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leading up to a race, drink more than usual to ensure you are properly hydrated. Those arriving from humid climes should keep in mind that sweat quickly evaporates in high, often dry climates. Don’t let sweat (or thirst) dictate whether you need to drink before, during, or after your race. Since you’ll also be less hungry at high altitude, eat according to your lowland habits as race day approaches. However, take in an extra 100 to 200 calories from carbohydrates per day, especially in the first few days at altitude. Carbohydrates are the body’s favored energy source at altitude. Consuming them can keep you fueled as race day approaches and fend off possible dramatic weight loss.

When running at high altitude, protect yourself from increased exposure to ultraviolet (UV) radiation by wearing protective clothing, including a hat, and applying sunscreen. UV exposure, which can damage the skin and eyes, increases with altitude; if present, snow cover will reflect the UV radiation to further amplify its effects. UV exposure peaks at midday, not at the hottest time of day, so protect yourself in late-morning hours. Sunburn can occur in cold temperatures and under cloud cover. Do not wait for symptoms of sunburn to develop before taking precautions, as effects can lag exposure by up to a day.

High Altitude Pulmonary Edema and High Altitude Cerebral Edema

High altitude pulmonary edema (HAPE) and high altitude cerebral edema (HACE) are rare but potentially life-threatening conditions. Serious forms of the conditions are unlikely below 10,000 feet. It is extremely rare for an ultramarathon to expose a runner to a high enough altitude for a long enough duration to trigger either condition. Both conditions are preventable as they are preceded by recognizable symptoms, the recognition of which warrants returning to lower elevations immediately. To reiterate the last point, do not stop on the top of a mountain to rest or wait out the symptoms of HAPE or HACE—descend immediately!

If this were a book on high-altitude mountaineering, these subjects would warrant an entire chapter regarding recognition and treatment; however, in the context of ultramarathons there are but three pieces of advice: Recognize the symptoms of HAPE and HACE, respect their seriousness, and remove the affected person to lower altitude as quickly as possible.

HAPE is the accumulation of fluid in the lungs. It is typically diagnosed by the occurrence of at least two of the following symptoms—difficulty of breathing at rest, cough, weakness or decreased exercise performance, and chest tightness or congestion—as well as at least two of the following signs: crackles or wheezing in at least one lung, blue skin coloration, rapid shallow breathing, and rapid heart rate. Having paced at the Hardrock 100, which includes seven 13,000-plus-foot passes, I’ve seen a runner turn around while climbing the final pass 85 miles into the race out of respect for the HAPE symptoms he was experiencing.

HACE, the rarer of the two conditions, begins as AMS and progresses as brain tissue leaks fluids, leading to swelling. Symptoms include those of AMS with the addition of confusion, changed behavior, difficulty speaking, hallucinations, blindness, limb paralysis, seizure, unconsciousness, total paralysis, or coma. One simple test for HACE is to see if person in question can walk in a straight line; an inability to do so indicates HACE.

Chill Out with Cold-Weather Running

Although a few ultras are run in extremely cold conditions, they’re much rarer than hot or high altitude ultras. As such, this section talks about the moderately cold conditions that most of us face in training and racing.

In cold weather, the saying “There’s no such thing as bad weather, just bad clothing” holds true.

(Photo courtesy of Nick Yardley)

Clothing

As suggested in chapter 7’s “Staying Safe on the Trails,” clothing is a runner’s shelter. While this book won’t give a full winter wardrobe lesson, there are some general points to keep in mind when dressing for the cold. To start, dress