Question: Why does my face get puffy at altitude?

[Moongidget]

So, I have this problem. I don't know if its only me, but it doesn't seem to affect other people I ski with, or at least to the degree it does me.

After every overnight ski trip, my face swells up and gets puffy. It doesn't hurt or anything, and throughout the morning it kinda goes away, until the next morning. Each subsequent day of the same trip, my face gets puffier and puffier. By day four, my face is so puffy, my eyelids are all gross and I'm certain strangers can tell something is wrong with me.

When I ski, I pretty much ski all day. I do take a Camelbak, and some days I completely drain it. After skiing, I do enjoy wine or another alcoholic drink, but I never drink enough to regret the following day.

It takes about 2 nights sleeping at home before the morning swelling goes away.


Any ideas?

Also, I had Lasik a few years back and this problem was 10X worse when I wore contacts all the time.

 

[pinto]

So, I have this problem. I don't know if its only me, but it doesn't seem to affect other people I ski with, or at least to the degree it does me.

After every overnight ski trip, my face swells up and gets puffy. It doesn't hurt or anything, and throughout the morning it kinda goes away, until the next morning. Each subsequent day of the same trip, my face gets puffier and puffier. By day four, my face is so puffy, my eyelids are all gross and I'm certain strangers can tell something is wrong with me.

When I ski, I pretty much ski all day. I do take a Camelbak, and some days I completely drain it. After skiing, I do enjoy wine or another alcoholic drink, but I never drink enough to regret the following day.

It takes about 2 nights sleeping at home before the morning swelling goes away.


Any ideas?

Also, I had Lasik a few years back and this problem was 10X worse when I wore contacts all the time.

I'm pretty sure that altitude causes water retention in some people ... it's just one of those things, like having a hard time sleeping. Not sure how to counteract, except to keep sodium levels down, keep drinking water, maybe some diuretics?

I had a puffy face issue a few months ago after going on a dirty martini kick. (A kick as in, my preferred cocktail over several weeks, not what would be the obvious result of a "kick" during one evening, lol.) I was waking up with really puffy eyes, after only one drink. I realized all the sodium in the olive brine added to the drink was doing it to me. So no more dirty martinis. :( So, don't drink dirty martinis at altitude, for sure!

 

[contesstant]

I definitely suffer from water retention and overall puffiness in my whole body at altitude, along with insomnia and headaches. I guess I should be grateful my face doesn't puff up! I do get some serious bags under my eyes, though.

I really don't have an answer for you other than you're not alone in the puffiness, mine just doesn't seem to be in my face. It might be worth talking to your doctor about. In the meantime, hydrate like crazy and maybe lay off ANY alcohol while at altitude.

 

[Christy]

I do get some serious bags under my eyes, though.

I get these too! I always thought I noticed them because I'm wearing contacts instead of glasses, which might otherwise hide bags, but maybe it's altitude. Whistler isn't exactly "altitude," but maybe it's enough.

 

[ski now work later]

Always happens to me, and even happened last week at Stowe, not exactly high altitude. I chalk it up to the hotels too, which are kind of dry.

 

[contesstant]

I get these too! I always thought I noticed them because I'm wearing contacts instead of glasses, which might otherwise hide bags, but maybe it's altitude. Whistler isn't exactly "altitude," but maybe it's enough.

I think they're more due to the insomnia :D but the altitude doesn't help. We were sleeping at 8200 feet at Mammoth. It's a high base and harder for me to adjust to than Tahoe.

 

[2ski2moro]

In fact, facial puffiness is a symptom of Altitude Sickness. So are the headaches and the sleep disturbances.

I think the nighttime symptoms are due to the way you breathe during sleep and the amount of oxygen you are able to take in.

Talking to your doctor is the best solution here.

 

[contesstant]

In fact, facial puffiness is a symptom of Altitude Sickness. So are the headaches and the sleep disturbances.

I think the nighttime symptoms are due to the way you breathe during sleep and the amount of oxygen you are able to take in.

Talking to your doctor is the best solution here.

Yep, I definitely have mild to moderate issues. I'm considering trying the prescription for it. Ginkgo bothers my tummy too much. But I usually do OK after a few days and it really doesn't bother me THAT much. I just deal with it. I did read that it's not good to take sleep aids to help with the insomnia as it can be dangerous because you just aren't getting enough oxygen.

 

[Moongidget]

Well, I don't suffer from anything but the ugly puffy face. Fall asleep fine, and I usually ski myself so tired that I can hardly keep myself up past 9 or so. I'll email the Doc and see what she says.

 

[Moongidget]

I talked to the Dr and I've got good news and bad news.

The good news. There is nothing to worry about. My issue is bothersome, not worrisome...

The bad news. I'm just one of those people who elevation affects this way and I have to live with the puffy face. Boo. :(

 

[SkiNana]

I would nonetheless avoid alcohol and increase non-alcoholic fluids at altitude if at all possible. When booking trips to high altitude destinations, try to choose accommodations (for sleeping) at lower rather than higher altitude (e.g: at Big Sky, there are condos at about 6,000 feet, at 7,500 feet, and at 8,200 feet, even some all the way at the bottom of the Spur Rd, at even lower elevation). In addition, try adding an extra pillow or two under your head and see if this affects your facial swelling at all.

This may not be "serious", but it clearly troubles you and detracts from your generally feelings of well being. You might ask your doc about a script for Acetazolamide (Diamox) which is often prescribed for high altitude problems. Since it is actually a diuretic it might be just the ticket, if not contraindicated for you for any reason.

 

[Moongidget]

Doc did say it might help to reduce salt & alcohol and sleep with an extra pillow.

We'll see if any of it helps; I'm headed to Vail for a 4 day this weekend.

 

[dividedsky75]

I live about 5 miles from the beach in NJ and our elevation is probably between 0 and 40 feet around here. I went to Winter Park, CO, for the first time this year and we were skiing at 10,000+ feet. I wasn't having trouble skiing but everything on my body blew up! My face and eyelids were totally puffy. I was having trouble sleeping as well. I guess a 10,000 foot elevation change will do that.

 

[Leila Zucker]

This is most likely Edema of Altitude, which you can think of as a mild form of Acute Mountain Sickness. No treatment is necessary, but if it is really bothering you, you can get your doctor to prescribe acetazolamide, which should help. You get better at night or when you go home because you are at lower altitude.

ER doc aka Dr.Layla, LeilaZ

 

[marzNC]

This is most likely Edema of Altitude, which you can think of as a mild form of Acute Mountain Sickness. No treatment is necessary, but if it is really bothering you, you can get your doctor to prescribe acetazolamide, which should help. You get better at night or when you go home because you are at lower altitude.

ER doc aka Dr.Layla, LeilaZ

What is it about aspirin that makes it good to take when going to high altitude?

 

[Leila Zucker]

No one really knows the mechanism. Altitude sickness is caused by hypoxia, which upregulates prostaglandins, which leads to sympathetic stimulation and pain. Probably aspirin blocks this. There have been a few small placebo controlled studies that show that it works, but that's about it. I say if it works, why not? Except one trip I took so much aspirin I got nosebleeds...oops!

 

[contesstant]

How much aspirin per day? We really can't get to a lower altitude at Mammoth--hopefully low enough (we will be sleeping at 7900 feet next week.) But I'd love to find something that will help me out a bit more. I end up popping a lot of ibuprofen thanks to the headaches I get so I guess I'd have to choose between the two, unless it takes very little aspirin. But I'm assuming I'd have to keep it in my system.

Last time, we slept at about 8300', so I'm hoping the slight decrease helps. I never have an issue while I'm actually skiing, thankfully!

 

[Leila Zucker]

Aspirin will only help with headache. I believe the study in BMJ (British Medical Journal) was circa 1998 and had subjects take one 325mg tablet one hour before arrival at elevation and repeating every 4 hours for a total of 3 doses.

To treat the puffiness, you need acetazolamide 125mg every 12 hours, and your doctor has to prescribe it. Take until symptoms resolve or you descend back to your normal elevation.

You're absolutely correct that sleeping at a lower elevation will help (one of the 3 reasons I rarely stay at any mountain, two being I'm cheap, three being I like to stay in nearby towns and take the shuttles and meet the locals. Even 500 feet makes a difference, though 1000 feet is better. Most people have difficulty starting around 8000 feet, though it varies significantly from person to person.

The only predictor of Acute Mountain Sickness (AMS) is having had it previously, but anyone can get it at any time. The definition of AMS headache after recent ascent plus at least one of the following:
1) tummy troubles (loss of appetite, nausea, vomiting),
2) tired (fatigue/weakness) ,
3) tipsy (dizzy/lightheaded), or
4) terrible insomnia (not just frequent waking).
I remember them as the four T's, a mnemonic I made up.

 

[contesstant]

My neighbor, who is a PA, is coming with us and agrees that it could help sleeping below 8000 feet. (He's a hardcore backcountry skier, being from Alaska will do that to you!) Anyway, I hope he's right.

I'll stick with the ibu since it also helps with the muscle aches I know I'll have. The rest of my symptoms are I think mild/moderate. A bit of insomnia, and headaches. I kind of lose my appetite but I eat so much normally that it doesn't bother me. The insomnia is probably the worst because lack of sleep affects everything.

I might try the acetalozamide in the future. Don't have time to get a script at this time--too busy this week! Thanks for the advice, though!!

 

[SkiNana]

My experience with acetazolamide was that it took 250mg. q12 hours to do any good. Then the soles of your feet tingle so much it feels like the sun is rising in them! Nonetheless, before we moved to altitude, I got so narc-ed above 8,000 ft I walked around with a stupid grin on my face and was the world's cheapest date since all I could drink was water, and gallons of that. (Now I don't need the acetazolamide, but I'm on topiramate, Leila, another CAI, so - same tingle!)

If you really anticipate a problem, your doc would probably just call in a script, or drop in to the local on-the-hill clinic when you get to Mammoth. You can be certain they're familiar with the syndrome and the medication, and the sooner you get on top of it the better. For that matter, your PA friend has prescriptive privilege as well, I imagine.