Men's Journal

Illustration by Joe McKendry

Q: I’m going hiking in the Andes this winter. What’s the latest advice on beating altitude sickness?

A: As a medical student, I raced a classmate of mine nearly 17,000 feet up Mount Kenya a few days after arriving there. As we reached the top, we had terrible pounding headaches and blood-tinged sputum when we coughed. We got sick fast and had to descend through the night into a national park, where, in near delirium, we were chased by a buffalo and nearly trampled by an elephant. Lesson learned: When you’re not used to altitude, the first rule is go slow. Oddly enough, studies have shown that travelers on organized group treks to high-altitude locations are more likely to die of altitude illness than travelers who are by themselves. Why? Probably peer pressure to stay on schedule. So my second piece of advice is, listen to your body and keep your own pace. Beyond that, here’s a trick: If you’re going for a day hike at high altitude (anything over 8,000 feet is generally considered high), do it within 24 hours of landing. You won’t be acclimatized — that takes 10 days — but your body also won’t be feeling some effects of sickness (headaches, vomiting) yet. That said, your breathing will be impaired, so don’t pass out. If you’re going for an extended period of time, there are a few drugs your doctor can prescribe. Diamox and dexamethasone can prevent illness when taken before an ascent and can speed recovery if taken right after symptoms develop. And then there’s sildenafil citrate (Viagra), which has been shown to lower pulmonary artery pressure, making it easier to breathe and helping to prevent sickness. Of course, there will be certain side effects that may make it harder to climb…

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Email your questions for Dr. Bob Arnot to dr.bob@mensjournal.com.

This article originally appeared in the November 2009 issue of Men’s Journal.

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