My throbbing head
Carry me over
This high pass
Make my belly warm and full
Despite the frigid air
Help me to catch the little frogs
And keep my brain from exploding.
That’s the little prayer to mamacoca I thought up during a long, cold night of high-elevation-induced insomnia last March. Earlier that day, as I sat on top of the pass trying to not vomit at the smell of my companions’ lunches, I had to wonder if the severe headache was a good enough excuse to throw myself off the cliff and hope to land somewhere, um, soft. I decided it wasn’t. The view was too nice.
Despite the North American slander and fear campaign about coca, Andean-Amazonian people have apparently been using the leaves of coca without ill effect for 5000 years or more. Chewing coca does not cause euphoria allegedly associated with the drug cocaine. Coca leaf has similar effects to drinking coffee or other mild stimulants, but give me a wad of beautiful, green coca leaves any day over mud-brown coffee.
The alkaloids released by chewing coca are mild vasoconstrictors and stimulants, and these properties fight against altitude sickness. The main problem with going to 5000 meters is that there’s only about half the oxygen available in the air as at sea level. Your body can respond to this hypoxia, or lack of oxygen, by hyperventilating to a point, shunting blood away from the digestive system and other non-essential activities to the brain, and in the long-term by making extra red blood cells to carry more oxygen. Going through the short-term acclimatization process can be pretty painful if you’re a lowlander like me. I experienced recently a severe case of acute mountain sickness, and I’m glad I had coca leaves to chew my way over the 5100 m Condor Pass. Some of the symptoms I experienced that day included severe (ice axe to the right eye) headache, severe nausea and suppressed appetite, insomnia, resting pulse of 100 beats per minute (mine is typically around 58-62), and swelling of hands/feet/face. Luckily I was spared the excessive flatulence that often accompanies these other symptoms. Anyway, I chewed my little green coca leaves and acclimatized after descending and spending a night at 5000 meters. Well, I acclimatized for the most part, but managed to hold onto the insomnia for five more long, cold nights.
Coca and even time at altitude (on the scale of my field trips) probably can’t do much for the insomnia because it’s caused by hyperventilation (your body’s response to the low oxygen availability at high elevations), and the resulting reduced blood carbon dioxide (CO2) levels. High CO2 levels in the blood trigger your next breath, but when suppressed by hyperventilation, that trigger is messed up and your body relies on another weaker, slower trigger: low oxygen. This is the “Ok. Brain cells are dying here, breathe!” trigger. At night, at high elevation, the lack of CO2 trigger and the slow oxygen trigger results in a weird, disrupted breathing pattern called Cheyne-Stokes breathing. You stop breathing for several seconds just as you’re about to fall asleep, and INHALE! you’re awake again. A drug called acetazolamide can keep blood acidity relatively high at altitude, which helps to maintain a more normal breathing pattern at night. It also makes you pee a lot, which speeds acclimatization by flushing out alkaloids.
Maybe I can help others avoid the same painful experience.
Mini-guide to altitude sickness:
1) Read about safe methods for traveling to high elevation and recognize the signs/symptoms of severe altitude-related medical problems. I recommend this website for a quick intro, and I recommend Wilderness First Responder training to anyone going to spend lots of time at high elevation or in the backcountry/doing fieldwork. Consult your doctor before traveling to high elevation for the first time.
2) Ascend slowly and keep your heart rate down. If you experience severe symptoms, descend! Brains DO explode and lungs DO fill with fluid. Severe headaches and fatigue cause people to make poor decisions. Take high elevation travel seriously, anticipate problems, and listen to your body.
3) Stay hydrated! The symptoms of altitude sickness and dehydration mask each other – no sense in making it worse than it has to be! Hydration can also help you flush out carbonates which lower blood acidity and mess with your respiration and sleep.
4) Carry and take ibuprofen to dampen the headache and prevent swelling.
5) Chew your coca for its stimulant and mild vasoconstrictor properties.
Well folks, we’re leaving on 22 July for the first real data-collecting trip. Wish us luck! We’ll report back soon from the field.