Comment by sonink | Hacker News Reader

Comment by sonink | Hacker News Reader

> The second method is more troubling. At altitudes above 3,000 metres, mild symptoms of altitude sickness are common. Blood oxygen saturation can drop, hands and feet tingle, headaches develop. In most cases, rest, hydration or a gradual descent is all that is needed. ...investigators found that Diamox (Acetazolamide) tablets, used to prevent altitude sickness, were administered alongside excessive water intake to induce the very symptoms that would justify a rescue call.

This doesnt sound accurate. I have trekked the Himalayas for over a decade - the risks of AMS are very real. Two people I have trekked with have died due to AMS on separate himalayan treks - both had trekked multiple times before, and were well aware of the risks. Both the fatalities were around 12000-14000 feet - much below the Everest Base Camp trek. When AMS hits, you need to descend - as fast as possible, with whatever means you have at your disposal. Otherwise you have unknowingly entered a Russian Roulette.

And Diamox is used as a preventative course for AMS - alongside excessive water intake - this is standard guidelines in all high altitude himalayan treks.

Were there other issues involved in the fatalities around 12-14k ft? Freezing etc?

In aviation rules you can have passengers at 12k ft without oxygen for an unlimited amount of time. The crew needs to use oxygen if you're between 10k and 13k for more than 30 minutes. Above 13k both crew and passengers must use oxygen immediately (EASA rules, FAA is different).

So they seem to consider 12k to not be dangerous to passengers.

Speaking from experience in the mountains: 12k at rest and 12k under subsequent days of exercise produce very different responses. What might be a mild headache sitting in the back of a plane could be a pretty distinct AMS case lugging a pack up and down mountains.

The main issue is that exercise exacerbates hypoxia. You're climbing a mountain, your muscles need oxygen, but you're not getting enough.

But the temperature does make it worse. Your body is trying to generate heat, which increases oxygen demand. Your blood vessels are constricting, so circulation is less efficient, limiting oxygen distribution. All together, this creates all sorts of health risks.

Sitting in a comfy plane seat browsing the internet is not the same thing. Besides, even healthy adults just sitting can experience mild hypoxia effects above about 10k ft - fatigue, mild cognitive effects, headaches. But if you're just sitting, it's generally tolerable. Of course, you don't want pilots working in those conditions for any length of time.

There are like a half dozen cities with 100.000+ population at over 12k feet altitude. And towns and villages a lot higher. So right, 12k is no's dangerous per se.

The problems come if you haven't acclimatized.

The very next sentence from that quote sounds a lot worse and harder to explain away though:

> In at least one case cited in the investigation, baking powder was mixed into food to make tourists physically unwell.

In Nepal, my parents always warned me before eating at some rest stops because they said the food was doctored with baking soda to make you feel fuller, guess it was true after all and not just an urban legend heh.

I've heard the same from South Indian friends, so I guess it's pretty widespread.

I've sometimes used baking soda to accelerate softening of beans, and I imagine the effect is more appreciable at higher altitudes perhaps? Some of the usage of baking soda could be innocent enough.

Try using it on meat. Turns it into pink slurry.

You're using too much! Its commonly used to improve meat texture, especially in Chinese cuisine. It's called "velveting".

you're thinking of corn starch

Both are used, for different reasons, but it's a pretty loose term. Can also use enzymes or other alkaline things. With or without a marinade. Pass through oil or water, or just stir fry with a little extra oil.

No reasonable person would be confused by use of baking soda as an ingredient in cooked food (reasonable) vs the addition of baking soda after cooking as an adulterant.

Did we discover a new diet hack?

A few thousand years ago:

https://en.wikipedia.org/wiki/Nixtamalization

Alkalinity softens the husk of legumes. Look up nixtamalization. It’s what the Aztecs invented.

An amount of soda sufficient to make you ill would be very VERY detectable in food. Speaking as someone who makes their own honeycomb toffee and soda bread, it's really easy to mess up the ratios and end up with an excess that tastes nasty, and that excess is pretty small.

A small amount won't make a different, it'll just stimulate a bit more H+ production from your stomach's proton pumps.

Edit: The article I read claims the scam involved baking powder, which makes even less sense given that it's even more noticeable, bitter and metallic.

I have to agree. A handful of times during my life that I had some bad heartburn but no antacids I used the tried and true method of a teaspoon of baking soda mixed in a shot of water and slammed it back. It tastes horrible. Even a teaspoon is so strong in taste I guess I would describe as salty. And no I did not feel unwell but my heartburn got better. And as a kid I once mistook 1/2 teaspoon baking soda and added 1/2 cup to a batch of cookies. The taste was so noticeable and disgusting the only option was to throw out the cookies. So a teaspoon is a home remedy, a half cup is impossible to ignore, I just don't understand how this report about it in the food could be true.

Ahhhh! Mystery solved. About 40 yrs ago I came to work to taste the most foul cookie (pretty cookie at that!). This is what they must have done. Nobody admitted to making the cookies. I always thought it was a gag. LOL

Namche (damn autocorrect) Bazaar which everyone in the Everest region passes through is a bit over 11K feet. 12-15K feet just isn’t that high in the scheme of things. Many peaks in the western US are in that range or more. Yes, minor headaches are pretty normal when acclimatizing. But anything more, you need to go down.

> 12-15K feet just isn’t that high in the scheme of things. Many peaks in the western US are in that range or more.

The highest peak in the contiguous United States is Mt. Whitney at ~14.5k feet

I went from sea level to 11k feet in the same day many times before. I would say the altitude effect is there but not as much as you might expect. A little quicker to be out of breath a little longer to recover it. Not sure what it is like at higher elevations or greater daily altitude delta.

Very much dependent on age, rest and general conditioning. I went from sea level to 14K at Pikes peak in 1 day and it was quite uncomfortable. I managed, but folks who lived in Denver with lower physical fitness levels than me, did better.

Agreed, we live at ~5K and went up to Pikes Peak; my wife and I had no problems (beyond minor headache), but my son's lips were turning blue and he was feeling pretty bad.

Other amusing things from that trip: we went up there the 3rd of July, and it snowed. We charged the car in Colorado Springs before we left, got up to the peak with 36% battery remaining. My wife worried we wouldn't be able to make it back. Got back to CS with ~70% battery left.

Lol, on my trip up Pikes Peak I was blissfully unaware that altitude sickness could be a thing. So I can't recall if I felt any different. I do recall the carburetor on my motorcycle was acting a little strange, however.

I went from ~500 ft above sea level (Palm Springs) up to 8,500 feet above sea level (San Jacinto Peak) in less than an hour via the aeria tram a couple months ago and it was very noticeable, my walking speed fell by a third and I was breathing a lot harder than I usually do.

San Jacinto is 10,834 ft, for what it's worth.

I guess fitness makes a difference from what these other comments are saying. My ex-wife and I lived in Long Beach (which is obviously sea level) when we were in ROTC and pretty regularly took day trips out to San Gogornio and walked to the summit in about five hours, which is ~11,500ft. Not once did that have any noticeable effect, but we were both pretty serious runners back in the day trying to become Army officers. On the other hand, she tried to summit Aconcagua during a spring break and couldn't make it due to altitude sickness. I've never been higher than Mt. Whitney, personally.

Even if you don't feel it, the altitude still makes a difference, though. I recall doing two-a-day hell weeks at Big Bear at the end of summer cross-country training in high school and there was a 5k up there at the end of that week. We all got worse times than typical at sea level, and somewhat amusingly, I recall a high school senior from Rim of the World High School (who lived up there) getting 2nd place overall the first year I ever competed in that race, beating way more seasoned competitors just because he was used to the altitude.

It works in reverse, too. There was an officer in my Armor Basic Officer Course from Colorado who gave himself rhabdo during the two-mile test the first week we in-processed, apparently because he was so used to altitude that he hadn't quite acclimated to Fort Knox atmosphere.

>I guess fitness makes a difference

Not really. Altitude sickness seems quite random in who it effects worst. I trekked to the top of Mera Peak (~21,000 ft) many years ago. 3 of the fittest people in our party got altitude sickness and didn't make it to the peak.

If anything, fitness makes you more susceptible to altitude sickness. It's not an inherent effect, but rather your habits driving you to do things you shouldn't. You are supposed to take things lazy and slow when acclimatizing to high altitude. But if you're fit, you may be used to moving too fast and pushing yourself too hard. You may not recover from exertion as quickly as you expect, and you may end up climbing higher every day than you should.

Altitude sickness typically starts after 12–24 hours. If you climb high and come back down in the same day, there is usually not enough time for the symptoms to start. And 11,500ft is not that high altitude. People routinely fly to Cuzco, La Paz, Lhasa, and Leh from sea level, and most of them suffer no serious ill effects.

It's pretty widely accepted in the climbing world that the primary effect of altitude in the short-term is a reduction in your cardiovascular fitness.

The better your heart is at getting oxygen into your muscles and organs, the better it can compensate for less oxygen.

Not a bulletproof solution to altitude sickness, but it's definitely one of a lot of variables that matters. It's also just true that some people are way more susceptible regardless, I've got friends who run competitive marathon times who get splitting headaches flying from sea level to denver.

Same. I've climbed Mount Adams (12,280 feet) several times, including once with an overnight stay at 9,500 feet as well as other times when I did the whole ascent and descent in a single day.

It's a tiring climb and a tiring descent, but I never felt a hint of altitude-related discomfort.

I lived near sea level and didn't often go anywhere more than about 1,000 feet above sea level in daily activities.

I think you mean continental United States, as Alaska and Hawaii are excluded, where-as Alaska is contiguous with the United States, but requires crossing through parts of Canada to reach by land. That said, yes Whitney is the highest in the continental US, and McKinley in Alaska is the highest in the US (and contiguous US) and is also the tallest in the world from base to peak and the third most prominent peak in the world.

It's exactly the other way around actually, continental US would include Alaska since it's still on the North American continent whereas contiguous US excludes both Hawaii and Alaska. Contiguous US refers to the lower 48 states.

Continental "could" include Alaska (it's even in the official U.S. Board on Geographic Names definition), but in practice when "continental US" are casually mentioned, it's rarely implied as included. Most use it as interchangeable with contiguous.

Contiguous states is the correct term.

“Continental” would be in Europe.

Wait, you guys don’t live on a continent?

HI lol

Both "contiguous us" and "continental us" are correct terms for referring to sets of US states, even though they are mistakenly often used interchangeably in casual talk:

"On May 14, 1959, the U.S. Board on Geographic Names issued the following definitions based partially on the reference in the Alaska Omnibus Bill, which defined the Continental United States as "the 49 States on the North American Continent and the District of Columbia..." The Board reaffirmed those definitions on May 13, 1999."

https://simple.wikipedia.org/wiki/Continental_United_States

"The contiguous United States, also known as the U.S. mainland, officially referred to as the conterminous United States, consists of the 48 adjoining U.S. states and the District of Columbia of the United States in central North America."

https://en.wikipedia.org/wiki/Contiguous_United_States

"Continental" is also a casual way to refer to European things, but that's a different overloading of the term. Continental is not confined to meaning "European", except where the context implies so (e.g. "continental philosophy", or "continental breakfast"). A leftover from the British refering to Europe as "the continent", it being the nearby continental body next to them.

>where-as Alaska is contiguous with the United States, but requires crossing through parts of Canada to reach by land.

Contiguous means the 48 connected (contiguous) states. It never includes Alaska.

And even though definitionally/officially continental could include it (it's in the same continent), in common use "continental US" is not meant to include Alaska either.

That’s like saying the US is contiguous with Japan, you just have to cross through parts of the Pacific Ocean to get there. Contiguous precisely means you don’t have to cross anything else to get there, it is connected.

https://en.wikipedia.org/wiki/List_of_the_highest_major_summ...

Many peaks in the western US are in that range. Lots more with several exceeding if you include Alaska in “the western US”.

There are 50+ peaks in Colorado higher than 14,000 ft and 1000+ higher than 12000 ft

*Naamche Bazaar

> 12-15K feet just isn’t that high in the scheme of things. Many peaks in the western US are in that range or more.

It's "not that high", but people frequently do get AMS at those attitudes or even lower.

I can’t provide cites but I understand people have had issues flying into Denver.

There's a big difference between doing a day trip to those altitudes which is normally ok, and sleeping that high which causes problems if not acclimatised.

> There's a big difference between doing a day trip to those altitudes which is normally ok, and sleeping that high which causes problems if not acclimatised.

I'm not sure what point you're trying to make. People regularly experience AMS at the heights far below what OP mentioned, whether on the day they arrive or on days 2-4, and that's not even accounting for strenuous physical activity.

I've been to Nepal a few times and started feeling AMS symptoms about 1-2 hours after arriving at our lodge in Namche. Diamox kept me going great for the nxt few days on our way to Tengboche where we maxed out about 13k feet, besides the heli flight back to Lukla. Similar symptoms even at a ski resort at 9k feet in the US. It's "not that high" but plenty high to induce AMS.

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