Altitude Sickness

Reading up on altitude sickness was an Aha! moment for me. In some ways, medical science doesn't have much of value to offer me in terms of thinking through the problem and coming up with new solutions.

Reading up on how alititude sickness works and what happens to the body at altitude was hugely eye opening and completely changed my understanding of my genetic disorder.

The general mental models for cystic fibrosis seem to kind of be that the lung issues and gut issues are "coincidental" and not directly related. At best, they get seen as having the same root cause but I think a lot of people in the CF community don't really even see them as that closely related.

I think most of the world sort of thinks: You have CF, so your body is broken and here is the raft load of issues you have: x, y and z.

And they seem to think of them as rather random defects. The world doesn't do a good job of thinking systemically about what CF does to the functioning of the body.

So when I read up on altitude sickness, one of the things I learned is that when the air is too thin, your body starts shunting waste gasses through the kidneys and you start peeing a lot more.

This happens because you can't breathe wastes out fast enough to keep up with the need to rid the body of waste gasses, so they begin accumulating in the bloodstream and they desperately need to go somewhere. Letting them just accumulate in the blood is a huge problem and simply not tolerable, so the body forces them through kind of a backup or alternate system: The renal system.

So this fact gave me a direct connection between lung function and gut function. That direct connection is the bloodstream.

A lot of my mental models relate to the bloodstream, actually. Learning to keep tabs on blood health as a means to move numbers meaningfully was a big part of the healing process.

You need more electrolytes at altitude because you pee more. The fact that you pee more means you dump a lot of other things in addition to fluids and waste gasses that have built up in the blood. This includes electrolytes but is not limited to electrolytes.

Dumping electrolytes drags other stuff with it, so when you are at altitude and peeing a lot, you need to drink more, you need more electrolytes and you need to be aware of knock-on effects caused by these issues.

This pattern fits CF issues shockingly well.

Cystic Fibrosis is essentially a salt wasting condition and if you realize that as you sweat out and urinate out high levels of salt, that salt is dragging a lot of other stuff with it, you suddenly have a good explanation for why you can never catch up -- why you need so much more in the way of calories and nutrients and so on.

Like a cup with a hole in the bottom, good luck getting it filled and keeping it filled. And, also, watch out for the mess it creates even if you can miraculously keep it filled.

Reading up on altitude sickness really helped me understand a lot about the salt-wasting aspects of CF and how that impacts my body systemically. Two other major issues are pH balance and how people with CF misprocess fats.

Learning about altitude sickness didn't help me with those issues but it was a major thing that dramatically improved my understanding of my body -- how it functions and malfunctions and how the various ways my body malfunctions are interrelated and not random, unrelated things.

A LOT goes wrong at altitude that doctors don't fully understand. There is more to it than is covered in this post. If you have CF or some other condition involving salt wasting or gut issues or lung issues, I highly recommend you pay attention to information about altitude sickness and what happens to the human body at altitude even before it becomes altitude sickness.

I have read articles about the physical experience of climbing Everest and what it does to your mind and body. I have found this fascinating and useful as a point of comparison for thinking about my own medical issues.