Denver Safety: Altitude Sickness

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Altitude Sickness or Acute Mountain Sickness is an ailment that potentially anyone can have when they visit areas with higher altitudes than they are used to, due to decreases in barometric pressure (though not oxygen content). Denver is called the Mile High City for a reason -- at an altitude of a mile above sea level, one can start to experience some of the effects of altitude sickness, though generally this condition becomes more pronounced at elevations around 8,000 feet (2,500 meters) and above. Some normal changes may occur when people travel to higher altitudes that are not altitude sickness. These include:

• Hyperventilation (breathing faster, and/or deeper than normal)
• Shortness of breath after exertion
• Changes in nightly breathing
• Awaking at night
• Increased urination

The above are generally nothing to worry about, though problems with breathing may be helped by a drug called acetazolamide. If you think you may have problems, get advice from your doctor before traveling to Denver.

Some people get Acute Mountain Sickness (AMS), which can be serious, at the higher elevations you will experience if you are touring through the Rocky Mountains. A diagnosis of AMS is usually given if a person has a headache accompanied by one of more of the following symptoms:

• Loss of appetite, vomiting and/or nausea
• Fatigue or weakness
• Dizziness or light-headedness
• Insomnia, difficulty sleeping

Some people liken AMS to a bad hangover or worse. It occurs because your brain tissue swells at higher elevations than it is used to. If you are feeling unwell at high altitudes assume that you are suffering from AMS unless there is another logical explanation that would be accompanied by other symptoms (food poisoning or a viral infection). To avoid AMS, try to get to a lower elevation until your symptoms subside, drink lots of fluid to avoid dehydration, and avoid traveling at high rates of ascent. If the symptoms continue or worsen, travel to a lower altitude. AMS can turn into High Altitude Cerebral Edema (HACE), a potentially fatal condition where the brain swells so much that it ceases to function properly. Symptoms of HACE include confusion, inability to think clearly, lethargy, ataxia (walking staggerdly, as if one was drunk), and changes in behavior. The person may not recognize they have HACE, but if you or a person you are with experiences any of these symptoms (especially ataxia), they need to immediately be taken to lower elevations for medical treatment.

Another very serious condition, called High Altitude Pulmonary Edema (HAPE) causes fluid in the lungs. If someone suffers chest tightness, congestion, gurgling breaths, blue or gray fingers or lips, cough producing frothy or pink liquid, and difficulty breathing even at rest, they should be taken to a lower elevation and receive medical treatment immediately.

Although not particularly common, keep in mind that these illnesses are possible, and that anyone is susceptible to them, even if you have traveled to high elevations before. For more information about AMS and related illnesses, see www.ismmed.org/np_altitude_tutorial.htm.

Another medical concern at higher elevations, particularly those in Colorado and Denver, is sunburn and skin cancer. The higher elevation means that there is less atmosphere protecting the skin from harmful solar radiation. This is especially true in Colorado, with both dry air that saps the skin of protective moisture and with the beautifully sunny days we have in the state. Colorado actually has the highest rate of skin cancer in the country, so it's always a good idea to wear a lot of high SPF sun-screen, hats, long sleeve shirts and pants. Don't think that you are protected from the sun in the winter either. The sun's rays can actually be reflected by the snow on the ground, still causing skin damage, so when in Colorado, do as the locals do, and wear sunscreen on any exposed skin surface at any time of the year.

• www.ismmed.org/np_altitude_tutorial.htm