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Asthma and Altitude
Q. What advice do you have for someone with mild asthma who wants to do fairly high-altitude climbing?
A. Some web sites such as IfYouSki.com declare that the colder weather at altitude can make asthma worse, though other experts (below) claim that asthmatics tend to do quite well at altitude. When in doubt, try the following:
According to Dr. Charlie Easmon, specialist adviser in travel medicine, in “Altitude Sickness” located at http://www.netdoctor.co.uk/travel/diseases/altitude_sickness.htm those people who are anemic, have blood clotting disorders, suffer from severe asthma, or have pre-existing heart or lung problems should try to avoid high altitude. Those who need to be particularly careful at altitude, but generally should be okay, include:
Thomas Dietz, MD, Consulting Staff, Department of Emergency Medicine, at the Providence Hood River Memorial Hospital, has written a tutorial on mountain sickness for the International Society for Mountain Medicine (http://www.ismmed.org/np_altitude_tutorial.htm). He asserts that asthmatics seem to do better at altitude than at sea level. If you happen to travel to altitude and you think it's your asthma that is causing difficulty while you are at elevation, he suggests you try taking your asthma medication, but if you do not improve fairly quickly assume it is HAPE (High Altitude Pulmonary Edema, which feels like fluid in the lungs) and treat it accordingly – in other words, descend immediately, as trying to go up any higher will only make it worse.
David Shlim, 1997; High Altitude Medical Advice for Travelers, adds that: “People with asthma have been thought to be at theoretically increased risk at altitude due to the possible adverse effects of cold and exercise. However, asthmatics have generally done very well at altitude, possibly due to the greatly decreased presence of allergens at high altitude. However, people with asthma should be cautioned to carry their medications with them at all times” (see http://www.ciwec-clinic.com/).
At Scientific American Frontiers, Gene Rapp asked Peter Bartsch: “I have had asthma and allergies all my life. They seem not to bother me in the mountains. I have climbed Denali in Alaska twice and had no trouble acclimatizing to the cold thin air. Is this because I have no allergies in the more 'sterile' environment? Also, I am hoping to attempt an 8000 meter peak some day. I am now 37 years old. The last time I climbed Denali I was 32 years old, but I have tried to maintain aerobic condition and am doing more rock climbing now than I used to. Is there any information I can get from other people who have climbed high who have asthma?”
Peter Bartsch responded: http://www.pbs.org/saf/1102/hotline/hbartsch.htm “…Asthmatics do better at high altitudes if cold air does not trigger their asthma. As you have climbed successfully twice one of the coldest mountains in the world, I think you have demonstrated that cold air doesn't do you any harm. The reduction of asthma is attributed to 2 major factors: 1) reduction of allergens in the air, and 2) reduced air density. I do not see any reasons why you should not be able to attempt an 8000-m-peak. Your chances to reach the summit should be as good as anyone else's in your party. Considering that you did not have any problems with your asthma on Denali, I predict that this will also be the case on an 8000-m-peak.”
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