Travel to Developing Countries - Travel Precautions

Precautions against Mountain Sickness. A reassuring study found that older people, even those with heart disease, can usually exercise safely at higher altitudes. They are advised, however, to take it easy for a few days at higher levels until they can adjust to the altitude. Those taking medication to combat hypertension should consult a doctor about increasing dosage if traveling to high altitudes. And anyone with a chronic medical condition should check with his or her doctor.

text continues below

The following are some measures for preventing mountain sickness.

As a rule, ascend no more than 1,000 feet per day at altitudes of 8,000 feet and above. Drink 6 to 8 glasses of water or juice a day and avoid alcohol.
Stop climbing when experiencing any symptoms of acute mountain sickness. Descend if symptoms worsen. Also descend immediately if there are any symptoms of HACE or HAPE.
Supplementary oxygen may be required for people who show signs of these conditions.
People who are hiking to very high altitudes may consider an inflatable chamber (Gamow bag and others). Such devices enclose a person, and when pumped up they simulate air pressure found at low altitudes.

Medications Preventing and Managing Mountain Sickness. Some medications are available for prevention or treatment of acute mountain sickness.

Ibuprofen (Advil) may be sufficient to manage headache associated with acute mountain sickness.
Acetazolamide (Ak-Zol, Diamox) taken one day before, and continued during initial exposure to high altitude, can reduce symptoms of acute mountain sickness, improve exercise performance and sleep, and reduce muscle and body fat loss. It may be used to treat minor symptoms of acute mountain sickness, but if symptoms persist, the trekker should descend.
Dexamethasone (Decadron Phosphate, Dexasone, Hexadrol Phosphate) is used to treat acute mountain sickness and cerebral edema (HACE). Dexamethasone is not recommended for prevention, however, because of potentially dangerous side effects.
Nifedipine (Adalat) is used to treat pulmonary edema (HAPE) and may be used for prevention in people who know they are at high risk for HAPE.
Preventive use of salmeterol (Serevent), a long-acting inhaled asthma drug known as a beta-adrenergic agonist, may reduce the risk for HAPE by over 50%.

Precautions for Divers

Travelers planning to descend rather than ascend must also take precautions. Individuals with the following conditions should not scuba dive:

Heart and lung problems
Bleeding disorders
Chronic ear infections
Insulin-dependent diabetes
Pregnancy
History of seizures
History of migraine headaches

Diving, in fact, is becoming known as a cause of many types of headaches, and anyone with a history of chronic or frequent headaches should discuss these issues with a health professional familiar with this sport.

Avoiding Air Embolism. Air embolisms are bubbles that obstruct blood vessels and can occur in divers who hold their breath while swimming up to the surface. They can be life threatening and cause long-term neurologic impairment, including memory lapses, impaired thinking, and emotional disorders. Even tiny bubbles may do some harm over time. One study found that in amateur divers who dive frequently, tiny bubbles appeared to increase the risk for small brain lesions and degenerating spinal disks.

To eliminate these bubbles, experts recommend that you: