Altitude Sickness / Food poisoning in Peru/ how to reintroduce food (eventually)

(Becky Searls) #1

Hi all!

I’m in Peru right now and somehow I’m sick. I know I have either:

-altitude sickness (I’m near cusco and machu pichu and it’s about twice as high in altitude as Denver, so this is very common among visitors) or

-food poisoning / montezumas revenge (I’ve literally only had their tea - boiled water- and soup- I imagine it boiled? And water…BUT I stupidly asked for ice in it :stuck_out_tongue_closed_eyes: Probably the ice was made with tap water.

More than likely it’s a combination of both.

Anyways, 3 days later, I still have the typical travelers diarrhea (http://wikitravel.org/en/Travellers'_diarrhea ) and day 1 was a lot of throwing up too. Here is my question:

WHEN I reintroduce food (can’t imagine when that will be as it sounds and looks absolutely awful to me), how would you suggest I do it - can I just kind of treat this like a water fast and reintroduce the way I usually do with small portions of keto friendly foods like a handful of nuts, or because this is a virus instigating the fast, should I follow common knowledge that suggests starting with bland (high carb) foods like rice, toast, saltines etc? Seems weird to do that but I also can tell my stomach is not going to be happy with fat right away - suggestions please??

Also side question: I’m using something a bit like pedialyte now and then to try to not get dehydrated but it has sugar in it - not sure I’ll be able to find magnesium citrate so I’m just trying to limit my intake of that and use more salt in my water. Usually when I fast, I still have bullet proof coffee so this is my first true water only fast - any tips for how to not dehydrate but also avoid unnecessary sugar intake? Would salt in my water be enough or do I just bite the bullet and drink some sugar in the name of not passing out (which I’m prone to and I’m traveling solo)

Thanks in advance!

(Richard Morris) #2

Tough question. If it were me I would just go with salt and water, and maybe get some epsom salts and soak my feet in a bath to take the Mg in subcutaneously and avoid the gut vector. But I’m not prone to blacking out. And if you are travelling alone this is not something you want to risk. Certainly if you don’t have a lot of body fat then you might have no choice and have to take easily absorbed energy in in the form of glucose - and then just readapt to fats once you are well again.

As for food to refeed, Ideally I would try to get some fatty meat in a broth of some kind. Maybe add some fat to it (like butter) and emulsify it in (shake/whisk it)

(Roxanne) #3

I feel for you, I was in a similar situation in Cusco a couple of years ago, but it was not just food poisoning/travellers diaharrea, but amoebic disentery, which must be treated with antibiotics. If you have awful gastric rumbling sounds throughout your abdomen, I’d strongly encourage you to go to a clinic. I ended up in the hospital there for two days with IV fluids and antibiotics.

I wasn’t Keto then, but almost every restaurant has “diet chicken soup” on their menu, specifically for those recovering from altititide sickness or travellers diarrhea. It is a clear broth with a chunks of chicken breast and a few veggies. That’s all I ate for about 3 days after I got out of the hospital - now that I’m fat adapted I would probably ask for butter to add to the broth, and more salt.

Wishing you the best for a speedy recovery!

(Becky Searls) #4

Ugh you poor thing!! I THINK I’m on the road to recovery and not in the same boat you were…I seriously cannot even imagine. I have seen that soup all over so good idea to make that my first meal. You think add butter? Or just let my stomach chill and broth only?

#5

I have a lot of experience with high altitude while in keto. Been at altitudes in excess of 4500 m in keto.

Here’s the best thing to do. Actually, should have done this before the climb. Eat liver every day for a week (or other high iron animal sources) prior to climb. When the body is at altitude, it starts to produce a lot of hemoglobin, in order to scavenge as much oxygen as possible. By loading your body with iron, you help build up The red blood cells at a faster rate.

When you sleep at night, adjust your bed so that your first half is slightly elevated. A good way to do this is shove your luggage or backpack underneath the bed mattress, so that you hinge (bend at the waist) with the top half of your body more elevated than your bottom half. You will breathe better and get deeper sleep.

If you do seek oxygen assistance (get a bottle of air or oxygen), only breathe from it of not more than 15 minutes. You need to train your body to breathe the lower pressure. So, you need to train your body to wean off the “easy breathing apparatus” and learn how to survive in high altitude.

If you can, eat LOTS OF BROTH. Bone broth is your best friend at high altitude. Even if you only have soup cubes, do that. Drink lots of water (air is dry) and then lots of broth to restore lost electrolytes.

Now that you are there, see if you can get some red meat or liver, even in small quantities. Your body is screaming for iron at high altitudes. So, broth, with bits of red meat or liver is your best friend right now. If you have dark (non sweet) chocolate, it helps too.

By the way, Dave Asprey came up with bulletproof coffee after seeing locals in high altitudes in Asia drink high fat yak milk. Glucose is not your friend at high altitude. In fact, I used to be in keto and survive very well without sickness, while others (eating tons of carbs) would suffer like hell. They would look at me eat butter, fat, eggs, etc…and throw the bread away. They told me I was eating unhealthy, and yet THEY were suffering (headache all day long, couldn’t think, couldn’t sleep, etc). Complete cognitive dissonance.

I have lots of experience with high altitude. If you have any other questions, let me know.

(Roxanne) #6

Let your stomach be your guide :slight_smile: You can always start with broth, and if stays down go back for another helping with butter. I don’t recall the quality of butter there or if was even available in the side? That was before I considered it to be a food group, lol.

Also double check whether the “diet chicken soup” includes rice or noodles - in most cases it doesn’t, but it may vary.

Are you actually staying in Cusco?
Good luck!

(Roxanne) #7

Interesting regarding the iron, I’ll keep that in mind the next time I travel to altitude!

(Stickin' with mammoth) #8

I concur. This is a medical emergency and that calls for triage. Get well, then keto on.

PS: I’ve had uber-fit climbing friends get altitude sickness in the Andes, one of them even went on to study it as a scientist after college. If it makes you feel any better (and it probably won’t) they don’t really know why some people get it and others don’t, they’ve only narrowed it down to a (probably) genetic blood thing. So if altitude sickness rears its ugly little head and bites you right in the ass, it’s not your fault.

#9

I’m a bit concerned seeing recommendations in this thread to increase glucose in diet, as ketosis reduces oxygen consumption. And it is well-known that hypoxia (the medical condition of a person experiencing less oxygen in respiration) can be helped with ketosis.

When you are at high altitude, you need

  • more red blood cells (eat lots of iron, preferably from animal source for extra bioavailability)
  • your top half of body slightly elevated during sleep, to increase oxygen absorption through lungs
  • drink lots of water (air is very dry) and lots of electrolytes to replenish the extra drinking of water
  • stay in ketosis, as it reduces your oxygen consumption and help high altitude acclimatization
  • fasting also helps to reduce oxygen consumption, so when you eat, eat small amounts, and fast (as in not multiple snacking all day long), intermittent fasting is better

Like I said…I did climbs in excess of 4,500 m many times. And I have also acquired medical clearance (certified by doctors) to go into ultra high elevations. This is where they put you on a treadmill, with tons of electrodes stuck all over your body, recording your body vitals, and info sent to two separate doctor specialists…and both doctors have to agree you can be certified for ultra high elevation.

Hypoxia is a serious thing. Be careful who you get recommendations from.

#10

Here’s a link to some info on Dr Dominic Dagostino’s work in research…he looked at how ketosis increases body’s performance in high altitude

Dr Peter Attia is another doctor who has looked at ketosis and high altitude.

I used a lot of their info to help me understand the ketosis advantage in ultra high altitudes.

(Becky Searls) #11

Thanks!! This does make me feel better. I am pretty fit- work out daily for about 1 hr- a mix of hog, HIIT, barre, Pilates, etc. so I knew it had to be something like that. I’ve also heard it helps to have more time to acclimate to the altitude. Unfortunately I only had 4 days. If anyone is curious about a Machu Pichu trip in the future, I’d suggest:

  1. Transfer directly form Cusco to Ollantaytambo in the sacred valley where elevation is lower (still much higher than Denver I think) and stay there 2 days to acclimate a bit and see the ruins and little towns nearby.

  2. Transfer from Ollantaytambo to Aguas Calientes (town closest to Machu Pichu) and stay there 2 nights- the night before you do MP (because you want to get there right away in the morning before it’s crowded to get good pictures! First bus leaves aguas calientes at 5:30 ) and the night after (because you’ll be tired from all the walking/hiking if you add a mountain Trek to the normal entrance which is already a lot of walking, and remember, possibly you’ll also be sick lol. On my second night I got an amazing “inka massage” which was like s full Swedish massage followed by a full hot stone massage. $30!!

  3. Transfer back from Aguas Calientes to Ollantaytambo and maybe spend the day there- depends on how much you saw before MP (I didn’t get to explore it before so I loved spending a whole day wandering, doing a mountain biking tour, climbing more Incan ruins). this was the day I finally felt well enough to eat the “chicken diet soup” recommended by a kind soul on this thread. Clearly MANY people suffer from altitude sickness because literally every restaurant sells this! I seriously felt better almost immediately after eating the broth–not sure if that’s correlation or causation as I was in the mend after 3 day starts of fasting anyway, but I think it may have speeded up the process.

  4. Transfer back to Cusco that same night or next day and probably spend a day exploring it before flying back to Lima. Unfortunately between getting sick my first night (I did NOT transfer directly as I suggested; spent the night in cusco at the highest altitude snd wouldn’t recommend it), and then getting back to cusco around 11:00 last night I didn’t really get to explore cusco much, but it is a very quaint beautiful place, especially in the historical center.

Thankfully, I am feeling better now. Here’s what I did to recover:

-let everything run its course (no anti vomit or pepto or anything. I did try some activated charcoal in case it was food poisoning but that didn’t seem to really help and maybe even was a bad idea because I know it sucks ip liquid and I was already at risk for dehydration

  • added salt to my water whenever possible. Also added some pedialyte-type stuff but it didn’t sit well, probably bc I’m fat adapted and glucose just made me feel worse

  • didn’t eat for 3 days. This was not difficult as even the thought or sight of food made me want to throw up

  • drank a LOT of water but a little at a time bc I found drinking a whole glass didn’t stay down

  • tried some Coke Zero. There was mixed info online about carbonation. I know for keto we often do soda water when fasting but lots of people online suggested that for travlers diarrhea it upsets your stomach more. I didn’t see a difference either way but I was careful to sip it slowly. I remember hearing that the syrup in coke helps settle upset stomachs like 20 years ago when I first went to Mexico…but therein lay much of my confusion–it seems like most of these tips work for people on a SAD but maybe not for those who are keto/fat adapted?

  • rested when possible

  • waited until I smelled food that smelled god to consider eating again, and even then, only ate the light chicken soup suggested

  • waited 3 hours to see how I did, felt better, so are a full meal: grilled lamb, and Parmesan quinoa risotto (not totes keto but pretty good!)

Woke up today feeling almost normal, just a few stomach gurgles, and with other symptoms gone. Thank goodness!

While in sure staying in ketosis IS the best for altitude I also have a hard time finding good sources of fat while traveling (I know @fiorella you’ve said it’s easy to find but I just disagree, sorry! When you have limited time and are mostly in touristy places it’s just not convenient to find a local market, ensure the safety of the products, and explain the type of fat source you want, then take it to a restaurant and request they prepare their traditional foods in a new way to accommodate you.) …

…so to conclude, I think the best tips I have are:

  • to NEVER HAVE ICE in your beverages and
  • BE CAREFUL of any fruit juices or smoothies/shakes because 1) sugar and 2) possibly made with contaminated tap water, like the ice and then
  • drink lots of broth
    -bring your own butter and salt if possible to add to your food, and stick to meat and cheese and nuts as much as possible bc veggies were probably also washed in tap water.
#12

It’s very common not wanting to eat when you are at high altitude. Hypoxia reduces hunger big time. How was your sleep?

(Becky Searls) #13

Pretty normal? Which for me since going keto has been all over? Lol. Some nights I’m super antsy–usually when fasting - and others I sleep deeply through the night

#14

Wow! That’s great for high altitude. Many cannot sleep in oxygen starved conditions. If you can sleep, it makes your recovery faster. Those who cannot sleep get on a chain reaction of disaster, as in can’t sleep, next day feel worse, then their second sleep is worse, and so on and so on. It can spiral out of control. If you can sleep, you are way ahead of many others.

(Becky Searls) #15

ABack in Lima now so doing ok! Now my issue is I’m still all over the place without good fat and I’m craving sweets didn’t first time since november. :flushed: Help!

#16

Enjoy the fusion Peruvian-Japanese sushi. Incredible stuff! Seriously. And at pretty good price. When I’m in Lima, I just go all out sushi as much as I can. A lot of it is sashimi style (no rice) with their fancy sauces. Their beef strips stir fry dishes are awesome too, with their hot sauces. Damn good stuff! OMG.

For your sweet tooth, see of you can get dark chocolate. Maybe will help? I dunno.