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christensent
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PostSun May 12, 2019 5:15 pm 
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One of my hiking/climbing partners has several times woken up on the second day of an alpine adventure (midnight-4am starts) and upon drinking any water at all or eating any snack, almost immediately vomits and sometimes other indications of digestive problems. For hours after, if any food or water is consumed at all, minutes later it is lost to vomit. General exhaustion and dehydration results and we have to immediately get down before it gets worse and the weather heats up.

This has happened on three trips, camps on these have been at 6.5k, 8k, and 10kft. Wondering if altitude could be related, but 6500ft is very low for that.

After a rest in the car on the drive home, she can keep food/water down but sometimes feels sick for a day.


Obviously this is a pretty serious situation in the alpine environment and she will consult medical professionals, but I'm curious if anyone has any experience with this/what might make it better?

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Learning mountaineering: 10% technical knowledge, 90% learning how to eat
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Anne Elk
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PostSun May 12, 2019 5:30 pm 
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It's impossible to comment on this without a lot more information. How much climbing experience?   Past history of symptoms at altitude?  Pre-existing digestive issues?  I think anything we could say here wouldn't be much more than conjecture and guessing.  Perhaps she could consult with someone expert in high-altitude medicine to inquire about lower limits of some altitude symptoms. It could even be psychological.

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"There are yahoos out there.  Itís why we canít have nice things."  - Tom Mahood
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texasbb
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PostSun May 12, 2019 6:25 pm 
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Anne Elk wrote:
It could even be psychological.

Nerves maybe?
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Anne Elk
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PostSun May 12, 2019 6:34 pm 
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It could absolutely be that if she's inexperienced, or not confident in the partner(s), etc.  The only symptoms I ever experienced at those lower altitudes (like flying to somewhere higher) was fatigue; and on hiking trips, hypoglycemia if I hadn't eaten enough, which does weird things to your head space.

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"There are yahoos out there.  Itís why we canít have nice things."  - Tom Mahood
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olderthanIusedtobe
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PostSun May 12, 2019 8:36 pm 
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Used to have a semi-regular hiking/climbing buddy that got the pukies fairly often.  I didn't know what caused it, not sure if he figured it out eventually.
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gray matter
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PostSun May 12, 2019 10:12 pm 
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Iíve had an experience like this just once.  I was not in particularly great shape for the trip I chose, I got slowed down by a storm, and ended up doing an emergency bivy because I was unable to make it back to my gear cache.  The following morning, I couldnít keep anything down.  What should have been a 2 hour hike back to my gear was a 4 hour slog.

Upon returning to my cache, I made some Top Ramen and super-saturated Gatorade.  I was able to keep that in my stomach.  So, in my case, I attribute my experience to dehydration and loss of electrolytes.  Perhaps, your partner might try some electrolyte tablets periodically on the first day of the climb to see if that helps.
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slabbyd
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PostMon May 13, 2019 5:32 am 
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Happened once to a partner of mine.  We concluded that navigation in the light cone of a headlamp for a couple hours just messed with his equilibrium.   Or maybe he was just lite.
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Sculpin
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PostMon May 13, 2019 6:54 am 
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Using any electrolytes in the water?

Its possible this could be cured with Gatorade.  Salty snacks are not a substitute for me.

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Even my best friends, they don't know, that my job is turning lead into gold. When you hear that engine drone, I'm on the road again, and I'm searching for the philosopher's stone - Van Morrison
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moonspots
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PostMon May 13, 2019 9:17 am 
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gray matter wrote:
...So, in my case, I attribute my experience to dehydration and loss of electrolytes.† Perhaps, your partner might try some electrolyte tablets periodically on the first day of the climb to see if that helps.

I'm going to suggest that this might be the base of the problem. On my first two "big" mountain summits, I could have benefited from this knowledge. Now I know.

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"Out, OUT you demons of Stupidity"! - St Dogbert, patron Saint of Technology
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Mikey
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PostMon May 13, 2019 4:14 pm 
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Obviously something is triggering her vomit "button".
Your vomit control system is connected to your chemoreceptor zone.  This chemoreceptor zone in your brain monitors your senses of smell, taste, and sight and your equilibrium.  The Chemoreceptor Trigger Zone  is an area of the brain medulla oblongata that receives inputs from blood-borne drugs orhormones, and communicates with other structures in the vomiting center to initiate vomiting.  The Chemoreceptor Trigger Zone  is located within the area postrema, which is on the floor of the 4th ventricle and is outside of the blood-brain.   This integrates the emetic (vomiting) response.  This is the area in which "a final decision is made" about whether to evoke an emetic (vomiting) response or not.  This decision is based heavily on the information which the Chemoreceptor Trigger Zone  relays to the rest of the vomiting center, but also the chemoreceptors in the GI Tract, the information sent to the vomiting center by the Vestibular system, and higher order centers located in the cortex.  The vomiting center is not a discrete or specific place in the brain, but rather an area consisting of many nuclei, axons, and receptors that together cause the physical changes necessary to induce vomiting. Also, emesis (vomiting) can occur by direct neural stimulation of the vomiting center.
Motion sickness (sea sickness) can trigger vomiting.
In my experience of leading many mtn climbs, I have never had a climber vomit (a few felt poorly, possibly out of shape).  Strange that drinking some water initiates vomiting.  That seems to imply that something is bothering the intestinal system.  There is a nerve (vagus nerve) that goes from the intestinal system to the brain. One problem with the vagus nerve is called gastroparesis, and common symptoms include nausea, heartburn, bloating, and vomiting.  It is interesting that my Mountaineering First Aid Instructor course did not cover this situation.  Wilcox's Mountaineering Medicine book's section on vomiting does not appear to have anything similar to this situation.
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wanderwild
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PostMon May 13, 2019 8:48 pm 
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Happened to me once when I was a young and dumb 19 year old before a Rainier climb. But large amounts of whiskey was the culprit that day. Barely squeeked through the climb running on shame and self hatred alone. Some people have to learn lessons the hard way, and I was one of them on that day. These days I respect objectives (and my body, and the bottle) a bit more.

Just an anecdote, not suggesting your friend is a closet boozehound. But whatever the reason, self inflicted and avoidable or not, puke sick in the alpine is NOT fun. I hope they figure out a solution.

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Grannyhiker
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PostTue May 14, 2019 8:50 pm 
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This identical symptom happened to my late dog on a 2010 Wind Rivers trip.  The morning of Day 2, he upchucked once, lost his breakfast.  (He had this sensitive Lab stomach, so it had happened occasionally at home in the past.)  We took it easy on that day and I withheld food but not water, the usual treatment.  The morning of Day 3 he upchucked several times, even after his stomach was empty.  I promptly turned around and aborted the trip.  However, with tiny feedings every few hours, he recovered just fine.  I still don't know what was wrong; we were at 8,000-8,500 feet altitude, and the previous year we got to 11,000 without problems.  But at least it didn't turn out to be one of the serious canine conditions (like gastric torsion or bowel obstruction) that can cause vomiting.  We never were at that high an altitude again, so I have no idea if it was the altitude or something else.  My vet speculated that he was gulping his food and water too fast and swallowing lots of air, which triggered the vomiting reflex.

Aborting the trip actually turned out to be a good thing, because if on schedule, we would have been stuck at 11,500 feet in foot-deep snow!  (This was  mid-August.)

I don't want to draw any parallels between my dog and your climbing partner, although it's interesting that they had similar symptoms!  Like others here, I'd suggest a physician specializing in altitude issues.  Has she ever tried diamox?

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May your trails be crooked, winding, lonesome, dangerous, leading to the most amazing view.--E.Abbey
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