Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Latest Posts

Why Only Some People Experience High Altitude Sickness

Andrew in Colorado, Summer 2011

Hi! Greetings from Breckenridge, Colorado. At 10,000 feet, I am told it is the highest resort town in North America. The Rocky Mountain scenery is breathtaking. But there’s a problem for about one in four of us who visit here, especially people like me who live at sea level. We can get hit with high altitude sickness and a few days ago, I was one of the unlucky ones.

What happens is your body isn’t used to the thin air and your blood has difficulty getting enough oxygen to your body. It usually happens at altitudes over 8,500 feet. You get an ongoing headache, you feel tired, you have insomnia (I was sleepless for two nights!), you could have nausea and certainly fatigue. Drinking lots of water and passing up alcohol can help, but even then some people have problems.

When I finally saw a family doctor – Doctor P.J. – he told me it’s genetic. Some people have trouble “acclimatizing” and others don’t, but there’s no easy way to know who will be affected before you make the climb. Now that I know I have difficulty I will take a prescription medicine (Diamox) ahead of coming up here again.

Doctor P.J. says even Read more »

*This blog post was originally published at Andrew's Blog*

Drug Safety In Preventing Acute Mountain Sickness

This is a guest post by Dr. Jeremy Windsor.


Steroids and Acute Mountain Sickness

In recent years, many attempts have been made to identify safe and effective medications to prevent acute mountain sickness (AMS). Acetazolamide (Diamox), currently the “drug of choice” for this purpose, is not perfect and occasionally causes objectionable side effects. Dexamethasone (Decadron), a powerful steroid medication, has become increasingly popular for prevention and treatment in certain circles. While there is ample evidence to suggest that dexamethasone is effective, a recent case report highlights that this drug is not without risk.

In the latest issue of the journal Wilderness & Environmental Medicine [WEM 21(4):345-348, 2010] in an article entitled ”Complications of steroid use on Mt. Everest,” Bishnu Subedi and colleagues working for the Himalayan Rescue Association (HRA) described the case of a 27 year-old man who was prescribed a course of three drugs, including dexamethasone, intended to support him during his attempt to climb Mt. Everest. After more than three weeks of taking the medications, the mountaineer noticed the appearance of a rash and decided to stop taking them. Rather than wait for the rash to subside, he chose to continue his acclimatization program and ascend to Camp 3 at 7010m altitude. The patient arrived exhausted and confused; onlookers quickly recognized that something was seriously wrong and so a rescue party was organized to help him back to safety. Read more »

This post, Drug Safety In Preventing Acute Mountain Sickness, was originally published on by Paul Auerbach, M.D..

Is Sunburn More Likely On The Beach Or In The Mountains?

While vacationing in Idaho and Montana last week (blissfully off the grid), I experienced something beautiful: altitude. At 6,260 feet Stanley, Idaho is a mile higher than my home in San Diego. The skies there were a brilliant blue. There was daylight well after 10PM. The mornings were a chilly 35 degrees. And I got sunburned.

How can this be? Montana is over 1,000 miles north of San Diego. Shouldn’t the sun be stronger down here? Read more »

*This blog post was originally published at The Dermatology Blog*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

Read more »

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

Read more »

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

See all book reviews »