Health problem after hi altitude walk

Bushwalking topics that are not location specific.
Forum rules
The place for bushwalking topics that are not location specific.

Health problem after hi altitude walk

Postby GrahameR » Mon 24 Jun, 2019 4:35 pm

Hi, I have been doing a fair bit of high altitude trekking (>3000m) over the last three years - Himalayas, Andes, US Rockies. A couple of months ago I did a hike to 5600m in nthn Bolivia. I felt fine during the trek (well ... very breathless) and felt very very fine after the trek. A couple of days later I got a cold (no big deal). Then it moved to my chest (still no big deal). This may or may not be related to what followed. (As the cold might have just been a fatigue reaction to the extreme effort of the ascent.) Along the way I got something equivalent of asthma - tight chest, shortness of breath and lethargy - but it is not asthma. As a result I have had to return to Oz. I have had xrays plus many many lung, heart, urine and blood tests as well as throat and nasal swabs. All fine. I have had antibiotics, bronchodilators, corticosteriods, puffers, decongestants etc etc etc. No effect. I visited two respiratory specialists in Bolivia who had no definitive diagnoses.

My excellent doctor in Melbourne is at a bit of a loss as to what to do next. And of course it might well be coincidence that I got this just a few days after the ascent.

As 5600m is well beyond anything in Oz there is not much expertise here on such things it seems. My question: does anyone know any GPs or clinics in Melbourne that might be able to tell me what it is that is affecting me?

It might have got marginally better over the intervening 2.5mths but really I need a definitive diagnosis for two reasons. First just to be cured and second so I am reassured that further high altitude ascents are not going to cause more problems.

I thought there might be some expertise and/or contacts via this site.
Cheers, and thanks, Grahame

PS: I'm 65 (not that that should matter).
GrahameR
Nothofagus gunnii
Nothofagus gunnii
 
Posts: 36
Joined: Mon 24 Jun, 2019 4:13 pm
Region: Victoria
Gender: Male

Re: Health problem after hi altitude walk

Postby Moondog55 » Tue 25 Jun, 2019 12:52 pm

Get your doctors to check for Mycoplasma pneumoniae
I have had very similar signs and symptoms for the last couple of months and my quack has only just ordered the specific blood and sputum tests. If what I have is/was a Mycoplasma infection then the recovery time is sometimes measured in months it seems
I have been through a similar regime of treatment
I have just finished a double course of Roxythromycin plus Doxycycline and in the last few days I have started to improve. Also and just to be on the safe side my GP has ordered TB cultures and an examination ruled out husk [ a lungworm infection common in Nuigini but where TB is rife and common] so my GP is also at a loss
Ve are too soon old und too late schmart
Moondog55
Lagarostrobos franklinii
Lagarostrobos franklinii
 
Posts: 11067
Joined: Thu 03 Dec, 2009 4:15 pm
Location: Norlane Geelong Victoria Australia
Region: Victoria
Gender: Male

Re: Health problem after hi altitude walk

Postby Biggles » Tue 25 Jun, 2019 4:28 pm

Your first action should be to speak to your GP again, and obtain a referral to a Specialist somewhere in Melbourne e.g. Epworth, Royal Melbourne/others) in respiratory medicine. You cannot see a Specialist without a referral (and neither Doctors nor Specialists should be named on internet forums). My first (impartial) thought, as a nurse, is the possibility of secondary pulmonary edema or unresolved high-altitude PE. This is a very common (and poorly managed!) problem in high altitude activities, especially those embarked on repeatedly. PE/HAPE is one of the primary causes of fatalities on ascents/descents of Everest.

Yes, age does matter when something like this has not been definitively diagnosed and/or a treatment plan worked out. The longer a thorough investigation is deferred, the more serious unexpected consequences could develop when you think you are fine to get going again. Maybe consider not doing any further activities at altitude until there is better insight into the baseline condition, and effective treatment.
“Is é comhrá faoin aimsir an tearmann deiridh ag an duine gan samhlaíocht.”
—Oscar Wilde, 1890.
User avatar
Biggles
Athrotaxis cupressoides
Athrotaxis cupressoides
 
Posts: 431
Joined: Thu 14 May, 2009 12:14 pm
Location: Up the Creek...Campbells Creek (nr. Castlemaine)
Region: Victoria
Gender: Male

Re: Health problem after hi altitude walk

Postby rcaffin » Tue 25 Jun, 2019 6:14 pm

A specialist would be good. Secondary PE - possible.

Have you had a sonargram scan of your heart to check for obstructed arteries? They can lead to a heart attack - but are very fixable. They do not show up on an X-Ray, afaik.

Cheers
Roger
User avatar
rcaffin
Athrotaxis selaginoides
Athrotaxis selaginoides
 
Posts: 1223
Joined: Thu 17 Jul, 2008 3:46 pm

Re: Health problem after hi altitude walk

Postby GrahameR » Tue 25 Jun, 2019 6:54 pm

Hi all

Exactly the sort of suggestions I was hoping for. I have had two ECGs and an echocardiogram (all good), plus three Xrays and lung function test - before/after corticosteroids (all good). And as mentioned a myriad of other tests. I had two consultations with respiratory specialists in Sucre, Bolivia. The first said 'all okay' or probably more the point she was maybe just saying all the tests were good (even if inconclusive!) The second had four possible diagnoses (guesses?)
The (unreliable) translations from Spanish were "i) chronic laryngitis secondary to GERD; ii) sensitive acid syndrome vs GERD; ii) allergic rhinitis; iv) episodic bronchial hyperreactivity ??"
(NB: the only meds I take are anti-reflux meds.)

So the suggestions re secondary pulmonary edema or unresolved high-altitude PE are very worthy of further investigations.

As for Mycoplasma pneumoniae, I will mention it to my doc but I did have antibiotics. Additionally, when I raised with the doc the chances of it being 'some weird Bolivian bug' he said one of the blood tests I had would have shown if was anything like that. But that may not cover M.p. so I will mention it to him. (Just checking quickly checking Dr Google my symptoms are similar but no chills or fever.)

Anyway, I have also emailed some overseas alpine/mountain medicine orgs. One has suggested a Dr Duff in Hobart as a good contact. So I will see if I can get him involved or at least making recommendations for Melbourne experts.

But all up a good result. Thank you deeply for all your assistance. I am a bit passionate about the high altitude trekking so I do want to get it sorted out definitively. If it means I can't do high altitude stuff then so be it. But I don't want a non-expert taking a safety first approach and saying don't go to the mountains when it might either be safe or alternatively it is safe just not to extremes like 5600m at age 65!

Again, cheers and thanks to everyone.
Regards
Grahame
GrahameR
Nothofagus gunnii
Nothofagus gunnii
 
Posts: 36
Joined: Mon 24 Jun, 2019 4:13 pm
Region: Victoria
Gender: Male

Re: Health problem after hi altitude walk

Postby wayno » Wed 26 Jun, 2019 5:59 am

I was sent to a cardiologist once for fatigue,
he then set about rubbishing running and any intense activity... he was rather old. and his views with them. he worked in a wealthy neighbourhood and was a friend of my GP.... easy money...

so make sure you see someone who isn't going to take the easy route and give you very conservative advice...

i avoid medical practitioners who don't look fit.. there's a whole world of them that are purely academic in their approach, have no concept of the world of outdoor exercise.
my dad had a minor heart ailment.. he was 79 and he could walk 8k a day, the doctor medicated the daylights out of him and his heart stopped. one opinion i got said the combinations of medications could have done that, the medications were normally used for elderly people who dont exercise much. and it wasnt a good combination, but that's an extreme case.
from the land of the long white clouds...
User avatar
wayno
Lagarostrobos franklinii
Lagarostrobos franklinii
 
Posts: 8782
Joined: Sun 19 Jun, 2011 7:26 am
Location: NZ
Region: New Zealand
Gender: Male

Re: Health problem after hi altitude walk

Postby Biggles » Wed 26 Jun, 2019 11:36 am

GrahameR wrote:Hi all

[...]I have had two ECGs and an echocardiogram (all good), plus three Xrays and lung function test - before/after corticosteroids (all good). And as mentioned a myriad of other tests. [...]


Just briefly: the battery of tests you have quoted would have identified PE. It is not at all difficult to diagnose on presentation and is easily identified in imaging. There may be secondary complications that have developed (pulmonary [?]), I don't know.

m. pneumoniae
Much more troublesome. And older people are most susceptible to it. There is currently not a thorough, fast, easily available and conclusive diagnostic process for positively identifying this bacterium, and that is besides the absence of an effective treatment (because of the cunning design of the bacterium that clevery evades both the immune system that would normally rear up and fight it, and (many, but not all!) antibiotics given to treat it: no cell wall on the bacterium means there is nothing for A/Bs to attach to and attack, and stop replication/persistence --> reason it won't go away without a fight.

Doctors in South America (Peru, Bolivia, Chile et al) are by and large trained by Australian specialists (Professors/Associate Professors --> attached to Universities and/or in Specialist practice) e.g. cutaneous oncologists (--> skin cancer/skin conditions), renal, orthopedic, opthalmology...many others).
Last edited by Biggles on Wed 26 Jun, 2019 7:06 pm, edited 1 time in total.
“Is é comhrá faoin aimsir an tearmann deiridh ag an duine gan samhlaíocht.”
—Oscar Wilde, 1890.
User avatar
Biggles
Athrotaxis cupressoides
Athrotaxis cupressoides
 
Posts: 431
Joined: Thu 14 May, 2009 12:14 pm
Location: Up the Creek...Campbells Creek (nr. Castlemaine)
Region: Victoria
Gender: Male

Re: Health problem after hi altitude walk

Postby Moondog55 » Wed 26 Jun, 2019 11:58 am

Doxycycline is currently the primary antibiotic prescribed for a M. pneumoniae infection but it seems to be only marginally effective in my case.
Good luck with the problem Grahame
Ve are too soon old und too late schmart
Moondog55
Lagarostrobos franklinii
Lagarostrobos franklinii
 
Posts: 11067
Joined: Thu 03 Dec, 2009 4:15 pm
Location: Norlane Geelong Victoria Australia
Region: Victoria
Gender: Male

Re: Health problem after hi altitude walk

Postby GrahameR » Wed 26 Jun, 2019 5:24 pm

Again thanks. I will update this when I get a diagnosis just FYI.

NB: I have an excellent GP but they are General Practitioners i.e. not specialists

Cheers, Grahame
GrahameR
Nothofagus gunnii
Nothofagus gunnii
 
Posts: 36
Joined: Mon 24 Jun, 2019 4:13 pm
Region: Victoria
Gender: Male


Return to Bushwalking Discussion

Who is online

Users browsing this forum: No registered users and 32 guests