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Heading to the Slopes? Take these Steps to Avoid Altitude Sickness

After a warmer than usual December, many ski resorts across the nation are finally able to open.

The beginning of January threatened to be the start of a disappointing ski season. Many resorts had reported little to no snow. The situation rapidly changed when the country was gripped with record snowfall and record low temperatures, yielding enough snow to allow resorts to open. The website, onthesnow.com, lists resorts that are open and projected dates for others across the nation.

The anticipation and exhilaration of skiing or snowboarding in fresh powder is unmet in any other winter sport. However, heading to a mountain at a higher altitude than you are used to can result in altitude illness.

Altitude Illness

According to the The CDC Yellow Book (health information for international travelers):

Altitude illness occurs at altitudes of 8,000–10,000 ft (≈2,440–3,050 m). (Sometimes lower altitudes, as low as 6,000 fee or 1829 meters), that can cause hypoxic stress.

Hypoxic stress results from decreased partial pressure of oxygen in the air at high altitudes. The decreased partial pressure of oxygen results in lower arterial levels of oxygen. The tissues that the arteries serve become oxygen starved, leading to serious health complications.

There are three types of altitude illness syndromes

Acute Mountain Sickness (AMS)

This is the most common form of altitude illness. It affects 22–53% of travelers in altitudes between 6070 feet and about 14,000 ft ( between 1,850 and 4,240 meters), with higher incidences being described at the higher elevations. Onset of symptoms usually occurs rather quickly- within 2-12 hours after arriving at a high elevation or ascending to a higher elevation.  

Symptoms of AMS include:

  • headache,
  • nausea,
  • vomiting,
  • fatigue,
  • dizziness,
  • and insomnia.

Very young children with AMS can develop loss of appetite, irritability, and pallor.

AMS can resolve within 12–48 hours if you do not continue to ascend.

Acetazolamide, taken before ascent can help prevent altitude illness in those predisposed, (history of altitude illness, rapid ascent to destination) and can shorten duration of altitude illness from 3-5 days to 1 day. (Acetazolamide is one of the Jase Case add-ons.)

If not appropriately treated, AMS can lead to HACE and/or HAPE:

High Altitude Cerebral Edema (HACE)

(HACE is rare form of high-altitude illness, causing cerebral edema and is fatal if not treated) Although HACE presents with similar symptoms as AMS, cerebral edema can lead to:

  • Altered mental status
  • Confusion
  • Drowsiness similar to alcohol
  • Coma and death if not promptly diagnosed and treated (within 24 hours)

In populated areas with access to medical care, HACE can be treated with supplemental oxygen and dexamethasone. In remote areas, initiate descent for anyone suspected of having HACE, in conjunction with dexamethasone and oxygen, if available. If descent is not feasible, supplemental oxygen or a portable hyperbaric device, in addition to dexamethasone, can be lifesaving. Coma is likely to ensue within 12–24 hours of the onset of ataxia in the absence of treatment or descent.

High Altitude Pulmonary Edema (HAPE)

HAPE is characterized by progression of symptoms over 1-2 days

  • Reduced exercise tolerance
  • Exertional dyspnea, and cough, followed by dyspnea at rest
  • Cyanosis
  • Productive cough with pink frothy sputum
  • Oxygen saturation values of 50%–70% are common.

Can rapidly progress to

  • Bronchospasm
  • Myocardial infarction
  • Pneumonia
  • Pulmonary embolism

Immediate descent from high altitude is almost always necessary. If immediate descent is not an option, use of supplemental oxygen or a portable hyperbaric chamber is critical.

Patients with mild HAPE who have access to oxygen (e.g., at a hospital or high-elevation medical clinic) might not need to descend to a lower elevation and can be treated with oxygen over 2–4 days at the current elevation. In field settings, where resources are limited and there is a lower margin for error, nifedipine can be used as an adjunct to descent, oxygen, or portable hyperbaric oxygen therapy. Descent and oxygen are much more effective treatments than medication.

Risk factors for altitude sickness include:

  • Traveling to the area too fast, not allowing the body to acclimate (allow 3-5 days gradual ascending to destination). This puts you at a lower risk for altitude illness than those who arrive at the higher altitude without allowing the body to acclimate.
  • Genetics may play a role; this is still unclear how or if it does.
  • Age, sex, physical fitness or training does not preclude one from altitude illness.

Be prepared- don’t let high altitude illness ruin your trip

Start slow- Slow ascent- over a period of 3-5 days can help the body acclimate to the altitude. The Wilderness Medical Society recommends avoiding ascent to a sleeping elevation of ≥9,000 ft (≈2,750 m) in a single day; ascending at a rate of no greater than 1,650 ft (≈500 m) per night in sleeping elevation once above 9,800 ft (≈3,000 m); and allowing an extra night to acclimatize for every 3,300 ft (≈1,000 m) of sleeping elevation gain.

Prevention through medication- With rates of altitude illness reach as high as 53 percent of travelers, medication such as acetazolamide can prevent or curb altitude sickness and should be in every high-altitude travelers medical preps.

According to the CDC, side effects to acetazolamide are rare, however, seek medical attention if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

With the add-on acetazolamide to your Jase Case, you can prevent or lessen the time away from the slopes. Be sure to have this valuable medication with you when you travel to high altitudes.

Acetazolamide can also treat glaucoma (acute angle-closure).

- Brooke Lounsbury, RN

Medical Content Writer

Lifesaving Medications

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September is National Disaster Preparedness Month

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Fall travel abroad offers an opportunity for cooler weather, more affordable airfares, and less crowded venues. This is an ideal time to head to distant continents and enjoy fall festivals and activities this time of year before winter sets in. Whether hiking in the Alps, shopping in a boutique in France, or enjoying authentic Asian cuisine while visiting Taiwan, you don’t want your much anticipated travel plans to be interrupted by a medical emergency.

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5 tips to avoid a medical emergency disrupting your travel

The vast majority of medical emergencies are unavoidable. With a little planning you can enjoy your trip without interruptions to a clinic or hospital.

  1. Plan your activities and make a list.

As you plan your activities, check travel advisories for any recommended or required vaccinations, insect or waterborne diseases, extreme weather events, and overall safety in areas you plan to travel.

As you plan your itinerary, download apps on your phone to make your travel experience easier. From checking in on your airline app, to weather updates for the area that you will be visiting, local eateries, and events, these apps are a useful tool to help streamline your travelling experience.

  1. Enroll in the Smart Travelers Enrollment Program (STEP) a free service that allows U.S. citizens traveling or living abroad to receive the latest security updates from the nearest U.S. embassy or consulate. Enrolling in STEP will help the U.S. embassy contact you and provide assistance during an emergency overseas. And, if your family or friends in the U.S. are having difficulty contacting you with urgent news while you’re traveling, they can use the information in STEP to reach you.
  2. Carry an adequate supply of your prescription medications.

 Make sure that you have at least two extra weeks’ worth (a month extra is even better, if the country allows) in case of emergency where you may be delayed returning home. Medications should be clearly labeled, with your name, what they are for(diagnosis) and include a written prescription from your health care provider. To avoid confiscation, check with the countries embassy for a list of medications allowed. If your medication isn’t allowed, talk with your healthcare provider about alternative medications that are allowed. Also, if you have a prescription for a narcotic based medication, check the International Narcotics Control Board for a regulations when traveling with controlled substances.

 If you use medical cannabis, it is advised you leave it at home. There are many international laws that could land you in jail, even if you have a prescription for it. For more information, speak with your health care provider and check out this site on laws regarding medical cannabis and travel.

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 The Jase Case is insurance against infections that would otherwise interrupt your travel plans and require a trip to an unfamiliar clinic or hospital. The case covers over 50 different infections including food poisoning, water borne diseases, urinary tract infections, strep throat, and malaria.  Round out your Jase Case with add-ons: fluconazole, for yeast infections, ondansetron for nausea, and now ivermectin, which is FDA approved for parasitic infections- common in many countries- (and it’s purported off label use), make these valuable additions to your medication stockpile.

In addition to the Jase case, carry a supply of over-the-counter medications, including antidiarrheal, laxatives, pain relievers, allergy medications, sunscreen, and a basic first aid kit for minor emergencies.

Check with your insurance provider (or check this site out for travel insurance ratings) for out of country medical coverage. Just in case you do have an emergency that can’t be handled with antibiotics or a first aid kit, you will need to have adequate insurance coverage for doctors and hospital stays.

  1. Dress appropriately for the weather, activity and climate you will encounter.

 Include appropriate footwear. It is impossible to plan for every type of weather on your way to your destination or once you arrive, but careful planning will definitely help!  If you plan on doing a lot of walking, or are venturing into the mountains for a hike, be sure to break in your shoes or hiking boots before your trip. Moleskin can really be a lifesaver, have some readily available in case of blisters or sore areas on feet. And be sure to remember your hat, it can protect you from sun and rain.

  1. Carry a dependable water bottle and filter.

(Check out this highly rated bottle and filter) And use it even at water fountains. Many stomach illnesses can be avoided by using a filtered water bottle. At restaurants in an area known for contaminated water, use your water bottle. Avoid ice cubes in these areas as these are an often-overlooked way of contamination.

Lastly, have fun, take lots of pictures and make memories! Being medically prepared will enable you to avoid unnecessary time away from your plans.

- Brooke Lounsbury, RN

Medical Content Writer

Lifesaving Medications

Everyone should be empowered to care for themselves and their loved ones during the unexpected.

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Planning a Trip This Summer? Don’t forget your Portable Medical Kit!

Whether planning an extended vacation or a last-minute weekend getaway, emergencies can happen anytime and anywhere. A portable, grab and go kit that carries not just basic first aid supplies but things you may need to prevent or manage minor illnesses can keep you and your family from having to interrupt your plans by seeking medical attention.

Depending on where you are headed- the great outdoors or jetting out of town, there are always a few things that traveling anywhere has in common.

  1. Your schedule is different, so your immunity is lower. Even if you plan your trip around your awake/asleep cycle, the very fact you are traveling makes life stressful. Stress doesn’t necessarily have to be a negative event. Even “good” stress can compromise health- Negotiating travel- whether by car or plane can be stressful. The end goal may be geared toward a fun filled vacation, but getting there may not be. Our immune system isn’t too happy with us when we are stressed and tends to not be as strong. Strange water, food, schedules and new areas traveled can set us up for illnesses we normally would shake off. For instance, you pull into a roadside restaurant (or airport food court) for a quick bite. You eat and leave, not knowing that the food wasn’t thoroughly cooked (rush hour). Several hours later, diarrhea, vomiting and low grade fever hit. These are classic signs of salmonella poisoning (from contaminated food). When functioning properly, the stomach has natural defenses against salmonella poisoning. The high acid content kills the bacteria. However, when our regular diet and routine are interrupted, we can succumb to illnesses that normally wouldn’t affect us.

 If able, have a cooler full of foods you normally eat to snack on your trip. Try not to eat out if possible. If traveling by plane, purchase bottled water, avoid drinking faucets (dangerous bacteria has been found in drinking fountain water) Bring extra food in case plane is delayed.

2. Heat and travel don’t mix- Be sure to keep plenty of water and electrolyte mix on hand . Dehydration is a very serious condition, leading to kidney failure and death. If you are traveling in an area known to be hot (even if it isn’t) be sure to pack electrolyte powder in your portable medical kit. If possible, travel early in the morning before the heat of the day. Keep a water bottle filled with water for each passenger in the car. Don’t forget about pets; remember a water dish and extra food for them also. Have at least an extra gallon of water stored in addition to each person’s water bottles.

3. Take frequent breaks- if traveling by car, trade drivers. Highway hypnosis is real. The monotonous job of driving for hours can lead to falling asleep at the wheel even though you don’t realize it. Take advantage of travel rest areas. Get out and stretch your legs. If you are the sole driver and are feeling fatigued be sure to pull over and take a nap or find a hotel if it is getting late.

In addition to a standard first aid kit, a travel medical kit should be added for extended trips away from home.

This type of kit should include:

  • Extra prescription medication and any otc supplements or vitamins- at least several days more than you think you may need in case your trip home is delayed.
  • Anti diarrheal medication (Imodium or Pepto-Bismol)
  • Age appropriate fever and pain reliever for all in group) Tylenol, ibuprofen, naproxen, etc.)
  • Antihistamine for allergic reactions and seasonal allergies
  • Sunscreen (with UVA and UVB protection, SPF 15 or higher)
  • Sunburn cream or Aloe gel
  • Moist towelettes to wipe hands in case there is no clean water at rest stations or airport restrooms.
  • Electrolyte powder packs
  • Travelers’ diarrhea antibiotic (check out Jase case antibiotics if you haven’t already)
  • Diarrhea medicine (Imodium or Pepto-Bismol)
  • Antacid (Tums)
  • Motion sickness medicine (Dramamine)
  • Cough drops, cough suppressant, or expectorant
  • Mild laxative
  • Hand sanitizer (containing at least 60% alcohol) or antibacterial hand wipes
  • Water purification tablets
  • Insect repellent (with an active ingredient like DEET or picaridin) Some essential oils have proven insect repellant properties. Check out this research paper for more information.
  • Insect bite anti-itch gel or cream (calamine lotion, hydrocortisone cream)
  • Cotton swabs (Q-Tips)
  • Tweezers
  • Paper cups

- Brooke Lounsbury, RN

Medical Content Writer

Lifesaving Medications

Everyone should be empowered to care for themselves and their loved ones during the unexpected.

Recent Posts

Keeping you informed and safe.

Join Our Newsletter

Our mission is to help you be more medically prepared. Join our newsletter and follow us on social media for health and safety tips each week!

April Sale | Add Ivermectin to a Jase Case order for up to 30% off!

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