GCA/steroids and altitude sickness query

[AlamedaCounty]

I'm hoping to go to Peru but wonder if the high altitudes (approx 13,000 feet) might cause problems with my GCA symproms or prednisolone effects?

[DorsetLady PMRGCAuk volunteer]

I think that’s something you need to discuss with Rheumy -probably depends what dose you are on, guessing is fairly low according to profile.. and your travel insurance company. Altitude can affect inflammation levels

There was someone who went to Bolivia (I think) last year - but at the moment can’t recall who that was -hopefully they see this and reply. But think they had PMR rather than GCA

[Gimme in reply to DorsetLady]

It was me who went to Bolivia with PMR.

[DorsetLady PMRGCAuk volunteer in reply to Gimme]

I know I remembered that -once back on dry land - up in the air when I first replied -have but a link to your post in my reply to PMRpro/ but AC will see it…

[PMRpro Ambassador]

You mean altitude in general I assume rather than whether you are more likely to develop altitude sickness itself?

Without knowing a lot more about your current dose and physical abilities it isn't easy to comment. If you live near sea level then whether you can manage walks/climbs at nearly 4,000m is another matter.

As DL says, there was someone who did a similar trip a year or so ago but their name escapes me.

[DorsetLady PMRGCAuk volunteer in reply to PMRpro]

Just remembered -Gimme - must have been the high altitude for me today,,

AC- see this -

healthunlocked.com/pmrgcauk...

[Gimme in reply to DorsetLady]

Thanks for the link, DL. You saved me having to rummage for it.

[Gimme]

I went to Bolivia last year with PMR, but I did have a lot of experience at high altitude prior to getting sick with PMR, so I would say that I was better placed to monitor how well I was doing than most and I am pretty good at taking care of myself. It's difficult to advise without knowing a little more about what you are planning to do, while you are there, i.e. where you are going and for how long? And how physically demanding the planned activities are. I know quite a bit about Peru, so I can probably gauge how difficult it would be, if you were well (not with GCA). The most important thing will be in getting adequate acclimatisation, so that is why I am asking.

But before I say anything else, I would echo DL on a couple of things.

If you haven't booked it yet, you will need to check with your insurance company that you will be covered for any existing conditions. I had a lot of problems with my insurance before I went to Bolivia, so I would advise getting that sorted before you hand any dosh over to the holiday company. It will save you a lot of stress and worry later.

Be aware that if you do get altitude sickness, the only solution is to go down, so you need to make sure that you are covered for that eventuality. It might result in extra travel and accommodation costs if you get sick and have to leave the rest of the group to descend from higher up. 13k is no walk in the park, although manageable for most people with proper acclimatisation, although you have to take into account that our tolerance of altitude reduces as we age, so we may need more acclimatisation time than a young fit person. If you are travelling in a group, the holiday company should have taken this into account when they planned the itinerary. Plus, whatever precautions you take beforehand, your body can have other ideas and how well you acclimatise can be unpredictable, which is why you need to have good insurance.

Medically, how you will manage is hard to say, as I have PMR and not GCA. I am also asthmatic. I am not a doctor and you will need their input. I am not in a position to comment on what complications might arise with GCA at high altitude, so you must get yourself passed as fit before you go. Not just to make sure that your insurance is not invalidated, but also to make sure that you are not miserable healthwise when you are out there and your trip is spoilt. I would also make sure that you have more than enough emergency pred to manage, should you be unfortunate enough to have a flare. I have PMR, but I made sure that I had enough pred with me, should GCA decide to pay me a visit, always a worry for a PMR sufferer.

How did I get on in Bolivia? Well, I am older, fatter and less fit than I was when I last went that high. I was 65. I also got a cold from a fellow traveller in the first week, which messed up my acclimatisation a bit and certainly my breathing when we went very high. Though we had very good gradual acclimatisation through the 3 weeks and we spent the second week at over 14 k, with some excursions up to 17-18k for short periods. I did struggle on the high passes, but I would say that with PMR, I wasn't much worse off than before getting PMR. I think the virus probably had a bigger impact. I would rate my trip as not a particularly difficult one as we were not trekking, just day walks from a vehicle. At times, the fatigue from the PMR was an issue, and I took time out to either kip on the bus and took a couple of half days out to sleep. So, check your itinerary for odd days where it may be possible to take a rest day in the hotel, if necessary. You also need to take into account how physical the trip will be, aswell as the altitude. It's important when you are high up that you keep your heart rate as low as possible, so if you are struggling, you will need to move a lot more slowly than lower down. If you have any demanding trekking to do, it might make it harder to keep up with the rest of the group.

That's a very short summary of the issues that you might need to think about beforehand. I would think at 13k, if you are in otherwise good health and with adequate acclimatisation, you will likely manage. But the health insurance and getting passed medically are the main thing.

In retrospect, I think I did a write up of my Bolivia trip. I'll see if I can find it.

[PMRpro Ambassador in reply to Gimme]

Brilliant reply - thanks!!!

[Gimme]

By the way, Peru is a fabulous destination. I loved it. Amazing scenery, nature, culture and archaeology. If you are well enough to travel and can get the insurance sorted, go for it! You won't regret it. Life is so very short and throughout my PMR journey, I have found that holiday breaks have done wonders for my overall sense of well being.

[AlamedaCounty in reply to Gimme]

Many thanks to all for the advice. I will have time to acclimatise and hope all should be OK.