Mt. Whitney Portal Store & Hostel Forums General Mt. Whitney Portal Store Message Board Ever Gotta Go But Can't?

During a dayhike exactly one week ago a buddy of mine experienced a strange symptom just past Trail Crest on our way up -- he needed to urinate but couldn't. I personally observed that he was definitely drinking plenty of fluids -- both water and electrolyte replacement -- but despite repeated attempts, nothing.

I've done a little basic research to better understand the situation, and all I could find is something called "oliguria" (diminished urination in relation to fluid intake), but have no idea how or if it relates to Acute Mountain Sickness. Quite the contrary, what I did find over and over is that a symptom of AMS includes "increased urination (altitude diuresis)" (emphasis added).

We did spend a few days and nights camping at the Portal to help with the acclimatization process, but also unfortunately my buddy experienced other symptoms of altitude sickness once past the Switchbacks -- nausea, headache, lack of appetite, and significant fatigue. Reluctantly, he agreed to pull the plug on the summit attempt, and on our way down we already started talking about plans for a possible 2009 return visit.

Any insight on this symptom is appreciated. Thanks.

BruinDave

how old is he?

Let's just say that the issues typically associated with a guy being able to go (especially as you get older, such as prostate issues) while not at altitude have been ruled out.

One additional piece of information: once down at lower altitudes, no problems at all.

high altitude shyness?

great question. will be interesting to see if one of the docs who hang here can help.

http://en.wikipedia.org/wiki/Paruresis

Perhaps you staring at him didn't help!
Lots of guys suffer from this, (although I find it seems to lessen after 6 beers

I have the opposite problem. Specially at high altitude. I piss like a race horse or a wolf marking his territory. I think it has something to do with acclimating to the altitude.

Rafael...

Well the plumbing isn't all that complicated. You have kidneys that make urine, tubes (2 ureters)to a holding tank (bladder)another tube from the bladder (urethra through the prostate) to the exit.Since he had the urge to go he probably had the kidneys working and a full bladder.The problem has to be from the bladder to the exit.There is a sphincter at the bladder/urethra junction that could restrict flow and the prostate could swell temporarily cutting off flow.It sounds like it definitely had something to do with altitude. My guess is the prostate swelled at altitude and cut off flow.That is my best shot.

Thanks, DRD.

Although this subject is a bit unusual, and easy fodder for jokes, this was a very serious issue (coupled with the other symptoms) that warranted getting down lower right away. Didn't know if anyone else has ever encountered this.

Thanks again. Never heard of a prostate swelling at altitude, but something to research.

BruinDave

Can't say that I know this to be an altitude symptom, but doesn't prove it isn't.

This is commonly called urinary retention, and what you are describing is NOT dehydration, or related to it. In ER's, I'd see this every day, it is actually common.

http://en.wikipedia.org/wiki/Urinary_retention

When we are not talking about prostate issues, my experience is that it is 90% of the time related to medication/drugs/herbs/supplements.

Inasmuch as our research showed around 80% of climbers on whitney are taking some sort of medication, I'd focus on that as a first likely culprit.

Well sometimes medical answers are difficult to come up with.This sounds like it definately had something to do with altitude as function returned at lower altitude. The reasons as to why is only speculation.I would definately have your friend discuss it with his doctor and maybe get a referal to a urologist.There was some kind of urinary retention that can be dangerous if it happens again.There might be some kind of obstruction present that changed with altitude and the decrease in atmosheric pressure.I still have a hunch it is related to the prostate for some unknown reason.
Ken might have something about meds.

Interesting information.

Related to this topic, has anyone ever experienced, temporarily and only at altitude a burning while urinating? I thought it may be partially due to dehydration after perspiring a lot during a climb.

Inability to urinate, but feeling the need to urinate, especially when combined with a burning sensation with the little urination that he is able to get out sound a lot like the symptoms associated with a kidney infection, but very shortly after those symptoms appear, he is likely to feel severe flu like symptoms--fever, extreme achiness, diminished energy, begging for a quick death . . .

Happened to have lunch today with a top Urologist in the LA area, and asked him about this. He also thought that prostate needed to be ruled out, and if it was, then his first thought was pharmaceuticals. He'd never heard of it as an altitude effect.

Burning (not part of this discription), inplies irritation. Infection would be possible, but would usually make a person feel like CRAP. Bad dehydration conceivably could do this, but would not have other symptoms beyond the dehydration ones.

Kidney infections usually more characteristically involve lower back pain that can range from mild to severe. Generally one cannot stand to have a mild blow to the area (back pathology usually doesn't mind that)

Interesting Ken. Yes, it is pretty much the only symptom and only has happened three times; all three times were during strenuous climbs above 13,000ft, then disappears, usually as a result of hydrating well and immediately.

Each time though, I was already pretty well hydrated during the day and night before. Perhaps it's something I am consuming (food, supplements, etc.). Never happened anywhere else.
No known infections either, other than occasional recurrances of mononucleosis from when I was younger (which is viral anyway, not bacterial), which flares up upon times of stress (after periods of heavy training coupled with little sleep, stress etc..)

Strange.