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The Impact of High Altitude on Pre-Existing Conditions

Posted Monday 02 September 2019 09:07 by in Altitude Sickness by Tim Deakin

altitude sickness

With increasing numbers of people travelling to more remote and exotic locations, journeying to high altitudes has becoming more popular than ever. High altitude is generally defined as any height between 1,500 and 3,500m, with 3,500 - 5,500m being classed as very high altitude and anything over 5,500m classed as extreme altitude.[1]

Altitude sickness can occur when you move between altitudes occurs too quickly for acclimatisation to take place effectively.[2] Mild forms of altitude sickness are known as acute mountain sickness (AMS), while more severe forms can develop into high altitude cerebral oedema (HACO) or high-altitude pulmonary oedema (HAPO).[3]

Symptoms of mountain sickness can change depending on what form of illness you have developed, and how severe it is. The most common symptoms of altitude sickness include dizziness, fatigue, shortness of breath, loss of appetite, lethargy and sleep problems. In more severe cases, these symptoms become worse and are accompanied by headaches, nausea and vomiting, as well as a tightness in the chest. In the most serious cases, the condition can lead to confusion, immobility and a fluid build-up in the lungs.[4]

But for those with pre-existing conditions, avoiding altitude sickness requires even more care and planning.

High altitude and pre-existing conditions

Most people can enjoy travelling to areas of higher altitudes if the necessary care is taken, but travellers with certain medical conditions should seek out medical advice before travelling to make sure their condition is stable, and won’t be worsened by the altitude change.

These conditions include:

Diabetes

Epilepsy

Heart conditions like high blood pressure and heart disease

Lung conditions like asthma and chronic obstructive pulmonary disease (COPD)

Sick cell disease[5]

Pregnancy also requires greater care in higher altitudes, as the World Health Organisation recommended avoiding altitudes higher than 3000m when pregnant.[6]

Age and disability can also impact the risk of altitude sickness when travelling, so be sure to consult your GP if you feel your chances of developing the condition may be higher.

Precautions against altitude sickness

No matter who you are and how robust your overall health is, it is vital that you take precautions when travelling to high altitudes.

It is generally advised that you avoid travelling from altitudes less than 1,200m to altitudes greater than 3,500m in a single day. When you reach altitudes higher than 3,000m, avoid increasing your elevation by more than 500m a day, and make room for a rest day every three or four days.[7]

If you do begin to develop symptoms of high altitude, don’t continue to ascend. Always attempt to descend if your symptoms worsen or become severe.[8]

Medications like acetazolamide can be used to lessen the impact of altitude sickness, aiding recovery, by causing a mild metabolic acidosis which increases respiratory rate, improving oxygenation.[9]

You can find safe and effective altitude sickness treatment like acetazolamide right here at Express Pharmacy. Get in touch with our pharmacists today by calling 0208 123 07 03 or by using our discreet online Live Chat service.

[1] Hackett, PR. Roach, RC. High altitude medicine in: Wilderness Medicine. 2011

[2] Palmer, BF. Physiology and pathophysiology with ascent to altitude. American Journal of Medical Science. 2010

[3] Charlton, T. PhD. Altitude sickness — a doctor’s story. Bupa UK. 2018

[4] Cleveland Clinic. Altitude Sickness. 2017

[5] NHS Fit for Travel. Altitude and Travel. 2018

[6] World Health Organisation. International Travel and Health: Travellers with pre-existing medical conditions and special needs. 2019

[7] Travel Health Pro. Altitude sickness. 2018

[8] Luks, AM. Et al. Wilderness Medical Society practice guidelines for the prevention and treatment of acute altitude illness. Wilderness Environ Med. 2014

[9] Williamson, J. et al. Altitude sickness and acetazolamide. BMJ. 2018


3 Golden Rules for Staying Safe on a Climbing Holiday

Posted Tuesday 15 January 2019 14:43 by in Altitude Sickness by Tim Deakin

mountain climbing medication

From the right climbing gear to the correct medical supplies, here’s everything you need to know about staying safe while mountaineering

Unlike beach holidays, climbing holidays are often physically demanding as well as enjoyable. Reaching a stunning peak makes all the hard work worth it, but it’s important not to forget about your health and safety when experiencing such extreme environments.

The right gear and careful planning are imperative, as is protection against altitude sickness, which describes a number of conditions that may occur after you have ascended rapidly into a high altitude area.[1]

With that in mind, here are our golden rules for staying safe on your climbing holiday.

Bring the correct gear

It’s important to remember that, while fun, mountaineering also carries many risks. The Royal Society for the Prevention of Accidents (ROSPA) reports that there are around 4,000 annual rock climbing accidents, and 1,000 accidents per 100 hours of hill walking.[2]

The correct gear is essential if you want to enjoy your experience safely. As well as the climbing equipment itself, you’ll also need sun protection such as sunglasses, facemasks or balaclavas and a sunscreen which protects against UVA, UVB and UVC rays. You’ll also need cold protection gear such as cold climate clothing, gloves, hats, socks and boots.

Take your time and plan ahead

mountaineering safetyA landmark study on Scottish Mountaineering Incidents by Dr Bob Sharp found that there is a gender difference in the likelihood of experiencing a mountaineering accident. Men, and particularly younger men, are around 8 times more likely to experience a fatal injury. Sharp’s study found that the most common causes of accidents are poor navigation (23%), bad planning (18%) and inadequate equipment (11%).[3]

No matter how big or small, any mountaineering expedition requires careful planning. You need to know exactly where you’re heading and how to get there, sticking to a clear path you’ve already established. If you’re travelling in a group (which is recommended), you’ll need measures in place in case somebody gets lost or injured.

Avoid altitude sickness

Altitude sickness is arguably the most common health risk associated with mountaineering and climbing. It can range from mild to severe or even fatal, as it includes acute mountain sickness (AMS), high altitude cerebral oedema (HACE) and high altitude pulmonary oedema (HAPE).

According to the Himalayan Database, death tolls rise as the altitude increases. Peaks in Nepal with heights between 6,500m and 6,999m have a mortality rate of 0.65%. In peaks over 8,000m, this rises to 2.11%.[4]

This theory is backed up by the NHS’s Fit For Travel, which says that the risk of altitude sickness can rise up to 25% at 2,500m, and up to 75% at heights greater than 4,500m.[5]

Risk factors for altitude sickness can include the rate at which you ascend, the change in altitude itself and the sleeping altitude. It can also be made more likely if you have a history of altitude sickness or an existing cardiovascular disease, though general physical fitness does not protect against it.[6]

In order to tackle altitude sickness effectively, you’ll need to take things slow. Stay hydrated and well-rested, and make sure you bring the necessary medication with you to protect against the condition.

Find safe and effective medication for altitude sickness right here at Express Pharmacy. You can order Acetazolamide from our site and have it delivered to you easily and quickly. If you have any further queries about your health and safety, contact our team. Simply call 0208 123 07 03 or use our discreet online Live Chat service.


The Science Behind Altitude Sickness

Posted Friday 04 January 2019 12:30 by in Altitude Sickness by Tim Deakin

altitude sicknessWhat really happens to your body when you climb?

For many of us, the best way to tackle the winter blues is to book an exciting winter getaway that’s full of adventure. Unfortunately, a lot of the most desirable spots in the world — the Swiss Alps, Machu Picchu and the Rocky Mountains — are also ones which carry a significant risk of altitude sickness.

What is altitude sickness?

Altitude sickness is actually a term which encompasses three different conditions that occur at high altitudes, the first and mildest being AMS: acute mountain sickness. According to the Centres for Disease Control and Prevention (CDC), around 25% of visitors to Colorado (the U.S. state with the highest altitude at 6,800 feet above sea level) experience symptoms of the condition. [1]

According to the U.S. National Library of Medicine, the most common symptoms of AMS include fatigue, nausea, dizziness, shortness of breath, a lack of appetite and difficulty falling asleep.[2] Headaches can occur within two to 12 hours of exposure to high altitudes and, in most cases, symptoms last between 12 and 48 hours, only leading to more long-term concerns if you continue to ascend.

It’s thought that AMS primarily occurs due to the way higher elevation impacts your brain. Ascending to a high altitude causes changes in the blood flow to the brain, and in some individuals this can lead to a swelling of the brain tissues.[3] However, most people who experience AMS will find that descending around 1,000 feet will alleviate the symptoms, according the CDC.[4]

Altitude sickness complications

In severe cases however, brain swelling can occur on a more significant scale, leading to a much more serious form of altitude sickness: high-altitude cerebral edema (HACE). This form of altitude sickness impacts the blood flow to the brain tissue, preventing the brain from being able to function normally. The tell-tale symptom that AMS has progressed to HACE is ataxia, or loss of balance. Other symptoms include intense fatigue and confusion, and prolonged brain swelling can lead to loss of consciousness or even death.[5]

High-altitude pulmonary edema (HAPE) is another possibly life-threatening complication which can result from altitude sickness. It can occur on its own or alongside AMS and HACE. HAPE occurs when fluid collect in the lungs, resulting in difficulty breathing.[6] The blood flow of the lungs begins to get erratic and cause more pressure in some pulmonary arteries than others. As the air sacs in the lungs fill up, your ability to oxygenate the blood decreases, causing a greater lack of oxygen.

According to the CDC, symptoms can include headaches, shortness of breath, increased heart rate, heart palpitations, fever, chest pain, fatigue and a mucus cough. It can become fatal even more quickly than HACE.[7]

Treating and preventing altitude sickness

altitude sickness medicationTaking things slowly and giving your body time to adjust is key to avoiding altitude sickness. The CDC advises that you should not travel from a low altitude to over 9,000 feet in a single day. Instead, they recommend increasing your sleeping altitude by no more than 1,600 feet a day.[8]

You should also make sure to stay hydrated and avoid substances like alcohol when climbing.[9] Effective altitude sickness relief medication can help you to travel safely and without worry.

Contact the Express Pharmacy team today by calling 0208 123 07 03 or by using our discreet online Live Chat service.


Taking a Winter Ski Trip? Here’s How to Stay Healthy in High Altitude

Posted Friday 02 February 2018 10:03 by in Altitude Sickness by Tim Deakin

Mountain sickness can ruin a winter break, so here’s everything you need to know to stay safe and healthy

After the excitement and indulgence of the festive period, it’s easy to feel a little down for the rest of winter. The weather’s still cold, the nights are still dark, and the celebrations are over. To counteract this, a growing number of us turn to the solution of a winter break to keep the fun going. For many of us in the UK, this means a picturesque ski trip to lift the spirits.

And whilst a ski trip is a great way to break up your winter, it’s important that you know how to ensure sickness doesn’t ruin your getaway. Altitude sickness can strike at any time if you are travelling way above sea level, so here’s all the information you need to guarantee your family a happy, healthy winter ski trip.

What is altitude sickness?

Altitude sickness, or acute mountain sickness, is a condition which occurs when you travel to a high altitude too quickly, meaning your body cannot adjust and function properly. As a result, breathing becomes difficult because you cannot take in as much oxygen as you normally would.

Any altitude above 8,000 feet is considered high, meaning the risk of acute mountain sickness is present. However, for most people the condition will occur at heights of 12,000 feet or higher, as at 12,000 feet there are roughly 40% fewer oxygen molecules per breath than at sea level.

If ignored, altitude sickness can result in an emergency medical situation.

Causes of altitude sickness

Factors such as physical fitness, age or sex have no bearing on your likelihood of obtaining altitude sickness when away. You also shouldn’t assume that just because you haven’t suffered from acute mountain sickness when skiing in the past, you won’t suffer from it in the future. Anybody can suffer from the symptoms of altitude sickness at a given time.

Symptoms of altitude sickness

Altitude sickness symptoms can include:

- Dizziness

- Tiredness

- Nausea

- Vomiting

- Headaches

- Shortness of breath

- Loss of appetite

Symptoms of altitude sickness don’t usually develop straight away, often taking between 6 and 24 hours to occur after you’ve been exposed to high altitudes. Symptoms are usually worse at night, and can feel similar to those of a particularly bad hangover.

Altitude sickness prevention

When you are in the UK, it is very unlikely that an individual will suffer from acute mountain sickness as the highest peak — Scotland’s Ben Nevis — is only 1,345 metres high, which is equivalent to 4,413 feet. However, this is the time of year when many of us head overseas for winter ski trips, so it’s more important now than ever to get to grips with prevention and treatment for altitude sickness.

In order to avoid altitude sickness, you should travel to altitudes above 8,000 feet slowly to allow your body to get used to your surroundings. You should also:

- Take 2-3 days to get used to high altitudes before going above 8,000 feet

- Avoid flying directly into high altitudes

- Rest every 600-900 metres you climb

- Avoid climbing more than 300-500 metres in a single day

- Drink plenty of fluids

- Avoid strenuous exercise for the first day of your trip

- Eat light, high calorie meals

- Avoid alcohol and smoking

- Medication for altitude sickness

Acetazolamide is an effective medication for the prevention and treatment of acute mountain sickness. It works by reducing the amount of fluid in the head and lungs, improving breathing and helping us adjust more quickly to higher altitudes. It should be taken initially 1-2 days before entering a high altitude area, and for at least a further two days after reaching your peak altitude.

Acetazolamide is available from Express Pharmacy.

For altitude sickness tablets or other effective NHS-approved medication for a variety of conditions, contact Express Pharmacy. You can use our discreet diagnosis process to find the right treatment for your condition, or call the team on 0208 123 07 03.

Tags: Acetazolamide General Health Travel Health

Altitude Sickness 101

Posted Tuesday 03 January 2017 14:41 by in Altitude Sickness by Tim Deakin

altitude sicknessIf you are the adventurous type and love the outdoors there are few greater thrills than embarking on a trek or a climb. From Mount Kilimanjaro in Tanzania to Khuiten in Mongolia, the Matterhorn in Switzerland to Annapurna in Nepal, there’s no better way to challenge yourself – to be rewarded by stunning views and a life-changing experience.

But while the physical and mental challenges of trekking are to be respected, one of the most important factors that anybody travelling up in the world needs to understand is the effect of altitude on the body. Altitude sickness has little respect for strength or physical fitness and can come in a number of forms. These include:

AMS: Acute Mountain Sickness

Common symptoms include headache, nausea, dizziness and exhaustion

HAPE: High Altitude Pulmonary Edema

Fluid on the lungs causing breathlessness. Often this is accompanied by a fever and a cough that produces frothy spit.

HACE: High Altitude Cerebral Edema

Fluid on the brain causing confusion, clumsiness, deterioriating levels of confusion

While cases of HAPE and HACE are extremely dangerous to climbers attempting high altitudes, they usually develop at altitudes of 3,600 metres. Much more common is AMS, which can affect day hikers and climbers at around 2,500 metres, although it is possible amongst those who ascend quickly to a height in excess of 1500 metres above sea level.

What causes altitude sickness?

Altitude sickness is related to the thinning of the air as you ascend higher above sea level. The greater the elevation, the fewer the number of oxygen molecules per break. Above 3000 metres, 75% of people will experience mild altitude sickness due to the depletion of oxygen in the body.

Suffering from altitude sickness is not a sign of physical weakness or age. In fact, age, gender and fitness levels have little to do with a person’s likelihood of getting altitude sickness.

Treating altitude sickness

While it is possible to acclimatize to the thinner air at altitude, people should take great care when attempting to spend a prolonged time at a height above 2500 metres. Ascending slowly (less than 500 metres per day) can help and staying hydrated and fuelled at all times is also important. Prescription medications such as Acetazolamide can also be effective in preventing and treating altitude sickness to decrease symptoms such as headaches, tiredness, nausea and shortness of breath.

Buy Acetazolamide now

For those suffering from AMS during an ascent, resting for 24 hours and taking Acetazolamide can help. If the symptoms subside it is safe to continue a climb. However, if the symptoms persevere, it is advisable to descend to a safe level to recover. If you find yourself suffering from HAPE or HACE then you should descend immediately with the help of those travelling with you.

Are there other remedies or medications that can help?

Although there is anecdotal evidence and old wives tales about other treatments and herbal remedies that are claimed to prevent altitude sickness, there are no proven alternatives to Acetazolamide. Indeed, some herbal remedies can have dangerous side effects or simply worsen the problem.

If you wish to discuss the symptoms of altitude sickness or discuss preparations for an upcoming trek further, why not consult one of our pharmacists today. Try our Live Chat facility or call 0208 123 0703.


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