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What is high altitude?

Welcome to the high country. 

Our bodies are used to working at “home” in a familiar environment. When we go climb in altitude we need to adapt. Altitude starts to have an effect on our bodies around 5,000 to 6,650 ft. and they try to make up for the change in oxygen levels.  This chart -> provides a comparative elevation reference when you're visiting Leadville or climbing Mt. Elbert.

Many people headed to the high country will have some altitude related illness. Dealt with correctly, it is unlikely to be a major problem. Dealt with incorrectly, altitude sickness can be disastrous - spoiling the trip for the person who is ill and those with them. Being honest about how you feel each day can make a difference ─ and knowing what’s happening to you could save your life. 

High Altitude Sickness

Leadville is the highest incorporated city in the continental United States.  The scenery that surrounds our small town is truly spectacular.  People travel from all parts of the globe to view our mountains and take advantage of the recreational opportunities found at this elevation.  Our wide-open spaces are truly breathtaking.

Back in the olden days of Leadville, travelers faced various symptoms they could not explain.  Today, much research has been done regarding high altitude living and how it affects our bodies.

The percentage of oxygen at high altitude is similar to that of sea level, approximately 21%.  However, as a result of lower barometric pressure at high altitude, the partial pressure or driving force of oxygen into the lungs is greatly reduced.  This results in Hypoxia or reduced oxygen entering the lungs and is the cause of many of the effects of high altitude.

High Altitude Sickness (also known as Acute Mountain Sickness) may occur in an individual many times or only once, regardless of past high altitude exposures or physician condition (exceptions include illness or preexisting medical conditions).

Most travelers never encounter any problems.  Locals say 1 out of 6 people will have some sort of affect. The degree of illness is usually minimal however occasionally someone may have more intense symptoms.

Symptoms may include:  Headache, Nausea, Dizziness, Insomnia, Fatigue, Disorientation, Difficulty Breathing.

On rare occasions serious altitude issues may occur and should not be taken lightly.    
If symptoms do not diminish or appear to worsen, seek immediate medical attention.

     Our goal is to help you enjoy our unique environment.

what is Ams/has?

Both terms are often used interchangeably.  Acute Mountain Sickness (AMS) and High Altitude Sickness (HAS).  

AMS is uncomfortable, not life threatening. Anyone can be affected.  Is doesn't matter if you are young or old; athletic or not.

If AMS symptoms become severe and you keep going higher - fluid in the brain (High Altitude Cerebral Edema (HACE) or fluid in the lungs (High Altitude Pulmonary Edema (HAPE)can happen and these conditions become life threatening.

Symptoms:

  • Headache

  • Nausea (feeling sick)

  • Vomiting (being sick)

  • Fatigue (feeling tired)

  • Poor appetite (not hungry)

  • Dizziness

  • Sleep disturbance

HAS/AMS Scorecard

Headache   

None                                            0

Mild                                              1

Moderate                                     2

Severe/incapacitating                3

Stomach     

Good appetite                                 0

Poor appetite, nausea                   1

Moderate nausea or vomiting      2

Severe/incapacitating                   3

Fatigue/Weakness

Not tired or weak              0

Mild fatigue/weakness     1

Moderate                            2

Severe/incapacitating      3
Dizziness 

None                                 0

Mild                                  1

   Moderate                               2           Severe/incapacitating           3         

Difficulty sleeping 

As well as usual               0

Not as well as usual         1

Woke many times            2

Could not sleep at all       3

                  

If you have a headache and a total of 3 or more, you should seek medical attention

HAPE 

(High Altitude Pulmonary Edema)

can develop in 1-2 hours or over several days and even when descending.

HAPE

What to check for:

  • Has there been recent ascent?

  • Does it take a long time to get breath back after exercise?

  • Are they breathless when resting?

  • Is the breathing rate increasing?

  • Is the heart rate > 100 beats per minute?

  • Can wet / crackling sound be heard in chest? Put ears to back below shoulder blades.

What to do:

  • Stay with the person at all times - do not leave them on their own.

  • Descend now - not later or in the morning.

  • Sit upright and keep warm.

  • Give oxygen if you have it.

  • Seek medical attention to be evaluated.

Your physician may prescribe any of the following:

  • Steroids

  • Nifedipine

  • Diamox

  • Oxygen

Consequence if ignored: Breathing stops. DEATH. In serious cases death can occur within as little as an hour after symptoms start.

Remember it is possible to have AMS, HACE and HAPE at the same time.

If you suspect HAPE, contact a medical professional immediately

HACE (High Altitude Cerebral Edema)

Can they:

  • Touch nose with index finger with eyes closed? Repeat rapidly.

  • Walk heel to toe in a straight line?

  • Stand upright, with eyes shut and arms folded?

  • Do simple mental math?

If the above problems exist, suspect HACE.

HACE can develop very quickly with no other problems or can follow AMS and HAPE.

What to do:

  • Stay with the person at all times - do not leave them on their own.

  • Descend now - not later or in the morning.

  • Sit them upright and keep warm.

  • Give oxygen if you have it.

  • Seek medical attention to be evaluated.

Your physician may prescribe any of the following:

  • Dexamethasone

  • Diamox

  • Oxygen

Consequence if ignored:

Loss of consciousness - confusion, drowsiness. Reduced breathing. Potential DEATH.

In serious cases death can occur within as little as an hour of symptoms being noticed.

Remember it is possible to have AMS, HACE and HAPE at the same time.

If you suspect HACE, contact a medical professional immediately

The main signs:

  • Severe headache.

  • Become clumsy.

  • Act differently - unhelpful, violent, lazy.

  • May have bad, non-stop vomiting.

  • Blurred vision.

  • See, hear, feel, smell odd things.

  • Confused.

Reduced consciousness.

SLEEP

Disturbed sleep during the first few nights at altitude is common and normal. You may be slow in getting to sleep, wake up a lot and feel that you have not slept well, or feel less refreshed. Poor sleep may be related to how well your body is adjusting. As you acclimatize sleep usually improves.

People with AMS/HAS struggle to sleep, suggesting poor acclimatization. Altitude may increase the number of times you need to urinate, so you lose more sleep.

Many changes happen because you breathe more and have shallower breaths. In some people this may cause periodic breathing at night, where rapid breathing is followed by periods when breathing briefly stops, sometimes causing you to wake up. This is more common over 9,000 feet.

Snoring may be made worse by dry, dusty air but obstructive sleep apnea does not appear to get worse with altitude.

THE LUNGS

Because the air is "thinner" at high altitude there is less oxygen available so breathing gets deeper and quicker to compensate. This “acclimatization” helps you cope better with the altitude.

Being more short-of-breath for the same exercise at sea level is normal. Other changes occur in the blood which you will be less aware of, allowing the blood to carry more oxygen to where it is needed.

People often develop a dry cough at altitude. It is not entirely clear why this happens, but while irritating, it is not usually serious.

Occasionally, more serious problems may occur with breathing. Fluid may collect in the lungs causing a problem known as “High Altitude Pulmonary Edema” (HAPE).

The Heart/blood

Travelling to altitude can have several effects on your heart. The lower oxygen pressure in the air and exercise you are doing can make your heart beat faster. This is not normally a problem but if you have a heart condition (e.g. angina) it can put extra strain on your heart. Your blood pressure may go up a small amount at altitude, but this effect is not normally noticed.

One of the adaptations of living at altitude is for the body to produce more red blood cells (so you can carry more oxygen). This can sometimes lead to the blood thickening, making the circulation sluggish. With this in mind, you should make sure you drink plenty of water.

If you have a known heart problem (such as an irregular heart beat, high blood pressure, a prior heart attack or angina) or if you have had surgery on your heart, you should talk to your doctor to make sure that what you are planning is not going to put undue strain on your heart. If you take medicines, make sure you take enough with you.

People with inherited sickle-cell trait are at risk and should avoid going to altitude.

If you are healthy, then travel to altitude will not put any more strain on your heart than rigorous exercise at sea level.

Pets at altitude

Yes, it happens.  Pay attention to your pet’s behavior and be sure to provide plenty of water throughout your travels ─ but don't overdo it.  Watch for a discoloration in the gums.  If your pet displays unusual issues, seek a veterinarian as soon as possible.

Oxygen at Altitude

A common misconception is that there is less oxygen at higher altitude.  In Leadville, we have the same amount of oxygen that is found at sea level which is 21%.  This 21% eventually begins to diminish at 70,000 ft of elevation. 

But there is a change...

As you go higher, the air pressure gets lower (the air gets “thinner”). The challenge we face at 10,200 ft of elevation is that we have less atmospheric pressure to breathe it into out lungs. At 10,000 feet elevation, the body "feels" like it is breathing in 14.2% oxygen due to this lower atmospheric pressure.

Oxygen is needed to give you the energy to move but is also needed simply to keep your body alive - for your brain and digestion to work, for healing cuts, and all those normal things your body does without you knowing about it. As your body gets less oxygen it adapts; you breathe faster and deeper and your heart rate goes up along with your blood pressure.

The people that live at 10,200 feet elevation adapt by making make more red blood cells to carry more oxygen. This change occurs after several months of living at elevation.

Oxygen alleviates many of the symptoms of high altitude sickness and has proven to save many a valued holiday.

eyes

  

The high level of UV light at altitude can

burn the eyes (snow blindness), like “arc eye” which welders can get - it feels

like sand in the eyes. Rest, padding the eyes, lubricant drops and painkillers will help.

Good sunglasses or goggles are needed on snow even when it’s cloudy - UV rays penetrate through clouds.

Choose glasses with ultra violet (UV) protection that are designed for the mountains. Prescription sunglasses and goggles can be made. Contact lenses can be used, but very strict hygiene is a must.

  • Contact lenses must be permeable to oxygen for the cornea to survive─ high altitude hinders this process. 

  • Make sure you remove your daily contact lenses at night.  

 

Don’t get laser treatment just before you travel - think ahead. Tiny bleeds at the back of the eye can occur (retinal hemorrhages), which can affect patches of vision. Usually these are not dangerous and will disappear after a few weeks.

  • Descend and see medical attention if you lose vision in either eye at altitude.

extremities

At high altitude you are at more risk from burning and freezing. High levels of UV radiation at altitude can easily cause sunburn.

Low temperatures and low oxygen levels make it easier for your skin to develop frostbite, especially in people who already have poor circulation (such as in Raynaud’s disease). Frostbite can happen to any body part in freezing temperatures and / or high winds. Early signs of frostbite are white, numb and hard skin. Re-warming can be very painful and the skin may go red, itchy, blotchy and swollen. If freezing goes on, blisters may develop and finally the skin can turn black and die. This is very serious and may lead to amputation of fingers and toes. Body parts most at risk of sunburn and cold injuries are those “sticking out?” - lips, toes, nose, chin, fingers, ears - so they will need extra protection.

  • Swelling around the hands, face and ankles at altitude is seen quite often. This may be serious and you should seek medical attention when available.

Oxygen Available in the mountains:

Medical grade oxygen is necessary for the treatment of HAS/AMS, as well as many other conditions.  This equipment does require a physician’s prescription.

Questions?

WE are here to help! Give us a call.

  • A referral is generally made either by the doctor or the patient themselves. 

  • Equipment is delivered and explained in the comfort of your own home or hotel.

  • Insurance billing available   

  • We provide medical oxygen service 24 hours/day, 7 days/week. 

anything else I should know about?

We're glad you asked...

Don't sleep with your contacts in.

Drink plenty of water.

Avoid Alcohol

Frostbite is possible, prepare accordingly!

don't forget sunscreen

wear sunglasses

use lip balm with uv protection

tell someone when you're headed into the back-country and when you expect to return

water boils at a much lower temperature

baking is a much different/more difficult experience at elevation than it is at sea level.

make sure your campfire is out before you leave