Breathing Challenges In Bolivia: Altitude Adjustments

Bolivia's soaring heights can make breathing difficult for travellers, with the country's highlands situated at over 3,000 metres (10,000 feet) above sea level. The capital, La Paz, is the highest capital city in the world at 3,640 metres (11,942 feet) above sea level. The thin air at such altitudes can cause symptoms of altitude sickness, including shortness of breath, headaches, nausea, lethargy, and loss of appetite. The body needs time to acclimatise to the lower levels of oxygen, and this process can take several days. However, the severity of altitude sickness can vary from person to person, and some may experience more serious health problems such as High Altitude Pulmonary Edema (HAPE) or High Altitude Cerebral Edema (HACE) if they do not descend to lower altitudes or seek medical attention.

The cause of altitude sickness

The human body requires time to adjust to the lower levels of oxygen in the air at high altitudes. When the air pressure drops, the amount of oxygen in the air remains the same, but the air pressure reduces, making the air thinner. As a result, the body has to work harder to receive the same amount of oxygen. This can lead to an increased breathing rate, deeper breathing, and a faster heart rate.

The primary cause of altitude sickness is ascending too high too quickly. The body needs time to adjust to the lower levels of oxygen at a specific altitude, a process known as acclimatization. This process generally takes one to three days at any given altitude. It is recommended to not increase your sleeping altitude by more than 300 meters per night and to limit physical exertion during the first few days of altitude exposure.

At altitudes above 2,500 meters, the body may start exhibiting signs of altitude sickness. Mild symptoms include a headache, nausea, loss of appetite, fatigue, and dizziness. More severe symptoms of altitude sickness include severe breathing difficulties, shortness of breath even when resting, a very fast heart rate, persistent cough, and changes in the ability to think.

In extreme cases, altitude sickness can lead to high-altitude cerebral edema (HACE) and high-altitude pulmonary edema (HAPE). HACE is when the brain swells and stops working properly, while HAPE is when fluid enters the lungs. Both conditions are uncommon but can be fatal.

Symptoms of altitude sickness

Altitude sickness, also known as sorche, is a condition brought on by the drop in air pressure and oxygen levels at high elevations. The symptoms of altitude sickness can vary from person to person, but typically include:

• Headache
• Nausea
• Lethargy
• Loss of appetite
• Shortness of breath
• Insomnia
• Vomiting
• Lack of coordination
• Fatigue and weakness
• Tightness in the chest
• Dizziness
• Blurred vision
• Numbness in the face and hands
• Loss of consciousness

In severe cases, altitude sickness can lead to High-Altitude Pulmonary Edema (HAPE) or High-Altitude Cerebral Edema (HACE), both of which are life-threatening conditions. HAPE occurs when fluid builds up in the lungs, while HACE is caused by fluid in the brain. Symptoms of these severe forms of altitude sickness include:

• Severe breathing difficulties
• Very fast heart rate and breathing
• Persistent cough, which may produce blood
• Irrational behaviour
• Inability to sit up or walk in a straight line
• Blue-tinged skin and nails due to lack of oxygen

It is important to note that altitude sickness can affect anyone, regardless of age, sex, or fitness level. The best way to prevent altitude sickness is to ascend slowly and allow the body to acclimatize to the changes in air pressure and oxygen levels.

Treatment of altitude sickness

Altitude sickness, or mountain sickness, is a group of symptoms that occur when one moves to a higher elevation too quickly, not giving the body enough time to adjust to the lower levels of oxygen and changes in air pressure. It usually occurs at altitudes above 8,000 feet.

The treatment for altitude sickness depends on the severity of the symptoms. If you are experiencing mild symptoms, you can try staying at your current altitude and waiting to see if your body adjusts. Rest, keep warm, and drink plenty of liquids. Do not go any higher until your symptoms are completely gone.

If you are experiencing more severe symptoms, or if your mild symptoms do not go away in a couple of days or get worse, you should descend to a lower altitude as quickly as possible. Do not exert yourself, and get medical help.

• Acute Mountain Sickness (AMS): AMS is the mildest and most common form of altitude sickness. Symptoms include dizziness, headache, muscle aches, and nausea. If you are experiencing mild symptoms of AMS, you can try over-the-counter medications such as ibuprofen or paracetamol. If your symptoms do not improve with medication, or if they worsen, you should descend to a lower altitude.
• High-Altitude Pulmonary Edema (HAPE): HAPE is a buildup of fluid in the lungs that can be life-threatening. It is the most common cause of death from altitude sickness. If you are experiencing HAPE, you should descend to a lower altitude and seek medical attention. You may also need supplemental oxygen and medications such as nifedipine, furosemide, and/or an inhaled bronchodilator.
• High-Altitude Cerebral Edema (HACE): HACE is the most severe form of altitude sickness and occurs when there is fluid in the brain. It is also life-threatening, and you should seek medical attention immediately. HACE is often treated with supplemental oxygen and the steroid dexamethasone. In remote areas, initiating descent, in combination with dexamethasone and oxygen if available, can be lifesaving.

In addition to the above treatments, the drug acetazolamide can help speed up acclimatization and resolve symptoms of altitude sickness. Spending a few days at an altitude below 2,500 meters before going any higher can also help prevent altitude sickness.

Prevention of altitude sickness

Altitude sickness, also known as soroche, is a condition brought on by the drop in air pressure and oxygen levels at high elevations. The higher you climb, the lower the air pressure and oxygen levels get. While our bodies can handle the shift, they need time to adjust gradually.

Plan your ascent

Give your body plenty of time to acclimatise naturally. If possible, don't fly to high altitudes. Start below 3,000 meters (10,000 feet) in cities like Santa Cruz or Sucre and work your way up.

Take it slow

If you do fly or drive into high altitudes, take it easy and do not move higher for the first 24 hours. Avoid intense physical exercise, and try to travel no more than 1,000 feet each day. Plan a rest day for every 3,000 feet you go higher.

Listen to your body

Different people will acclimatise at different rates, so move at your own speed and don't push yourself to keep up with others. If you are on a trek and start feeling unwell, walk down a bit to get more oxygen.

Stay hydrated

Drink lots of water and avoid coffee and alcohol. The body loses a lot of fluid when acclimatising, so it's important to drink at least four to six litres of water per day.

Eat a balanced diet

Eat plenty of carbohydrates and make sure you are always eating balanced, nutritious meals throughout the day. Although it is common to lose your appetite at higher altitudes, it is important to keep eating. Try to eat six light meals instead of three heavy ones.

Take medication

Medications such as acetazolamide (Diamox) can help prevent and combat the symptoms of altitude sickness. Talk to your doctor about which medication is best for you, given your medical history and trip plans.

The dangers of drinking alcohol at altitude

Bolivia's soaring heights can cause altitude sickness, which can be an extremely unpleasant experience for travellers. The thin, dry air at high altitudes can cause a range of symptoms, including headache, nausea, lethargy, and loss of appetite. In more severe cases, altitude sickness can lead to dangerous conditions such as High Altitude Pulmonary Edema (HAPE) and High Altitude Cerebral Edema (HACE), which can even be fatal.

To prevent and manage altitude sickness, it is crucial to stay properly hydrated, get adequate rest, and avoid activities that further strain the body, such as intense physical exercise. One of the most important recommendations for travellers is to avoid consuming alcohol at high altitudes. Here are some insights into the dangers of drinking alcohol at altitude:

Dehydration

Alcohol consumption at high altitudes can significantly increase dehydration. The body already loses a lot of fluids when acclimatising to the thin, dry air, and alcohol exacerbates this by acting as a diuretic, causing increased urination. Dehydration can affect physical and cognitive functioning, leaving individuals unable to safely perform certain activities such as driving.

Impaired Breathing and Oxygen Deficiency

Alcohol may hinder the acclimatisation process at high altitudes. As the body struggles to adjust to the lower oxygen levels, alcohol can impair breathing and further decrease oxygen levels in the blood. This exacerbates the symptoms of altitude sickness, such as shortness of breath and fatigue.

Exaggerated Effects of Alcohol

While recent studies have disputed the claim that alcohol has a more potent effect at high altitudes, the combination of alcohol and altitude can still lead to increased impairment. The symptoms of alcohol intoxication, such as dizziness and impaired coordination, closely resemble the effects of altitude sickness. As a result, individuals may feel relatively more impaired when consuming alcohol at high altitudes.

Increased Risk of Severe Altitude Sickness

Alcohol can increase the risk of developing severe forms of altitude sickness, such as HAPE and HACE. These conditions occur when fluid builds up in the lungs or brain, respectively, and they require immediate medical attention. Alcohol's impact on breathing and oxygen levels can contribute to the development of these life-threatening conditions.

In conclusion, while alcohol itself may not become more potent at high altitudes, its consumption can have dangerous consequences for individuals in these environments. It is crucial for travellers to be aware of the risks and take the necessary precautions to ensure a safe and enjoyable experience at high altitudes.

Frequently asked questions