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Ask Dr. Lang.

Q What precautions should I take to avoid high-altitude illness when climbing to high elevations?

A The higher you climb, the less oxygen that's available for you to breathe and the greater the risk that you'll develop high-altitude illness, which includes acute mountain sickness (AMS) and the more serious high-altitude cerebral edema and high-altitude pulmonary edema.

Avoid traveling directly to altitudes above 8,000 feet in a short period of time. Make your climb gradually, giving your body a few days to acclimatize to the thinner air. Typically, the closer you live to sea level, the longer your body will need to get used to the higher altitude. Avoid over-exertion above 8,000 feet, rest frequently, drink plenty of fluids, and sleep at an altitude of about 1,500 feet lower than where you spend your waking hours.

Talk to your doctor about medications such as acetazolamide (Diamox, Dazamide) that can speed up the time it takes your body to acclimatize to the high altitude. Also, if you have chronic conditions such as heart disease, high blood pressure or lung diseases, ask your physician if you can travel safely to high elevations.

Q I have rheumatoid arthritis, and I've read about a link between RA and heart disease. What should I do to lower my risk of heart problems?

A Studies continue to suggest that rheumatoid arthritis (RA) raises your risk of cardiovascular disease (CVD). The inflammatory immune response that causes the bone and joint damage of RA may also damage the lining of blood vessels, contributing to a buildup of cholesterol-laden plaque associated with atherosclerosis.

Don't wait for CVD symptoms to arise. If you haven't had an evaluation already, talk to your doctor about a cardiac risk assessment. An assessment should include testing for CVD risk factors such as blood pressure, cholesterol and diabetes, as well as advice for addressing other risk factors such as smoking and obesity.

Also, you can take steps yourself to lower your CVD risk. If you smoke, quit, and if you need help, find a smoking-cessation program near you or visit the American Lung Association Web site ( Lose weight by adopting a diet rich in fruits, vegetables, whole grains and low-fat dairy products, and low in saturated fat, calories and carbohydrates. And, get at least 30 minutes of moderate-intensity exercise (walking, swimming and biking are good examples) each day.

Q What can I do to prevent motion sickness when I take a cruise?

A There are several steps you can take to combat seasickness. First, try to choose a cabin toward the middle of the ship and near the waterline, where the ship's rocking from the waves is less intense. Get plenty of air, and look out on the horizon when you're on deck.

Since tiredness can make you more susceptible to seasickness, get plenty of rest. Drink plenty of water, stay hydrated and avoid excess alcohol, which can speed up dehydration and also lower your body's resistance to seasickness.

Nutritionally, don't overeat, avoid heavy, greasy foods that can upset your stomach, and try eating dry crackers to help settle your stomach.

Over-the-counter medications such as dimenhydrinate (Dramamine), diphenhydramine (Benadryl) and meclizine (Antivert) can help prevent and treat seasickness, but they also may cause drowsiness. Other options include prescription promethazine (Phenergan) or a scopolamine patch. Both of these prescription drugs may cause drowsiness, and patients with glaucoma should not use scopolamine. Talk to your doctor before using any medications for motion sickness.


Richard S. Lang,

M.D., M.P.H., F.A.C.P.
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Author:Lang, Richard S.
Publication:Men's Health Advisor
Date:Nov 1, 2006
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