Shared Science - Wilderness & Environmental Medicine
WEM and The Journal of Special Operations Medicine (JSOM) participate in a shared science program. This opportunity is made possible through a reciprocal partnership between the journals. Click here to see the JSOM articles selected for WEM readers, please visit:
- Acute exposure to hypobaric hypoxia can give rise to acute mountain sickness, and in some severe cases, high altitude pulmonary edema (HAPE) and high altitude cerebral edema (HACE), that can sometimes lead to the loss of life. However, once the acute phase evolves into gradual adaptation to a fixed “chronic hypoxia” altitude, following the Adaptation to High Altitude Formula (adaptation to high altitude = time / altitude), the organism does remarkably well. Life under chronic hypoxia, where an optimal hematocrit is reached for every fixed altitude, following a logarithmic curve in relation to time, is practically as normal as that at sea level.
- Some people do not present AMS on several altitude exposures, however, unexplainably, they may have it occasionally. Several tests have been tried in order to determine who will have AMS, however, none to date are able to achieve with absolute certainty who will get AMS. Some tests include having subjects breathe a hypoxic mixture. Others have created exercise protocols with exposure to hypoxia and some other techniques. However, none have been successful. We have successfully diagnosed and treated patients with AMS of different intensity, over many years of work at high altitude, some having undiscovered pathologies that became evident on exposure to high altitude.
- Millions of permanent high-altitude residents, born at high altitude, living normal lives, practicing sports, sleeping well, reproducing, and enjoying entertainment, occasionally descend to sea level, for work or leisure. This is a change where the organism perfectly adapted to chronic hypoxia is suddenly exposed to a hyperoxic environment and needs to adapt to the new circumstance. Although no alarming symptoms and signs such as those that can be seen in acute mountain sickness exist like headaches, nausea, or vomiting, there are signs that show evident changes in the body.
- Adaptation to high altitude is fundamental for life to go on. It is a time and altitude dependent phenomena, because the organism needs the adequate time to build the defense mechanisms to face environmental changes. Quoting the late Gustavo Zubieta-Castillo: “The organic systems of human beings and all other species tend to adapt to any environmental change and circumstance within an optimal period of time, and never tend towards regression which would inevitably lead to death.”