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Rising to New Heights (Altitude Sickness)

By Dr. Peter W. Kujtan, B.Sc., M.D., Ph.D.

Article published on October 13, 2007 in
The Mississauga News
Portrait of Dr. Peter W. Kujtan, supplied 2005
Dr. Peter W. Kujtan

As you enjoy your leisure reading, I am trekking in the South American Andes. It is an eclectic journey of discovery, spiritualism and knowledge renewal. I hope to share some of the adventure with you. I am a firm believer that history dictates the future, and that ruins such as Machu Pichu hidden in these mountains can teach us much about ourselves.

One of these lessons has already come to pass. It is called altitude sickness. The last time I felt these effects was in the Canadian Rockies, where skiing can quickly get you up to the 10,000 foot elevation. It is a condition to be aware of for any traveller planning to visit destinations above 7,000 feet. Acute mountain sickness should be suspected when you arrive at a new elevation, and within hours begin to experience a headache, accompanied by intestinal symptoms such as nausea or vomiting, fatigue, dizziness and difficulty sleeping. There is no good test to diagnose altitude sickness, and it is often attributed to things like asthma, migraine, hang-over, dehydration and food-poisoning. It relies on good old-fashioned clinical gumption. Almost half the people arriving at a destination above 10,000 feet begin to feel the effects. It is worse if you are under 50 years of age, and tend to live near sea-level, like Mississauga, Ontario, for example. Strangely, intensive training cannot prevent it and things like heart disease, pregnancy and diabetes donít make it any worse. The problem with missing the diagnosis is that it can progress to High-Altitude Cerebral Edema. As your brain swells, you develop trouble walking, concentrating and stupor. As your brain swells, it can herniate out of the base of the skull and prove fatal. A similar condition called High-Altitude Pulmonary Edema can develop concurrently, where your lungs begin to fill with fluid, making it harder to breathe.

Acclimatization is the process of preventing altitude sickness by ascending in stages. For example, if you live in Toronto and decide to visit the highest freshwater lake in the world called Lake Titikaka situated at the 10,000 foot level in the Andes, it is worth making the journey by rising to the 7000 foot level for a few days. This allows the needed time for your lungs, kidneys and heart to make crucial adjustments. Some hotels in cities of the Peruvian Andes actually provide their guests with supplemental oxygen to facilitate the transition and as a treatment for minor altitude ailments. As a rule of thumb, every day that you spend at the intermediate altitude allows you to quickly ascend another 1000 feet up to a maximal altitude of 14,000 feet.

The first rule of treatment is to avoid making things worse by continuing to climb, or better yet, start to descend. Administering oxygen is very helpful. We often give a medication called Diamox (acetazolamide) which is a mild diuretic that can also decrease the production of brain fluid, and help prevent symptoms of altitude illness. As we climb, there is less air pressure pushing against our body, and so things tend to swell slightly. It is like loosening the belt buckle once the Thanksgiving turkey is done. The other commonly used drug is a steroid called Dexamethasone. Medical advancements are rising to new heights all the time, and even Silendafil, more commonly known as Viagra, is finding a new niche in altitude medicine. But in this neck of the woods, they have been chewing on cocoa leaves for eons to combat mountain fatigue. It is bitter tasting but seems to work.

It is wise to check your travel destinations with regard to altitude and plan accordingly. I bid you Hasta Luego from somewhere in South America.

Related resources:

Altitude sickness from Wikipedia, the free encyclopedia. "Altitude sickness, also known as acute mountain sickness (AMS), altitude illness, or soroche, is a pathological condition that is caused by acute exposure to low air pressure (usually outdoors at high altitudes)."

Outdoor Action Guide to High Altitude: Acclimatization and Illnesses by Rick Curtis.

Altitude Sickness from MD Travel Health. "Altitude sickness may develop in travelers who ascend rapidly to altitudes greater than 2500 m."

Why Altitude Can Make You Sick & What to Do About It from Weill Cornell Medical College.

Altitude Illness from CDC Travellers' Health, Centers for Disease Control and Prevention.

Altitude or Mountain Sickness - High Altitude Trekking & Climbing from the Travel Doctor.
Altitude Sickness by Peter Hackett, M.D. "Acute mountain sickness is better prevented than treated."

Other Articles by Dr. Kujtan