DEAR DR. DONOHUE: Our 37-year-old daughter lives in Denver. She took her younger sister skiing where the altitude was 11,800 feet. Our younger daughter lives in Toronto, where the altitude is 250 feet. She felt discomfort or worse at the higher level.

Is it safe for an unacclimatized person to travel to such an altitude abruptly? How best should one treat altitude sickness? Are there potentially any serious or lasting effects of altitude sickness? – P and H.M.

ANSWER:
At high altitudes the pressure of oxygen in the atmosphere drops, so less gets into the blood. Most healthy people can tolerate altitudes of 5,000 feet (1,500 meters) to 8,000 feet (2,400 meters) without difficulty. Older people and people with heart and lung disease might become short of breath at such heights.

An unacclimatized person, trying to function at 8,000 feet (2,400 meters) or more, can run into trouble if the person doesn’t make the ascent slowly. Above 8,000 feet, people should not ascend more than 1,000 feet a day without returning to a lower altitude to sleep. They can continue to go higher if they descend 1,000 feet each night to sleep. They will know they are pushing too fast if a moderate amount of activity leaves them breathless and bushed.

Acute mountain sickness, a formidable illness, occurs to unacclimatized people in the first six to 24 hours at a given height. People become short of breath, dizzy, have a dry cough and are nauseated. They often have a headache.

High-altitude pulmonary edema, an even more serious illness and an emergency, fills the lungs with fluid. People cough, and the cough’s mucus is pink or bloody. These people have to be taken quickly to a lower altitude, and personnel experienced in the treatment of this condition have to manage definitive treatment.

People who fully recover from either usually don’t have permanent damage. They are vulnerable to a second episode, however.

Your daughter can protect herself on her next visit by slowly ascending and by taking Diamox. It’s a mild diuretic that affords good protection against altitude sickness.

DEAR DR. DONOHUE: What’s the minimum time advised between sets of exercise? I workout in a gym that has many exercise machines, and I like to do three sets of exercises at each one. However, there’s always someone waiting to use the machine, so I can’t sit there for five minutes to recover between sets. I have to speed things up. – M.R.

ANSWER:
In 30 seconds, muscles recover 50 percent of their energy needs. In one minute, they make a 75 percent recovery. In two and a half minutes, the recovery is 95 percent.

Somewhere around two minutes, therefore, is a reasonable rest. Why don’t you move to another machine after one set? You can move to a station where you exercise a different set of muscles, like the legs, and then come back to the arm machine. You won’t waste time, and you won’t irk the other patrons.

DEAR DR. DONOHUE: I’m writing for my son and his girlfriend, both in high school. They both play soccer, not only on the high-school level, but for teams outside the school. My concern is for the girlfriend.

During games, the girls do a lot of blocking of the ball using their chest area, and some of the shots are pretty direct. Are there any studies showing this may be a health concern to them in later years? – C.P.

ANSWER:
I haven’t seen any such studies, and I can’t find any. However, I don’t believe there is a danger. Plenty of people have written to me about getting breast cancer after a breast injury. That is not something that is often written about in medical literature. I cannot substantiate such a link.

If anyone has evidence to the contrary, please write. I would be happy to print that evidence. I cannot, however, print anecdotal experience – someone’s personal belief stemming from what happened to her.

DEAR DR. DONOHUE: My son is 20 and a junior in college. When he applied to the college, slightly more than two years ago, he had to have a physical exam. Protein was discovered in his urine then. The doctor made no mention of what needed to be done at the time, and we forgot about it. Now it dawns on me that this might be serious. Should we pursue this now? – C.B.

ANSWER:
Yes, you should. The kidneys cleanse blood by filtering it. Stuff necessary for health stays in the blood as it passes through kidney filters. Protein should stay in the blood. It should not leak into the urine. If it does, that implies some kind of kidney damage.

There are instances when protein in the urine is an innocent finding. Some people, after a day on their feet, spill protein into the urine, but their urine specimen after a night lying horizontally in bed is free of protein. This is an innocent quirk and doesn’t signal kidney trouble. Perhaps this is what your son has. Nevertheless, all the bad things that can cause urine protein have to be checked and eliminated.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.


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