Mountain Sickness

What is mountain sickness?

Mountain sickness is a condition that happens when you travel to high altitudes (heights). Mountain sickness is also called high altitude sickness. It is your body’s response to the lower oxygen level in the air at higher altitudes.

What are the types of mountain sickness and what causes them?

Oxygen levels in the air decrease as altitudes get higher. When there is less oxygen in the air, your body cannot get the oxygen it needs to function properly. The following may occur when your body has decreased levels of oxygen:

• Acute mountain sickness: Acute mountain sickness occurs when you go to areas with a lower oxygen level than what your body is used to. Your body needs time to adjust to lower oxygen levels. If you go to higher altitudes too quickly, you can get mountain sickness. Acute mountain sickness often occurs in people who do mountain climbing, skiing, or hiking. Acute mountain sickness normally occurs within 6 to 24 hours of traveling to a higher altitude. You can get mountain sickness within one hour of being at a higher altitude.
  
  
• Chronic mountain sickness: Living in areas with lower oxygen levels for long periods can lead to chronic (long-term) mountain sickness. When your body has less oxygen it makes more red blood cells. The increased amount of red blood cells can cause your blood to become thick. When your blood is too thick, your body may not be able to get the right amounts of oxygen to your organs. The decreased oxygen level then leads to chronic mountain sickness.

What increases my risk of getting mountain sickness?

• Being dehydrated (loss of body fluids).
  
  
• Exercising soon after reaching a higher altitude.
  
  
• Having had mountain sickness in the past.
  
  
• Having heart or lung disease.
  
  
• Normally living at a low altitude.
  
  
• Obesity (weighing more than what is healthy for your height).

What are the signs and symptoms of mountain sickness?

You may have any of the following:

• Headache.
  
  
• Breathing faster, shorter breaths than normal. You may begin to feel like you cannot catch your breath.
  
  
• Decreased appetite for food, nausea (upset stomach), or vomiting (throwing up). You also may have a dry mouth.
  
  
• Feeling light headed or dizzy. You also may feel confused.
  
  
• Feeling weak or more tired than normal.
  
  
• Needing to urinate more than what is normal for you.
  
  
• Racing (fast) heart beat.
  
  
• Swelling in your face, hands, and feet. You also may have a burning feeling in the palms of your hands and bottoms of your feet.
  
  
• Trouble sleeping.

What medical problems might I get when I have mountain sickness?

The following may occur with acute or chronic mountain sickness, and may be life-threatening:

• High altitude cerebral edema: High altitude cerebral edema (HACE) is when your brain swells and fluid collects around it. HACE normally can occur 3 to 5 days after arriving in high altitudes, but can happen at any time. Ask your caregiver for more information about cerebral edema.
  
  
• High altitude pulmonary edema: High altitude pulmonary edema (HAPE) is when fluid collects in your lungs. Ask your caregiver for more information about pulmonary edema.
  
  
• Heart failure: Right sided heart failure may occur when your blood has become thick from living at very high altitudes. Thick blood causes the heart to work harder and may lead to heart failure. Ask your caregiver for more information about heart failure.

How is mountain sickness diagnosed?

Your caregiver may know you have mountain sickness by learning your signs and symptoms. Your caregiver may use a mountain sickness scoring system to check how bad your illness is. You also may need the following:

• Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.
  
  
• Chest x-ray: This is a picture of your lungs and heart. Caregivers use it to see how your lungs and heart are doing. Caregivers may use the x-ray to look for fluid in your lungs, or for signs of an infection. Chest x-rays also may show if your heart is enlarged.
  
  
• Computerized tomography scan: This is also called a CT scan. A special x-ray machine uses a computer to take pictures of your brain or lungs. The pictures are done to show if you have fluid around your brain, or in your lungs. You may be given dye before the pictures are taken. The dye is usually given in your IV. The dye may help your caregiver see the pictures better. People who are allergic to iodine or shellfish (lobster, crab, or shrimp) may be allergic to some dyes. Tell your caregiver if you are allergic to shellfish, or have other allergies or medical conditions.
  
  
• Magnetic resonance imaging: This test is also called an MRI. During the MRI, pictures are taken of your head. An MRI may be used to check your brain for swelling and fluid. You will need to lie still during an MRI. Never enter the MRI room with any metal objects. This can cause serious injury. Tell your caregiver if you have any metal implants in your body.

How is mountain sickness treated?

Treatment for mountain sickness depends on how severe (bad) your symptoms are. Mild mountain sickness may go away by resting and allowing your body to get used to the decreased oxygen. In many cases, moving down to a lower altitude will take away your symptoms. Treatment for mountain sickness may decrease your symptoms such as headaches, dizziness, and swelling. Treatment may make it easier for you to breathe, and may even save your life. You may need any of the following:

• Medicines:
  
  
  • Ibuprofen or acetaminophen: Ibuprofen and acetaminophen are over-the-counter medicines that may help your headache pain. Ask your caregiver how much medicine you should take, and how often.
    
    
  • Antinausea medicine: This medicine may be given to calm your stomach and prevent vomiting.
    
    
  • Carbonic anhydrase inhibitor: This medicine may be given to decrease swelling, and increase the blood flow to your brain. This medicine may also make it easier for you to breathe.
    
    
  • Steroids: Steroid medicine may be given to decrease inflammation (swelling).
  
  
• Oxygen: You may need extra oxygen to help you breathe easier. It may be given through a plastic mask over your mouth and nose. It may be given through a nasal cannula, or prongs, instead of a mask. A nasal cannula is a pair of short, thin tubes that rest just inside your nose.
  
  
• Phlebotomy: During phlebotomy some of your blood is removed through a vein to reduce the amount of blood in your body. Phlebotomy may be needed if you have thick blood from chronic mountain sickness.

What can I do to prevent mountain sickness?

• Bring a first aid kit with medicines to prevent headaches. Talk to your caregiver about what medicines you can bring that may help prevent mountain sickness. Make sure you have water in your first aid kit to prevent dehydration.
  
  
• Do not do heavy exercise right after you travel to higher altitudes. Your body cannot adjust right away to the changes in the oxygen level. Heavy exercise may increase your chance of getting mountain sickness.
  
  
• Do not drink alcohol or take sedatives (sleep medicines). Alcohol and sedatives make it harder for your body to adjust to the decreased oxygen level.
  
  
• Travel to higher altitude slowly to allow your body to get used to the decreased oxygen level. Do not go up more than 300 meters daily when you are above 3000 meters. Every 2 to 3 days you should stop and rest for one full day. You may need to rest more often when you are above 4000 meters.
  
  
• Travel higher during the day and sleep at lower altitudes at night to allow your body to adjust better. Pregnant women should not sleep higher than 3500 meters to prevent pregnancy problems. If you are pregnant, talk to your caregiver before going to high altitudes.
  
  
• If you start to have symptoms of mountain sickness, rest for 24 hours or go down to a lower altitude. Do not continue traveling to higher altitudes until your symptoms improve.

Where can I find more information?

Contact the following:

• International Society for Mountain Medicine
  P.O. Box 31142
  Colorado Springs , CO 80931-1142
  Web Address: http://www.ismmed.org
  

When should I call my caregiver?

Call your caregiver if:

• You have a fever.
  
  
• Your symptoms, such as headaches and dizziness do not get better after going to a lower altitude.
  
  
• You have a new cough.
  
  
• You have questions or concerns about your condition, medicine, or care.

When should I seek immediate help?

Seek immediate care or call 911 if:

• You begin to have trouble walking.
  
  
• Your lips, nails, or skin are very white or blue in color.
  
  
• You have trouble breathing at rest, or you are taking more than 30 breaths each minute.
  
  
• You have fainted (passed out), or had a seizure (convulsion).
  
  
• You have a worsening cough, noisy breathing, or you cough up pink, foamy sputum (spit).
  
  
• You have chest pain, strong, fast heartbeats, or you feel a flutter in your chest.
  
  
• You have behavior changes or hallucinations (seeing or hearing things that are not there).
  
  
• You have signs of a stroke: The following signs are an emergency. Call 911 immediately if you have any of the following:
  
  
  • Weakness or numbness in your arm, leg, or face (may be on only one side of your body)
    
    
  • Confusion and problems speaking or understanding speech
    
    
  • A very bad headache that may feel like the worst headache of your life
    
    
  • Not being able to see out of one or both of your eyes
    
    
  • Feeling too dizzy to stand

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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