Guru Magazine - - Contents - HE­LEN KNOWLES

Go­ing ski­ing this win­ter? Or does the thought of al­ti­tude sick­ness give you cold feet? He­len Knowles ex­plains why go­ing too high can re­ally bring you down – and what to do about it.

Chill out

When you first ar­rive, your body quickly adapts to high al­ti­tude by in­creas­ing your rate and depth of breath­ing, as well as in­creas­ing your blood pres­sure and heart rate. If you pause for a mo­ment and take your pulse when you get to the lodge, you may even no­tice that your heart has sped up. As the days pass, the body will start to pro­duce more of the hor­mone called ery­thro­poi­etin (bet­ter known as EPO). It is a pow­er­ful sub­stance: many Tour de France cy­clists, Lance Arm­strong in­cluded, have in­jected ex­tra EPO doses to im­prove their per­for­mance in the moun­tains. EPO stim­u­lates the pro­duc­tion of more red blood cells, which in­creases the oxy­gen-car­ry­ing ca­pac­ity of the blood, in­creas­ing oxy­gen de­liv­ery to the mus­cles and there­fore mak­ing you more ‘fit’. It nat­u­rally takes a while, but by the end of the week, you’ll be fly­ing down those slopes! It’s just cruel for­tune that, by then, it’ll be time to head back home.

From highs to lows: moun­tain sick­ness

So while most of us get out of puff and tired more than usual, an un­lucky, but rel­a­tively small, num­ber of peo­ple ex­pe­ri­ence some­thing much worse when ar­riv­ing at the ski re­sort – al­ti­tude sick­ness. If you get it, you will know about it in the first day: symp­toms usu­ally start within ten hours of as­cent. A bad headache is usu­ally the main symp­tom, and it can feel like you’ve caught the ‘flu: fa­tigue, feel­ing sick, lack of ap­petite, not sleep­ing well and light-head­ed­ness. Un­for­tu­nately, this is made all the worse for the keen skier suf­fer­ing from al­ti­tude sick­ness by a rapid as­cent (as you ex­pe­ri­ence on the road trans­fer to the re­sort), ex­er­tion (ski­ing), and al­co­hol (due to the knock-on ef­fects of de­hy­dra­tion). The best way to avoid al­ti­tude sick­ness would there­fore be to ski gen­tly (if at all), eat lots of starchy foods, drink plenty of wa­ter and avoid al­co­hol for the first few days of your trip – even if this may lead to a rel­a­tively dull start to the hol­i­day. It’ll be worth it be­cause get­ting al­ti­tude sick­ness can be se­ri­ous and can only be ‘cured’ by de­scend­ing to a lower al­ti­tude. And need­ing to leave the re­sort would make you a real par­ty­pooper.

Beat­ing down the cold

One of the other chal­lenges with be­ing on a moun­tain­side in win­ter is that it is cold. Very cold. This chill keeps all the snow light and fluffy and makes for fan­tas­tic ski­ing – which is great, as long as you can keep warm. Shiv­er­ing with cold will se­ri­ously hin­der your ski­ing abil­ity, no mat­ter how fit and ac­cli­ma­tised you are. Un­der nor­mal con­di­tions, your body is bril­liant at keep­ing its in­ner body tem­per­a­ture at about 37 oC. oC. In cold en­vi­ron­ments (just like at high al­ti­tudes) the body needs to make sev­eral in­ter­nal ad­just­ments to help keep you alive. The first – and prob­a­bly the most im­por­tant – change is what what

you you do. do. When your brain tells you that it’s cold enough to freeze the nose off a po­lar bear, you put on warm, in­su­lat­ing clothes to keep you feel­ing cosy (which, if you’re a skier, come in lots of bright colours you wouldn’t nor­mally be seen dead in…).

If you’re no t warmly wrapped up enough, your body’s first re­ac­tion is to nar­row the sur­face blood ves­sels to re­duce blood flow through the skin. This makes your skin look pale and means

that less heat is lost from your skin. Un­for tu­nately this oc­curs at the cost of pro­gres­sively painful cool­ing of the ex­trem­i­ties, es­pe­cially the hands and feet. Some peo­ple are more prone to this painful numb­ing than oth­ers. Per­son­ally, I take this as an op­por­tu­nity to rapidly bring out the boot-warm­ers! The next re­sponse to cold in­volves you do­ing odd things: you jump up and down, flap your arms, stamp your feet, and gen­er­ally look silly in or­der to in­crease your ac­tiv­ity level. This is very ef­fec­tive in the short-term: in­creased mus­cle ac­tiv­ity pro­duces heat and makes you feel more com­fort­able again. Shiv­er­ing has the same sort of ef­fect. How­ever too much ac­tiv­ity, es­pe­cially un­der all those clothes, will cause you to sweat. And sweat­ing will cool you down fur­ther. You just can’t win some­times! If you’ve reached this sweaty, shivery point then now is the time to de­clare that enough is enough and point your skis down the moun­tain. There re­ally is no bet­ter ex­cuse for re­ally need­ing need­ing a hot choco­late or vin chaud.

But it’s worth it…

Af­ter all that, it might seem like my con­clu­sion is that al­ti­tude and cold are hor­ri­ble, can make you ill, and are gen­er­ally un­com­fort­able. Maybe… but tak­ing it easy, be­ing pre­pared and mak­ing the most of a few bits of com­fort­ing tech­nol­ogy (oth­er­wise known as hot choco­late stops, head­ing for home when you get too cold and get­ting qual­ity ski cloth­ing and boot warm­ers) are more than up to the task of com­bat­ting th­ese en­vi­ron­ments. And let’s face it, th­ese high, cold, snowy places re­ally are the per­fect win­ter play­ground for grown-up kids. I, for one, can­not wait to step into my skis at the top of the world in search of a win­ter adren­a­line-rush.


Dhillon, S. (2012) En­vi­ron­men­tal hazards: hot, cold al­ti­tude and sun. In­fec­tious Disease Clin­ics of North Amer­ica

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