Travel Tips

Important Things to Know Before Traveling to High Altitude Locations

ALTITUDE SICKNESS:  Traveling to high altitudes can cause health problems even if you have not had problems at high altitudes in the past.

There are 3 types of altitude sickness:

  1.  Acute Mountain Sickness (AMS)—AMS is the most common type of altitude sickness  and is characterized by headache, fatigue, becoming easily tired with minimal exertion, feeling light headed, difficulty sleeping, nausea, vomiting, and loss of appetite.  It usually happens within a day of traveling to high altitude.
  2. HACE (High Altitude Cerebral Edema)—HACE is much less common, but is very serious and can be life threatening.  It involves swelling of the brain.  It is characterized by AMS symptoms but more extreme headache and fatigue.  Victims may have difficulty with normal walking, and develop confusion and irritability, similar somewhat to being drunk.  Symptoms usually start 1-3 days after arriving at high altitude and HACE is an emergency.  The treatment requires oxygen and moving to a lower altitude immediately.
  3. HAPE (High Altitude Pulmonary Edema)—HAPE is also uncommon, but, like HACE, is serious and can be life threatening.  In this condition, the lungs fill with fluid and the victim struggles to get enough oxygen. The symptoms are coughing, difficulty breathing, inability to sleep lying flat, and inability to tolerate physical exertion– such as walking up hill.  The victim may cough up blood tinged sputum, and observers may notice they appear blue in color. Symptoms usually start 2-4 days after arriving at high altitude.  The treatment requires oxygen and moving to a lower altitude immediately.

Treatment of Altitude Sickness depends on the type.  Many people suddenly placed at high altitude will have Acute Mountain Sickness. It can usually be managed with patience and observation.  People with AMS should rest and stay at the altitude where they are without going any higher until feeling better.  Tylenol and Ibuprofen can help with headache symptoms as can reasonable hydration.  Taking medicines that can be prescribed by a physician such as Diamox and Dexamethasone can both treat and help to prevent Acute Mountain Sickness, HACE, and HAPE.  If one develops HAPE or HACE, going to a lower altitude immediately is necessary.

If you have had HAPE or HACE in the past, you should not go to high altitudes without consulting your personal physician who is knowledgeable about your past medical history.

Risk Factors —It is not possible to know in advance if you will become ill when traveling to high altitude.  Being physically fit does not decrease your chances of developing High Altitude illnesses.  There are some risk factors:

  • Prior history of High Altitude Illness
  • Exercising at High Altitude before adjusting to the altitude.
  • Drinking alcohol before adjusting to the High Altitude.
  • Rapid ascent (less than 1 day) to altitudes above 9,000 feet.  Lima is at about 5,000 feet and Arequipa is at 7,700 feet.  Chivay (Casa Chapi) is at about 12,000 feet.  Macusani is at about 14,000 feet.
  • If you have a medical problem that affects breathing. (Not asthma)

Pre-Existing Medical Conditions —People with certain medical conditions need to take precautions.

  • Diabetes:  Blood glucose monitors may be inaccurate at High Altitude.  Check the manufacturer’s recommendations for High Altitude use.
  • Angina or previous heart attack:  Check with your doctor to make sure it is safe to travel at High Altitudes.  If you experience chest pain, shortness of breath, or dizziness while at High Altitude, seek medical help immediately.
  • Asthma:  Asthma does not worsen at High Altitudes.
  • Lung Disease or diseases that interfere with sleep or breathing:  sedative-hypnotic medicines (sleeping aids, narcotic pain medicines), alcohol, sleep apnea, COPD, restrictive lung disease (pulmonary fibrosis), cystic fibrosis, pneumonia, and some congenital heart diseases.
  • Sickle Cell disease is worsened in low oxygen situations and a sickle crisis may be  triggered.
  • Pregnancy:  Travel to moderate altitudes during pregnancy appears to be safe (2500m/8200ft) but above that there may be a higher incidence of complications.  If you are pregnant, discuss the risks with your physician.