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ALTITUDE ILLNESS
ALTITUDE ILLNESS
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GENERAL INFORMATION
DEFINITION--Any of several illnesses associated with higher-than-usual altitudes. Illnesses are of several types, including:
Acute Mountain Sickness (AMS).
High Altitude Pulmonary Edema (HAPE).
High Altitude Cerebral Edema (HACE).
High Altitude Retinal Hemorrhage (HARH).
Subacute and Chronic Mountain Sickness (CMS). This illness is a complication that represents failure to recover from AMS over a long period of time. These illnesses affect most body systems, especially the brain, heart, lungs, gastrointestinal tract, circulatory system and electrolytes.
Other altitude-related problems include frostbite, blood clots in the legs and lungs, dehydration, swollen feet and ankles.
Pre-existing illnesses that are aggravated by high altitude include sickle-cell disease or trait, chronic heart disease or chronic lung disease.
SIGNS & SYMPTOMS--------------------
AMS: Headache, nausea, vomiting, shortness of breath, sleep disturbances.
HAPE: Shortness of breath, cough, weakness, headache, coma.
HACE: Severe headache, staggering gait, hallucinations, stupor. These indicate swelling of the brain. Death will occur without descent.
HARH: Visual disturbances, including spots before the eyes. Blood clots and bleeding into the retina occur in 50% of those who go above 17,000 feet.
CMS: Shortness of breath, fatigue, bloated face and body, congestive heart failure after years of living at high altitude (rare).
CAUSES & RISK FACTORSInsufficient oxygen at high altitudes. Following are the altitudes at which each type of illness can occur:
AMS: 7,000 to 8,000 feet or higher.
HAPE: 9,000 to 10,000 feet.
HACE: 10,000 to 12,000 feet.
HARH: 17,000 feet. Additional factors that contribute to development of altitude illness include:
Fatigue or overwork.
Previous episodes of altitude illness.
Chronic illness of any sort, particularly cardiovascular and lung diseases.
Obesity.
Age over 60.
Excess alcohol consumption.
Use of mind-altering drugs, including narcotics and tranquillizers.
HOW TO PREVENTDon't ascend to heights that cause symptoms. If you must climb, become acclimatized gradually by a slow ascent.
WHAT TO EXPECT========================================
DIAGNOSTIC MEASURES
Your own observation of symptoms.
Medical history and exam by a doctor.
Laboratory studies such as EKG and chest x-ray.
SURGERYNot necessary nor appropriate for these disorders.
NORMAL COURSE OF ILLNESSUsually curable without residual impairment after returning to lower altitudes.
POSSIBLE COMPLICATIONSPermanent brain, eye, heart and lung damage. Worst cases of HAPE and HACE can lead to death.
HOW TO TREAT========================================
NOTE -- Follow your doctor's instructions. These instructions are supplemental.
MEDICAL TREATMENTSee a doctor to determine the extent of damage and possible complications. He may prescribe medication.
HOME TREATMENTFollow these instructions:
AMS: Descend to lower altitude if illness lasts 2 or more days.
HAPE: Oxygen, rest and diuretics help, but rapid descent is usually necessary.
HACE: Oxygen and corticosteroids help, but rapid descent to lower altitudes is the only certain way to recover.
HARH: No treatment except to descend.
CMS: Return to lower altitudes if symptoms persist.
MEDICATION Your doctor may prescribe:
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For AMS: Diamox (carbonic anhydrase inhibitor).
For HAPE: Oxygen, furosemide (diuretic), morphine (narcotic pain reliever).
For HACE: Corticosteroids.
ACTIVITY--------------------
If any altitude illness occurs, decrease activity to a level at which symptoms disappear.
Resume normal activities gradually upon returning to normal altitude.
DIETNo special diet.
CALL YOUR DOCTOR IF========================================
You have symptoms of any altitude illness.
New, unexplained symptoms develop. Drugs used in treatment may produce side effects.
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From Complete Guide to Sports Injuries by H. Winter Griffith, M.D. Copyright by Putnam Publishing
Group. Electronic rights by Medical Data Exchange.
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