Into Thin Air

Into Thin Air is the name of a best-selling book by Jon Krakauer, the true story of an expedition to climb Mt. Everest that went horribly wrong. Several climbers – including the author – make bad decisions while on the mountain because the thin air prevents adequate oxygen from reaching their brain. It is a very good book and I highly recommend it.

I used to say that was what I was going to do if they ever found a cure or a complete surgical correction for my Heart Defect: Climb Mount Everest. I’ve abandoned that goal, because reaching the top of the mountain is only half the challenge. You have to come down the mountain! Gravity will do that for you, but after falling 25,000 feet, it probably won’t matter how good my heart is!

The January 2010 issue of The American Heart Journal features new guidelines for heart patients who want to engage in high altitude activities. Primarily this applies to those of us who normally reside at lower altitudes and travel to a higher altitude. Someone from a higher altitude should actually exercise better when going to a lower altitude, because of the slightly higher oxygen level.

Along with advice for general cardiology patients and those with Coronary Artery Disease, the article has advice for those of us with Congenital Heart Defects and Congestive Heart Failure. We should expect (even anticipate) that our exercise tolerance will be lower while at higher altitudes.

The normal practice when climbing Everest is to be on the mountain a month a more, climbing higher in the day and returning to a lower altitude to sleep. This allows your body to acclimatize to the higher altitudes, and you work your way up the mountain in this manner before attempting a climb to the summit. A CHDer can’t acclimatize that much, so we should stay at “moderate” altitudes and intentionally restrict our activity level.  “Moderate” is up to the individual, since every CHDer is different. While I was in Colorado for the Bolder Boulder last May, the only adverse effect I could tell was a nosebleed – and since I had a nosebleed those at altitude in the Great Smoky Mountains, I was almost expecting it. (The Smoky Mountains are not nearly as high as Boulder, so I actually expected it to be worse than it was)  My PulseOx, which is usually 80%, dropped to 77% – but I could not tell it was lower.

The doctors writing the report feel that moderating your activity level and staying below 4,950 feet above sea level should serve Cardiac patients well. Boulder is 5,430 feet above sea level and other than the nosebleed mentioned earlier, I felt no ill effects. They also advise medication adjustments (The article mentions Beta Blockers, my doctor authorized extra diuretics if needed.) The article does not mention supplemental oxygen but my doctor ordered it for nocturnal use.

Every person is different, and every heart disease – Coronary Heart Disease or a Congenital heart Defect – is different. Consult your personal doctor before traveling to high altitudes.

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