October 2014

Altitude Sickness

Altitude sickness: if you’ve ever been unfortunate to experience it, you’ll certainly know about it. For those who are lucky enough to escape it, altitude sickness, also known as Acute Mountain Sickness (AMS), is the term given to symptoms such as (but not limited to) headaches, loss of appetite, sickness, and dizziness. Often described as similar to a bad hangover but without the drinking, altitude sickness is highly unpleasant, and in extreme cases can even be fatal. But why does it happen?

By: Elisabeth Scourfield
Projects Abroad Volunteer
Cambridge - United Kingdom


Coca Tea
Photo: Jessica Eastwell

According to Web MD, it occurs most frequently when people who are not accustomed to high altitudes move from a low altitude to over 8,000ft. The higher up you go, the thinner the air becomes, and when you ascend too quickly, your body cannot receive as much oxygen as it needs. This causes you to breathe faster and leads to symptoms such as headaches, etc. AMS is the most common and mildest form of altitude sickness, and is able to affect anyone. Even experts do not know who will be affected, as factors such as fitness and gender seem to have little relevance. I recently completed a Salkantay trek to Machu Picchu, and the two people most affected by the altitude were young male skiers. It’s likely that in regular conditions they would have been the fittest and healthiest of the group!

The build-up of carbon dioxide in the blood is what signals to your brain that you need to breathe; so, when this is low the signals are reduced.

On a more technical level, altitudeclinic.com explains that the percentage of oxygen in air remains at 21% at both sea level and high altitude. What changes is the barometric pressure, causing air to become “thinner.” As you ascend, your body gets used to the decreasing oxygen, and at any moment there is an “ideal” altitude where your body has a good balance. This is usually the last elevation at which you slept. When you extend beyond this, you first reach a level where your body can tolerate this but is not yet acclimatized. When you go beyond this point too quickly, there is not enough oxygen for your body to function properly. Also, according to the International Society for Mountain Medicine (ISMM), increased breathing leads to a reduction in carbon dioxide in the blood (which is usually a waste product removed by the lungs). The build-up of carbon dioxide in the blood is what signals to your brain that you need to breathe; so, when this is low the signals are reduced.

If you can, you should try and plan your ascent to higher altitudes slowly, taking a few days to acclimatize. The more gradually you ascend, the more time you will give yourself to become accustomed to the altitude.

What most people suffer is unpleasant, but bearable. However, in rare cases the illness can be much more deadly, as it can affect your lungs and brain. This is because high altitudes can cause fluid to build up in the lungs or the brain. Symptoms of this can include confusion, inability to walk straight, faintness, a bubbling sound in the chest, and even having your lips and fingernails turn blue. The technical names for these conditions are high-altitude pulmonary edema (HAPE) when related to the lungs, or high-altitude cerebral edema (HACE) when related to the brain.

As a country with many high altitude terrains, altitude sickness is a common problem for Bolivia and its visitors. La Paz, for example, stands at over 11,480ft (3,500m) above sea level, with its airport in El Alto even higher at over 13,000ft (4,000m), making it a potentially difficult arrival for anyone flying in from lower elevations. Cochabamba stands at a slightly lower 8,392ft (2,558m). Altitude can be separated into categories of ‘high altitude’ of 5,000 – 11,500ft (1,500- 3,500m), ‘very high altitude’ at 11,500 – 18,000ft (3,500 – 5,500m), and ‘extreme altitude’ above 18,000ft. Therefore, despite being about 5000ft lower than La Paz, Cochabamba is still well within the bracket for high altitude, making it a potential hazard for those arriving straight from low altitudes! When judging if an illness is altitude sickness, the ISMM offers this advice: “A useful rule of thumb is: if you feel unwell at a higher altitude, it is altitude sickness, unless there is another obvious explanation (such as diarrhea).”


Coca Leaves
Photo: Ximena Noya

So, what can be done to prevent this? First, it is necessary to take simple hygiene precautions. This includes basic travel advice such as drinking plenty of water, not eating large quantities of unknown foods, and avoiding alcohol and tobacco when you first arrive. It is also advised to eat a high-calorie diet including plenty of carbohydrates. If you can, you should try and plan your ascent to higher altitudes slowly, taking a few days to acclimatize. The more gradually you ascend, the more time you will give yourself to become accustomed to the altitude.

And what if you are already suffering? The first thing is to not go any higher – during this time you should get plenty of rest and stay well hydrated. A typical South American prevention/ treatment for suffering from altitude is to chew coca leaves or drink coca tea (mate de coca). The effectiveness of this is not certified by doctors, but it is commonly used in Andean regions and locals will swear by it.

In 2013, the New York Daily News discovered an alternative prevention technique to the traditional coca leaves – coca beer! Ch’ama, meaning “strength” in Quechua, is made from malt, yeast, hops, and soaked coca leaves, and is designed to combat signs of altitude sickness. According to the New York Daily News, the beer has been produced since 2011 by Cerveceria Vicos, a brewery based in Sucre, and is claimed by the owner to be an “energizing” tonic.

So, fingers crossed you are lucky enough to escape ever suffering from this high elevation sickness! However, if you do, you can at least understand a little bit more about why on earth your body has decided to punish you this way – and hopefully treat or prevent it too!

The zampoña - an old instrument, but new to me
A few days ago, three volunteers and I went to the national park of Toro Toro. We visited this beautiful place with a guide, and not only was he great, he also introduced us to an ancient instrument: the zampoña.
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