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Stopping altitude sickness

Dr. Drew WernerVail, CO Colorado

Colorado had a record number of visitors in 2006. Nearly 26 million people came to our beautiful state to vacation, visit family or engage in business. We are the No. 1 ski destination in the country, and once again, Vail is the top ranked ski mountain. While skiing, riding and winter recreation are the biggest reasons tourists come to Eagle County each year, summer and warm weather activities are bringing more and more visitors throughout the year. What does this have to do with a medical article? Well, most of our visitors, friends and family come from lower altitude, and that places many of them at risk for high altitude sickness.Dear Doc,My family is getting ready to come out to visit. Last year my mother suffered from high-altitude sickness. I’m worried about her trip this year and wonder if there is any advice I can give her to keep her from getting it again?- Worried about lowlandersDear Worried,Your question is an excellent one. With an average altitude of 6,800 feet, Colorado is the only state in the nation which lies entirely above 1,000 meters (or 3,315 feet) elevation. High altitude is any elevation above 5,000 feet. Although high altitude sickness may start at this elevation, it is not commonly seen until altitudes of 8,000 feet or more. Also known as Acute Mountain Sickness or AMS, it is actually a spectrum of illness ranging from mild symptoms, which usually resolve in 24 to 48 hours, to the more severe High Altitude Pulmonary Edema (HAPE) and High Altitude Cerebral Edema (HACE).The reason people suffer from AMS is thought to be from low blood oxygen levels at high altitude, as well as disordered breathing at night which worsens the problem. Remarkably, our bodies can adapt to higher elevations, but it takes time. A rule of thumb is to take two days to travel to 8,000 feet and one day for each 1,000 feet of elevation above that. If only our busy lives allowed that much time. Instead, whether by car or plane, travelers rapidly arrive at their destination then climb, hike or ride a lift even higher during their first day here. The ensuing headache, dizziness, nausea, fatigue and sleep difficulties are the hallmarks of AMS. Uncommon, but more severe symptoms such as shortness of breath and confusion signal a trip to the doctor, or a return to lower altitude.AMS can affect anyone, even people in excellent physical condition. If you have underlying medical conditions you may be at risk for more severe symptoms. It is also important to know that if someone has had AMS before, they are more likely to get it again. Nevertheless, there are some important things you can do to prevent AMS.Altitude sickness preventionFirst and foremost, go slow. I know there is a temptation to get out and go up to the top as soon as possible, but 48 hours in bed with AMS is much worse than hanging in town your first day here. Next, be sure to stay well hydrated before and during your travel. Riding in a car or on a plane is not conducive to drinking plenty of fluids, but make the extra effort. Remember that you need roughly half your body weight in ounces of fluid daily. Avoid caffeine and alcohol, which may increase the risk for AMS at least for your first 48 hours here. Finally, if you feel a headache coming on, it is probably AMS and not just sinus congestion. Rest and take acetaminophen or ibuprofen.If you have had AMS before, ask your doctor about taking acetazolamide (also known by the brand name Diamox) 125 mg twice daily. It is especially helpful in preventing AMS caused by disordered nighttime breathing. If symptoms persist or worsen, do not hesitate to seek medical attention at one of our excellent local hospitals, or through our many excellent local physicians who will be very familiar with this condition. Planning on preventing AMS is no different than planning your stay here. The best plans make the best experience. Dr. Drew Werner of the Eagle Valley Medical Center writes a regular column for the Daily. He encourages health questions. Write him by e-mail to editor@vaildaily.com or c/o Editor, Vail Daily, P.O. Box 81, Vail, 81658.


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