High altitude pulmonary Edema: A big problem

Doctor’s Corner with Dr JOSEPH KABUNGO
IN MY previous article, I started discussing sport participation and the serious medical problems associated with this.
This had to deal with playing soccer at high altitudes and some of the important issues, which have to be considered.
High altitude medical problems are not a feature of the game in Zambia but this condition becomes important as the level of competition increases and national teams have to travel across continents and play games.
One of the conditions that were discussed associated with high altitude in relation to competition dealt with High Altitude Cerebral Edema (HACE). Cerebral edema has symptoms which include confusion, changes in conscious level, seizures, vomiting, hallucinations, blindness, paralysis which can be partial or complete, staggering gait i.e. inability to walk straight, difficulty in speaking, fatigue and ultimately coma.
This serious medical complication is one, which any team will dread to have when playing at high altitudes.
The other complication, which I will go through, has to deal with lungs. Whenever the lungs are affected because of the sudden increase in altitude, the picture becomes so apparent.
It is not all the time that this complication will arise but it has to be thought of all the time.
This complication involving the lungs is similar to what happens when the brain is affected.
This condition affecting the lungs is as a result of accumulation of fluid, which eventually affects the function of the lungs.
Since this picture is rare and seen when playing at very high altitudes, it is referred   to as high altitude pulmonary edema (HAPE).
This is so because the lungs are affected as a result of ascending to very high altitudes.
I remember late Dennis Liwewe in his soccer commentaries was so particular about the conditions the Zambian team was playing under especially if it was not at the same altitude like Zambia.
This is the reason why the term acclimatisation is so much used so that physiological challenges could be overcome.
Some of the symptoms of HAPE are difficulties in breathing, chest tightness, weakness or decreased exercise tolerance, rapid heart rate, rapid shallow breathing.
It has to be appreciated that problems with high altitude like HAPE and HACE will occur at high altitudes of more than 4000m above sea level.
In healthy athletes, the rate of acclimatisation varies between individuals.
For athletes who are travelling from Zambia and have to go and perform at very high altitudes, it is always important to know the level or how high the place is in order to avoid problems.
It is not only the issue of avoiding the clinical conditions but also achieving maximum acclimatisation.
For our country to achieve desired results in different sports disciplines, it is important that we pay particular attention to details, which might look small, but can be a thin line between qualification to the World Cup or success at a major event.
Altitude is just one of the components of these details in sport but a lot has to be done in terms of nutrition, fluid intake, management of injuries and psychological preparedness of teams or athletes.
Modern coaching and sport in general cannot be separated from the beautiful art of medicine, which implies that understanding of basic sciences is a must for the coaches.
Acute mountain sickness or high altitude illness refers to symptoms that arise as a result of travelling to high altitudes.
For questions and comments write to Dr Kabungo Joseph.

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