How To Avoid HAFE

Sonoma Pass
Staying back for a reason?

Without a doubt elevation gain can do some pretty nasty things to your body.  Most outdoor adventures have heard of AMS – Acute Mountain Sickness.   It can cause severe headaches, nausea, and vomiting.   Fluids accumulating in tissue, known as edema, can make a bad situation worse, much worse.  If fluid builds in the lungs it is known as HAPE – High Altitude Pulmonary Edema.   When it accumulates in the brain, it is known as HACE – High Altitude Cerebral Edema.   Both HAPE and HACE are potentially lethal, requiring immediate medical attention.

Given the life threatening seriousness of HACE and HAPE, it feels somehow inappropriate to worry about HAFE.  But should a legitimate altitude caused affliction be completely ignored simply because there are other afflictions even worse?  That’s like saying you can’t hate the Red Sox because there are Yankees.  Ridiculous, right?

Public awareness of HAFE varies depending on whether you or someone close to you has suffered from it.  By close I mean anything less than about 15 feet.  Let’s face it, HAFE stinks.  I mean literally.  HAFE stands for High Altitude Flatus Expulsion.  No I am not making this up!  Look it up.

Paul Auerbach, MD and York E Miller, MD submitted their observations to the Western Journal of Medicine.  In it they wrote:

“The syndrome is strictly associated with assent…

I had to read that several times to make sure it wasn’t some kind of a pun.  I’m pretty sure it is.  In fact, it may be two.

“… and is characterized by an increase in both the volume and frequency of the passage of flatus, which spontaneous occurs while climbing to altitudes of 11,000 feet or greater.”

So I guess at 10,999 feet you really have no excuse.

“The use of digestive enzymes and simethicone may minimize the hazard.”

May minimize?  Doctors, we really need some answers here.  I smell someone not taking this seriously enough.

“At present, we can advise victims that the offense is more sociologic than physiologic.”

I am not sure what pseudo-logic Dr. Paul and Dr. York are prescribing, but according to my spell checker sociologic is not even an actual word.  My dictionary defines physiological as “characteristic of normal, healthy functioning”.   In other words, paraphrasing the doctors:

The offense is more something that does not exist than it is characteristic of normal healthy functioning

That seems about right, I think.  One thing I do know is that victims are often so ashamed of this abnormal act that they resort to deceit.  Regardless of what your climbing companions are telling you, there are no such thing as Rocky Mountain Barking Spiders.

What to do?

Like both HAPE and HACE, HAFE appears to be caused by excessive and rapid altitude assent.  To reverse the symptoms, descent is usually the best option.  Yes I agree, descent is a very appropriate pun.  If descent is not possible, then you are going to have to find a way to weather this storm.  I recommend using the lightening storm safety model: spread out!  No sense in everyone getting caught up in friendly fire.

Your other option, of course, is to always travel below 11,000 feet.  If you do, however, find yourself still being productive at lower elevations, you are going to have to come up with something better than Barking Spiders.

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