Your Healthy Family: Treating altitude sickness

Posted at 5:26 PM, Jul 25, 2018
and last updated 2018-07-25 19:26:01-04

Every week during the summer tourist season, Dr. John Hall, an emergency room doctor with UCHealth Pikes Peak Regional Hospital in Woodland Park, Colorado, treats a wide variety of people suffering from altitude sickness.

Following up on our first story detailing the subtle symptoms of altitude sickness that strike first, to the more alarming symptoms that signal the need to seek medical treatment, Dr. Hall says everyone needs to be aware of altitude sickness.  

“It doesn’t matter your age, doesn’t matter how often you come to a high altitude, your body is acclimated to where you spend the most time.  If you are normally in Phoenix, Arizona, Miami, Los Angeles, New Jersey, areas that are pretty close to sea level, if you come up here you’re going to have symptoms,” Dr. Hall says.

Becoming light headed, short of breath, nauseous, having a headache and or chest pains don’t necessarily strike the moment you arrive at a higher altitude.

Altitude Sickness Onset

  •  A few hours
  •  A few days
  •  A week  

“Sometimes, onset can be pretty rapid, within just a few hours sometimes. It can be a few days, to even a week, it just all depends on activity level.”

There are health conditions that can make people more susceptible to altitude sickness, such as being older, says Dr. Hall.  

“We see patients all the time that come in and say, ‘I’ve been coming here every summer for 40 years,’ and I have to remind them that they’re not 40 years younger any more.  People who have suffered heart failure, or who have pulmonary disease or cardiopulmonary disease, asthma, COPD, are also at risk.”

Altitude Sickness Risk Factors  

  • Age
  • Heart failure
  • Pulmonary disease
  • Asthma
  • Cardiopulmonary disease
  • COPD

Altitude sickness may seem like a simple thing to avoid and head off at the pass, but Dr. Hall says it’s even snuck up on him after he traveled to Colorado while he was living in Chicago and working as a medical resident.

“I’m an avid rock climber and ice climber, and I came out to do some ice climbing with my father-in-law.  I got off the plane and spent the night at his house in Littleton. The next morning we woke up at 4 a.m., started driving up in the mountains and we were climbing at an elevation of about 11,000 feet.  I literally hit a wall, and I could not move. I was hanging on the rope saying ‘why can’t I swing my axe, why can’t I kick my feet into the ice, why can’t I move?’ I felt a little short of breath, and I had a pretty good headache and I was a little nauseous and I was like ‘what is going on?’ ’’

Luckily Dr. Hall’s climbing partner that day also works in medicine.  “I explained (what was happening to me) to my father-in-law, who’s a phenomenal emergency room physician assistant, and he said ‘I think you have altitude sickness’, and I was like ‘nah’… and he was like ‘yes’.  I was thinking ‘I run 5 miles a day, come on, I can do this’, and he was telling me, ‘No, think about it. You just get off the plane last night from Chicago where you’ve been living for the past couple of years and now we’re at 11,000.  I think you have altitude sickness’, and sure enough he started lowering me down on the rope and by the time I got on the ground I felt great. Just a couple hundred feet of elevation can make a huge difference. Then we kept hiking down and by the time we got to the car and back to Littleton I felt like of myself again.”

While there are several ways to treat altitude sickness Dr. Hall’s personal experience highlights the biggest.

Altitude Sickness Treatment

  • Get to a lower elevation
  • Supplemental oxygen
  • I.V. Fluids
  • Medication

“The most definitive treatment, and really the only definitive treatment for altitude related illness is descent to a lower elevation.  We are very frequently telling people you need to go down to Colorado Springs. Colorado Springs is about 3,000 feet lower than us (Woodland Park) so most people as soon as they get down there they feel immediately better.”

Before sending people to a lower elevation, Dr. Hall says, some things can be done to stabilize the patient.    

“Many people will require supplemental oxygen.  We can give them IV fluids, and we can give medicines called diuretics that allow them to kind of get some that fluid off their lungs.”

And Dr. Hall says it’s important to understand that altitude sickness can be avoided with a few simple steps that involve planning ahead.

“Talk to your doctor before you travel.  There are medications, there is one particular medication called Diamox, which is the standard of care for anybody going to elevation.  You take it three days prior to coming up here, it’s a single pill taken twice a day for three days. Then when you come up here it helps decrease the risk and decrease the symptoms of altitude related illnesses and can potentially save lives if you have the significant comorbidities we talked about.  Don’t just tell your doctor you’re going to Colorado, tell them you’re going to be staying at 8,000 or 9,000 feet elevation.”

If you are generally healthy, simply planning a few extra days into your travel plans in the right places will do the trick.

“If you don’t have significant health issues, staying at a lower elevation for a few days ahead of time for 2 or 3 days will help you acclimate before going up to a higher elevation,” Dr. Hall says.