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How to Survive a High Altitude Vacation
by Gerry Watkins

Mountain vacations can be hazardous to your health if you aren't prepared for problems associated with altitude changes. At least 40 percent of mountain visitors suffer some ill effects from the change. Some experience nothing more than mild shortness of breath. Others develop flu-like symptoms connected to acute mountain sickness. My husband and I once became victims of this illness.

Pictured above are The Maroon Bells, a range of snowcapped peaks near Aspen, Colo. Photo courtesy of Denver CAB.

The travel brochure had portrayed a peaceful setting: a blue lake rimmed with fir trees accented by a backdrop of rugged, snowcapped peaks; campers seated at an inviting picnic spread; a fisherman displayed a beautiful rainbow trout ready for the frying pan. These images filled our minds as our plane landed in Denver.

We could hardly wait to catch that first trout.

We'd driven to Colorado for previous vacations, but this time we opted for air travel, spending those extra days in a cabin high in the Rocky Mountains. But one thing we hadn't counted on; it takes time to adjust to higher elevations, and the days we spent driving there in the past had given us time to become acclimated.

After getting on the road in our rental car I noticed the discomfort I'd felt upon arrival getting worse. My mouth and skin felt dry, my head ached, and I felt nauseous. The fishing fantasy faded into the background; I began to fear that we'd picked up flu germs somewhere along the way.

By nightfall, neither of us felt very hungry, so we ate a light meal and turned in for the night, hoping to sleep it off. But sleep wouldn't come, in spite of the allergy and sinus medications we took every four hours.

Three miserable days later we found our way to a local medical clinic. The doctor there diagnosed high altitude sickness, administered oxygen therapy and gave us a supply of Diamox. We discovered we'd been wrong to take the allergy and sinus medication, and should have been taking fluids from the time we left the plane.

"Take it easy for the next few days, and then ease into your activities," advised the doctor. "Leave off aspirin, sleeping and sinus medications."

RTM's travel editor Rachel L. Miller was one of the 20%-30% of Colorado visitors who fall prey to altitude sickness. She felt the first symptoms within 24 hours and described the sickness as "very flu-like, but with lightheadedness and occasional disorientation." She finally felt partially recovered on her third (and last) day in Colorado. "It probably wasn't so smart that I was doing so much physical activity during my trip -- I know now that probably didn't help my case much." Doctors advise rest if you come down with altitude sickness.

The incidence and severity of altitude sickness are related to altitude, speed of ascent, physical exertion and prior acclimatization. Some people are particularly susceptible to it and experience similar episodes with each exposure. Symptoms of headache, shortness of breath, anorexia or nausea, weakness dyspnea and "flu-like" malaise may begin 6 to 48 hours after ascent.

Symptoms of this illness include headaches, nausea, loss of appetite, and insomnia, or inability to sleep soundly through the night. In severe cases patients may experience extreme shortness of breath, a cough, congestion and difficulty with thought processes.

Still others may develop a rare condition known as high altitude pulmonary edema (HAPE), similar to pneumonia. Fluid collects in the victim's lungs, causing breathing difficulty, accompanied by a cough. This illness is serious and, if not treated, can lead to death. HAPE seems to occur more during the winter months than during summer, probably because summer visitors come to the mountains to relax rather than to party.

The sickness can occur regardless of a person's age or overall health, and it seems to attack men more frequently than women.

Mountain illnesses develop within the first few days of arrival and should disappear as your body adjusts to the altitude. The adjustment could take anywhere from three days to three weeks. That could ruin a vacation.

Families with children too young to tell their parents how they feel should watch closely for the symptoms. If diarrhea or vomiting occurs, maintain body fluids by giving the child water, milk, or juices. Consult a physician if the condition worsens or doesn't improve.

Even a mild cold can cause an earache at higher altitudes. The barometric pressure changes drastically when you are driving over mountain passes. If you suspect infection, see a doctor. A pain relief medication containing acetaminophen, such as Tylenol (never aspirin) may be used until you can obtain treatment.

What causes mountain illness? Cooler, drier air at high altitudes contains less oxygen than sea level air. "Breathing faster is the only way the body can adapt to the altitude," the doctor at Summit Medical center in Frisco, Colorado told us. "When you breather faster, you lose more body fluids. Lips and skin feel dry and scratchy."

Some doctors believe the lack of oxygen causes extra fluid to develop in brain cells, prompting them to swell and bringing on the sickening symptoms. Other doctors believe the change in body fluid affects the kidneys and changes the blood chemistry.

Diamox, a drug prescribed for altitude sickness (or acute mountain sickness), controls fluid secretion. It is also used in the treatment of glaucoma (excessive pressure in the eyes), epilepsy (for both brief and unlocalized seizures), and fluid retention due to congestive heart failure or drugs. Common side effects include: change in taste, diarrhea, increase in amount or frequency of urination, loss of appetite, nausea, ringing in the ears, tingling or pins and needles in hands or feet, vomiting.

RTM does not prescribe or support the use of any medications. Please see your doctor for treatment or the prescription of medications.

Physicians usually treat the illness by giving the patient oxygen therapy and a form of Diamox. Oxygen therapy creates a better bloodstream balance and makes breathing easier. In our case, one treatment was sufficient. Others may need several treatments during their stay. Diamox allows more oxygen to be taken in by the lungs, so the victim can breathe faster and more deeply. If treatment doesn't bring relief, the patient should move to a lower elevation.

Treatment can salvage the remnants of a vacation, but it's best to avoid the illness altogether if possible and take full advantage of your time in the mountains.

Give your body time to adjust by spending an extra day or two traveling to your high-altitude destination. Increase your fluid intake as soon as you start to climb to higher elevations. Plan to rest and relax the first day or two after you arrive. Take frequent breaks from your activities, and avoid narcotics and alcohol, at least for the first few days, because they can escalate mountain illness symptoms.

Begin your battle against the illness before you leave home. A few minutes of aerobic exercise, such as walking or swimming each day, will increase your endurance. Better still, a sustained exercise program will build stamina for improved resistance.

Any person with a history of heart, circulatory, or lung problems should check with a doctor before leaving home. Your doctor can help you prepare for a healthful stay.

Proper precautions can prevent other health problems associated with high altitudes. Severe sunburn happens more easily at higher elevations. Use plenty of sunscreen and wear sunglasses. Protect yourself and your time while enjoying your holiday.

-- Gerry Watkins is a free-lance journalist and webmaster of the award winning site