How to scale heights with a lung disease

Any patient with lung disease might not do well at high altitudes but the type and severity of the disease will determine the likelihood of difficulty in a high-altitude environment.

The pathophysiology of high-altitude illnesses has been well studied in normal individuals but little is known about the risks of high-altitude travel in patients with pre-existing lung diseases. Although it would seem self-evident that any patient with lung disease might not do well at high altitudes, the type and severity of the disease will determine the likelihood of difficulty in a high-altitude environment.

Many people travel to high altitudes each year. People who ascend to such elevations are at a risk for many problems, including acute mountain sickness (AMS), high-altitude cerebral oedema (HACE) and high-altitude pulmonary oedema (HAPE). The most significant change at high altitudes is the reduction of oxygen levels. Factors increasing susceptibility are: a history of altitude sickness, quick increases in altitude, how cold the area is, how much exercise a person does at a high altitude, use of alcohol or sleeping pills, and more.

Tests to take

Spirometry to measure lung function, arterial blood gas test to measure the oxygen and carbon dioxide levels in the blood, oxygen saturation in fingers, the 6-minute walking distance test to determine a person’s capacity for functional exercise. After performing these tests, travelling with supplemental oxygen can be allowed. There are different types of ventilatory disorders that might affect one’s response to high altitude, including daytime obesity hypoventilation, sleep apnoea, ventilatory control disorders and neuromuscular disorders.

In summary, continuously counsel a specialist when making a trip to a height higher than 2,000 m above ocean level. Any individual who encounters cerebral pains, exhaustion, sickness should look for medicinal consideration.

(The author is senior consultant,
pulmonology, Paras Hospitals)