Altitude Sickness
Altitude sickness is a potentially fatal illness that certain, possibly genetically predisposed, people experience when they travel to high elevations. In individuals with predisposing conditions such as advanced age, sickle cell anemia or chronic lung and/or heart disease, altitude sickness may occur at elevations as low as 6,000 feet. There have been isolated reports of it occurring as low as 4,000 feet. For many healthy people, it is most often seen after sudden ascents to over 9,000 feet. Anyone with a predisposing medical condition should consult a doctor prior to a trip to such high elevations.
Symptoms
The symptoms of altitude sickness vary in severity and worsen in an individual the higher they ascend. Initially, about 6 to 12 hours after climbing to a high altitude, one might sense drowsiness, headache, rapid heartbeat, nausea, loss of appetite and marked fatigue. Such a spectrum of symptoms is termed “Acute Mountain Sickness.”
High-Altitude Cerebral Edema (HACE)
If symptoms are allowed to progress without receiving treatment or descending to a lower altitude, swelling of the brain may occur. If brain swelling (High-Altitude Cerebral Edema or HACE) starts you might experience, in addition to the symptoms of AMS, confusion, difficulty concentrating, insomnia, difficulty with walking and even more profound fatigue. Again, if treatment or immediate descent is not accomplished, symptoms may progress eventually leading to coma or death.
Treatment
One way to test for severe altitude sickness, is to perform what is commonly referred to as a "field sobriety" test, employed by law enforcement officers when they evaluate someone for excessive alcohol consumption. In this test, a person tries to walk heal-to-toe along an imaginary straight line. If while trying to perform this test, a person wavers significantly or falls to the side, HACE is diagnosed and descent to a lower elevation is mandatory.
High-Altitude Pulmonary Edema (HAPE)
In some people swelling of the lungs may occur (High-Altitude Pulmonary Edema or HAPE) with or without symptoms of Acute Mountain Sickness or High-Altitude Cerebral Edema. This may be evident by difficulty breathing with even short-lived activities. If breathlessness does not resolve with rest, then immediate descent is also required. The most important aspect of this illness is to recognize signs and initiate treatment or descend. Never climb to higher levels when altitude sickness is suspected.
Treatment
There are medications that can help if used wisely. Acetazolamide (Diamox®) can be used to prevent Altitude Sickness and treat symptoms once they arise. Steroids such as Dexamethasone "DEX" or decadron have been used successfully to treat symptoms (DEX is given as a 4 milligram injection every 6 hours.) Steroids are best reserved for the treatment and not the prevention of Altitude Sickness. Nifedipine, 10 milligrams every 8 hours, has been shown to prevent and treat the symptoms of HAPE.
Note: Always descend if medications do not improve the situation and never climb higher whether you have medications or not. Medications can be lost or damaged and if you are using them to climb higher and you run out of sudden, severe symptoms and even death may ensue. Other important preventative measures include staying well hydrated, avoiding alcohol and making your ascents slowly so that your body can get used to higher altitudes.
