DON’T PANIC

Don’t be afraid of high altitude! Over 200 million people live above 2000m of altitude. Immediate return is not the first solution. The economic costs are very high, and you lose the opportunity to complete your essential mission in La Paz or to share a vacation with relatives or friends. If you panic, your heart beats faster, and this can aggravate your condition.

HYDRATE YOURSELF

Drink plenty of water, preferably mineral water. Also, drink tea infusion and orange juice. In Bolivia, drinking our natural Coca leaf tea infusion is very good.

AVOID COLD

The effects of high altitude also depend on the distance you travel, the difference in season and temperature, and the time of day you arrive. Cold weather aggravates the effects of high altitude. High altitude is like an allergy to a certain food: some people have a bad reaction, and others don't.

AVOID TABACO AND ALCOHOL

Tabaco compromises your breathing capacity. Alcohol metabolism is altered at high altitudes. Alcohol can lead to oxygen desaturation in the body, particularly during sleep. People affirm that when first arriving at high altitudes, they get drunk faster than at sea level. Alcohol can produce more dehydration. It aggravates high altitude first arrival symptoms, producing a faster heartbeat. But the next day, you can have some alcohol, and thereafter, normally.

AVOID IMMEDIATE PHYSICAL EFFORT

Don't carry heavy weights. Please don't run, don't climb stairs fast, take it easy. When you climb stairs, take deep breaths. Don't stop breathing while you concentrate on climbing! (very important!!)

WATCH WHAT YOU EAT

ALWAYS take simple precautions for basic hygiene. Your organism is immune to the bacteria and viruses that surround you in your usual habitat and not to those of a new environment. Upon arrival, you should not ingest unknown foods in significant amounts for the first time. Digestive enzymes develop a specific capacity and function for each type of food. Although some foods taste delicious, one should NOT stuff oneself the first day. Avoid whole milk for the first days. And above all, don't overeat on the first day.

SLEEP LOW

This refers to the city of La Paz. The airport is located at 4100m, and the city's center is at 3600m. But there are good hotels at 3,500m in the center or 3300m in the lower area of Calacoto, twenty minutes from the center. Adjustment to high altitude is complex and varies significantly between individuals and on different trips for the same individual. Some do not show symptoms; they eat, drink, exercise, and even compete in sporting events. However, tolerance to high altitude does not depend on physical strength.

PRECAUTIONS

The precautions you take depend on your symptoms A slight headache and a sensation of a lack of air with pressure on the chest can last for some hours. This could be accompanied by vomiting, in which case the latter would alleviate the heavy feeling of indigestion and make you feel better. If these symptoms worsen and persist in the first 12 hours of arrival, take an analgesic, rest in bed, and cover yourself with a blanket. If the symptoms last 24 or 48 hours and prevent you from sleeping, do not panic, but do call a doctor, preferably a high-altitude specialist. It is best to seek medical assistance soon, as you can avoid serious complications (see below) that will later require hospitalization. The more serious cases should receive adequate medical attention and a precise diagnosis. High altitude sickness generally is associated with some chronic affection that surfaces with hypoxic stress (oxygen reduction). In many cases, the manifestations of sickness at high altitudes are due to overlooked health problems at sea level. Once diagnosed and treated at a high altitude, you may return home in better conditions than before traveling! All who travel to high altitudes should know that the organism is subject to a series of adaptive mechanisms in its new environment. This is valid for well adapted high altitude residents, like those born in La Paz or in the Altiplano region (3000-4000 m), who have to go up to the mines or panoramic areas, like ski resort Chacaltaya (5200 m) or La Cumbre (4600 m) on the way to their destination of the Yungas valleys (600 m), for example.

MEDICATION

No specific and adequate medication is yet known for severe acute high altitude sickness (also known locally as Sorojche). The diuretic acetazolamide [DIAMOX], 125 mg has been recommended to prevent acute illness and sleep better, previously taken one day before ascent to high altitude as a prophylactic. It is not 100 % effective, and we normally don't recommend it due to the side effects. Take one tablet of Aspirin 500 mg with some food one-half hour before you arrive at a high altitude. And always remember that your illness may be associated with a common affection that went untreated. The most frequently detectable causes are broncho-pulmonary disease, hypertension, heart and kidney disease. Nowadays, the technology and facilities permit adequate treatment and health care in a specialized high-altitude clinic such as our High Altitude Pulmonary and Pathology Institute (HAPPI-IPPA) the best!!. So you have nothing to fear.

SUMMARY OF NORMAL MECHANISMS OF HIGH ALTITUDE ADAPTATION

More frequent breathing, proportional to the altitude you rise up to.
Increased pulse (minor tachycardia)
Skin and mucous membranes are dry, particularly in the respiratory tracts.
Minor headache in some.

SUMMARY OF CLINICAL ABNORMAL MANIFESTATIONS OF HIGH ALTITUDE ADAPTATION

Exaggerated increase in respiratory frequency, with difficulty breathing and a sensation of a lack of air (dyspnea) and/or cough.
Exaggerated increase in pulse rate (frank tachycardia), with a sensation of heart palpitations , precordial oppression, and a perception of pulses in the neck and head arteries.
Sensation of pulses in the temples and ear accompanied by nausea and headache. Increase in arterial pressure.
Gastrointestinal symptoms like nausea and vomiting.
Disorientation and lack of coordination.

WHAT SHOULD YOU BE ON THE LOOKOUT FOR?

Children adapt best to changes in altitude, and paradoxically, they also have a greater susceptibility to high-altitude pulmonary edema [HAPE], with around 0.1 to 1% incidence. HAPE can be fatal unless medical help is sought. However, these life-threatening sicknesses can affect anyone at any age.

Symptoms of HAPE are:

Shortness of breath
Fast pulse rate
Phlegm that can be blood-stained
Maybe blue lips

You might be able to detect signs of HAPE before a physician is consulted. In four out of five cases, the HAPE TONGUE (described by us) is white with red spots (ulcers) irregularly distributed of varying sizes that go away when the condition improves. The therapy is generally based on oxygen therapy and rest. However, there are individual variations, and it is best to be treated in our specialized clinic that has a Hyperoxic/Hypoxic Adaptation Chamber.

Another affection that rarely presents itself is HIGH ALTITUDE CEREBRAL EDEMA (HACE) and in our experience 0.1 – 0.5 % incidence;

Symptoms of HACE are:

Blurred vision
Unable to walk straight
Dizziness
Lack of coordination
Disorientation
Delirium and coma in severe cases

Immediate treatment with no second thoughts is also determined by medical consultation. Our clinic has treated these pathologies with 100% success" since 1970

WHY ARE WE AFFECTED BY HIGH ALTITUDE?

The sea level percentage of oxygen in the air (21%) remains 21 % at high altitude, remains 21 % at high altitude. Yet, the air is "thinner" because of the low barometric pressure. Some individuals do not have the capacity to adapt immediately to this lower pressure of oxygen that enters our lungs. When supplementary oxygen is given, it increases the concentration of the gas in the lungs, compensating for the deficit of oxygen that the organism requires to metabolize nutrients and convert them into energy.

Knowledge of what precautions should be taken is very useful when changing environments. Don't be afraid of high altitude; be well informed and take precautions.

FINAL ADVICE

Exaggerated fear constitutes stress and, therefore, a significant loss of energy. Please don't waste your energy; it is fundamental to adaptation!

DON'T BE AFRAID OF HIGH ALTITUDE, HAVE KNOWLEDGE OF IT... AND ENJOY YOUR STAY!!!

@Copyright 1/24/96 IPPA - La Paz, Bolivia
Last update: 19/12/2018