Report From Mt. Fuji

Richard Crume

July 2010

 

I hope this review of my recent Mt. Fuji climb will be useful to others planning their first ascent of Japan’s highest mountain. Although there are several helpful websites about climbing Mt. Fuji, I was surprised by the rigors of the climb and several challenges encountered along the way. Nevertheless, climbing the mountain was a magnificent experience that I will cherish for a lifetime.

My climb took place overnight, beginning around 10 pm on July 10 and returning the next day at about 1 pm, a journey up and back of about 15 hours. Joining me were two Japanese friends – Masaya and his girlfriend Naomi. Masaya, who had climbed the mountain once before, provided valuable guidance along the way, and his and Naomi’s companionship enriched the experience.

 

Sunrise at the Summit

The trip up the mountain took longer than expected, mainly because I began to develop symptoms of altitude sickness and needed to make several acclimation rest stops along the way. Even so, we reached the summit around the time of sunrise. Many climbers arrive at the summit by 4:30 am or earlier, waiting patiently in the cold wind to catch the first glimmers of sunlight. The climbing season for all but the most experienced climbers is June through July, when the weather conditions are tolerable and the trails clear of snow.  

Most climbers begin at the Fifth Station, which is the highest elevation accessible by car. Among several routes to the top (each with its own Fifth Station), we took the Kawaguchiko-guchi trail, which is the most commonly used pathway and the best for seeing sunrise along the way. Some Mt. Fuji literature suggests that the ascent from the Kawaguchiko-guchi Fifth Station takes just 5 to 6 hours and the descent around 3 hours, but these timeframes were unrealistic for us. Allowing for snack and toilet breaks, pauses to take in the spectacular views, occasional rest stops to acclimate to the altitude, and bottlenecks near the summit, our journey required 8 hours to the top and another 5 back down.  This pace seemed to be about average, with some climbers moving faster while others took more time to reach the summit.

 

 Richard at a Kiosk Along the Trail at Midnight

In planning for the climb, I did not fully anticipate the difficulty of the ascent. Because many Japanese climb Mt. Fuji, I assumed it would be easy, especially for someone like me who exercises regularly and is in good health. Wrong! The beginning of the trail, although on a fairly steep incline at times, was easy. But after the Eighth Station, we found ourselves on steep and rocky terrain where there was no identifiable trail. Instead, chains and ropes guided us upward while providing a lifeline to grab onto. Picking one’s way through this surface of rocks and boulders was no easy task, especially given the degree of incline and the darkness. Although I carried a hand-held flashlight, a headlamp would have been much preferable in this area so that both hands were free to grab rocks and catch oneself during a stumble.

Later, the rocks and boulders gave way to smoother trail, but then the rough-and-tumble surface started up again as we neared the top. This latter part of the trail was the most arduous, requiring steady concentration to maintain good footing, especially after dark.

This is not a technical climb, and people of all ages and abilities handle it without too much difficulty. But in the middle of the night on an empty stomach with a strong wind blowing, the going gets tough at times, and you need to be prepared to stop now and then to catch your breath and to let faster climbers pass by. I had read that about half of Mt. Fuji climbers are foreigners, but for my overnight climb, most appeared to young Japanese men with an occasional young woman tagging along. I did see a couple of children who were seemingly unaffected by the altitude and lack of sleep, and several older couples were doing just fine. Regardless, there are a few serious accidents on the mountainside each climbing season, so it's best to be patient during the climb and not take any chances.

After spending some time on the summit, we traveled down the mountain at a steady pace, with only several rest stops. Still, the descent took a full 5 hours. The smooth and sandy return trail looked easy, but we quickly discovered how difficult it was to keep our footing while going downhill on the loose surface material. Traveling at a slow pace, we still slipped and fell to the ground several times, as did other climbers. I recall only two toilet stations on the return trail, so be prepared to use them wisely.

 

 Walking Sticks are Burned with Stamps Representing the Station

While planning for the journey to the summit, I discounted the possibility of altitude sickness, a common ailment for many Mt. Fuji climbers. Because I had previously climbed to even higher elevations in the U.S. without any adverse health consequences, I reasoned that Mt. Fuji would be no different. Wrong again! Altitude sickness symptoms include some combination of a throbbing headache, loss of appetite, nausea, and hyperventilation, all of which I had at one time or another – during the steepest climbing near the top, I could hardly take more than a few steps at times without stopping to catch my breath. Some other climbers seemed to be in the same condition, and I noticed that quite a few bought oxygen bottles at the Fifth Station to help make breathing easier. Next time I climb, I may consider taking preventative altitude sickness medication, and maybe I’ll grab one of those Fifth Station oxygen bottles on the way up.

Of course, consult your doctor before taking any medication for altitude sickness. Also, you should immediately stop climbing if altitude sickness symptoms persist or if you are otherwise not feeling well. To avoid altitude sickness, some climbers rest at one of several mountain huts along the way, and others make a point of stopping for a time (a half-hour or longer) at each station. There are two first aid stations along the trail, and many climbers avoid the ill effects of climbing by turning around before reaching the summit. (The mountain huts take reservations and typically charge 5,000 to 7,000 yen for a stay of several hours; sometimes a warm meal is included.)

I was looking forward to using my new camera to capture the moment of our arrival at the summit and to photograph mountaintop scenes. But upon reaching the top, all I really wanted to do was to find the toilet and then the soba shop. I did take a few photos, but the weather was cold and windy, and frankly, there is not a lot to photograph up there. I took some shots of the volcanic crater, the soba shop, and the truly incredible views down the mountainside; I made sure to get “TOP MOUNT FUJI ALT 12,395” and “SUNRISE TOP MOUNT FUJI 2010” stamps burned into my walking stick to prove I was actually there (stamps are available in both English and Japanese); and then it was time to head back down to a warmer climate. Once at a lower elevation, my altitude sickness symptoms completely disappeared.

 

Masaya and Naomi Enjoying Soba at the Summit

My clothing choices generally worked out well, thanks to some good advice found on several web sites. My clothing included:

·       Low-cut, water resistant hiking shoes

·       Wool hiking socks

·       Several layers of breathable t-shirts (one long sleeve)

·       Flannel shirt

·       Heavy fleece outer layer

·       Hooded rain jacket

·       Hiking pants and pull-over rain pants

·       Wool knit hat

·       Warm gloves and light cotton gloves

Because of fluctuating wind chill temperatures and levels of exertion, I frequently added or removed layers to stay comfortable. (The Fifth Station temperature when we departed was a comfortable 24˚C/75˚F, while at the summit the next morning the temperature was below freezing with a blustery wind.) The light wool hat knitted by my Japanese mother-in-law was especially valuable as the temperature dropped overnight.

 

Mt. Fuji’s Volcanic Crater

One clothing mistake I made was not to bring a pair of light cotton gloves for grabbing onto chains, ropes, and rocks. My heavy down-filled ski gloves were too bulky for this purpose, and consequently, I had to use my bare hands. This would have been a real problem had the weather been a little colder. (Light cotton gloves are for sale at the Fifth Station.) Additionally, as noted earlier, a headlamp would have been helpful in negotiating the higher elevations of the trail. Be sure to bring extra batteries.

I brought plastic sandwich bags to keep my cell phone, wallet, and camera dry; an eyeglass band to prevent my eyeglasses from blowing away when the winds picked up near the top; a baseball cap to keep the sunlight off my face during return trip; a large plastic bag to carry out my trash; and a small roll of toilet paper (although not needed). Some climbers also carry sunscreen and sunglasses. I managed to stuff all these supplies, some snack food, extra clothing, and water into a medium-size, waterproof backpack.

I also carried with me two liters of water (four bottles), which proved to add considerable weight to my backpack. Since drinks are available along the way, next time I will probably bring just a liter.

Fortunately, I took along plenty of 100 yen coins (100 yen is equivalent to about one U.S. dollar, depending on the exchange rate). The toilet facilities ask for a 200 yen donation (at one toilet it is required), and the walking stick stamps at each station are 200 yen each (300 yen for two stamps on top). Three sizes of walking sticks are available at the Fifth Station for around 1,000 to 1,500 yen, and drinks and snacks along the trail require small change. A reasonably priced warm meal can be had at several coffee shops upon return to the Fifth Station.

Be sure to bring some food for the climb because there are long distances between several snack kiosks, none of which offer anything very appetizing – mainly canned drinks and instant noodles. (I did run across bananas at one location.) The soba for sale on top of the mountain was tasty and comforting after the long climb, and the soba shop provided a welcome refuge from the frigid morning air – prices ranged from around 800 to 2,500 yen.

And don’t forget your camera!

Since the trails may be closed for inclement weather, even in the summer, check the weather forecast in advance. The following web page provides a summit forecast:  http://www.snow-forecast.com/resorts/Mount-Fuji/6day/top.

A good review of the Mt. Fuji climbing experience, including trails, transportation, supplies, and equipment, can be found at Japan-Guide.com: http://www.japan-guide.com/e/e6901.html.

Climbing Mt. Fuji, another excellent web page that provides all sorts of interesting and useful Mt. Fuji information, including almost daily updates during the climbing season, is at: http://www17.plala.or.jp/climb_fujiyama/index.html.

Some information on altitude sickness from the Outdoor Action Program at Princeton University is copied below. Additionally, the Japan-Guide.com reference above has a short section on altitude sickness and the use of oxygen bottles.

Thank you for reading my Mt. Fuji report. If you found this information helpful, or if you have any questions, please write me at mtfujiclimb@gmail.com. Also, if you care to share a few sentences or paragraphs about your Mt. Fuji experience, I will post them here.

 

Richard Crume

July 23, 2010

 

 

Outdoor Action Guide to
High Altitude: Acclimatization and Illnesses

by Rick Curtis, Director, Outdoor Action Program


Traveling at high altitude can be hazardous. The information provided here is designed for educational use only and is not a substitute for specific training or experience. Princeton University and the author assume no liability for any individual's use of or reliance upon any material contained or referenced herein. This paper is prepared to provide basic information about altitude illnesses for the lay person. Medical research on high altitude illnesses is always expanding our knowledge of the causes and treatment. When going to altitude it is your responsibility to learn the latest information. The material contained in this article may not be the most current. Copyright © 1995 Rick Curtis, Outdoor Action Program, Princeton University.


High altitude-we all enjoy that tremendous view from a high summit, but there are risks in going to high altitude, and it's important to understand these risks. Here is a classic scenario for developing a high altitude illness. You fly from New York City to a Denver at 5,000 feet (1,525 meters). That afternoon you rent a car and drive up to the trailhead at 8,000 feet (2,438 meters). You hike up to your first camp at 9,000 feet (2,745 meters). The next day you hike up to 10,500 feet (3,048 meters). You begin to have a severe headache and feel nauseous and weak. If your condition worsens, you may begin to have difficulty hiking. Scenarios like this are not uncommon, so it's essential that you understand the physiological effects of high altitude.

What is High Altitude?

Altitude is defined on the following scale High (8,000 - 12,000 feet [2,438 - 3,658 meters]), Very High (12,000 - 18,000 feet [3,658 - 5,487 meters]), and Extremely High (18,000+ feet [5,500+ meters]). Since few people have been to such altitudes, it is hard to know who may be affected. There are no specific factors such as age, sex, or physical condition that correlate with susceptibility to altitude sickness. Some people get it and some people don't, and some people are more susceptible than others. Most people can go up to 8,000 feet (2,438 meters) with minimal effect. If you haven't been to high altitude before, it's important to be cautious. If you have been at that altitude before with no problem, you can probably return to that altitude without problems as long as you are properly acclimatized.

What Causes Altitude Illnesses

The concentration of oxygen at sea level is about 21% and the barometric pressure averages 760 mmHg. As altitude increases, the concentration remains the same but the number of oxygen molecules per breath is reduced. At 12,000 feet (3,658 meters) the barometric pressure is only 483 mmHg, so there are roughly 40% fewer oxygen molecules per breath. In order to properly oxygenate the body, your breathing rate (even while at rest) has to increase. This extra ventilation increases the oxygen content in the blood, but not to sea level concentrations. Since the amount of oxygen required for activity is the same, the body must adjust to having less oxygen. In addition, for reasons not entirely understood, high altitude and lower air pressure causes fluid to leak from the capillaries which can cause fluid build-up in both the lungs and the brain. Continuing to higher altitudes without proper acclimatization can lead to potentially serious, even life-threatening illnesses.

Acclimatization

The major cause of altitude illnesses is going too high too fast. Given time, your body can adapt to the decrease in oxygen molecules at a specific altitude. This process is known as acclimatization and generally takes 1-3 days at that altitude. For example, if you hike to 10,000 feet (3,048 meters), and spend several days at that altitude, your body acclimatizes to 10,000 feet (3,048 meters). If you climb to 12,000 feet (3,658 meters), your body has to acclimatize once again. A number of changes take place in the body to allow it to operate with decreased oxygen.

  • The depth of respiration increases.
  • Pressure in pulmonary arteries is increased, "forcing" blood into portions of the lung which are normally not used during sea level breathing.
  • The body produces more red blood cells to carry oxygen,
  • The body produces more of a particular enzyme that facilitates
  • the release of oxygen from hemoglobin to the body tissues.

Prevention of Altitude Illnesses

Prevention of altitude illnesses falls into two categories, proper acclimatization and preventive medications. Below are a few basic guidelines for proper acclimatization.

  • If possible, don't fly or drive to high altitude. Start below 10,000 feet (3,048 meters) and walk up.
  • If you do fly or drive, do not over-exert yourself or move higher for the first 24 hours.
  • If you go above 10,000 feet (3,048 meters), only increase your altitude by 1,000 feet (305 meters) per day and for every 3,000 feet (915 meters) of elevation gained, take a rest day.
  • "Climb High and sleep low." This is the maxim used by climbers. You can climb more than 1,000 feet (305 meters) in a day as long as you come back down and sleep at a lower altitude.
  • If you begin to show symptoms of moderate altitude illness, don't go higher until symptoms decrease (&quotDon't go up until symptoms go down").
  • If symptoms increase, go down, down, down!
  • Keep in mind that different people will acclimatize at different rates. Make sure all of your party is properly acclimatized before going higher.
  • Stay properly hydrated. Acclimatization is often accompanied by fluid loss, so you need to drink lots of fluids to remain properly hydrated (at least 3-4 quarts per day). Urine output should be copious and clear.
  • Take it easy; don't over-exert yourself when you first get up to altitude. Light activity during the day is better than sleeping because respiration decreases during sleep, exacerbating the symptoms.
  • Avoid tobacco and alcohol and other depressant drugs including, barbiturates, tranquilizers, and sleeping pills. These depressants further decrease the respiratory drive during sleep resulting in a worsening of the symptoms.
  • Eat a high carbohydrate diet (more than 70% of your calories from carbohydrates) while at altitude.
  • The acclimatization process is inhibited by dehydration, over-exertion, and alcohol and other depressant drugs.

Preventive Medications

  • Diamox (Acetazolamide) allows you to breathe faster so that you metabolize more oxygen, thereby minimizing the symptoms caused by poor oxygenation. This is especially helpful at night when respiratory drive is decreased. Since it takes a while for Diamox to have an effect, it is advisable to start taking it 24 hours before you go to altitude and continue for at least five days at higher altitude. The recommendation of the Himalayan Rescue Association Medical Clinic is 125 mg. twice a day (morning and night). (The standard dose was 250 mg., but their research showed no difference for most people with the lower dose, although some individuals may need 250 mg.) Possible side effects include tingling of the lips and finger tips, blurring of vision, and alteration of taste. These side effects may be reduced with the 125 mg. dose. Side effects subside when the drug is stopped. Contact your physician for a prescription. Since Diamox is a sulfonamide drug, people who are allergic to sulfa drugs should not take Diamox. Diamox has also been known to cause severe allergic reactions to people with no previous history of Diamox or sulfa allergies. Frank Hubbell of SOLO recommends a trial course of the drug before going to a remote location where a severe allergic reaction could prove difficult to treat.
  • Dexamethasone (a steroid) is a prescription drug that decreases brain and other swelling reversing the effects of AMS. Dosage is typically 4 mg twice a day for a few days starting with the ascent. This prevents most symptoms of altitude illness. It should be used with caution and only on the advice of a physician because of possible serious side effects. It may be combined with Diamox. No other medications have been proven valuable for preventing AMS.

Acute Mountain Sickness (AMS)

AMS is common at high altitudes. At elevations over 10,000 feet (3,048 meters), 75% of people will have mild symptoms. The occurrence of AMS is dependent upon the elevation, the rate of ascent, and individual susceptibility. Many people will experience mild AMS during the acclimatization process. Symptoms usually start 12-24 hours after arrival at altitude and begin to decrease in severity about the third day. The symptoms of Mild AMS are headache, dizziness, fatigue, shortness of breath, loss of appetite, nausea, disturbed sleep, and a general feeling of malaise. Symptoms tend to be worse at night and when respiratory drive is decreased. Mild AMS does not interfere with normal activity and symptoms generally subside within 2-4 days as the body acclimatizes. As long as symptoms are mild, and only a nuisance, ascent can continue at a moderate rate. When hiking, it is essential that you communicate any symptoms of illness immediately to others on your trip. AMS is considered to be a neurological problem caused by changes in the central nervous system. It is basically a mild form of High Altitude Cerebral Edema (see below).

Basic Treatment of AMS

The only cure is either acclimatization or descent. Symptoms of Mild AMS can be treated with pain medications for headache and Diamox. Both help to reduce the severity of the symptoms, but remember, reducing the symptoms is not curing the problem. Diamox allows you to breathe faster so that you metabolize more oxygen, thereby minimizing the symptoms caused by poor oxygenation. This is especially helpful at night when respiratory drive is decreased. Since it takes a while for Diamox to have an effect, it is advisable to start taking it 24 hours before you go to altitude and continue for at least five days at higher altitude. The recommendation of the Himalayan Rescue Association Medical Clinic is 125 mg. twice a day (morning and night). (The standard dose was 250 mg., but their research showed no difference for most people with the lower dose, although some individuals may need 250 mg.) Possible side effects include tingling of the lips and finger tips, blurring of vision, and alteration of taste. These side effects may be reduced with the 125 mg. dose. Side effects subside when the drug is stopped. Contact your physician for a prescription. Since Diamox is a sulfonamide drug, people who are allergic to sulfa drugs should not take Diamox. Diamox has also been known to cause severe allergic reactions to people with no previous history of Diamox or sulfa allergies. Frank Hubbell of SOLO in New Hampshire recommends a trial course of the drug before going to a remote location where a severe allergic reaction could prove difficult to treat.

Moderate AMS

Moderate AMS includes severe headache that is not relieved by medication, nausea and vomiting, increasing weakness and fatigue, shortness of breath, and decreased coordination (ataxia). Normal activity is difficult, although the person may still be able to walk on their own. At this stage, only advanced medications or descent can reverse the problem. Descending even a few hundred feet (70-100 meters) may help and definite improvement will be seen in descents of 1,000-2,000 feet (305-610 meters). Twenty-four hours at the lower altitude will result in significant improvements. The person should remain at lower altitude until symptoms have subsided (up to 3 days). At this point, the person has become acclimatized to that altitude and can begin ascending again. The best test for moderate AMS is to have the person "walk a straight line" heel to toe. Just like a sobriety test, a person with ataxia will be unable to walk a straight line. This is a clear indication that immediate descent is required. It is important to get the person to descend before the ataxia reaches the point where they cannot walk on their own (which would necessitate a litter evacuation).

Severe AMS

Severe AMS presents as an increase in the severity of the aforementioned symptoms, including shortness of breath at rest, inability to walk, decreasing mental status, and fluid buildup in the lungs. Severe AMS requires immediate descent to lower altitudes (2,000 - 4,000 feet [610-1,220 meters]).


There are two other severe forms of altitude illness, High Altitude Cerebral Edema (HACE) and High Altitude Pulmonary Edema (HAPE). Both of these happen less frequently, especially to those who are properly acclimatized. When they do occur, it is usually with people going too high too fast or going very high and staying there. The lack of oxygen results in leakage of fluid through the capillary walls into either the lungs or the brain.

High Altitude Pulmonary Edema (HAPE)

HAPE results from fluid buildup in the lungs. The fluid in the lungs prevents effective oxygen exchange. As the condition becomes more severe, the level of oxygen in the bloodstream decreases, and this can lead to cyanosis, impaired cerebral function, and death. Symptoms include shortness of breath even at rest, "tightness in the chest," marked fatigue, a feeling of impending suffocation at night, weakness, and a persistent productive cough bringing up white, watery, or frothy fluid. Confusion, and irrational behavior are signs that insufficient oxygen is reaching the brain. One of the methods for testing yourself for HAPE is to check your recovery time after exertion. If your heart and breathing rates normally slow down in X seconds after exercise, but at altitude your recovery time is much greater, it may mean fluid is building up in the lungs. In cases of HAPE, immediate descent is a necessary life-saving measure (2,000 - 4,000 feet [610-1,220 meters]). Anyone suffering from HAPE must be evacuated to a medical facility for proper follow-up treatment.

High Altitude Cerebral Edema (HACE)

HACE is the result of swelling of brain tissue from fluid leakage. Symptoms can include headache, loss of coordination (ataxia), weakness, and decreasing levels of consciousness including, disorientation, loss of memory, hallucinations, psychotic behavior, and coma. It generally occurs after a week or more at high altitude. Severe instances can lead to death if not treated quickly. Immediate descent is a necessary life-saving measure (2,000 - 4,000 feet [610-1,220 meters]). There are some medications that may be prescribed for treatment in the field, but these require that you have proper training in their use. Anyone suffering from HACE must be evacuated to a medical facility for proper follow-up treatment.

Other Medications for Altitude Illnesses

  • Ibuprofen is effective at relieving altitude headache.
  • Nifedipine rapidly decreases pulmonary artery pressure and relieves HAPE.
  • Breathing oxygen reduces the effects of altitude illnesses.

Gamow Bag (pronounced ga´ mäf)

This clever invention has revolutionized field treatment of high altitude illnesses. The bag is basically a sealed chamber with a pump. The person is placed inside the bag and it is inflated. Pumping the bag full of air effectively increases the concentration of oxygen molecules and therefore simulates a descent to lower altitude. In as little as 10 minutes the bag can create an "atmosphere" that corresponds to that at 3,000 - 5,000 feet (915 - 1,525 meters) lower. After a 1-2 hours in the bag, the person's body chemistry will have "reset" to the lower altitude. This lasts for up to 12 hours outside of the bag which should be enough time to walk them down to a lower altitude and allow for further acclimatization. The bag and pump weigh about 14 pounds (6.3 kilos) and are now carried on most major high altitude expeditions. Bags can be rented for short term trips such as treks or expeditions.

Cheyne-Stokes Respirations

Above 10,000 feet (3,000 meters) most people experience a periodic breathing during sleep known as Cheyne-Stokes Respirations. The pattern begins with a few shallow breaths and increases to deep sighing respirations then falls off rapidly. Respirations may cease entirely for a few seconds and then the shallow breaths begin again. During the period when breathing stops the person often becomes restless and may wake with a sudden feeling of suffocation. This can disturb sleeping patterns, exhausting the climber. Acetazolamide is helpful in relieving the periodic breathing. This type of breathing is not considered abnormal at high altitudes. However, if it occurs first during an illness (other than altitude illnesses) or after an injury (particularly a head injury) it may be a sign of a serious disorder.

Sources:

  • Mountain Sickness, Peter Hackett, The Mountaineers, Seattle, 1980.
  • High Altitude Illness, Frank Hubble, Wilderness Medicine Newsletter, March/April 1995.
  • The Use of Diamox in the Prevention of Acute Mountain Sickness, Frank Hubble, Wilderness Medicine Newsletter, March/April 1995.
  • The Outward Bound Wilderness First Aid Handbook, J. Isaac and P. Goth, Lyons & Burford, New York, 1991.
  • Medicine for Mountaineering, Fourth Edition, James Wilkerson, Editor, The Mountaineers, Seattle, 1992.
  • Gamow Bags - can be rented from Chinook Medical Gear, 34500 Hwy 6, Edwards, Colorado 81632, 970-926-9277. www.chinookmed.com

Additional Reading:

  • Altitude Illness Prevention & Treatment, Steven Bezruchka, The Mountaineers, Seattle, 1994.
  • Going Higher, Charles Houston, Little Brown, 1987.
  • High Altitude Sickness and Wellness, Charles Houston, ICS Books, 1995.
  • High Altitude Medicine and Physiology, Ward Milledge, West, Chapman and Hall, New York, 1995.

This article is written by Rick Curtis, Director, Outdoor Action Program. This material may be freely distributed for nonprofit educational use. However, if included in publications, written or electronic, attributions must be made to the author. Commercial use of this material is prohibited without express written permission from the author. Copyright © 1998 Rick Curtis, Outdoor Action Program, Princeton University.

 

 

 

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