Mile High Workouts

My family and I have gone on a much needed vacation. After dealing with the pandemic and taking extra shifts in the urgent care clinic we needed a mental health break. We ended up in Colorado from Iowa to visit family and shut off a bit. While here, I have been trying to keep up on my health and I am reminded of the struggles of ‘low-landers’ as they head to higher elevation and have to adjust. It can be very humbling to feel in shape but come to a high elevation and getting winded very easily. This is a typical response for those that live at lower elevations when visiting the mountains and should be taken into consideration if one plans to partake in physical activity while visiting.

Climbing Arthur’s Seat outside of Edinburgh

When arriving to higher elevations (about 1600 meters ~5248 feet) from lower elevations, there are several physiologic adaptions that begin. With lower oxygen available (due to lower pressure and concentration of gases) people will start to breathe quicker. To move the blood to the lungs, the heart will beat faster and blood pressure increases for a short period of time. The body will start to produce more hemoglobin and kidneys will cause the body to get rid of fluid. So heart rate will increase, respiratory rate increases, and urinary rate will increase when at elevation. It takes the body about 10-14 days to acclimate, which typically, and unfortunately, is longer than the average American vacation.

Snapped this on the way up Mount Bierstadt in Colorado

For those who plan on ascending rapidly above 3000 meters (~9,842 feet) - for example climbing a fourteener in Colorado or flying to a ski resort - there is a risk of more severe effects that occur due to these changes:

High Altitude Illness

This is the more mild of the altitude illnesses. People will note headache, lack of appetite, nausea, vomiting, dizziness, fatigue, etc. Basically the hangover feeling without the prior fun. To treat this a quick descent and steroids can be considered. If someone experiences this, they are at risk of having it again and should take precautions when going to elevation in the future. These precautions can include discussing preventive medication with a physician prior to travel and planning a slower ascent.

High Altitude Pulmonary Edema/High Altitude Cerebral Edema

These are more severe in nature and need quick care. This is a big reason medical personnel will travel with mountain climbers when tackling Everest. Some teams will take along a hyperbaric chamber to mimic lower altitude and pressures to help with this. This would be something to look up and make sure you are prepared for and to discuss with medial providers prior to visiting very high elevations, especially if you have had issues before. This is similar to High Altitude Sickness, but the lungs and brain start to have effects and more severe symptoms occur. Again, descent is the mainstay of treatment and prevention prior to the trip is recommended.

Snowshoeing in the foothills around Denver during medical school

There are those that try to take advantage of these changes to help with athletic performance. Some will train at elevation and live at lower elevation to reap benefits, while others will live high and train low. Both have some backing in research but the effects are typically short lived. There are high tech facilities now too, for those that can’t take advantage of altitude that will induce hypoxic environments, but again results typically are short lived.

These are basic recommendations for the everyday person. Elite athletes are able to overcome these changes at altitude more efficiently due to their fitness level, but it can still take some effect. As for me, the weekend warrior type, I plan on feeling like it’s the first time I’ve ever jogged in my life the first few days at elevation.

Stay safe out there and as always-- keep moving!