High Altitude Headaches

Anyone else get massive headaches on Day 1 of a big day at elevation (like 9,000 feet +) and then perfectly fine on day 2 and afterwards? I've been doing weekend trips from sea level to the High Sierra's for years, but it hasn't been until recently that I get a major headache half through day 1 that is almost debilitating and then wake up fine on Day 2, still at elevation, ready to conquer the world, not breathing hard at all. This same scenario has played out on my last 4 trips. But I don't understand why it hits me so hard on day 1 and then I feel instantly acclimated the next day. 

Obviously, this is a form of altitude sickness. But based on all my research, acclimation takes at least 3-7 days to really sink in and up to two weeks to be fully acclimated. 

Does this happen to anyone else? What did you do to prevent the Day 1 headache?

This is normal altitude sickness, yessss.

Acclimation takes time, yessss.

... Acetazolamide / Diamox can speed up acclimation... 125mg twice daily (half of the 250mg tab they come as).

Edit: Some studies say it can decrease endurance performance at altitude and some say otherwise. At sea level it does decrease endurance performance.

The prevention is gradual acclimation, obviously. Hydration and some medications can help with the terrible feelings, but ultimately the definitive prevention is gradual acclimation.

Had it once, ruined my day 

Anyways, here is what science geeks say - 

For the study, 58 men and 28 women traveled to an area of the White Mountains northeast of Bishop, Calif. They spent the night at 4,100 feet and were given either 600 milligrams of ibuprofen or a placebo at 8 a.m., before heading up the mountain to a staging area at 11,700 feet. There, they were given a second dose at 2 p.m. Then they hiked about 3 miles up to 12,570 feet, where they received a third dose at 8 p.m. before spending the night on the mountain.

Of the 44 participants who received ibuprofen, 19 (43 percent) suffered symptoms of altitude sickness, whereas 29 of the 42 participants (69 percent) receiving placebo had symptoms, according to the study. In other words, ibuprofen reduced the incidence of the illness by 26 percent.

The researchers also noted less severe symptoms overall in those who took the drug compared with those in the placebo group. But this reduction in severity did not meet the researchers' predetermined statistical significance based on the self-reporting questionnaire that was used.

Here is a link if you enjoy big words - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5478153/ 

BTW - if you decide to take ibuprofen - make sure you drink lots of water.

Our physiology changes as we get older. Our body's response to altitude can change (sometimes dramatically) from year to year.

Is your fitness level the same? Just because you've done something before and know what to expect doesn't mean it's any easier on the body. I am guilty of this lax in attitude and have come to realize the older i get, the more effort i need to make in order to stay 'fit'.

jcs

Yes and it is miserable.

About 1 in 4 or 1 in 5 trips from the bay area to the High Sierra I get absolutely hammered. Usually starts some time during sleep the first night after driving up, and can be debilitating on day 1. Last time was on a mission to do the SW Face of Conness. I woke at 4 feeling like hell, headache got worse on the approach leading to vomiting. Toughed it out but couldn't fire up for the SW Face, ended up doing the W Ridge (carrying the #6, yes). It is a beast to push through that first day bc my body doesn't want food or liquid when it hits.

Incidence is total hit or miss: over the last years, fine on day 1 during trips to the Hulk, Temple Crag, 3rd Pillar, Cathedral/Matthess. Hammered on day 1 of Conness, a backpacking trip through Desolation, (sleeping at only 7k alt), cragging in Tuolumne.

That trip was the final straw for me, so talked to my doc and he prescribed Acetazolamide, a generic form of Diamox. 125mg tabs. This weekend will be my first time using it. Will report back. Usage reads:

Take 1 tablet by mouth 2 times a day starting 1 day before reaching high altitude, then continue for at least 2 days

Sirius wrote:

Yes and it is miserable.

About 1 in 4 or 1 in 5 trips from the bay area to the High Sierra I get absolutely hammered. Usually starts some time during sleep the first night after driving up, and can be debilitating on day 1. Last time was on a mission to do the SW Face of Conness. I woke at 4 feeling like hell, headache got worse on the approach leading to vomiting. Toughed it out but couldn't fire up for the SW Face, ended up doing the W Ridge (carrying the #6, yes). It is a beast to push through that first day bc my body doesn't want food or liquid when it hits.

Incidence is total hit or miss: over the last years, fine on day 1 during trips to the Hulk, Temple Crag, 3rd Pillar, Cathedral/Matthess. Hammered on day 1 of Conness, a backpacking trip through Desolation, (sleeping at only 7k alt), cragging in Tuolumne.

That trip was the final straw for me, so talked to my doc and he prescribed Acetazolamide, a generic form of Diamox. 125mg tabs. This weekend will be my first time using it. Will report back. Usage reads:

Glad I'm not alone! Did you feel perfectly fine after Day 1 on those trips?

Yes, super interested to hear about your experience with acetazomaide/diamox. 

I have a buddy that swears by the ibuprofen and ginkgo biloba combo. He hits the both pretty heavy on the first day, dials it back for subsequent days. Seems to have worked really well for him! Same setup too, i.e. sea level weekend warrior in the high Sierra.  

Same here. A comment from Sirius reminded me of something:

It is a beast to push through that first day bc my body doesn't want food or liquid when it hits.

Personally, as in, for me... I found dehydration to be a big part of the problem. I started loading up on water on the drive and approach,  like drinking too much and having to piss a lot of it out. But it really helped with headaches and overall nausea and also made it easier to eat and drink on the first big day. I'd also eat a robust dinner the night before. I'm sure mileage will vary.

Reporting back after trying Acetazolamide for the first time this past weekend:

- No symptoms sleeping at 7,300 the first night after driving up from sea level. This is where I've often begun to feel the effects in the past, so, good start.

- Day 1: Woke up feeling well. No symptoms on the approach or on route, at ~12k. Started feeling familiar symptoms on the descent back to camp. Felt awful on arrival, could barely eat, crashed out. Slept at ~9,800.

- Day 2: Woke up feeling well. Climbed all day, descended to TH. No symptoms.

I'll take these results - better than the usual, everything going to hell on the first night/early morning. Not 100% sure the altitude is what got me at the end of Day 1. Symptoms felt familiar - headache, nausea, some tightness in the chest on deep inhale, no desire to eat or drink - but it had been a heavy day for me. Maybe I just bonked.

Even if you're not taking vitamin I, drink lots of water.  One of the first things to do when going to altitude.

I never had altitude headaches when I was younger, seemed when I turned 40 I began getting them pretty frequently.   I tried acclimating if I could and always drank tons of water and ate good but nothing seemed to help.  I found taking Diamox prior to heading into altitude helped and if that didn't help a Rx for Sumatriptan, a migraine med seemed to take care of it.   Good luck with yours.

Research that shows huffing smokes fights AMS.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5623483/