I’m hiking up to the base camp of Mt. Everest, which is at 17,000 feet, and I’m worried about the effect that altitude may have on my asthma. Will the thin air cause any adverse effects? And if I were to suffer an attack, would the altitude make the symptoms worse? Is there anything I can do beforehand to avoid any asthmatic hitches?
Prior to your trip, your asthma must be in ideal control. This should be documented by your physician and with pulmonary function tests. Also, well before your trip you should have completed a rigorus training program, outlined by a person familiar with the conditioning required for a climb to 17,000 feet.
The very dry and cold air that you will encounter at that altitude poses an additional problem since cold dry air, when inhaled, triggers asthma. Covering the mouth and breathing through wool cloth, or breathing through the nose, can help. Certain asthma medications, other than just the use of bronchodilators, have been demonstrated to lessen cold air-induced asthma (e.g. nedocromil and the leukotriene modifiers), and your physician may want to add these medications if you are not already using them. Furthermore, many people — including non-asthmatics — will use a medication called a carbonic anhydrase inhibitor that lessens the likelihood of altitude sickness.
After obtaining your physician’s consent for the trip, you should also have an action plan in place for any problems. The action plan might need to include when and how to use an oral corticosteroid or even injectable epinephrine (adrenalin).