Friday, March 6, 2009

Tips for living at high altitude


Poet Emily Dickinson called the hills her friends. Most of us who live here in the high altitude adore our mountains, and they are our friends, not just for their beauty, but for the outdoor activities they provide. However, there are some things you can do to help visiting friends and family adjust to the thinner air. Likewise, if you're lucky enough to travel to Peru or Zermatt this spring, simple precautions can prevent a lot of altitude-related illnesses.

Ketchum, like Denver or Flagstaff, Ariz., is actually moderate altitude (greater than 5,280 feet). High altitude is defined as elevations above 8,500 feet (Baldy, Colorado ski resorts, the high point on the North Rim of the Grand Canyon, the Matterhorn and, of course, the world's highest summit, Mount Everest, at 29,028 feet.)

Nobody wants to start a ski vacation with a splitting headache, and Dr. Keith Sivertson, Blaine County emergency medical director, has some good advice for visitors upon arriving here. First, because we're not sleeping above 8,000 feet, we are not technically at high altitude; Ketchum is high desert. But altitudes as low as 3,000 feet can impose physiologic limitations on the body, and even mild dehydration can compromise performance during exercise. Add to that increased sweating and quick evaporation of that cold, dry air, and you've lost up to two liters of water a day.

Most people, especially those over 60, are sippers, and are not drinking enough to replace their sweat losses, furthering their risk of dehydration. A simple way to tell that you are dehydrated, Sivertson says, is that you're not having to get up in the night to pee (and that your pee isn't clear in the morning). The American College of Sports Medicine suggests drinking two glasses of water two hours before exercise, and to drink during exercise at a rate that matches your sweat loss. In other words, as Sivertson says, many of the symptoms ski patrollers see at Seattle Ridge, like nausea, headaches, weakness and a heavy feeling, are signs of dehydration, not altitude sickness.


Getting off the mountain is important if there is a feeling of fullness in the chest or shortness of breath, as these can be serious health matters. Mike Lloyd, Sun Valley Ski Patrol director, has his staff trained to take no chances with that.

Evangelista Torricelli, in the 1600s, was the first person to realize that the atmosphere above us creates pressure that can support weight. At higher elevations, there's less pressure of oxygen moving from the air into our blood, resulting in less oxygen to help our muscles and heart function. Many people experience high-altitude illnesses when they rapidly ascend to elevations above 8,000 feet. The most common of these is acute mountain sickness. Neither being in shape (a good idea no matter what) or age seem to affect whether a person will develop symptoms. More life-threatening are high-altitude pulmonary edema and high-altitude cerebral edema. Descending to lower altitudes and medical care are essential for these three illnesses.

While you may not know your susceptibility at high altitude, there are some things to do for your next trip or trek. Try to go a few days earlier, and if you can't, try to pre-acclimatize by planning several weekend hiking trips to a similar altitude in the month prior to departure, to judge whether you are susceptible to mountain sickness. Limit your rate of ascent, and while at altitude, stay hydrated and consume enough calories. If you are skiing, trekking or climbing at altitude, you can be using up to 500 extra calories a day. The energy used to support body functions, basal metabolic rate, burns up 200 of these calories, so it's important to eat enough calories.

Have a great trip.

Connie Aronson is a Ketchum-based health fitness specialist and personal trainer.

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