Asthma and Altitude

Hi,

Long time lurker, first time poster here. Given some of the great advice elsewhere on these boards that I have benefitted from in the past, I am hoping that someone might be able to help me here.

Essentially, my asthma is fairly moderate, but has gone downhill over the past year or so - most probably due to moving to a different area of the country. Anyway, that is something that I am still figuring out with my GP, but I am currently on Seretide 125 twice a day, and have had two short courses of Pred over the last few months, as well as being nebulized on a few occasions.

My question though, is this. I am a secondary school teacher and have been offered the chance of taking a group of kids on an expedition to the Indian Himalayas next summer (2012). I have spoken to my GP about this, who is very positive about the whole thing - suggesting that I can be given lots of medications/anti-biotics etc. and that my asthma should be more under control by then once we get over this tricky period.

I am still a bit unconvinced though! My main worries are the pollution in Dehli (where we would be spending a few days at the start and end of the expedition); the altitude (the expeditition would potentially include climbing Stok Khangri - over 6000m high) - and even without this, I would be trekking at very high altitudes (4000m +); and the fact that I would obviously be in a position of responsibility, so don't want to be taking any chances.

Any advice or information that anyone could give me would be hugely appreciated - anything from stories of other asthmatics who have travelled in this area, or have trekked at high altitudes, to facts on whether inhalers even work at such high altitudes, or information on people who could at least give me advice on it.

Thank you in advance!

[Hidden]

hi slinky

i am in slightly similar position - i,e, responsibility as i will be taking group of brownies away end of may for pack holiday and concerned re:attack..

however i have discussed with cons, asthma nurse and the leader i am going wiv is a doctor also!

TIPS:

1.just ensure you pack plenty of your medication as well as extra just incase,

2.ensure you have at least 2 x relievers with you at all times,

3.phone with u

4.you know details of local hospitals/gp/ pharmacies etc

5. people around u aware of what to do if u have an attack (i have taught my brownies first aid and about asthma attack and they have already helped me in a demo...)

discuss your concerns with your cons/ asthma nurse, maybe they can adjust your action plan?

take pred/ antibiotics with you - precaution?

as long as your well prepared, you be fine, relax, enjoy

x x x

[Skee-skee]

My boyfriend did World Challenge in the Indian Himalayas many years ago! They had a great experience, I think experience is definitely the word as it was a while before they decided they would want to go to India again!

Asking your GP for advice sounds like a great start. I would also consider have you been at altitude before, if so how did you cope, what are you like in hot climates (have you been anywhere similar) and how are you with polluted cities are you OK walking around central London?

There is no reason to think that you will cope worse with the altitude just because you are asthmatic. I went to Africa on a university expedition society trip and there were two asthmatics and we actually found we coped better with the altitude as being breathless at rest wasn't a new experience!

When you go on the trip make sure you have lots of spare medication and a supply of pred/antibiotics. You might be more proactive about taking pred when away (ask your GP). Not all medication likes being cold so keep your inhalers under your clothes so that they don't get too cold. Also make sure you get good travel insurance (i.e. you are covered adequately by a company with a good reputation). I am not sure whether this applies in India, but in Africa we had to take out membership of the Flying Doctor service BEFORE travelling (they won't come out however much you pay them, if you aren't a member).

If you still have any worries after investigating a bit more and speaking to your GP you could ask a speciliast travel medical company for advice. Nomad are good- we used them at Uni and they really know their stuff (this was 9 years ago though), they employ nurses who have travelled widely. That way you could chat to someone medical who would have an idea about the environment you are going to, medical provision in that country etc.

Finally (!) if you only take Seretide 125 there are so many more things you can try before you go. Keep going back to the GP till your asthma is better controlled.

Sorry for the essay.

Bryony

[Hidden]

Snowygirl,

Thank you so much for taking the time to reply - it was useful advice and great to hear from someone in a similar kind of position.

I help with quite a lot of Duke of Edinburgh Award expeditions in the UK, so am quite used to dealing with my asthma in that kind of environment, and within the context of being in a position of responsibility, and your advice definitely holds true there.

My real issue, I guess, is with the unique set of circumstances surrounding an expedition to the Himalayas - for example, medical help is going to be literally days away; normal phones don't work at that kind of altitude (I have heard that some mobiles even explode - not sure if that's true, but it sounds exciting!!), and no-one can seemingly tell me for sure that my inhalers won't explode.

I am usually pretty gung-ho about things but there are currently just too many unknowns for me to feel like I can make a sensible decision.

[Hidden]

Bryony,

That is massively helpful - thanks! That's just the kind of advice that I was hoping to receive. I will definitely look into it all a bit more, but that is an excellent starting place - thank you.

[Skee-skee]

Glad to be of service!

I would have thought the inhalers would be fine, they do survive a trip in an airplane after all (I am sure I am not the only one who has accidentally left them in hold luggage). Having said that a breath activated turbohaler might be safer than a pressurised canister!

On the time it would take to get help, my dad (who is a gp) has an interesting view point. He says that if you are more than 2 hours from help you might as well be 2 days away. If you go walking in the Cairngorms for a day you could easily be more than 2 hours away from help! Though I think I might have taken this too much to heart as I have experienced medical care on every continent except South America (then again I've never been there)!!!

I would definitely consider asking some experts like NOMAD for advice. They did our custom expedition medical kit and gave us advice for our trip. If you are a Sunday Times reader the founder/owner Paul often does travel medical tips in the travel supplement.

Don't let your asthma rule you, just manage and minimise the risks like you are doing. It sounds like a fantastic trip.

Take care

Bryony