Dear Diary,

Altitude Sickness

Wikipedia, the free encyclopedia

Altitude sickness – also known as acute mountain sickness (AMS), altitude illness, hypobaropathy, “the altitude bends,” or soroche – is a pathological effect of high altitude on humans, caused by acute exposure to low partial pressure of oxygen at high altitude. It commonly occurs above 2,400 meters (8,000 feet). It presents as a collection of nonspecific symptoms, acquired at high altitude or in low air pressure, resembling a case of “flu, carbon monoxide poisoning, or a hangover.” It is hard to determine who will be affected by altitude sickness, as there are no specific factors that correlate with a susceptibility to altitude sickness. However, most people can ascend to 2,400 meters (8,000 feet) without difficulty.


Acute mountain sickness can progress to high-altitude pulmonary edema (HAPE) or high-altitude cerebral edema (HACE), which are potentially fatal.

Symptoms that may indicate life-threatening altitude sickness include:

Pulmonary edema (fluid in the lungs)

  • Symptoms similar to bronchitis
  • Persistent dry cough
  • Fever
  • Shortness of breath even when resting

.Cerebral edema (swelling of the brain)

  • Headache that does not respond to analgesics
  • Unsteady gait
  • Gradual loss of consciousness
  • Increased nausea
  • Retinal hemorrhage

The most serious symptoms of altitude sickness arise from edema (fluid accumulation in the tissues of the body). At very high altitude, humans can get either high-altitude pulmonary edema (HAPE), or high-altitude cerebral edema (HACE).    

HAPE can progress rapidly and is often fatal. Symptoms include fatigue, severe dyspnea at rest, and cough that is initially dry but may progress to produce pink, frothy sputum. Descent to lower altitudes alleviates the symptoms of HAPE.

HACE is a life-threatening condition that can lead to coma or death. Symptoms include headache, fatigue, visual impairment, bladder dysfunction, bowel dysfunction, loss of coordination, paralysis on one side of the body and confusion. Descent to lower altitudes may save those afflicted with HACE.

Before dawn, Marta was fixing breakfast. David and Agustin, who had driven up from Cafayate the night before, were out with their horses. Jorge, too, had brought up three horses, two mules and two burros. One of the burros was not much bigger than a large dog. We thought it must not be fully grown.

“No, no…” Jorge told us. “It’s just a burrito.”

We took that to mean that there was a species of dwarf burro in the valley and that we shouldn’t worry when he loaded it with gear for our four-day trek out to the Puna.

Jorge and Gustavo then saddled up the horses and packed up the mule and the other burro. It was not obvious how the mountains of supplies would stay on their backs, but they seemed to have a system for rigging them up.

“Napoleon invaded Russia with less stuff,” we said to Sergio.

The hierarchy of ranches – or at least those owned by foreigners – is as follows: owner, administrador, encargado, capataz. In our case, the administrador is a lawyer in Salta. The encargado is the link between the outside world and the ranch; he brings supplies and keeps an eye on things and reports back to the administrador, who in turn reports to the owner. The capataz is the ranch foreman. It is he that actually makes things happen.

Sergio is the encargado. Jorge is the capataz.

“Well, we need a lot of stuff,” Sergio replied. “It’s rough up there.”

We would realize, 12 hours later, how rough it was.

“Hmmm… cold winds,” Jorge said, looking up at skies. There were clouds, high, light, in a fish-scale pattern. This time of year, that pattern marks the arrival of winter winds.

After a quick breakfast of eggs, toast and coffee, we mounted up. Marta and Gustavo waved goodbye – “Que vayan bien” – and the expedition took off.

On the map, it looked simple enough. We would ride for 10 hours, to the house of our most distant puestero – Sylvia. There, we would set up camp, spend the night, and move out the next day to our destination, Río de los Patos.

Horses, riders, mules and burros headed out quietly, going around the back of the house and up the trail over the hill to the main “road” to the high pasture. We had not been gone more than half an hour before our plan ran into trouble. The packs on the burros shifted to one side or the other and needed to be readjusted. Each time, Jorge leapt from his mule (he always prefers a mule for mountain trekking) and hitched up the wool ropes, pulling them hard to get them cinched up again.

The burro did not appreciate the tugging; he turned his head to try to bite


“Ahh… burro!” Jorge yelled at him, smiling.

We have been over this part of the trail many times. But our guests found it challenging.

“I hope the rest of the ride won’t be this steep,” said David, an American, an avid horseman, who lives down in Cafayate.

“No,” we replied, “it will be much worse.”

Soon, we were on the “road” and moving along fairly well. But it was already clear that we were falling behind.

“We’ve got to get there before nightfall,” Jorge explained. “Otherwise, it will be very hard to set up our tents and prepare our dinner.”

Getting there before nightfall became our principle preoccupation. To that end, Jorge drove the burros along.

“Ayyyup! Ayyyup!”

“You drive the burros and you pull the mules,” he explained. “Different personalities. Burros can’t be led. Mules can’t be pushed.”

The burros were unattached, but they went where Jorge drove them, up the “road” to the pass… and then down the “road” to the big valley on the other side.

The valley is called Compuel. It is about 10,000 acres, with a river running through it. Despite its size, Compuel supports only 200 of our cattle. It could take 100 or so more, but the valley is becoming the site of a range war. Much of the available pasture is eaten by burros, sheep and llama that do not belong to us. And their owners believe – probably correctly – that we will be unable to get rid of them. But that’s another story for another day…

David checked his GPS…

“We’re at 3,500 meters [11,500 feet]. And if this is right, it’s about 40 kilometers to where we’re going tonight, and we’ve gone about halfway.”

But it was already 2 in the afternoon and we needed to stop for lunch.

The wind was blowing hard. Jorge led us to a big rock that provided shelter. There in a corner, he built a fire, put stones around it, skewered pieces of lamb on sharpened sticks and laid them over the coals.

Agustín is a young Argentine, from Buenos Aires, but married to a local girl and now living in Cafayate. Friendly and good-looking, with dark hair and pale skin, he trained as an oenologist in Bordeaux, France, and in Italy, and now speaks both French and Italian as well as Spanish. He is developing a business in the valley of producing very high-quality wines, which he sells to the Chinese at high prices. He brought several bottles of wine – each one an example of what the valley could produce – for the trip.

“This is a Tannat,” he said pulling out the cork.

He poured the wine into our plastic cup while Sergio came around with roasted lamb.

“If we leave here by 3, we ought to get there at 7,” Jorge calculated. “That’s cutting it close, because it gets dark at 7:30.”

The Wikipedia entry on “mountain sickness” tells us that experienced mountain climbers go up no more than 300 meters per day, giving themselves time to adjust to the higher altitude. We had already gone from the main house, at 2,800 meters, to our high pasture at 3,500, an increase of more than twice that amount.

But we had not consulted Wikipedia or any other authority before beginning our expedition. We had it only on Jorge’s say-so that this was something that could be done. And our plan included an ascent of another 500 meters – to 4,000, or more than 13,000 feet – by the end of the day. We would go up 1,200 meters – four times the mountain climber recommendation – in a single day.

After lunch, we packed up the mule and burros, checked our horses’ cinches, and moved on. We were now riding across the valley, on a wide, flat, swampy plain with green grass watered by a little river curling along the valley floor. After an hour, we entered a defile and turned onto a path on the side of the hill. Climbing, we continued on the side of the hill, higher and higher. Several times we had to stop and reorganize the packs. Each time, Jorge jumped from his mule to do the work, often running ahead to catch the burros. Agustín dismounted to help. It took two men – one on each side – to push and pull the load into place, and then to tighten up the ropes.

We tried to help, but the task required more local jargon and coordination than we could manage. In addition, we were noticing already that the air was getting thin. Even the exertion of dismounting and mounting again caused heavy breathing.

The task was never easy. It was made much more difficult by the narrow little path, squeezed by rocks on one side and a cliff on the other, on which we had to do the work.

It was on one of these efforts that your editor almost died…

We’re acquiring a local reputation.

“Don Bill is not a good horseman. But at least he gets up after falling off.”

“Don Bill is not a good cattleman, but he can run fast and jump a fence to get away from the bull.”

“Don Bill is not very smart, but he’s pretty tough for a gringo.”

The source of our reputation comes from several incidents, the most recent of which we have begun to describe. We were riding along on our expedition to the Río de los Patos, on a difficult path on the side of a mountain. On the right, we were hemmed in by large rocks. On the left, was a drop-off of several hundred feet. Forced to halt when one of the burro’s packs slipped to the side, we had to get off our horse on the left side, because there was no room on the right. This left us standing on a ledge, about a foot wide, before walking forward to see if we could help Jorge.

Jorge signaled that he needed no help, so we stood on our rocks, holding the reins of our horse.

Suddenly, for no apparent reason, the horse jumped up toward us. He pushed us off the ledge. We fell about 15 feet down, into some briar bushes and rocks. We might have fallen much farther, with fatal consequences, but we held the horse’s reins in our right hand and used it to break our fall. This was not without its own dangers; we might have pulled the horse down with us and on top of us, but we had no time to think. Fortunately, the animal held his ground.

Bruised and stuck with thorns, we got up, climbed back up to the horse and remounted.

“You were lucky,” commented Agustín. “It could have been much worse.”

The march went on. Up… and up… and up… the valley. There were pampas grasses in the river. On the hillsides were grasses and thorny bushes in some places. In others, nothing but rocks.

The burros – driven ahead by Jorge – came out of the narrow passage first. Then, the rest of us followed, with Agustin pulling the pack mule. The rocky valley gave way to a wider, grassier space. A river ran through it as it widened out into broad, grass-covered hills.

Each horse had his personality. Elizabeth rode a very energetic black Criollo. It liked to be first, and bobbed its head when held back. Maria, Jorge’s wife, was covered from head to toe – hat, scarf, coat, pants, boots – and mounted on another Criollo, brown with a white face. David and your editor were both on buckskin-colored Criollos and Agustín had a rented horse – a fine-looking Paso Fino.

We had warned Agustín that the Paso Fino were not tough enough for mountain trekking.

“Don’t worry. He’s very strong,” he replied.

He had to be. We rode steadily, a total of about 10 hours, most of it uphill. The oxygen content of the air fell. And it was getting colder.

We pulled jackets, scarves and gloves out of our bags. David put on a poncho.

As we got into higher, greener pastures we noticed a group of llamas. Funny-looking animals, with long necks and small heads, they were not afraid. Instead, they were curious. They studied us as we rode by.

Among the llama were several very young ones, with spindly legs. All were covered in a deep nap of wool – some white, some black, some brown, and many mixtures. And as we approached the stone hut, where Sylvia lives, the llamas increased in number. There were dozens of them at first, then hundreds.

Sylvia is a woman of about 40 or 45. She walks with a limp, with one leg off at an angle to the other.

“Her mother died when she was a baby,” Maria explained. And her father was off in the mountains. She was left with her older brothers. She developed some sort of abscess or infection in her leg. Her brothers didn’t pay much attention and it went untreated. She was crippled.”

Sylvia was dressed in a pair of pants, over which she had a bright orange skirt. Above it was a homemade sweater, probably of llama wool. On her head was an Andean hat – also decorated with flower patterns in rich colors. Despite the cold, she wore neither coat nor gloves, nor any foot covering except sandals. This detail seems so unlikely, given the cold, that we could hardly believe it. But we saw nothing else on her feet the whole time we were with her.

We arrived about a quarter after 7. The light was already fading, with the last rays of sunshine creeping up the mountain to the east. We made haste to unsaddle the horses and unload the mule and burros. Then Jorge arranged them in pairs. He hobbled one of the animals in each pair with a wool rope tied to its front legs, then he tied another rope from the hobbled animal’s neck to its partner. With one thus hobbled and the other tied to it, they couldn’t go far but could still graze and get water.

It was getting colder and colder. Our hands were getting numb, trying to put together tents and help Jorge with the horses. But soon, the work was done. The local horses trundled out into the pasture and were soon lost in the darkness. The two horses from Cafayate, however, seemed confused. They stayed in front of the house until Jorge finally shooed them away. Even then, they hesitated, unsure of what they were supposed to do.

Sylvia knew we were coming. The courtyard of the house, the space between three small buildings, had recently been swept.

The buildings were built out of stone, everywhere in much abundance. There was little attempt at architectural perfection. Walls were not necessarily straight. Doors, of cactus wood held together with rawhide, were cockeyed. The kitchen had no door at all. Its entryway of granite, was shiny with the oil of hands that must have rubbed against it for many years, often greasy from slaughtering one of the many llamas or sheep in the valley.

“They don’t have anything but llama and sheep,” Jorge explained. “They don’t have a fruit orchard or a kitchen garden. Nothing will grow up here but grass.”

“How do they live? They can’t live just on sheep and llama.”

“Yes, they do, and a few cattle. Well, they come down and get some apples and nuts from us. I just give them to them. And they trade with the other people for corn. They get enough to live on. Meat, milk, cheese – with corn and nuts.

“And now they get support from the government; they can buy things and bring them back here on mules.”

Sylvia has a sharp look on her face and speaks in a local patois that sounds a bit like a yell or a bark. It takes a while to understand her. From what we could make out, her father gave her this puesto four years ago. Her brothers didn’t want it. Too far. Too cold. Too barren.

There are no trees. Just open, grass-covered mountains, with snow on the ones to the west and a gurgling river a few yards down from the house.

She has three children. The oldest is a boy who worked for us for a while then moved away. He currently works in the construction trade in Salta. He seemed bright and confident.

Her daughter, Claudia, stays up at the puesto full-time, looking after the sheep and the llama. Claudia is about 18 years old. She is a little chubby and dresses in jeans, tennis shoes, a heavy sweater and the same broad-brimmed Andean hat as her mother.

Her youngest daughter, Nancy, stays at the school near the main house. Nancy is one of the girls in Elizabeth’s English class, and one of the quickest to catch on. Sylvia spends most of the school year down near the school, at a small adobe house owned by the ranch, so she can be with Nancy.

“Do I understand this right?” we asked Maria. “Claudia stays here by herself most of the time while Sylvia is down in the valley with Nancy?”

“Yes, it’s very strange that a girl of that age lives alone so far from everyone. But that’s the way it has been for the last four or five years. Sylvia comes back sometimes. But it’s a 14-hour walk, so she can’t do it very often.

“Claudia is not entirely alone, though. There’s another family up here – well, maybe four hours away on foot – and they get together once a week or so. They are all cousins or half-siblings. It’s hard to follow because Sylvia’s father had more than one family.”

In the kitchen, there was a fire on the dirt floor, surrounded by stones. A grill had been placed over the fire, on which there were two pots and one kettle. In one of the pots was our evening meal – rice.

Smoke filled the kitchen. There was no chimney. The smoke went out through the roof or through the open doorway. There were no cabinets. No sink. No running water. No kitchen table. No refrigerator or stove. Sylvia, Claudia and Elizabeth sat on tiny chairs around the fire, talking.

Elizabeth cut up some sausage we had brought with us and put it in the rice. It was very tasty.

“No, thank you,” Jorge said when offered a plate.

“You’re not eating?”

“No… I never eat anything for dinner when I’m up here. Otherwise, I won’t be able to sleep.”

Taking Jorge’s lead, we had a couple of bites and passed the plate back to Elizabeth.

Night fell as we scrambled to put together our bedding. We had air mattresses, but the air pump didn’t work. We tried blowing them up, as if we were giving them mouth-to-mouth resuscitation, but it was hopeless. It was hard enough to breathe, let alone blow something up.

Instead, we collected the horse blankets and lay them on the ground. That would be our bed. On top, we put down our sleeping bags, with a poncho on top of them.

One of the buildings was a bedroom. In it were two beds, covered with several layers of llama-wool blankets.

“You’re welcome to sleep inside,” Sylvia offered. “Claudia and I can take one bed.”

Agustín, who had not brought a tent, took the offer. Meanwhile, Sergio and Jorge set up their tents in the lee of stone walls, trying to protect themselves from the driving wind. David had a sausage-shaped one-man tent that he put up near ours.

We drank some local herb tea and all went to bed.

But we did not go to sleep. The wind howled, threatening to blow away our tents. Even protected by the buildings and stone walls, it blew hard against the thin tent walls.

And it was cold. The temperature had already dropped below freezing and the night had just begun.

We crawled into our tent. The ground was like concrete, even with the fleecy saddle covers under us. But our sleeping bags were warm. Elizabeth went to sleep straightaway, exhausted by the day’s ride.

Dogs began to bark. One, then two, then all three. What was out there? A puma? There were surely no other humans for many miles.

After a while, the dogs settled down. The wind blew harder. It was a bitter cold wind. How did the dogs and the horses stand it? The horses had been ridden hard all day, without food. Now, the night was freezing cold and they had no protection from the wind.

Out on the top of our tent, a flap blew open. It was small. Maybe it was a good thing; we needed all the oxygen we could get. Out through the hole, we saw the starriest sky we’ve ever seen. Millions of stars… a whole dust cloud of them. There was no moon to compete with them. And no atmosphere to block them. They were so bright that, even without a moon, it was light outside.

We lay awake, contemplating the series of events and thoughts that had brought us – now beyond retirement age – to be sleeping outside on the hard ground, at 13,000 feet, with a hurricane wind blowing through the walls of a light tent. We don’t like camping out, never have. We don’t have any special appreciation for nature, or for “roughing it,” or for pitting ourselves against the elements. The whole experience was foreign… even curiously bizarre.

And yet, there was something charming about it. We pulled up the edges of our sleeping bag and wrapped a wool scarf around our head. The sleeping bag was designed so that your head fits into it. But we are too tall, so our head poked out.

We had no pillow. And all the saddle blankets were beneath us. So we brought up one of our boots and rolled up a jacket to put on top of it. Thus, curled up… and snug in our sleeping bag… we were strangely at peace with the world. Howl ye winds! Drop ye temperatures! We are ready for you.

But one thing was beginning to bother us: We couldn’t breathe. Each time we began to fall asleep, we awoke, gasping. Awake, the body took in as much air as it needed. But when it settled into sleep rhythm, the lungs did not get enough air. And the moment we started back to consciousness, sucking air as if we had been underwater, was terrifying. What if we didn’t awake? What if the body got tired of fighting and simply let us drift off into unconsciousness? What if some deeper problem resulted from not having enough oxygen in our blood, something like brain damage?

We decided to stay awake. We listened to the wind, flapping the sides of the tent… picking up dust and blowing pieces of cardboard around the courtyard. We looked at the stars and wondered what worlds they might hide. We thought about our ride… about how Sylvia and her daughter could stand such a rude life… We thought about our business, our family, our future.

We wondered how come people still lived as they had 1,000… 2,000… many thousands of years ago. This was like Jacob, Esau and Isaac in the Old Testament – pastoral people of the Mideast 5,000 years ago.

No, it was much worse. They had fruits and vegetables… even wine… in the House of Abraham. And they weren’t freezing their derrieres off.

We didn’t think about money. Or the stock market. Or economics. Or any of the things that are supposed to be the subjects of this Diary.

In fact, the only thing connected to the subject was a sudden realization: that money really didn’t matter very much.

Of course, this was a fantasy, probably caused by the lack of oxygen. Without the money to buy the ranch, we wouldn’t we sleeping in a dirt yard, without a mattress.

Without the money to hire Jorge and Sergio, we wouldn’t have been able to do this 10-hour horseback ride… with another 30 hours left to go.

Without the cash to pay for an expensive lifestyle, we wouldn’t now be outside on a freezing cold night in the middle of nowhere, at least a day’s horseback ride back to our house… and then another five hours in a truck to get back to medical facilities, restaurants, hotels and the rest of what is normally associated with a decent lifestyle.

Without the resources to afford the “good life,” we couldn’t share Sylvia’s pot of rice cooked over an open fire in a smoky kitchen with a dirt floor.

And without the financial means to live where and how we want, we wouldn’t now be lying awake gasping for air in a flimsy tent in the high Andes.

Without money, we’d now be in a comfortable house somewhere in the suburbs… enjoying a modest retirement on Social Security and perhaps a little pension.

The night went by. Often we drifted off to sleep for a second or two… then awoke, drawing oxygen as fast as we could. Many times we wondered… was it 2 a.m.… or 4 a.m.…?

We were eager for dawn.

“I give up. This isn’t working for me.”

We didn’t know what time it was. It was still dark. But the voice was David’s. He was decamping. From his tent into the kitchen. It was too cold outside.

We wondered how much warmer the kitchen would be, without a door. The walls would protect him from the winds. And the stones would still have some of the day’s heat. The floor might even retain some of the heat from the fire. But it wouldn’t be warm.

The night continued.

Finally, a light appeared. Voices. It was Sylvia talking to David. She had gotten up early so that she could walk for hours to round up her cattle for vaccination.

We stayed in our tent. It was still dark. And it was bitter cold. At least, as long as we stayed in our sleeping bags, we would be warm.

It grew lighter. Now, Jorge’s voice greeted Sylvia. And Agustín came out of the bedroom.

“Buenos días, how did you sleep?” he asked David.

“Sleep? I didn’t sleep. Falling asleep would have been a death sentence. I would have frozen.”

“Oh… too bad. I slept like a baby.”

“I feel like I didn’t sleep either,” said Elizabeth. “But I know I must have. I don’t remember much from the night.”

“I remember every minute,” we replied.

Sergio was coming out of his tent when we got out of ours.

“This is crazy. These tents almost blew away. And out on the Puna, where we’re going today, it will be colder. And the wind can blow these tents away. This is crazy.”

“I agree,” said David. “We can’t go on. We’ll all freeze to death.”

Jorge had already set out to bring in the horses. Two of them – those from Cafayate – were still close at hand. But our horses and the mules had wandered away, far down the valley. We couldn’t see them from the house.

Jorge walked on, gradually disappearing from view. He was gone for a good half an hour before we saw him again, this time mounted on a horse, bareback, and driving the rest of the animals in front of him. He brought them up to the house, where we threw ropes around their necks and got out the saddles.

Freezing didn’t worry your editor. He expected to suffocate long before. Or succumb to something related to mountain sickness as described in Wikipedia. It was one thing to go without sleep for one night. It was another to go for three nights, while spending all day in the saddle.

And even if we survived, which seemed unlikely at the time, we might regret our decision to lead seven people on a hellish four-day trip. We put the question to the only person who knew what he was doing.

“Jorge, what do you think? Should we go back or go forward?”

“Wait a minute,” David interrupted. “First, let’s put this in perspective. We’re at about 13,000 feet. We’re exhausted. We’re freezing. And here at least we can make a little fire. Out there, we’ll be 1,600 feet higher… with stronger winds… and no wood to make a fire. I don’t even know if the horses will survive. They won’t have anything to eat. And it will be damned cold.”

Out beyond the courtyard where this discussion took place, was the pasture. Through it, ran a river. But we no longer heard the burble of running water. During the night, it had frozen over. Horses walked on it without breaking the ice.

“Well, Jorge, what do you think?”

Jorge smiled. He was as at ease and confident in the cold as in the heat… at 15,000 feet as at 8,000.

“Either way is fine for me.”

We packed up, saddled up and loaded up.

We rode from sunup to sundown and rounded the hill behind the ranch house just before dark. Sergio, who had ridden ahead, had already made a fire in the fireplace. Nicanora, Marta’s sister, was in the kitchen with Sylvia’s daughter Nancy and her own daughter Rucha. Soon, hot water was flowing from showerheads… cold beer was being poured out of aluminum cans… and a warm stew was set on the table.

“I am so glad we’re not out on the Puna,” said Sergio. Every head nodded in agreement.

Market Insight:

A Rough Ride for Silver Investors

by Chris Hunter, Editor-in-Chief, Bonner & Partners


The last four years have been rough for investors in silver…

As you can see from today’s chart, the price of silver has been in a downtrend since April 2011.

Since its April 2011 peak of $48.44 an ounce, the price of silver is down 67%.

This makes it the second-worst bear market for the metal since you could buy it on exchanges in the late 1960s.

The worst bear market for silver was between 1980 and 1982, when silver prices dropped by about 90%.