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Unveiling the Hidden Risks of Living at High Altitude on our Kidney Health, and What it Might Mean for Your Child

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The hallmark concern for the body living at high altitude is low oxygen. We breathe in less, and thus less is sent throughout our blood stream to our tissues. We are quick to think about how this affects our heart and lungs, but what about our kidneys? What are our kidneys even responsible for?

Kidneys filter, reabsorb, and excrete our blood in the form of urine. They connect our cardiovascular system with our genitourinary system. The flow through the kidneys also helps monitor and adjust our blood pressure. Their importance is truly undervalued. When they receive less oxygen than preferred (hypoxia), they will become injured. Specifically, the glomerulus (term for the filter) will become affected. When this happens, it is not efficient at filtration, and protein will spill out into our urine (proteinuria), a key feature of High Altitude Renal Syndrome (HARS).

Zooming further in below

And even further…

Another issue involves uric acid, the chemical at fault for causing gout. Due to the filter injury sustained from low oxygen, uric acid excretion is affected. It can thus build up in our musculoskeletal system and other tissues. It is famous for causing red, swollen, and painful joints. The enzyme that helps create uric acid (xanthine oxidase) is also turned on by reactive oxygen species during hypoxia. This then causes further uric acid crystal deposition in our body. This can present in patients from adolescent years through adulthood, ranging from fleeting pain to amputations from severe bone infections. We have found that for younger patients, diet plays a lesser part than genetic predisposition and hypoxia.

So how is this treated? We are still researching the best course of action. We can treat with drugs that work by inhibiting the previously specified enzyme: xanthine oxidase. These include oral allopurinol, febuxostat, and even IV pegloticase infusions. But we are primarily focused on prevention and holistic care here, so we would prefer to use supplemental oxygen therapy for those that struggle to maintain oxygen saturations in the healthy ranges. Acetazolamide is also helpful in cases. This medication works to increase our respiratory drive, helping us breathe off CO2 and breathe in more oxygen. Contact us to see what method might be right for you.

This research was brought to us by a stroke of luck. A stranger on an airplane, and a son’s coworker. This stranger happened to be a nephrologist (kidney doctor) who is studying how altitude affects the kidneys. In working with him and his team at University of Colorado Anschutz, the team at Ebert Family Clinic in Frisco, Colorado (9000′) have been ordering broader lab panels (including uric acid) for their patients and seeking those with questionable renal labs. Another patient seen by the Ebert Family Clinic team has been severely impacted by gout. With multiple amputations before the patient’s 30th birthday, this case has motivated the health care team to prevent this from happening to others in their high altitude community.

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Carter Odean is a third-year medical student at Rocky Vista University. He was born and raised outside of Denver, Colorado before heading to Gonzaga University in Spokane, Washington where he studied biology and completed research on an invasive bee species there while playing club lacrosse. After graduating in 2019, he then came back to Denver to complete his Master’s in Biomedical Sciences at Regis University. After Regis, he started as a Clinical Research Coordinator at Anschutz Medical campus, working on multiple Diabetes Mellitus Type 2 research trials. He is in the Rural & Wilderness Track which is his favorite part about school. He plans to work as a rural Pediatrician or Family Medicine Physician. In his free time, you can find him dirt biking, fly fishing, skiing, and relaxing with friends and family. 

References

  1. Schoene, R.B. “High altitude renal syndrome: polycythemia, hyperuricemia, microalbuminuria, and hypertension.” High Alt Med Biol. 2002 Spring;3(1):65-73. doi: 10.1089/152702902753639371. PMID: 11949751.
  2. Bigham, A.W., Lee, F.S. “Tibetan and Andean patterns of adaptation to high-altitude hypoxia.” Hum Biol. 2014 Oct;86(4):321-37. doi: 10.3378/027.086.0401. PMID: 25700353; PMCID: PMC4438718.
  3. Beall, C.M., Cavalleri, G.L., Deng, L., et al. “Natural selection on EPAS1 (HIF2α) associated with low hemoglobin concentration in Tibetan highlanders.” Proc Natl Acad Sci U S A. 2010 Mar 9;107(25):11459-64. doi: 10.1073/pnas.1002443107. Epub 2010 Feb 22. PMID: 20176925; PMCID: PMC2895106.
  4. Simonson, T.S., Yang, Y., Huff, C.D., et al. “Genetic evidence for high-altitude adaptation in Tibet.” Science. 2010 Sep 10;329(5987):72-5. doi: 10.1126/science.1189406. PMID: 20616233; PMCID: PMC3490534.
  5. Schoene, R.B., Swenson, E.R. “Cobalt-Induced Chronic Mountain Sickness: Pathophysiological Mechanisms and Genetic Susceptibility.” High Alt Med Biol. 2017 Mar;18(1):1-5. doi: 10.1089/ham.2016.0106. PMID: 28145824.Baillie, J.K., Bates, M.G., Thompson, A.A., et al. “Endogenous urate production augments plasma antioxidant capacity in healthy lowland subjects exposed to high altitude.” Chest. 2007 Dec;132(6):S275. doi: 10.1378/chest.132.6.275. PMID: 18079246.
  6. Yu, K.H., Wu, Y.J., Tseng, W.C., et al. “Risk of end-stage renal disease associated with gout: a nationwide population study.” Arthritis Res Ther. 2012 Jun 27;14(3):R83. doi: 10.1186/ar3818. PMID: 22738152; PMCID: PMC3446515.
  7. Bhat, A., Deshmukh, A., Anand, S., et al. “Acute Myocardial Infarction due to Coronary Artery Embolism in a Patient with Severe Hyperuricemia.” J Assoc Physicians India. 2019 Nov;67(11):90-91. PMID: 31801335.
  8. Khanna, D., Khanna, P.P., Fitzgerald, J.D., et al. “2012 American College of Rheumatology guidelines for management of gout. Part 1: systematic nonpharmacologic and pharmacologic therapeutic approaches to hyperuricemia.” Arthritis Care Res (Hoboken). 2012 Oct;64(10):1431-46. doi: 10.1002/acr.21772. PMID: 23024028.
  9. Schoene, R.B., Swenson, E.R. “Treatment of Cobalt-Induced Chronic Mountain Sickness.” High Alt Med Biol. 2017 Mar;18(1):74-77. doi: 10.1089/ham.2016.0135. PMID: 28145823.
  10. Schoene, R.B., Hackett, P.H., Henderson, W.R., et al. “High Altitude Medicine and Physiology, Fourth Edition.” CRC Press, 2007.
  11. Burtscher, M., Mairer, K., Wille, M., et al. “Risk of acute mountain sickness in tourists ascending to 4360 meters by cable car.” High Alt Med Biol. 2004 Summer;5(2):141-6. doi: 10.1089/1527029041352154. PMID: 15265307.
  12. Baumgartner, R.W., Bärtsch, P. “Chronic mountain sickness and the heart.” Prog Cardiovasc Dis. 2010 May-Jun;52(6):540-9. doi: 10.1016/j.pcad.2010.02.009. PMID: 20417390.
Backcountry, Backpacking, Exposure, Health, High Altitude, Huts, Mountaineering, Summit Huts

Lightning Strikes in Colorado

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My love for hiking developed during my childhood explorations of the breathtaking landscapes of the Sierra Nevada. As I ventured into the rugged mountains and hiked along scenic trails, I couldn’t help but feel a deep connection with nature. However, my passion for hiking was not without its moments of caution. On several occasions, I witnessed the awe-inspiring yet intimidating power of lightning storms dancing across the vast mountain skies. These encounters instilled in me a profound curiosity about the risks associated with lightning strikes in high-altitude regions.

When I moved to Colorado for PA school, my awareness of the dangers posed by lightning strikes grew even stronger. The dramatic topography and frequent thunderstorms in Colorado amplify the risk for individuals exploring high-altitude areas. It was during my last clinical rotation at a burn unit that I had the opportunity to care for several patients who had been struck by lightning. Witnessing the effects firsthand fueled my determination to educate the public about the actionable steps they can take to stay safe during lightning storms.

Lightning strikes

​Lightning possesses an immense amount of energy, with a voltage of over 10 million volts (in comparison, most car batteries measure 12.6 V).1 Additionally, a lightning bolt reaches incredibly high temperatures, reportedly up to 30,000 Kelvin (53540.33 F).1 Lightning injuries occur in different ways, including as direct strikes, side splash, contact injuries, or ground current. 

Direct strikes are uncommon, accounting for only 5% of cases, and happen when a person is directly struck by lightning.2

Contact injuries occur when a person touches an object that is struck by lightning. 2

Side splash injuries occur when the current jumps or “splashes” from a nearby object and then follows the path of least resistance to reach the individual. These injuries make up about 1/3 of all lightning related injuries. 2

Ground current is the most prevalent cause of injury, accounting for half of all cases, and occurs when lightning strikes an object or the ground near a person and subsequently travels through the ground to reach the individual. 2

In Colorado, an average of 500,000 lightning flashes hit the ground each year. Based on data since 1980, lightning causes 2 fatalities and 12 injuries per year throughout the state.3According to data since 1980, lightning causes an average of 2 fatalities and 12 injuries annually throughout the state. 3 Colorado ranked third in the United States for the number of lightning fatalities between 2005 and 2014, as depicted in Figure 1.

Fig. 1. Lightning fatalities by state. 3

The high number of injuries attributed to lightning in Colorado can be influenced by several factors. One of these factors is the easy access to high elevation terrain, such as 14ers (mountains with a peak elevation of at least 14,000 feet). This accessibility allows inexperienced outdoor enthusiasts to venture into potentially dangerous situations due to their lack of knowledge and preparation.

For instance, individuals who are not familiar with summer weather patterns may embark on a hike above the tree line late in the day, underestimating the risk of a storm forming. This lack of understanding puts them in an exposed and perilous position should adverse weather conditions arise.

Even with thorough preparation and extensive knowledge of weather patterns, it is still possible to find oneself in a situation where you have to weather a storm. Given that a significant proportion of Colorado’s hiking trails are located above the tree line, where appropriate shelter is sparse, hikers are more susceptible to lightning strikes in these exposed areas. 

Pathophysiology of Lightning Strike Injuries

The overall ratio of lightning injuries to deaths is 10:1 and there is a 90% chance of sequelae in survivors.4 The primary mechanism of injury in lightning strikes is the passage of electrical current through the body. The high voltage and current can cause tissue damage through several mechanisms, including thermal injury, electrical burns, and mechanical disruption of tissues. The severity of the injury depends on factors such as the voltage and current of the lightning bolt, the duration of contact, and the pathway the current takes through the body.

Lightning strikes can cause various types of injuries, with cardiac and respiratory arrest being the most common fatal complications.5 The path of least resistance determines the flow of electricity through different organs in the body, with nerves being the most conductive, followed by blood, muscles, skin, fat, and bone. 5 When lightning strikes, the electrical surge can induce cardiac arrest and cessation of breathing by affecting the medullary respiratory center. As a result, most patients initially present with asystole and may progress to different types of arrhythmias, commonly ventricular fibrillation. 5

Interestingly, there have been case reports documenting successful resuscitation of lightning strike victims who were initially apneic and pulseless for as long as 15 to 30 minutes. 5This has led to the recommendation that in the immediate aftermath of a lightning strike, individuals who appear to be dead should be prioritized for treatment.

Superficial skin burns are experienced by around 90% of lightning strike victims, but deep burns are less common, occurring in less than 5% of cases. A characteristic skin manifestation of a lightning strike is the Lichtenberg figure, which is considered pathognomonic. Neurological symptoms can also occur, including keraunoparalysis, which is a transient paralysis affecting the lower limbs more than the upper limbs. This paralysis is often accompanied by sensory loss, paleness, vasoconstriction, and hypertension, and is thought to result from overstimulation of the autonomic nervous system, leading to vascular spasm. In most cases, this paralysis resolves within several hours, but in some instances, it may last up to 24 hours or cause permanent neurological damage. 5

Additionally, it is common for lightning strike victims to have a perforated tympanic membrane (eardrum) or develop cataracts immediately following the incident. These injuries to the ear and eyes are associated with the intense energy of the lightning discharge. 6

What can hikers do to stay safe?

Preparation

Monitor weather forecasts: Stay updated on weather conditions before engaging in outdoor activities, especially in areas prone to thunderstorms. Pay attention to thunderstorm warnings or watches issued by local authorities. Having a mobile or handheld NOAA Weather Radio All-Hazards (NWR) can also be helpful as it can transmit life-saving weather information at a moment’s notice. 

In Colorado most thunderstorms develop after 11 am, so it is best to plan your trip so that you are descending by late morning.7 Fig. 2 shows number of lightning fatalities by time of day in Colorado between 1980 and 2020. The vast majority take place after the 11 am threshold.

Fig. 2  Lightning fatalities in Colorado by time of day3

What to Do If Caught in a Storm

If you can hear thunder, you are close enough to be struck by lightning. Lightning can strike up to 25 miles away from the storm. 7 Once you hear thunder, if possible quickly move to a sturdy shelter (substantial building with electricity or plumbing or an enclosed, metal-topped vehicle with windows up). Avoid small shelters, such as picnic pavilions, tents, or sheds. Stay sheltered until at least 30 minutes after you hear the last clap of thunder.

Fig 3. Areas to avoid when sheltering from lightning.

If you are outdoors and cannot reach a suitable shelter, avoid open areas, hilltops, and high places that are more exposed to lightning strikes. Seek lower ground and stay away from tall objects, such as trees, poles, or metal structures. Bodies of water, including lakes, rivers, pools, and even wet ground, are conductive and increase the risk of a lightning strike. Move away from these areas during thunderstorms. Separate group members by at least 20 ft as lightning can jump up to 15 feet between objects.

​If a strike is eminent (static electricity causes hair or skin to stand on end, a smell of ozone is detected, a crackling sound is heard nearby), the current recommendation is to assume “lightning position”, pictured in Fig. 4.

Fig. 4. Lightning position8

To potentially reduce the risk of ground current injury from an imminent lightning strike, another strategy is to insulate oneself from the ground. This can be done by sitting on a pack or a rolled foam sleeping pad. However, it’s important to note that this and the lightning position should be considered a strategy of last resort and not relied upon as the primary means of prevention. Maintaining this position for an extended period can be challenging, and it’s crucial to prioritize seeking proper shelter and following established lightning safety guidelines to minimize the overall risk of injury. 5

Case Study

25 YO F presents to the Burn Unit as a transfer from Cheyenne Regional Medical Center s/p lighting strike. Patient (pt) was caught in a thunderstorm on a hike and sheltered under a tall tree. Suddenly, she felt like she was being lifted up into the air and then dropped. Pt had a brief (<5 sec) loss of consciousness (LOC). When she woke up, she was completely numb and couldn’t move any of her extremities. Witness (friend) states the lightning splashed from the tree to the pt. Pt denies hitting her head with the fall. She denies taking blood thinners. She has no past medical history (PMHx) or past surgical history (PSHx).

Physical exam 

Neuro: AOX4, No CN deficit on exam, LE paralysis resolved, LE paresthesia improving but still present

HEENT: L ruptured tympanic membrane, hearing loss on L side

CV: RRR

MSK: Soft compartments diffusely

Skin: Lichtenberg figures on bilateral LE 

Fig. 6. Lichtenberg figure on LLE

V/S: BP: 128/92, HR: 96, RR:18, SPO2: 98%, Temp 98.1F. 

CBC, CMP, troponin were all WNL. Serum hCG negative. CK mildly elevated (222) 

EKG showed NSR.

CXR, CT brain, and c-spine neg for acute injury

She was admitted to the UC Health burn center for observation with tele. Her lab work and vitals remained stable throughout her hospitalization. She was evaluated by the trauma team with a negative trauma work up. The day of discharge, she was tolerating a regular diet, ambulating and sating well on room air. She was deemed appropriate for discharge home without patient audiology and ophthalmology follow up. 

References

1. US Department of Commerce N. Understanding lightning science. National Weather Service. April 16, 2018. Accessed July 8, 2023. https://www.weather.gov/safety/lightning-science-overview. 

2. Cooper MA, Holle RL. Mechanisms of lightning injury should affect lightning safety messages. 21st International Lightning Detection Conference. April 19-20, 2010; Orlando, FL. 

3. US Department of Commerce N. Colorado Lightning statistics as compared to other states. National Weather Service. March 4, 2020. Accessed July 7, 2023.https://www.weather.gov/pub/Colorado_ltg_ranking. 

4. US Department of Commerce N. How dangerous is lightning? National Weather Service. March 12, 2019. Accessed July 8, 2023. https://www.weather.gov/safety/lightning-odds. 

5. Chris Davis, MD; Anna Engeln, MD; Eric L. Johnson, MD; Scott E. McIntosh, MD, MPH; Ken Zafren, MD; Arthur A. Islas, MD, MPH; Christopher McStay, MD; William R. Smith, MD; Tracy Cushing, MD, MPH. Wilderness Medical Society Practice Guidelines for the Prevention and Treatment of Lightning Injuries: 2014 Update. WILDERNESS & ENVIRONMENTAL MEDICINE. 2014; 25, S86–S95 

6. Flaherty G, Daly J. When lightning strikes: reducing the risk of injury to high-altitude trekkers during thunderstorms. Academic.oup.com. Accessed July 8, 2023. https://academic.oup.com/jtm/article/23/1/tav007/2635599. 

7. NWS Colorado Offices – Boulder G. Colorado Lightning Awareness Week june 19-25, 2022. ArcGIS StoryMaps. June 25, 2022. Accessed July 8, 2023. https://storymaps.arcgis.com/stories/11d021f1b800429a869ead2dc32c0f96. 

8. McKay B and K. How to survive A lightning strike: An illustrated guide. The Art of Manliness. April 25, 2022. Accessed July 8, 2023. https://www.artofmanliness.com/skills/outdoor-survival/how-to-survive-a-lightning-strike-an-illustrated-guide/. 

A woman with long, light brown hair over her shoulders wearing a blue, sleeveless shirt with red details smiles with blue eyes.

Sophia Ruef is a Physician Assistant student at Red Rocks Community College in Arvada, CO. She grew up on the central coast of California and earned her Bachelor of Science degree inBiology with a concentration in anatomy and physiology from Cal Poly San Luis Obispo. She worked as an EMT and a tech in the Bay Area after her undergraduate education. In her free time, she enjoys hiking, backpacking, canyoneering, and spending time with family and friends.

Acclimation, Alcohol at Altitude, Altitude Science, Athletic Training, Backcountry, Backpacking, Child Growth & Development, Exposure, Health, High Altitude, High Altitude Training & Fitness, Huts, Hyperbaric Therapy, Medicine, Mountaineering, Naturopathic Medicine, Sleep at Altitude, Summit Huts

HAFE: High-Altitude Flatus Expulsion

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Often, at high altitude we hear complaints of gas pain and increased flatus in our infant population. Parents often wonder, are we doing something wrong? Is my child reacting to breastmilk, or showing an intolerance to certain foods?  Actually there is another explanation for increased flatus and gas pain in the high-altitude region of Colorado. 

The term HAFE was coined by Dr. Paul Auerbach and Dr. York Miller and published in the Western Journal of Medicine in 1981. Their discovery began In the summer of 1980, when the two doctors were hiking in the San Juan Mountains of Colorado on a quest to summit three 14ers. During their ascent they noticed that something didn’t smell right! As the pair continued to emit noxious fumes, they began to put their scientific brains to work and discovered HAFE. The symptoms include an increase in frequency and volume of flatus, or in other terms an increase in toots! We all have familiarity in watching our bag of potato chips blow up when reaching altitude or our water bottle expanding as we head into the mountains. This reaction is due to a decrease in barometric pressure. Based on Boyle’s law, decreased barometric pressure causes the intestinal gas volume to expand, thus causing HAFE (Skinner & Rawal, 2019).

A graphic illustrating how Boyle's law works: the pressure of a gas increases as its volume decreases.

To my surprise, a gas bubble the size of a walnut in Denver, Colorado (5280 ft) would be the size of a grapefruit in the mountain region of Summit County, CO (8000+ ft)! Trapped gas is known to lead to discomfort and pain. The use of simethicone may have merit in mitigating the effects of HAFE. Simethicone works by changing the surface tension of gas bubbles, allowing easier elimination of gas. This medication, while benign, can be found over the counter and does not appear to be absorbed by the GI tract (Ingold, C. J., & Akhondi, H., 2022). 

While this phenomenon may not be as debilitating as high-altitude pulmonary edema (HAPE), it deserves recognition, as it can cause a significant inconvenience and discomfort to those it inflicts. As the Radiolab podcast explained in their episode The Flight Before Christmas , expelled gas in a plane or car when driving up to the mountains can be embarrassing. While HAFE can be inconvenient, it is a benign condition and a matter of pressure changes rather than a disease or pathological process. We would love to talk more about HAFE at Ebert Family Clinic if you have any questions or concerns!

A bald eagle flies over a misty settled into the valley against the blue-green pine forest of a mountain.
A bald eagle flies toward its nest atop a bare lodgepole pine.

As always, stay happy, safe, and healthy 😊

Taylor Hollingsworth is finishing her final semester as a family nurse practitioner (FNP) student at Georgetown University. Originally from the east coast, Taylor plans to start her FNP career in North Carolina close to family. She has a passion for pediatric and family wellness and has worked as a pediatric intensive care unit nurse for 6 years! In her free time, Taylor loves to hike, fly fish, run, and spend time with her fiancé Logan. 

References

Auerbach, P. & Miller, Y. (1981). High altitude flatus expulsion. The Western Journal of Medicine, 134(2), 173-174.

Chemistry Learner. (2023). Boyle’s Law. https://www.chemistrylearner.com/boyles-law.html

Ingold, C. J., & Akhondi, H. (2022). Simethicone. StatPearls Publishing. 

McKnight, T. (2023). The Flight Before Christmas [Audio podcast]. Radiolab. https://radiolab.org/episodes/flight-christmas

Skinner, R. B., & Rawal, A. R. (2019). EMS flight barotrauma. StatPearls Publishing. 

Acclimation, High Altitude, High Altitude Training & Fitness, Huts, Medicine, Mountaineering, Summit Huts, Wildlife

Section House in December: Moose Country

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Section House sits at 11,481′ (3499 m), on Boreas Pass, just south of Breckenridge, Colorado. It isn’t the highest hut in the Summit Huts system, but its unique location and history is what makes it one of the most challenging.

Many of the huts in the Summit and 10th Mountain Division systems sit on a hillside, below tree line, which provides a significant amount of weather mitigation. Section House is right at the tree line, on the pass, which means any wind and weather will likely be funneled right into you. And because you are in one of the highest counties in the United States, weather is highly variable.

I’ve done this hut in a blizzard before, arriving to find the padlock on the front door was frozen shut. That may have been the most I’d ever despaired in my life up until then.

Even in great weather, however, the temperature alone is a liability. When we set out from the trailhead this time, it was sunny and relatively balmy for December, in the 30’s (Fahrenheit). But the temperature in the shade can be several degrees lower, and as the sun sets below the Ten Mile Range, the temperature starts to drop by the tens of degrees really quickly.

The Stats

Distance: a little over 6 miles; GPS and some maps may differ by tenths of a mile. If you tell your friends 6, they may resent you.

Timing: the same hike has taken me a couple hours with no weight on my back besides water, on well-packed snow. This time, it took over an hour a mile, including frequent breaks, thanks to all the weight I was carrying and pulling. Additionally, we constantly had to redistribute weight among sleds and backpacks to relieve shoulders and keep sleds from tipping over. If you decide to pull a sled, keep the weight low and as evenly distributed as possible. The other very limiting factor was the last half of the trail was covered in at least a couple feet of unpacked, fresh powder. Our lead was breaking trail in snowshoes.

While the grade going back down to the trailhead isn’t steep enough to keep momentum without skating, it is significantly easier and faster, and took us half the time even after waiting for moose to safely cross our path.

Elevation gain: about 1100′.

Capacity: 12 people.

Packing

I’ve pulled a sled both times I’ve done this hut. I don’t regret it, but it is challenging at best in calm weather. Unless you are going for more than a couple nights, I’d recommend packing everything into a backpack.

Because the elevation gain is so gradual, the challenge with weight is the distance. Pack your weight so it will still be comfortable on your shoulders after three miles. The advantage of pulling a sled was having less weight on my shoulders, but after several miles, even minimal weight can dig into your muscles.

The only source of water around this hut is the snow you melt, which is why it isn’t open in the Summer season. Water purifying filters are the quickest way to refill all your containers at the hut, but you will want plenty of water for the hike in alone. Running out of water on the trail is dangerous. An added risk: when the sun went down on us after the first three hours in, the water in our CamelBak nozzles started freezing if we weren’t regularly sipping on them.

Bring a sleeping bag. Most huts I’ve been to have blankets and pillows on the mattresses, but this one does not. This is also one of the oldest and coldest cabins; built in 1882, it takes hours to heat up by wood stove, especially if no one has been in it recently.

Moose

Now forget all the advice I just gave you and center your whole packing strategy around how you plan to evade a charging moose.

This region is moose country: high, high meadows filled with willowy wetlands. They don’t care how cold it is. In the dead of night, one of us opened the front door to use the outhouse and a young bull was standing right in front. On the trail back, two different parties ran into a moose and her calf right on the trail. They are not in the way. You are on their trail.

But seriously, pack to be prepared for your comfort and sustenance on the trail and at the hut. The only thing you can do about the moose is give them a lot of space while avoiding any confrontational, jerky movements that may suggest any predatory intent. If moose perceive a threat, they are liable to charge, male or female. If they charge, drop everything weighing you down and pray-run (praying while running).

When we ran into the moose on the trail, we stayed over 50 meters away and just waited while the moose wandered further off our path. As soon as they were about 50 meters off our path, we proceeded with caution. But we waited for over 30 minutes, and would have waited longer if we needed to.

Skis vs. Skins vs. Snowshoes

This was the most highly contested logistical conversation among our party. In the end, four of us were on cross country skis (without skins), one was on skis with skins, one was on a split-board with skins, and one was on snowshoes.

This really depends on the conditions. Two weeks prior, three of us hiked the trail in boots, on well-packed snow after days of warm, dry weather. Days before we left for the trip, however, a series of storms blew several feet of snow in, which changed everything. Boots alone were definitely not an option.

Most people, who aren’t hiking to the hut, will stop and turn around at the halfway mark where historical Baker’s Tank stands. This means the trail up until that point will reliably be pretty packed down. Because of the recent snow, however, no one could be sure what conditions would be like for the second half of the trail.

Freshly-broken trail through fresh snow past the midway point to Section House.

Sure enough, Baker’s Tank to the hut was unbroken trail through deep, soft snow. Our lead, on snowshoes, was cursing all the way to the hut as he carved the path for the rest of us. But in deep snow, snowshoes are sometimes the most comfortable option for an ascent, especially if you are inexperienced on skis and skins.

The advantage to skinning up on a split-board or downhill skis is the width of the blades. They are wider than cross country skis, which makes balancing the extra weight more comfortable and stable.

On a packed track, cross country skis were relatively comfortable, if narrow. The boots are more similar to normal footwear, so are more flexible and comfortable than ski or snowboard boots. Price was also a determining factor: renting skis or a split-board can cost upwards of $45 per day at most rental shops. We found cross country skis for $10 per day at Wild Ernest Sports, above Silverthorne, and they worked well. One thing about cross country ski boots, however, is that they aren’t as well-insulated as downhill ski or snowboard boots. Trekking through deep snow in them requires much better waterproofing and insulation than we were prepared with.

Jupiter rising in the dusk on the way up to Section House.

As for skins, although the trail grade is very gradual, there is enough of a grade at times that you will be thankful for the traction that skins provide. So unless you’re on cross country blades, you’ll want some skins.

Altitude & Acclimatization

One advantage of carrying all the weight we did was that it forced us to make a slower ascent and take frequent breaks. These are two things you can do to minimize the affects of the altitude on any ascent. In our party, all but one of us have lived at an altitude over 7,000′ for at least one year. Most of us have lived over 9,000′ for several years. But this was the first hut trip over 10,000′ for three of us, one of whom flew in two days before from sea level.

Fortunately, no one in the group experienced any severe symptoms of acute mountain illness, and I credit that to our meticulous supervision of each person’s blood oxygen saturation as well as our slow ascent. The first night we were at the hut, the lowest oxygen saturation we saw was 85%, but most were between 85 and 90%, which, at over 11,000′ is not surprising. If some slow, deep breaths hadn’t brought oxygen levels up, I would have been more concerned.

Hitting kickers behind Section House.

As seems to be tradition on our expeditions, we arrived well after dark. But these days, sunset is at 4:30 pm. Luckily, the weather was calm, and the trail is quite obvious. Our biggest concern after dark was the tremendous drop in temperature. With no cloud cover and a recent cold front, it was well below freezing, and the only thing that kept us from freezing was the constant movement, which kept us progressing forward.

Ken’s Hut, next to Section House.

By the time we had all made it to the hut and built up a fire warm enough to kick our boots off, our socks were steaming in spite of how cold our extremities were. It took well into the night to heat up the hut, and we all spent the first night sleeping around the wood stove. Yes, it took seven hours for the last of us to make it to the front door of Section House, but the spring trip to the Benedict Huts outside of Aspen was still loads more difficult — and we didn’t even pull any sleds! The next day was windless, sunny, clear, and warmer outside than it was inside, which allowed us to get back out on our skis and snowboards to enjoy the backcountry without weight on our backs.

robert-ebert-santos

Roberto Santos is from the remote island of Saipan, in the Commonwealth of the Northern Mariana Islands. He has since lived in Japan and the Hawaiian Islands, and has made Colorado his current home, where he is a web developer, musician, avid outdoorsman and prolific reader. When he is not developing applications and graphics, you can find him performing with the Denver Philharmonic Orchestra, snowboarding Vail or Keystone, soaking in hot springs, or reading non-fiction at a brewery.