Tuesday, July 8, 2008

More from the Search and Rescue front:

This was just posted to our Wilderness Squad mailing list and is important enough that it should be brought to light for the general public.  Not to mention, it's more along the lines of my usual posts.

First a little background:  Two serious conditions that one can face when traveling to high altitude (8000+ feet) locations are known as HAPE and HACE, High Altitude Pulmonary Edema and High Altitude Cerebral Edema respectively.  Both are conditions that are caused by the body's reaction to an increase in altitude without proper acclimitization. 

HAPE is the accumulation of fluid outside the blood vessels in your lungs which leads to shortness of breath, coughing (and pink, foamy sputum), increased heart rate and decreased oxygen levels in the bloodstream and can occur within a few hours of ascent. 

HACE is the swelling of the brain tissue due to the same fluids leaking from the bloodstream into the brain.  Symptoms include headache, decrease in alertness and coordination, weakness, loss of consciousness and coma.  HACE is most likely to occur after a week or more at altitude, but can occur as rapidly as within a few days.

Both are serious and can be fatal if not treated.  The two easiest forms of treatment are rapid descent and administration of oxygen.

Rick Kovar can be proud.  I paid attention in class (which is good since I was serving as the Medical Overhead person on one of the team's High Altitude trainings.)

Proper acclimitization helps in preventing both HAPE and HACE.  Basically once you get above 8,000 to 10,000 feet, you should "climb high, sleep low."  Don't sleep more than 1,000 feet above where you slept the night before.  It's also best to stay a few days at a base camp to let your body become used to the altitude before starting any strenuous activities such as hiking.

So, with all the wonderfulness that comes with altitude sicknesses behind us, let's move on to the reason behind this post:

Excerpts from the Western Journal of Medicine, 1981 February 134(2), pages 173-4:


High Altitude Flatus Expulsion (HAFE)

To the Editor: We would like to report our observations upon a new gastrointestinal syndrome which we will refer to by the acronym HAFE (high altitude flatus expulsion). This phenomenon was most recently witnessed by us during an expedition in the San Juan Mountains of southwestern Colorado, with similar experiences during excursions past. The syndrome is strictly associated with ascent, and is characterized by an increase in both the volume and the frequency of flatus, which spontaneously occurs while climbing to altitudes of 11,000 feet or greater. The eructations (known to veteran backpackers as “Rocky Mountain barking spiders”) do not appear to vary with exercise, but may well be closely linked to diet…

While not as catastrophic as barotraumas nor as debilitating as HAPE, HAFE nonetheless represents a significant inconvenience for those who prefer to hike in company… At present, we can advise victims that the offense is more sociologic than physiologic.

HAFE should be added to the growing list of medical disorders that are associated with exposure to high altitude. We are planning a prospective study for the summer of 1981.

Paul Auerbach, MD and York E. Miller, MD
You really have got to admire some people and their creative excuses to get away from the office.

1 comment:

Beth D. said...

I thought you had a new post, I already read these!