude sickness I wasn't feeling very comfortable. The probability of not being afflicted with altitude sickness seemed to me to be too chancy. But I was a Boy Scout and still believe in the motto "Be prepared"... Further research led me to the following, apparently not widely known alternative:

Normobaric Hypoxic Altitude Training

Internet research eventually led me to the subject of athletes improving their overall performance by training under low oxygen conditions at normal altitudes (normobaric hypoxia). There are numerous other applications for low oxygen training. The application which caught my particular interest is that normobaric hypoxic training can be used to prepare one's body for the conditions encountered during exertion at high altitudes.

Living in Germany's Rhein-Main region I was fortunate in finding a nearby clinic "B.A.S.E." located in Mainz which offers such services. Under the friendly and highly qualified medical supervision of doctors Sonja- and Hermann Claus, I was to become prepared not only physically but also mentally.

IMG 1622After an initial fitness test 2 months prior to Kilimanjaro, suggestions were made as to how I should best structure my cardio-training. In my particular case this involved increasing the time spent on my elliptical trainer from 30 minutes up to 60 minutes every other day, while keeping my heart rate in the range between 90-105bps rather than the 135bps I had been doing.

Two weeks prior to Kilimanjaro I had daily one-hour sessions of altitude simulation. The first 4 days involved just relaxing in a comfortable chair while breathing air with a reduced oxygen content (e.g. simulated 3500m altitude). With the aid of a pulse oximeter, which measures pulse rate and the blood oxygen saturation, my body's response and subsequent acclimatization to the reduced oxygen level was monitored.

Starting on about the 5th day I got up out of the chair and was put on a treadmill. During the following sessions my body was learning to cope with the reduced oxygen level under "operating conditions". From a psychological standpoint I was becoming increasingly aware of my body's reaction to varying workloads and was learning to listen when my body said to "slow down" a bit. As I was told: "When climbing Kilimanjaro you have no influence over distance, steepness of trails or altitude, but you can chose your own pace !" This corresponds exactly to what one hears numerous times from the Kilimanjaro guides and porters: "Pole´, Pole´" (go slowly, go slowly).

All in all I'm very pleased with the results of my visits to B.A.S.E.
It was in the final moment of summiting that I first realized that I had experienced no symptoms of altitude sickness whatsoever... no splitting headache, nausea, vomiting or any other scary thing.
What I did experience though was the extreme exhaustion of the climb itself in conjunction low oxygen levels and an overwhelming lack of sleep from the long summit night (beginning at midnight).