Avoid Altitude Illness With Rest, More Fluids

Altitude sickness isn’t just a winter hazard that threatens alpine skiers and glacier climbers. Summertime travelers bound for such popular California vacation spots as Lake Tahoe (elevation 6,228 feet), Mammoth Lakes (7,500 feet and up), Mt. Whitney (14,494) and other elevated destinations should be on the alert for altitude sickness symptoms and related health hazards.

Altitude sickness, also known as mountain sickness, can occur at elevations as low as 5,000 feet, but is more likely at 7,000 feet and above. It strikes because of the reduced atmospheric pressure (and thus reduced oxygen) at higher altitudes. This causes the heart and lungs to work harder to deliver oxygen to the body.

Risk of sunburn rises with the altitude too, and the descent can trigger ear problems.

Altitude sickness can be mild, with the main symptom being a headache. Dizziness, nausea and difficulty sleeping are other symptoms. Travelers with mild cases are advised to stop ascending, descend if possible, drink plenty of fluids and rest.

More serious, life-threatening types of altitude sickness include high altitude pulmonary edema (in which fluid accumulates in the lungs making breathing difficult) and high altitude cerebral edema (in which fluid swells the brain, with mental and motor skills adversely affected). Immediate medical attention is crucial in these cases.

At Mammoth Hospital in Mammoth Lakes, a brochure giving high altitude health tips is always available, said Marcia Burditt, a registered nurse in the emergency department. “We have people all year round come in with altitude sickness,” she said. At the center of town, the elevation is about 7,500 feet. At the base of the mountain, it is 9,000 feet.

A study published in the Western Journal of Medicine found that older persons in good health are no more likely than younger people to get mountain sickness and in fact may be less likely. “I think it’s generally safe for older people, 60 and above, to go to 5,000 to 10,000 feet,” Swenson said, as long as they are aware of the symptoms of trouble.

People with a history of cardiovascular or respiratory problems should consult their physician before going to high altitudes. They should make sure the physician knows all of the medications they’re taking, including over-the-counter preparations, said Alan Tucker, professor and head of physiology at Colorado State University, Fort Collins. Some drugs alter the body’s natural response to exertion, and exertion at higher altitude is more difficult than the same workout at sea level. Otherwise healthy people with a history of altitude sickness should ask their physician about the merits of prescription medication to combat it.

An editorial earlier this year in the British Medical Journal addressed precautions for children, who often can’t verbalize the effects of mountain sickness. It advised that children under age 2 sleep no higher than 6,500 feet while on mountain excursions, and that children 2 to 10 sleep no higher than 9,750 feet.

To further reduce risks, nurse Burditt advises visitors to “take it easy the first couple of days, drink plenty of fluids.”

High altitude travelers should pay extra attention to sunscreen applications. “The filtering effects of the atmosphere diminish with altitude,” Swenson said.

When descending from a high elevation, ear problems can occur if air pressure is not equalized properly. “Ear problems could occur on descent from as little as 1,000 feet,” said Dr. Fred Linthicum Jr., head of histopathology at the House Ear Institute in Los Angeles.

People who have had a cold or who have nasal allergies should use over-the-counter nasal drops or a decongestant about an hour before descent, Linthicum said, to minimize problems. And if a traveler contracts a cold while at a high elevations, “it’s best to stay there until the cold is over.”

Healthy Traveler appears the second and fourth week of every month.