images2images

Precautions and Considerations

image

Enjoying a hard-earned lunch on the summit of Mt. Whitney

While a hike up the Mt. Whitney Trail is generally considered a fairly safe endeavor, there are some things you should take into account before departing from Whitney Portal. All of the major concerns are outlined in this chapter. Indeed, all of the items listed (even bears, though rarely) do injure people on this trail each year. Some of the concerns described here are serious medical issues that can result in an emergency situation (e.g. hypothermia and altitude sickness), while others are mostly nuisances (e.g. blisters). However, since all can keep you from reaching the summit, you’ll want to minimize their impact on your trip and learn to recognize early on when discomfort can morph into a dangerous condition.

Perhaps it’s because of my background in science, but when I am in the mountains, I like to remind myself of the term “homeostasis.” It is defined as the maintenance of a stable internal environment in the body, despite changes in the external environment. As you hike up Mt. Whitney, the external environment is constantly shifting: Oxygen availability and temperature decrease with altitude, but your cells need constant amounts of oxygen and your internal temperature must be maintained at a constant level. In addition, your blood sugar must be maintained, and the concentration of sodium ions, potassium ions, and many other ions must also be maintained at a constant level. Although the body does a very good job fine-tuning internal conditions, you have to supply it with the essential materials: oxygen, food, and water.

ACCIDENTS AND INJURIES IN THE SIERRA

If you need one last push to read this section, visit the websites described below. They provide you with real-life stories of injury and death in the Sierra Nevada and generally strike home the reality of dangers in ways describing the medical conditions cannot. The Inyo Country Search and Rescue Team website provides details of many accidents and rescues that have occurred on Mt. Whitney (and other Sierra peaks) since approximately 2003 (see www.inyosar.org, and look under “missions”). In addition, the “What can go wrong on Mt. Whitney” topic on the Whitney Portal Store website (www.whitneyportalstore.com; thread number 39077) is a great source of information.


It is also important that you have the knowledge, experience, and gear to appropriately respond to changes in your external environment. This section covers the essential considerations you need to make to avoid physiological problems like altitude sickness, hypothermia, dehydration, electrolyte depletion, as well as other potential hazards like lightning, injuries, blisters, and bears.

Altitude Sickness

The International Society for Mountain Medicine, a group that encourages research on and shares information about mountain medicine, advises its members to abide by its first golden rule of visiting alpine environments: “If you feel unwell at altitude, it is altitude illness until proven otherwise.” Altitude sickness is the hazard most likely to affect you on your hike up Mt. Whitney. According to one study conducted during July and August 2006, more than half of the people attempting to summit Mt. Whitney via the Mt. Whitney Trail suffered from the form of altitude sickness known as Acute Mountain Sickness (AMS), a collection of symptoms, including a headache, that occur when a person rapidly ascends to high altitude.

Many people on the Mt. Whitney Trail plan a rapid ascent (and descent), thinking they don’t need to worry about the more severe forms of altitude sickness, High Altitude Cerebral Edema (HACE) and High Altitude Pulmonary Edema (HAPE), because these usually take more than 12 hours to develop. Just keep the “usually” in mind; there are cases of HACE and HAPE along the Mt. Whitney Trail, and they often require emergency evacuations. Even relatively mild AMS can impair your judgment, and there is no way to quantify how many accidents are due to poor decisions people made because of AMS.

What follows is a description of how the body responds to decreased oxygen availability and a summary of the symptoms of AMS, HACE, and HAPE. This information is an overview only; if you wish to learn more, I strongly recommend Charles Houston’s Going Higher (Mountaineers Books, 2005) and the website of the International Society for Mountain Medicine: www.ismmed.org/np_altitude_tutorial.htm.

CAUSES OF ALTITUDE SICKNESS

The root cause of altitude sickness is hypoxia, the insufficient supply of oxygen to the body’s tissues. The Earth’s atmosphere becomes thinner at higher elevations because, with increasing altitude, there is less weight, and therefore less pressure, exerted by the atmosphere above. As a result, the air at high elevation is lower density than the air at sea level, and thus gasses in the atmosphere, including oxygen, are more spread out. At the summit of Mt. Whitney, there is 58 percent as much oxygen in a given volume as there is at sea level.

Hemoglobin is the protein in red blood cells that carries oxygen to all of the body’s cells. As the partial pressure of oxygen in the air you breathe decreases, the amount of oxygen hemoglobin carries to your cells decreases, hence the hypoxia.

In response to the low barometric pressure and low oxygen pressure, the body secretes stress hormones, which affect different parts of the body differently. In the brain, stress hormones cause increased blood flow and hence increased blood supply (and blood pressure) to the capillaries, the smallest blood vessels, in the brain. The increased blood pressure causes the capillaries to leak, which leads to swelling (edema) of the brain tissue. HACE occurs when this swelling is particularly severe. In the lungs, the elevated stress hormone activity causes constriction of the pulmonary vessels, thus increasing resistance to blood flow. In some cases, this leads to increased fluid leakage from the capillaries into the tissues and air spaces (alveoli) in the lungs, reducing the area across which gas exchange can occur and causing HAPE. Also contributing to the body’s responses to hypoxia are hormones secreted from the kidney that cause sodium (salt) retention, which in turn causes fluid retention and swollen hands and feet.

Age, genetic factors, level of exertion, and the elevation at which you live appear to be the best predictors of susceptibility to altitude sickness. Anecdotal evidence suggests that teenagers and young adults are more susceptible to altitude sickness than young children or older adults. However, altitude sickness is fickle, affecting the same person differently on different occasions. Even very fit people get altitude sickness. All of which indicates physicians still don’t know what makes a person prone to altitude sickness. One study showed that people with more space between their brains and skulls are less susceptible to altitude sickness, because their brain can swell a little without pushing against their skull.

SYMPTOMS OF ALTITUDE SICKNESS

Acute Mountain Sickness (AMS) is actually a collection of symptoms on a continuum that, at its more severe end, includes High Altitude Cerebral Edema (HACE). If you are at high elevation, you by definition have AMS if you have a headache together with one or more of the following symptoms:

Other symptoms that may occur when you have AMS include apathy, paleness or sick appearance, shortness of breath, low urine output, and edema of the ankles.

HOW THE BODY ACCLIMATES TO HYPOXIA

The body uses many interlinked processes to compensate for hypoxia, some immediate and some longer term. These allow most individuals to successfully acclimatize to elevations of about 17,000 feet over the course of a month. On a long weekend climb of Mt. Whitney, your body will just be starting to adjust, which is why it is important to begin acclimatizing in advance. Three processes important to acclimation are:

Hyperventilation: At higher elevations, there are fewer oxygen molecules in each breath. This leads to an increased rate of breathing, known as the “hypoxic ventilatory response.” This continues for many weeks at altitude and is very important for maintaining higher blood oxygen levels.

Increased blood alkalinity and increased output of bicarbonate in urine: Breathing faster causes the blood to offload more carbon dioxide to the capillaries in the lungs, increasing blood alkalinity (higher pH). However, higher blood pH leads to a negative feedback response: a decreased rate of breathing countering the hypoxic ventilatory response. Since the body needs to maintain the high breathing rate to take in more oxygen, it must counter the higher blood pH. It does this by excreting bicarbonate, an alkaline compound, via the kidneys, shifting blood alkalinity back toward normal. This relatively slow response continues for several days and is probably the main form of acclimation on a trip that lasts between a few days to a week.

The prescription drug acetalzolamide speeds up this process (and allows it to begin at low elevations) by increasing bicarbonate excretion and by increasing blood carbon dioxide levels, thus causing increased ventilation and increased intake of oxygen. It is also a diuretic and enhances sodium excretion, helping to decrease peripheral swelling.

Increased red blood cell count: Although this response begins immediately, it takes your body many weeks to increase its red blood cell count sufficiently to offset the decrease in oxygen pressure.


HACE, a severe form of AMS, is characterized by more acute edema in the brain. In addition to more extreme symptoms of AMS, individuals with HACE have mental confusion and a loss of coordination. If a member of your party appears to be developing these symptoms (e.g. cannot walk in a straight line), he or she must descend immediately. HACE can lead to death within hours to days.

HAPE symptoms include a cough, decreased performance, chest congestion, and shortness of breath while at rest. The often mentioned symptoms of severe respiratory distress, coughing of blood, and gurgling sounds in the chest occur later in the progression of the condition. As with HACE, an individual with these symptoms must descend rapidly. The greatest number of altitude sickness fatalities are due to HAPE. HAPE is more common in men than in women and can appear in people well acclimatized to high elevations who have descended to low elevations for just a few days and then reascend.

PREVENTING ALTITUDE SICKNESS

There are many actions you can take to reduce the likelihood of AMS symptoms:

MEDICAL TREATMENTS FOR ALTITUDE SICKNESS

Although it’s by no means necessary if you prepare and acclimate properly, many people climbing Mt. Whitney elect to take medication—mostly aspirin/ibuprofen, and occasionally prescription drugs—in hopes of decreasing their susceptibility to altitude sickness. Some of these medications are described below. Note: I do not recommend taking medications to prevent altitude sickness. If you choose to pursue any drugs, prescription or otherwise, please do so under the care of a medical doctor, and be sure to research the contraindications and side effects of any medication you plan to take.

Aspirin and ibuprofen: Both of these anti-inflammatory drugs help relieve headaches, although many people prefer ibuprofen because it is effective in smaller doses. Taking an anti-inflammatory drug prophylactically may prevent you from feeling lousy due to a headache. If you feel better, you also tend to eat and drink more, which may further minimize altitude sickness.

Acetazolamide: This prescription medication (the main brand name is Diamox) gives your body a head start acclimatizing by acidifying your blood. Common side effects include more frequent urination and a tingling sensation in your toes and fingers. People who are sensitive to sunlight or sulfa drugs may have additional side effects and should consult a doctor about their allergies and sensitivities.

Dexamethasone: This prescription drug is a corticosteroid thought to stabilize edema in blood vessels. It may therefore decrease brain swelling and is used to treat severe symptoms of AMS and HACE, but not HAPE. Dexamethasone is usually carried on high-altitude expeditions. Some doctors also prescribe it as a preventative medicine against altitude sickness. Side effects can include an upset stomach, high blood sugar, and mood changes.

Hypothermia

Hypothermia is a potentially lethal condition that results from an abnormally low body temperature. Usually presumed to occur at cold temperatures, it can happen at an air temperature as high as 70°F, especially if the person is wet from rain or sweat and/or the conditions are windy. Since temperatures on the Mt. Whitney Trail between Trail Camp and the summit rarely rise above 70°F, hypothermia is a condition to take seriously when planning your hike. Hypothermia can occur with little warning and rapidly leads to a loss of mental function, which is why you must be aware of the early symptoms. You should constantly monitor yourself and group members for symptoms of hypothermia if attempting the summit on a cold, wet, or windy day. It is because of these very real dangers that you should carry extra clothes and a space blanket up the mountain.

Hypothermia sets in when the core body temperature drops below 95°F, only a 3.6°F decrease from normal. The first symptom is shivering—the body’s attempt to rewarm itself. Signs of confusion and difficulty speaking may occur when the core temperature drops below 94°F. In the advanced stages of hypothermia, shivering stops, the body’s core temperature drops below 90°F, and a person may no longer feel cold. He or she will become incoherent, with severely limited judgment. Death can result if your body temperature drops below 80°F.

Mild hypothermia can be treated in the field, while severe hypothermia must to be treated in a medical facility so the patient can be rewarmed properly. Poor heart function and sudden cardiac death is possible if a severely hypothermic patient is not handled carefully. This makes it imperative to catch and reverse mild hypothermia before the condition worsens.

If an injury (or poor planning) forces you to spend a night on the mountain, if your clothes get wet in a storm, or if you are underdressed on a cold, windy day, you are at severe risk of hypothermia. Here are a few ways to minimize your chances of becoming hypothermic:

If you suspect someone in your group is hypothermic:

Hydration

Dehydration is yet another ailment that leads to headaches and low energy. The body needs to maintain a constant amount of water in its cells and tissues to function, as well as to effectively transport blood and oxygen to the organs. While hiking, you will lose water by urinating, by sweating, and during respiration. The latter can be greatly exacerbated at high altitude, because you breathe more rapidly and the air is very dry.

However, it is also unhealthy to drink too much water, which can upset the balance of electrolytes in your body. You must keep up with water loss, but do not overdo it. Some references suggest you drink 24 ounces of water per hour while walking—an amount that could lead you to consume 13.5 quarts during an 18-hour day. This is not realistic for most people and possibly not healthy due to electrolyte depletion (see the section on fuel). Indeed, even under much hotter desert conditions, 8 quarts per day is generally adequate, and 5 to 9 quarts during a one-day ascent of Mt. Whitney (or nearly twice as much during a two-day ascent) should suffice for most people.

WATERBORNE PESTS

Unless you plan to carry all the water you need for your hike (approximately 5 to 9 quarts), you’ll need to obtain water on the trail. The southern fork of Lone Pine Creek sees such heavy use that most hikers choose to treat water along the Mt. Whitney Trail to prevent contamination with protozoa like giardia or cryptosporidium or bacteria like E. coli. However, you are unlikely to contract a virus from water in the Sierra Nevada; viruses do not survive long in the cold, harsh conditions of the alpine environment.

If you choose not to treat your water, there are several sources that, until they intersect the Mt. Whitney Trail, do not pass through heavily used areas. They include a spring in Bighorn Park, east of Outpost Camp; the outlet from Mirror Lake; and the spring that appears about 400 feet above Trail Camp. (See articles by Dr. Robert Derlet and Dr. Robert Rockwell in the Yosemite Association’s “Nature Notes” archive for additional information on the purity of Sierra water sources: www.yosemite.ca.us/library/yosemite_nature_notes/.)

If you do choose to treat your water, keep in mind that different treatment methods kill or remove different microbes:


Initial signs of dehydration include thirst, a dry mouth, fatigue, dark urine, dry skin, and loss of appetite. As the condition worsens, you may note nausea, headaches, muscle cramps, increased respiration and heart rate, and decreased sweating and urination. If a member of your group gets dehydrated, have that person take a break and slowly drink water with electrolytes. Severe dehydration requires medical attention.

Food

You will burn approximately 6000 calories during your one-day ascent of Mt. Whitney and about 9000 calories during a two-day journey. Although you’re unlikely to consume that many calories on your walk, don’t skimp on food to save weight.

Food provides the body with the molecules the cells—including the cells in the muscles—use as energy. Food is also the body’s source of various ions, or electrolytes. It’s important to eat frequently as you exert yourself, because your muscle cells will run out of glycogen, the form in which they store carbohydrates.

“Electrolytes” is a catchall term for a collection of salts, including sodium, potassium, and calcium; the relative concentrations of these electrolytes is essential in maintaining nerve and muscle function, blood acidity, hydration, and the delivery of oxygen to your cells.

POOR METABOLIC FUNCTION

Metabolism is the sum of all the chemical and physical processes that occur in the body that turn the food you eat and the oxygen you breathe into energy that the body can use. These processes occur within the cells, and poor metabolic function can happen if there is an insufficient supply of food and oxygen to the cells, or if the cells are not effectively using the food and oxygen they receive.

The link between high elevation and hypoxia, a deficiency in the amount of oxygen reaching the body’s tissues, is obvious. However, other conditions, including dehydration, hypothermia, and electrolyte depletion also, by complex physiological pathways, cause poor metabolic function by affecting the supply of substances to the cells and the use of substances by the cells.

Since all of these conditions make cells less efficient at metabolizing food and oxygen, they physiologically reinforce one another, exacerbating the poor cellular function caused by other conditions. This means that if you are dehydrated or low on electrolytes, you are more likely to display symptoms associated with poor metabolic function. For instance, headaches at high elevation are generally attributed to altitude sickness. However, they are probably due, in part, to dehydration and not eating enough.


While your kidneys do a good job balancing the relative concentrations of the different electrolytes, they can do their job only if the electrolytes are present in your body. It’s up to you to consume sufficient food. As you hike, stop frequently and eat small amounts of food. If it’s a hot day and you are sweating a lot, it is a good idea to supplement the electrolytes (and sugars) in your food with electrolyte-containing energy drinks. Also be sure to drink electrolyte mixes if your appetite is diminished due to the altitude and exertion. Finally, beware of drinking too much water, which can throw off your electrolyte balance, especially if you’re not eating adequately.

HINT: I prefer the flavor of plain water while hiking, so instead of filling a whole bottle with an energy drink, I bring a small cup and bag of electrolyte mix and mix up a cup during a few of my longer breaks.

Lightning

From the upper switchbacks to the east of Trail Crest all the way to the summit of Mt. Whitney, the trail is exposed, leaving hikers vulnerable to lightning strikes. Moreover, should a storm suddenly develop, there is no escape route along these last miles. Byrd Surby, the first recorded fatality on Mt. Whitney, was killed by lightning near the summit in 1904, just eight days after the Mt. Whitney Trail was completed. Lightning on or near the summit has actually killed very few people, but more have been struck and sustained injuries of varying severity.

As described in the weather section, thunderstorms are much rarer in the Sierra Nevada than in most other mountain ranges, and it is often safe to be at high elevations throughout the day. However, on other days, it is imperative that you head down by noon.

Before you begin your hike, check the weather forecast at the National Oceanic and Atmospheric Administration website: Go to www.wrh.noaa.gov/vef, and click on a location due south of Bishop and a bit north of the latitude of Death Valley. If the probability of precipitation is 10 percent, it is my experience that you will stay dry 50 percent of the time, but you need to get a very early start to safely summit Mt. Whitney. If the probability of precipitation is even 20 percent, you will probably get wet and should accept from the outset that you may not be able to summit.

Regardless of the forecast, turn around promptly when you see tall, dark, flat-bottomed cumulonimbus (thunder) clouds nearby. Clouds can build very quickly: Scattered white clouds can evolve into a nasty storm in less than two hours, less time than it takes most people to hike round-trip from Trail Crest to the summit. It takes even less time for a seemingly distant storm to move overhead. If you hear even distant thunder, head down quickly. In clear air, thunder can be heard from a distance of approximately 10 miles. (While lightning can move vertically through the sky and can strike while there is clear sky above, this is rare and is not a major concern.)

Lightning occurs to alleviate charge imbalances between the clouds (usually negative) and the ground (usually positive). These imbalances develop because negative and positive charges are separated within clouds, leading to charged water molecules. The negative charges within a thundercloud cause equal positive charges to develop on the ground. Negatively charged “leaders” descend from the cloud and can lead to a much stronger return strike if they drop to within 100 feet of the ground. Most lightning strikes occur at the beginning and at the end of a thunderstorm. Also, you generally have a brief “safe” period to move after a nearby lightning strike, before the ground charges redevelop.

PROTECTING YOURSELF AGAINST LIGHTNING

In 1990, after a lightning-caused fatality in the summit hut (and a subsequent lawsuit), the hut was retrofitted. It was grounded with wires and a wood floor was installed to insulate visitors from the ground. Nonetheless, it is still recommended that you do not sit out an electric storm inside the hut. Instead, should you be caught near the summit in a lightning storm, follow the tips described here to help minimize your chances of being struck and to reduce the risk of sustaining severe injury if you are struck. Once a storm is overhead, it is more important to follow these rules than to try to reach lower ground:

TREATING LIGHTNING INJURIES

Should a member of your party be struck by lightning and stop breathing, immediately begin CPR. CPR is more likely to be successful following a lightning strike than many other injuries, as the electrical shock can stop a person’s heart from beating without actually causing much internal damage. Indeed, 80 percent of strikes are not fatal. (But be prepared to continue CPR or rescue breathing for a long period of time.)

Treat burns by immersing small wounds in cool water (or if available, run cool water over the wound), applying antibiotic ointment to the wound, and covering it with a sterile gauze pad held in place with tape. Plan evacuation and seek medical attention immediately.

For more information about lightning safety, look for the guidelines produced by the National Outdoor Leadership School at www.nols.edu.

Falling and Knee Problems

A common ailment on the Mt. Whitney Trail is knee problems, especially during the steep descent. Don’t be tempted to run down the trail for an earlier dinner or because you continued to the summit after your turnaround time: Most injuries occur at the end of the day, when you’re tired.

The two best ways to avoid knee problems are to walk slowly and to use trekking poles. Walking slowly puts less force on your knee with each step, and using trekking poles takes some weight off your knees. And a bizarre suggestion: Especially if you’re wearing a heavy pack, turn around to walk down those occasional really tall steps backward, which significantly reduces the pressure on your knees by employing the stronger muscles of your upper legs. While I can’t tell you how much this reduces strain on your knees, it helps me tremendously, and I have converted many friends. Also, if you have knee problems, wear a knee brace.

If you do twist a knee, stop promptly and take anti-inflammatory drugs (such as ibuprofen or naproxen). You may choose to wrap your knee with the elastic bandage in your first-aid kit, but don’t wrap it too tightly. Then continue (slowly!) down the hill, with the help of your group members and perhaps some trekking poles as crutches. (If you twist an ankle, using sports tape is better than using an elastic bandage, as the elastic bandage will provide less stability and support.)

Blisters

Even with broken-in, comfortable shoes, it is easy to get blisters when ascending (and descending) more than 6000 feet and hiking 21 miles. However, there are many tricks to minimize the severity of blisters and to tackle hot spots are soon as they begin to form. For instance:

The book Lightweight Backpacking and Camping (Beartooth Mountain Press, 2005) has many suggestions for reducing the possibility of injuries, especially blisters. Preventative measures include treating your feet with alcohol for the week before a long hike to toughen your foot and applying Tuf-Skin to your feet before your walk.

If a blister should develop, treat it promptly. Some people are content taping over small blisters with a piece of sports tape, but it is often better to apply blister bandages or a piece of moleskin, followed by sports tape. An old trick is to cut a piece of moleskin into a donut shape, such that the blister is surrounded by a raised ring of moleskin, although many people now use blister bandages. Large blisters are best drained with a sterile pin before patching. Blisters on toes can be very difficult to treat, as taping one toe often causes a blister on the neighboring toe when the tape (or other blister treatment) rubs. Another option is to tape a toe blister with thin tape to minimize rubbing and to proactively tape the neighboring toe.

Bears

The American black bears’ taste for human food makes them a big nuisance along the Mt. Whitney Trail. But unless you’re fighting them for your food, they are not a danger to humans. Despite their name, black bears come in a variety of colors, including tan and brown. As a result of human visits as well as human food in the high-elevation Sierra Nevada, these smart and highly adaptable creatures have expanded their range upward in these mountains. Historically found predominately in the mid-elevation conifer forests of the western Sierra, black bears now roam up to the Sierra Crest and along many of the eastern Sierra drainages, including Lone Pine Creek.

During the 1990s, hikers increasingly returned to trailheads with shreds of stuff sacks and food wrappers. As a result, hikers visiting many parts of the Sierra, including the Mt. Whitney Trail, are now required to carry bear-resistant food canisters (see for more information). Thankfully, the strict food-storage policies are working: At least 95 percent of hikers are complying with the regulations, very few people are losing food, and, in some locations, bears appear to be retreating to lower elevations. When camping, make sure your food is always by your side during the day, and lock your food canister promptly when you finish preparing your meals. This is especially important at Trail Camp, where you will find quite aggressive marmots and ravens, and they aren’t about to relocate to lower elevations.

image