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Altitude Sickness

In order to function at altitudeshigher than a few thousand feet above sea level, the hu-man body must make several adjustments to compen-sate for the reduced availability of oxygen, especiallywhen exertion takes place. People who begin strenuousexercise in the mountains without first becoming accli-matized may become very uncomfortable or in somecases seriously ill. Some individuals have difficulty evenwithout exerting themselves.

Acute mountain sickness can begin a few hours ordays after arrival at altitudes over 6,500 feet. Headache,loss of appetite, nausea, and fatigue are its primarysymptoms. Irregular breathing patterns during sleepmay cause frequent awakening, but with time sleep pat-terns return to normal. More severe cases are evidencedby changes in consciousness, cyanosis (a bluish dis-coloration of the skin, area beneath the nails, and lips),and a staggering gait.

Rapid ascent to higher altitudes (usually over 8,000feet) followed by heavy exertion can lead to a serious dis-order in which fluid leaks from small blood vessels intothe air sacs of the lungs. Shortness of breath, cough,rapid heart rate, and fatigue develop over one to threedays, and a characteristic gurgling sound may be heard ifone listens to the chest. If untreated, this condition,known as pulmonary edema, can progress to cyanosis,changes in consciousness, coma, collapse of the car-diopulmonary (heart and lung) system, and even death.Mild mountain sickness will usually improve withrest, increased fluids, and mild pain relievers forheadache. A physician might prescribe the drug acetazo-lamide (Diamox) to help reduce symptoms. People who are more severely ill must be escorted or carried to alower altitude as soon as possible. Improvement beginsafter the victim descends a thousand feet or more andreceives oxygen by mask. Never let the victim descendalone. A thorough evaluation by a physician is manda-tory before returning to a high altitude.

The most effective tneasure to prevent altitude-related illness is to allow enough time - two to four days,if necessary - for a child to become accustomed to thereduced oxygen concentration before beginning strenu-ous activities at a higher altitude. Increasing fluid intakewill help, as will a high-carbohydrate diet. Teenagers oradults who have experienced acute mountain sickness(or worse) in the past may benefit from taking acetazo-lamide (Diamox) on the day of ascent and for two daysafter arrival. Teenagers involved in rock climbing orother mountain activities should be warned not to ig-nore symptoms because of peer pressure or a misguideddesire to tough bout when they feel sick. Assume any ill-ness at high altitude to be mountain sickness or one ofits more serious variations until proven otherwise, andtreat it accordingly.

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