Mt. Whitney Portal Store & Hostel Forums General Mt. Whitney Portal Store Message Board Hiking Mt. Whitney with an Asthma

I have a friend that is contemplating hiking our mountain next year via the main trail but she suffers from asthma. Any info or recommendations?

Hi Wes,

Shona my wife has well controlled asthma. When we were up on Whitney in October she had a real struggle. The cold air coupled with her taking on board cold fluid made it very difficult for her to breath at one stage.

She had reliever medication with her and taking this allowed her to make the summit.

The cold air can be a trigger factor.

Hope this helps

Search the board for "asthma". Six turn up, several are good to read.

Mild or severe asthma?
What are her triggers (i.e., cold air, exercise, certain allergens, hard laughter, excessive coughing, etc.)?
Is it currently controllable in whatever form it exists?

CAT, She has mild to moderate that is controlled. Environmental things such as chemicals, colognes or smoke seem to trigger it.

Wes-
Not knowing more of her medical history, it is difficult to give you specifics. Those with asthma can have an "asthma attack" triggered by environmental factors such as the cold temps, dry air, pollens, etc. This is usually results in bronchospasms and/or bronchial inflammation. Albuterol (the most common rescue inhaler) can control this and I ABSOLUTELY WOULD NOT hike without it. If she isn't using them already, she should also be on a steroid inhaler (Flovent, etc.) or better yet a combination steroid and long acting beta agonist (Advair) prior to attempting a Whitney hike. First sign of asthma (wheeze or cough) would be a reason to stop and re-evaluate.
dr.kenny

Wes - I have occasional mild asthma that can be triggered either by cold air, a sudden excessive burst of physical activity (such as sprinting up a steep hill for longer than just a few seconds), or a couple of other odd minor triggers (none of the ones you mentioned). I always carry my Proventil spray (albuterol) with me when I hike, but rarely ever need to use it, because I do my best to avoid exceeding my known limits in known trigger areas.

However, at the first sign of asthma pre-symptoms, I take a single spray of Proventil (one inhalation usually does the trick for me), and then I keep on hiking, although perhaps at a slower pace until the spray kicks in and the symptoms go away. Waiting to see if the first spray works before continuing to hike (or alternatively inhaling a second spray if the first one doesn't do the trick) would certainly be a wise choice as well, although in my own situation, I have found it necessary to take that extra step only very rarely. But everyone is different.

Hopefully, colognes and chemicals won't be a problem for your friend on Whitney (just the smell of hot sweaty dayhikers!), although if there are fires burning in the area, depending on wind direction, smoke sometimes can occur in the Whitney area. There have been times that smoke has been thick enough to block visibility of the valley below from the surrounding mountains.

If your friend is not already taking Singulair, I would highly recommend she ask her doctor about prescribing this for her (10mg, once daily). Previously, I was using my rescue inhaler at least daily (sometimes more), even though my asthma was and still is only mild. But then, from the very first day I began taking Singulair, and during that first year thereafter, I can count on one hand the number of times I had to use my inhaler! I have been taking Singulair for several years now, and the positive results are still the same as they were during that first year. Although the Singulair pills are not large, if she is not into swallowing pills, Singulair does come in a pleasant tasting chewable form (5mg pills). I chew 2 of these at the same time each morning when I first get out of bed.

So my two cents is that if your friend's asthma is already controlled, she will probably do just fine if she brings her meds along, uses her inhaler immediately at the first sign of trouble, knows her triggers and limitations, and stays within those limits. I hope the foregoing is useful.

CaT

For those not familiar, the newer classification system of the last few years for Asthma, has changed how people are classified.

It is based upon the amount of proventil a person uses. Mild is defined as once a WEEK or less, on a regular basis. Moderate is more than once a week, regularly.

Prior to this new system, it was impossible for someone from New York to be understood in California, in terms of their severity. Also, a very significant number of folks underestimate their severity. The importance, is that any asthma beyond mild probably represents an ongoing progressive deterioration of lung function that is permanent. This is why excellent chronic control is so important.

Those who do mountaineering with asthma should be prepared for an exacerbation, and should definitely be on a controller, such a regularly used orally inhaled steroid for at least two weeks before the trip, singulair (although statistically not as good), or both. I'd also carry prednisone or dexamethasone pills, in the case of an attack. Many people find altitude is a trigger, and you won't know until you are up there.

G'luck!

Ken,

Being an official storm spotter for the Natl Wx Svc (NWS) in Central Ohio, I am familiar with NWS' official designations for "severe" weather. I only mention that to say that I understand that there is often a difference between the officially recognized designations for things versus the commonly used designations for the same (in the instant case, "mild", "severe", etc. for asthma). Perhaps, in the case of asthma, you could apply the terms "mild" and "severe" to both the overall character of the disease (i.e., how many meds you have to take and how frequently you have to take them to maintain control) and the intensity of each individual episode/attack.

To clarify my post above, when I used those terms, I was referring to the severity of the individual episode/attack itself. In common usage terms, I would view frequency of medication as more of a control versus non-control issue than a mild versus severe issue. But that is strictly from the personal "in my shoes" viewpoint of a lifelong asthmatic, which takes nothing away from the official definitions. As mentioned in my previous post, in my pre-Singulair days (during adulthood), I was using my inhaler daily, which by the official definition, would be something beyond "mild". However, none of my asthma episodes/attacks (again, in adulthood), regardless of frequency of inhaler usage, were ever anything other than mild in their symptoms.

Just wanted to be sure my previous post was understood in this context. Years ago, in my pre-elementary school days, I used to have occasional severe episodes/attacks brought on by a nifty cat allergy at the time, which has since remissed; so I do have a baseline experience against which to compare the severity of any attacks I have now.

Sorry for the length; just wanted to clarify.

CaT

As always, my advice is to talk to a physician knowledgeable about high altitude medicine. Taking medical advice on this board from someone with unknown medical knowledge and who is not familar with the individual case is unwise. To give such advice is <you fill in the blank>.

Sierra Sam, I don't quite understand. At least one participant in this thread is "a physician knowledgeable about high altitude medicine."

How would Wes' friend go about finding such a physician? They aren't exactly listed in the yellow pages.

In order to follow the advice here, Wes' friend would need to see her doctor anyway to acquire the prescription drugs mentioned. If I were the one with the asthma, I would be glad to carry these recommendations to my doctor, and in effect, get a second opinion from my doctor before he/she would write the prescription. And I think my doctor would be glad that I had some knowledge of the situation and recommended drugs when I came in.

Wes,

Asthma patients are usually told to make sure they keep their inhaler close to them should they need it. It is advice worth repeating here. As I'm sure you're aware over the course of a climb it is possible to change clothing layers a couple times in a day. As your partner adds or removes clothing they should make sure their inhaler is still on their body.

Some climbers carry their inhaler in their pack and I try to discourage people from this practice. It should be on their body in a zippered pocket that is always easily accessible. Also, all asthma patient's partners should know where it is so they can help get it out in case the patient can't do it with the onset of an attack.

One scenario that has happened to a few asthma patients over the years is as they get tired one of their partners carries all or part their pack. If an attack comes on and the pack isn't close by it can be disastrous.

You might even suggest they carry an extra inhaler and put it in a different place. This also adds in a buffer in case one of them gets accidentally damaged while on the trail.

Also, when carrying the inhaler keep it close to the patient's body so it stays warmer instead of in an outside layer.

Many asthma patients have had very successful climbing careers. I hope this helps.

All the best,

Kurt

Steve-

I have seen a lot of incorrect medical advice on this board. Unless you know them, there is no way for anyone to know the credentials of someone posting on this board. In addition, the best you can do is to get general advice, not a considered medical opinion based on your specific case (allergies, other meds you are taking, etc.) Hardly the right way to get (or give) an informed medical opinion. In this infotech era, surely you wouldn't suggest that it is very hard to find a qualified high altitude physician. If you don't have access to the internet try 1. asking your physician, 2. calling a major teaching hospital in Denver, Salt Lake City, Seattle, etc. 3. go to a medical library and look at the journals and books on high altitude medicine and see which physicians write them, 4. asking climbers or climbing stores 5. ask someone who does have internet access to do a search for you.

You are betting your health, and possibly your life, on getting the correct medical information to go many hours away from civilization in a physically challenging place. Not a situation where I could recommend taking anonymous medical advice from someone with unknown/unverified creditials and limited knowledge of your personal medical situation.

Sam, reasonable points about the need for specificity regarding what an individual should do.

However, understanding that many people, perhaps most, with asthma do not get any regular treatment from a physician.....because they perceive that they don't have a need, and use OTC stuff, or nothing, I think it is reasonable to impart that going into higher altitude introduces factors that are not apparent at lower elevations....and that the propspective asthmatic mountaineer may want to get further evaluation before climbing.
It *is* more complicated at altitude, and problems up there are hard to deal with, if the tools are not present.

As for your reasonable-sounding 5 suggested sources, my experience of those suggestions has been fairly uniformly unsuccessful in locating an expert in the person's local area. However, others may have different experiences.

Ken-

I agree that you might not find someone local, but would suggest that a serious medical issue is worth a drive or even a phone consultation over anonymous medical advice.

Sam, I can see your point.

I'm not sure that anyone is going to give specific medical advice over the phone, though.
At least in California, probably not legal. If for a person in another state in which the physician is not licensed, almost certainly illegal. Complex stuff.

I'd be surprised that someone would cross state lines in trying to find a consult for a problem that *they* don't neccessarily consider much of a problem for them.

Hopefully, if there is someone in that situation, they will consider the situation carefully.

Wes B,

Just wanted to cut through all this bantering and make sure you got your question answered...

Kurt I sure did. I thank everyone for their advice and input on this subject. This is exactly why I came to this forum for her concerns. Not only do you get experience (which is invaluable), you get advice to go beyond the board (which is likely the best thing to do)and you get some great tips (such as Kurt's).

I will pass this along to her. I hope she actually logs on and interacts herself (no one can really speak about ones condition accurately except oneself).

Based on this information I really do feel that she will get the help and information she needs to experience what we all have. She has had permits via the lottery in the past but decided not to attempt a main trail hike due to her condition. Hopefully it will happen.

Right on Wes... I wish her well and hope she'll pursue giving the Whitney trail an attempt next year!

All the best,

Kurt

Hi Wes,

I posted at the start of this chain with personal experience, I can only echo what Kurt has said and possibly suggest a name;

Paula Radcliffe

I don't know how well that name is known to you, She is the World Record Holder for the Womens Marathon and she is also Asthmatic!

I hope you both Enjoy Mt Whitney when you choose to do it.