How to avoid altitude sickness – a doctors personal experience.

I thought I was prepared for altitude sickness, I’d read all the info, got the right medications, got fitter in the gym and planned my trip to allow some time for acclimatisation. After arriving in Quito at 2800m I felt fine. A couple I met over lunch, told me I’d notice feeling short of breath soon but at that point I felt pretty smug that I so far, was not affected! I hoped I was in the lucky few that barely noticed the altitude.

A few hours later that all changed! I started to feel quite asthmatic so I took a few puffs on my ventolin, thought no more of it and went off to a pharmacy in search of suncream. Whilst there I came over really dizzy and had to hold onto the counter. My appetite was not what it normally is over dinner and by the time I got back to my room, even activities like getting dressed were making me very short of breath. Closing my eyes in the shower, I almost fell over! Then there was the insomnia. As shattered I was after 3 flights and a long long journey to get to Quito, and in such a comfy bed, I thought I was sure to sleep like a baby but I barely slept at all! The same happened to my room mate. And then after waking up I had a nose bleed which almost never happens to me! Add to this a headache, palpitations and a constant sense of nausea and unbalance and I can’t say it’s a pleasant experience! Any trace of smugness I had earlier in the day had well and truly vanished!

I was not alone in this either. Those of us in my travel group who had flown in that day were suffering the most but even one of the girls who had acclimatised in Peru, had oxygen sats of just 91% a few days previously (she’s also a GP and bought her sats probe with her!) To put this into context, patients with chest infections who drop their sats below 92% usually get promptly admitted to hospital and usually they don’t look too good by that point! So it’s no wonder we were all feeling so ropey! I was very relieved to be descending to sea level the following day but apprehensive about what the coming weeks had in store – eventually climbing to 4600 metres on the Lares trek! I was only hoping my Diamox prescription would work wonders!

Back at sea level in The Galapagos, my symptoms quickly resolved and I felt great! Mid-way through the trip, a few other travellers joined our boat, one of whom had come from the Lares trek in Peru. He told me whilst seeing a doctor for a different reason, his oxygen sats were checked in Cusco (3400M elevation) and they were only 84%. He had only experienced a headache at this point but promptly got started on the Acetazolomide the same day! I have to admit I was now feeling quite apprehensive about my upcoming 3 day trek in the Andes.

Back in Quito, after my Galapagos trip was over, the symptoms especially shortness of breath returned quickly – even having a phone conversation felt like a challenge! Thank god there was lift in the hotel! But the next day I noticed I was holding a conversation whilst climbing a hill – perhaps there was little improvement after all?! Though I didn’t have long to feel the relief as my next destination was Lake Titicaca at 3800 M. Now I was reaching some serious altitude!

Not so lucky here, I had 2 flights of stairs to climb with my backpack. I was a mess at the top – it was like I’d just ran up Everest! The following day involved a very steep 30 minute walk up to a village on an island and even the competitive athletes I was travelling with were short of breath! Being short of breath coming DOWN the hill was definitely a new experience for me!

At this point various people I was travelling with were experiencing a variety of symptoms everything from nausea to headaches to dizziness. For me it was mostly respiratory symptoms now. The symptoms often came abruptly and intermittently. One minute you feel normal, the next minute short of breath at rest! At this point I started trying the local remedies made from coca leaf. Don’t worry, though related to cocaine, cocoa leaf is completely legal and widely used for the relief of altitude symptoms. It raises your heart rate so though the cocoa toffees are good – don’t over-do it! Aside from the toffees, there were honey flavoured sweets, peppermint flavoured chewing gum or you could opt for cocoa tea or even just chew the leaves. I don’t recommend the later – they do not taste good!

A few days ahead of my trek, I started my Diamox tablets otherwise known as Acetazolomide. They work as a diuretic which essentially means you will pee a lot and I sure did! Every 20 minutes after the first tablet but that improved after the first few hours! Other people talk about other side effects such as pins and needles but pins and needles are actually also a symptom of high altitude so it is difficult to know which is the cause and effect! But otherwise I had no problems with Diamox and did not encounter anyone who had done either!

Even with Diamox, a few practice walks I did at the Scared Valley and Ollytatambo were pretty exhausting – I counted my lucky stars that there were less stairs on the Lares trek! That said I would be going to 4600m! To say I was a little apprehensive was an understatement!

Fortunately when I started the trek and met my guides, they were incredibly reassuring. One stays at the front and back at all times so you will never be trekking alone! It was drummed into us that there were no prizes for finishing first and slow and steady was the way to conquer altitude sickness. That theory worked for me. We walked at a slow but consistent pace not needing to stop for many breaks. The scenery was so mind-blowing that I barely noticed the shortness of breath at first! I started to struggle after about 4000 m and the last 200m stretch was a real push. I was now dizzy, nauseous, off-balance, tingling from head to toe and of course, short of breath! But I took it REALLY slowly and the feeling of achievement when I reached the summit was even greater than it would have been otherwise!

So was it all worth it?! Absolutely without a doubt! The Peruvian Andes are just stunning and I was lucky to experience hiking them. To read more about my Lares trek experience, please click here.

So here are my top tips for how to cope with altitude!

  • Go slow. Nothing is a race at high altitude!
  • Give yourself TIME. The longer the better though an absolute minimum of 2-3 days. I had about a week and was definitely starting to notice improvement by then!
  • Visit a travel doctor before you leave and get a prescription of Diamox. Even if you just keep it in your first aid kit for just in case.
  • Try local remedies with cocoa leaf – my favourite was the toffees which actually taste more like coconut!
  • Take plenty of simple pain relief medication for headaches.
  • If you start experiencing severe shortness of breath, confusion, drowsiness or a severe headache that doesn’t resolve with pain relief, descend and seek medical advice ASAP!

Don’t let the altitude put you off. Be prepared, be sensible and take things slow and steady and you will make it!

Have you experienced high altitude? Did you have different experiences? I’d love to hear about them!

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