Acute Mountain Sickness

Acute Mountain Sickness:  Sick and Tired

 

 

There are a few times in my life that I find myself “sick and tired”.  For example, I am usually sick and tired of my kids leaving the lights on in the house after every one of them has gone to bed (I have 3 teenagers and a couple of ‘tween’agers so, go figure).  Although I never imagined I could get sick and tired of skiing, I found myself this weekend literally sick and tired.  For a while, I thought this was the new me in my forties and that I had to just suck it up.  But then I began to recognize the symptoms of high altitude pulmonary edema and I realized (thankfully) that this wasn’t the start of my midlife crisis, but rather a form of acute mountain sickness.

Acute mountain sickness, also known as altitude sickness or “the altitude bends” is an illness that most commonly occurs at altitudes above 8000 ft.  It is the physiologic consequence of decreasing consecration of oxygen and lower air pressure that occurs at higher altitudes.  You would think living at 7200 ft. in Laramie your body would acclimate to these effects but if you are a skier, climber or otherwise rapidly ascend and undergo significant physical exertion to get there, you are at risk.

Its symptoms for most are like mine, mild; however if allowed to progress, it can become very serious or even fatal.  Most people will experience fatigue, headache, mild nausea or loss of appetite but you may also experience difficulty sleeping, dizziness or vomiting.  When combined with physical exertion, such as downhill skiing, symptoms may advance to shortness of breath, rapid pulse, a dry cough and chest tightness.  This occurs as fluid accumulates within the tissues of the lung and eventually you begin coughing up blood.  You may notice this as a metallic taste to your cough, as I did.  As the disease progresses, fluid accumulates in the tissues of the brain (called cerebral edema) bringing on worsening headaches, confusion, altered consciousness and incoordination.  The combination of these fluid shifts at their worst can lead to death.

                Treatment fortunately is very simple:  descend to a lower altitude.  Symptoms usually abate quickly over a few days.  For the extreme problems there are appropriate medications and supportive therapy.  The best treatment is of course prevention.  In my case, better physical conditioning before would have slowed progression.  Ascending slowly, sleeping at lower altitudes or even acclimating a day or two every 2000 ft. during your ascent will help.  If you anticipate having difficulty, your physician may prescribe you a medication to take during your trip that will help prevent those fluid shifts.  If you have heart or lung disease you should avoid high altitudes.