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The Struggle With Altitude Sickness in the Ecuadorian Andes Is Real

With the beautiful views come the very real struggles of hiking 13,000 feet above sea level.

“The summit’s just there,” yells my guide, pointing over the spindly grasses clinging to the steep side of Pasochoa Volcano. I look out over the perfect pyramids of ice and stone that encircle us like the rings of a planet and silently plead with my heart to slow its beat, with my lungs to breathe more deeply.

My eyes brim with tears as my partner wraps his arms around me. “You’re a trooper,” he whispers. “And troopers don’t cry.”

“I’m not crying,” I pant into the gales of sharp, howling wind. “We’re 13,000 feet above sea level. It’s just the altitude, I swear.” I’m only half lying.

The four-day lodge-to-lodge trek through Ecuador’s Avenue of the Volcanoes was my idea. We’d hike by day and cozy up to the fireplace at night in a dreamy checkerboard of adventure and relaxation. The trail itself didn’t concern me. We’d done longer trails before; we’d even done them carrying all of our gear. It was the thought of the Andean altitude that turned my blood cold.

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Our trek would have us ranging between 11,000 and almost 16,000 feet above sea level, twice the altitude of the highest point of the Sierra Nevada Mountains, where we hiked a few times a year. I know exactly how that quick rise from sea level to mountain range makes your body work twice as hard for the trail, the way it feels like your boots have been dipped in molasses.

But in the Ecuadorian Andes, those symptoms are just the front line of a full-body revolt. It’s harder to sleep and easier to cry at extreme altitudes. Passing gas is at a near constant, as lowered atmospheric pressure causes the gasses in the stomach to expand and search for immediate escape. The body has to work so hard just to function regularly that it redirects the energy from the digestive system to more crucial processes like breathing. Digesting food is, apparently, not that essential. Basically, extreme altitude is a succubus, and there’s not a single thing you can do to stop it from feeding.

The first day’s hike is brutal, hours of trudging up the slopes of Pasochoa at ungodly steep angles with the soul-sucking banshee of elevation wreaking havoc with my digestive system. I’ve got nothing left in the tank by the time we reach the summit but, with the hardest part of the day behind us, I am buzzing with adrenaline and bowled over by the view: Green fields below, purple volcanoes in the distance, a sky shrouded in webs of cloud and fog.

Cotopaxipungo HotelShoshi Parks

Not long after—somehow going down is three times faster than climbing up was—we’re at the foot of Pasochoa and passing through the gates of Cotopaxipungo Hotel. A fire burns with welcome in the wood-beamed, Spanish colonial-inspired hacienda. I sit in front of it, cradling my canelazo, a traditional hot cider made with cinnamon, naranjilla fruit, and aguardiente. It’s so soothing that, for the first time all day, I feel almost normal.

It’s a rough night, though. I can’t sleep, and my stomach refuses to settle. By morning, I’m exhausted again, but Alejandro, our guide, promises there will be less climbing today—we’re moving between volcanoes, not up their slopes.

The day is brilliant and bright, and Alejandro can’t believe how many of the country’s largest volcanoes we can see from the trail. We count seven peaks with names like Antisana, Sincholagua and Cayambe that watch our progress through the pastures and ranch lands of the local chagras (Andean cowboys).

“Did you know that Indigenous people in the Andes and Himalayas have evolved to withstand extreme altitudes?” I ask my partner that night as I research the symptoms of altitude sickness. I’m still not keeping food down, and, unless my FitBit is also in revolt, my resting heart rate has been steadily creeping upwards. It’s higher than I’ve ever seen it. 

“They have larger lungs and more oxygenated blood, which keeps them stronger and more physically active at high altitudes,” I read. “So, we’re doing something so intensely challenging that the Native human population has had to genetically adapt just to survive it?”

“That explains a lot,” he says.

At breakfast the next morning at the Hacienda Porvenir, a brick-red, thatch-roofed farmhouse at the edge of Cotopaxi National Park, I ask Alejandro if he’s ever had guests who haven’t been able to tolerate the altitude. He nods solemnly. It’s not uncommon that people just can’t make it, he says. He’s even had to drive people back to Quito because they’ve come dangerously close to hypoxia, a potentially life-threatening condition that can develop in low-oxygen environments.

Hacienda PorvenirShoshi Parks

I feel like garbage but I lace my boots, fill my backpack, and hit the trail like the trooper I am. The only clouds in the sky are the mysterious weather patterns created by Cotopaxi itself. “It’s never this clear,” says Alejandro giddily. “You guys are really lucky.”

We are, I agree. Despite the war going on inside my heart, lungs, and belly, I am completely thunderstruck by the beauty of the páramo. Vast plateaus of golden grasses wave like wheat in the wind, and out of the soil grow sprigs of purple lupine and bushes tipped with bristly pink chuquiragua flowers. More than half a dozen Andean condors gather overhead, dipping and rolling on the drifting currents.

Upwards we hike along the slopes of Rumiñahui Volcano, ever upwards, until there is nowhere left to go. I balance on the thin ridge, looking down at the wild horses grazing in the volcano’s caldera and out over the last miles standing between us and the country’s second-largest volcano. It takes the last of my breath away.

That night in the Tambopaxi Lodge, the mountain climber guest house at the foot of Cotopaxi, Alejandro explains that the athletes will be on the trail by 3 a.m. when the páramo is still deep in darkness. They have to get up to the summit before the sun melts the ice or the weather whips itself into a frenzy of wind, rain, and snow. We will only be going as far as the glacial line, where there is a refuge with a small cafe and sleeping space for climbers eager to get a jump on the day. “Don’t worry,” he says, watching me as I survey a cabinet full of oxygen canisters. “You’ll be fine.”

And fine I am, for a little while. But the succubus refuses to leave my side. She greedily sucks down my oxygen and drums out a beat on my tired heart. The grade grows steeper, slowing me down to the closest thing to standing still you can do while still moving. I refuse to let her win.

In the end, I make it to the mountain refuge 15,953 feet above the sea, and as we descend, first to the foot of Cotopaxi, then on to Quito. Drops of rain fall like tears of frustration on the windshield as I feel the succubus slinking away.

“Don’t take it so hard,” I whisper to her through the window, half-unhinged with the pride of having conquered the hardest physical challenge I’ve ever willingly undertaken. “Troopers don’t cry.”

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Seamus April 11, 2023

Acetazolamide?