two men on a ski slope If you are planning a mountain climbing, hiking, skiing or snowboarding trip, you may have your sights set on a high altitude destination such as the Peruvian Andes or the ski resorts of Colorado.  These destinations carry with them the thrill of a tingling physical challenge as well as the risk of developing altitude sickness (also known as mountain sickness).

Altitude sickness results from your body’s decreasing ability to absorb the oxygen necessary to convert nutrients to energy because of the thinning of the air as you ascend.   This change results in symptoms that can hit anyone regardless of his fitness level.  In fact, it often strikes younger, more fit members of climbing expeditions and may be less common in those over the age of 50. Tolerance to high altitude varies tremendously between individuals, and can vary from trip to trip for the same individual, though cold weather seems to worsen the effects.

Anyone with chronic medical conditions or a history of asthma, lung or heart problems should discuss travel to a high altitude destination with a physician well in advance of travel. Individuals who suffer from the following chronic medical conditions should never travel to high altitude destinations:

  • Chronic Obstructive Lung Disease (including Emphysema and Chronic Bronchitis)
  • Congestive Heart Failure
  • Sickle Cell Anemia
  • Pulmonary Hypertension

It is common for those visiting a high altitude destination to breathe more frequently and experience increased heart rate and pulse. Dryness of the skin and mucous membranes occurs, as does a minor headache. These are normal characteristics of a body adapting to high altitude.

Severe symptoms such as these, occurring within the first 36 hours at altitude could be indicators of the onset of altitude sickness:

  • Extreme increase in breathing frequency, with shortness of breath and/or cough
  • Very rapid heart rate with palpitations, chest discomfort or a perception of pulses in the neck and head
  • Severe headache
  • Nausea and/or vomiting
  • Fatigue and sleeplessness

Severe cases of altitude sickness can result in death, so it should be taken seriously. Mild symptoms of altitude sickness can be treated with rest at a stable altitude and acetaminophen or other analgesic (pain medicine).  If symptoms persist for more than 24 hours, seek medical attention. If possible locate a physician who is experienced in high altitude medicine.  Descent to a lower altitude is crucial. Never ascend if your symptoms are getting worse.  Some physicians will prescribe medications such as dexamethasone and/or nifedipine prophylactically for travelers to high altitudes, but this practice is controversial.

To avoid altitude sickness, allow your body time to adapt to the thinning air, stay hydrated and follow all the normal safe-travel tips.  Food poisoning, jet lag and other situations manageable at regular altitudes will be much worse in high altitudes.

Don’t be up in the air about taking care of yourself; make sure you are grounded with good information and preparation.  Otherwise, you may be grounded longer than you planned.


About The Author

Frank Gillingham, M.D. serves as Chief Medical Director for HTH Worldwide. Frank has led HTH Worldwide's international business development efforts in Europe and Canada and has been a guest speaker at international business conferences and has authored a series of articles on travel medicine, including pieces on travel information available on the Internet and the role of physicians working with travel insurers. Frank is a Board-Certified Internist and Emergency Medicine Specialist. He is also a private emergency physician in Southern California and a former emergency department director and member of the UCLA emergency department staff. Frank completed residency training at Los Angeles County/USC Medical Center, received his M.D. from Albert Einstein College of Medicine and his B.A. from the University of Pennsylvania .

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