The rugged, primitive and high altitude San Juan Mountains give many people concern for their health when vacationing, hunting and living here. It is a natural concern. The body gives feedback that alerts one to the change of environment. Bones and muscles more used to concrete and carpet than rough terrain communicate through pain. The lungs find less oxygen in the air at this altitude and shortness of breath is the result. Other pains are a type of feedback and are also reasons for natural concern. The following is a discussion of the most common of these.

Go Equipped for the Conditions
There are many medical situations created because of thoughtlessness in the area of being equipped for the environment. Local doctors often see patients with injuries to the feet, ankles and knees caused by walking on trails in inadequate shoes and socks. Shoes with support and traction are a must for hiking in the forest, even on the most popular and improved trails. Good socks can prevent painful blisters. There are several good businesses where adequate shoes and socks can be purchased in Pagosa Springs.

The most likely places to find trouble by falling are places that are steep and wet, but a person from less rugged terrain can do injury without falling or even knowing it. It is later in the evening or the next morning when ankles and feet start hurting and swelling from overexertion and stresses the body parts are not accustomed to. Start hiking short distances with a variety of terrain and build up to longer more difficult trails.

Important Tip
Everyone in your group should have fishing licenses. Even the least expensive fishing licenses come with a twenty-five cent extra charge that covers the holder for all expenses involved in search and rescue. Even the smallest injury on the trail can require expensive help to get the patient out of the forest and this is the cheapest insurance you can buy.

Thin Air
Probably the most unique environmental factor we have here that can influence health is lower atmospheric pressure. In layman’s terms, the air is thinner. This means that oxygen does not get into the blood as easily or readily as at lower altitude. This translates into more shortness of breath when exercising. It can mean serious trouble for those with poor cardiac health and even for an occasional healthy, conditioned individual.

Heart Disease
Coronary Heart Disease (CHD) remains the leading cause of death in the United States. Simply described, CHD is a condition in which the blood vessels and arteries carrying blood and therefore oxygen into the heart muscle become narrowed or obstructed. The heart is a muscle which requires oxygen to function properly. The oxygen requirement varies however, with the demands made of the heart. As the heart beats harder or faster, as with exercise, it needs more oxygen and thus more blood to flow through the coronary arteries. If narrowed or obstructed, the coronary arteries may not carry sufficient blood to some part of the heart. In the worse case this can cause a heart attack, that is, death of part of the heart muscle. A heart attack will, if survived, weaken the heart. More drastically, the injury to the heart may initiate an irregular beating of the heart which may cause sudden death. Indeed, such sudden death from arrhythmia can occur without warning pain in an individual with CHD.

Narrowed coronary arteries, still sufficient at low altitude, may be insufficient at high altitude due to the decreased amount of oxygen carried by the blood. Thus a person able to exercise at home may have problems with the same degree of exercise at high altitude. Of course, matters are potentially worse for a person used to a sedentary existence that comes to vacation or hunt and does more exercise here at altitude then he is used to doing at home.

Cautions regarding heart disease:

1. At least initially, don't exercise harder here than you think you can at home.
2. Try to be in reasonable physical condition before you exercise at high altitude.
3. Take the first day or two easy as you test your reaction to the altitude.
4. If you are over forty and non-active, consider consulting a physician before undertaking any strenuous exercise.
5. If you have known CHD, expect it to be a potential problem at high altitude.

Altitude Sickness, Don’t be S.O.B.
Mild Shortness Of Breath is a condition that is normal for those coming from lower elevation. It should be monitored but not worrisome unless it becomes more serious. Fortunately, serious S.O.B. is relatively rare and usually affects individuals who spend more than 24-hours continuously at elevations above 8-10,000 feet. It involves headache, nausea, anxiety and shortness of breath, which is worse when one lies down. The problem is swelling of the lung tissue. The cause is unclear. The treatment is to return to lower altitude immediately. The result of a severe or neglected case can be death. Headache and an often surprising degree of shortness of breath with exercise are common at high altitude. Do not worry that you have altitude sickness unless you continue to feel more and more short of breath even at rest. Try laying down flat; if the symptoms increase in a few minutes it is time to go down. If you don’t improve back in Pagosa go to a local doctor.

Breathing Tip
It is helpful to remember to breathe in advance of work or exercise. For example, when you’re hiking and a hill is seen coming up, start breathing heavily before you start up the incline. This will provide extra oxygen to the muscles before they are depleted and you are tired. Just be careful not to over breathe and get dizzy.

Hypothermia
Loss of body heat is dangerous and can be fatal. It can occur gradually and undetected. If it occurs more at high altitude, it is merely because it generally gets colder than expected at high altitude. Many cases of hypothermia occur during seasons other than winter, at times when the ambient temperature is above freezing. They occur due to victim ignorance of the possibility of the condition. They are corrected by proper planning, the use of adequate clothing and avoidance of wetness and wind.

1. Wear or carry layers of adequate clothing in the Rockies! It can potentially freeze any night of the year, particularly at higher altitudes. When hiking you may sweat and moisten your clothes. If you then remove clothes to cool off, you may cool too fast and hypothermia can occur. Cool off slowly.
2. Protect exposed parts including ears, nose, fingers and toes.
3. The victim of localized frostbite should reheat the affected area with warm water (not above 110 degrees) only after danger of refreezing has passed.
4. Frostbitten tissues should not be rubbed or otherwise traumatized. A person may gently hold the area for warmth but apply little pressure.
5. The victim of generalized hypothermia should be reheated with dry cloths and an external heat source that will not burn. A victim can be warmed by others lying in close contact, covering all when possible.
6. All victims should see a doctor. Significant generalized hypothermia can be manifested by a slowing of thought and movement. The victim may be irrational though calm. Shivering, if it occurred, will have stopped.
7. If you are in the forest and need to make fire, use the lowest limbs on any pine or spruce tree. These limbs are long dead and usually bone dry so it is easy to build a quick and hot fire. They are generally called “snappers” because when pulled they snap off. Naturally you will pick a spot where the fire will not spread.

A problem often seen here is when a person becomes injured or affected by a condition and does not want to cause the other members of the group to suffer, so he or she hides or downplays the symptoms. Sometimes the person affected insists they are willing to wait alone while the others finish the activity. People having any of these symptoms may be absolutely insistent they are fine and need no help because their thinking and decision making is compromised. Your group should pledge together to listen to each other and accept help before a hike or exercise begins.

Top of Page