Article #2: High Country Hunting, by Andrew Crow

Andrew Crow is an avid mountaineer, climber and backcountry hunter from Bozeman, Montana. While not a physician, his experience at high altitudes has provided him with valuable perspective on the rigors of high country hunting and the basic treatment of the more common ailments that can affect hunters at elevation. Consult a physician for more detailed information.

Hunting at high elevation is as extreme a sport as any other endurance activity at elevation – mountaineering, mountain biking, climbing, etc. While there are some hunts in China, Russia or Mongolia that can take you to elevations over 13,000 feet, all hunts in North America will occur only in the high altitude range (5,000 – 11,500 feet). Hunts that occur over 14,000 feet will require much more knowledge about altitude and its dangers than ones less than 11,000. If you are planning on one of these hunts I recommend you check out the resources provided by Wilderness Medical Institute (www.nols.edu/wmi). Also read up on the methods for proper acclimatization developed by extreme altitude climbers and mountaineers.

At these altitudes one runs a high risk of developing edema of the lungs or brain. These are life-threatening conditions that require immediate descent and medical treatment. It is very important to understand these risks and takes the necessary precautions.

Big game hunts in North America will not expose you to elevations that run serious risk of edema, but a severe case of Acute Mountain Sickness (AMS) could bring a quick end to your hunt. Therefore, it is important to understand what happens to your body as you gain elevation and how best to prevent experiencing the negative side effects.

At 12,000 feet the concentration of oxygen is the air is approximately 40 percent less than at sea level. It takes time for your body to adjust to this change. Initially, your body will be hypoxic (deprived of oxygen) until it adapts to the change in oxygen levels. With time it compensates by increasing the amount of hemoglobin in your blood stream. This allows your blood to absorb more oxygen from the lungs and carry the necessary amount to vital organs and muscles. This process takes time – usually a week or more.

If you ascend too quickly, you can develop a range of symptoms that are the result of Acute Mountain Sickness (AMS). AMS is often referred to as altitude sickness or mountain sickness and has a wide range of symptoms. The most common comparison is that it feels a lot like a hangover: headache, nausea, vomiting, fatigue, dizziness, light-headedness or faint. Often times it is associated with apathy, irritability and mood swings. Bad cases can result in confusion, disorientation and impaired memory.

In extreme cases AMS can develop into edema causing fluid to collect in your lungs or around your brain. High Altitude Pulmonary Edema (HAPE) and High Altitude Cerebral Edema (HACE) are life-threatening conditions that require immediate descent and medical attention. While very rare at anything less than extreme altitude, cases have occurred as low as 7000 feet. For this reason it is good to know and be able to recognize the symptoms should they appear.

Typically a headache on a mountain hunt is the result of dehydration. If you experience a headache, drink a liter of water and take some ibuprofen or aspirin. If the headache persists, it is likely you are suffering from AMS. Unless more serious symptoms develop, try spending the night at your current elevation. Drink plenty of fluids and eat whatever you can. Carbohydrates are best, but sometimes one can only choke down some chocolate or dried fruit. What is important is that you get some calories in your system. Avoid alcohol, tobacco or sleeping pills and try and get some rest. I like to take aspirin as it is easier on your stomach than ibuprofen if you are nauseas, plus it helps thin out your blood which can thicken as hemoglobin levels increase.

If you or anyone in your party develops a cough that produces a pink, frothy sputum or suffers from unsteadiness, confusion, drowsiness or goes unconscious, it is possible they suffer from a form of edema. The only cure for HACE or HAPE is descent; oxygen and dexamethasone are useful temporary measures if available.

While altitude sickness can strike anybody, even the most fit, being in good shape will not only prepare you for the rigors of the hunt, it will also help your body adjust to higher altitudes more quickly. Individuals who are in good physical condition are more aware of how of their body is responding. They can focus on acclimatization knowing that their legs and lungs are strong. They can be confident that any feelings of fatigue are the result of less oxygen in the air and deal accordingly. If you are in poor physical condition, your body will be taxed by the altitude as well as the exertion. This will put you at much greater risk of suffering from AMS or worse.

To better adjust to extreme altitudes, take day trips to higher elevations but return to a lower elevation to sleep and recover. A good rule of thumb is to ascend no more than 3,000 feet every other day as long as you are feeling well. As soon as you experience symptoms of AMS, delay moving higher or move back down the mountain if you’ve already changed camps. The ONLY cure for any altitude related sickness is to get to lower elevations.

Often hunters are limited by the time they have available for the hunt. However, do not let time constraints determine the time you have to acclimatize. Be sure your group or outfitter allots enough time for your body to properly adjust, especially if you are coming from sea level.

Dehydration and, to a lesser extent, caloric deficiency are the two most common causes of AMS after gaining altitude too quickly. Drink a minimum of 3 to 4 liters a day and monitor your urine to determine your level of hydration. When properly hydrated your urine should have a light yellow tint to it, about the color of champagne. Once your urine turns yellow you are already dehydrated. It can take your body more than 24 hours to recoup from dehydration. The worst thing you can do on a hunt is become dehydrated. It leads to a host of problems that could negatively affect your chance of success.

If you begin to feel any symptoms of AMS while ascending, stop. While we are all temped to push through the pain or discomfort, doing so when acclimatizing risks bringing an early end to your hunt. Pay attention to what your body is telling you and adjust accordingly.

Once you’ve acclimatized and are focused on the hunt, be sure to stay well hydrated and fed, avoid alcohol, tobacco and sleeping pills and your chances for success will increase dramatically.