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News--
WEDNESDAY, May 14 (HealthScoutNews) -- Hiking in
rarefied air high in the mountains can be heavenly. It can also give you a
ferocious headache.
Dr. N. Stuart Harris, a longtime mountain climber and resident emergency
physician at two Harvard-affiliated hospitals, knows all about "high-altitude
headaches," caused by reduced oxygen levels.
Harris also knows ibuprofen, which has been widely viewed as the best
medicine for high-altitude headaches, can worsen the nausea that typically
accompanies the headaches.
He wanted to find out whether acetaminophen, which doesn't cause nausea,
would be as effective for high-altitude headaches. So he set out to answer the
question -- by testing the two pain relievers on hikers trekking some 14,000
feet up in the mountains of Nepal.
The conclusion: Acetaminophen and ibuprofen are equally effective, both
providing headache relief within a few hours, Harris and fellow researchers
report in the May issue of the Journal of Emergency Medicine.
"Up until now, there hasn't been any evidence to suggest that there was
anything better than ibuprofen" for high-altitude headaches, Harris says. "It
had become accepted as the standard of treatment. Ours is the first study
proving that acetaminophen is as effective as ibuprofen against high-altitude
headaches."
Of course, quick relief -- without nausea -- is no small concern when you're
thousands of feet up in the mountains in an area so remote that it takes 12 days
to hike to the nearest road and five to seven days to hike to the nearest
airstrip.
"If you aren't both physically fit and feeling well, then you stay put,"
Harris says.
This gives your body time to get acclimated to the higher elevations. "But,"
he says, "taking a rest day without a headache is much more fun."
You don't have to be hiking in the shadows of Mount Everest (news - web sites) to experience high-altitude headache, the primary
symptom of "acute mountain sickness" -- a syndrome that also can cause not only
nausea, but also sleeplessness, loss of appetite and fatigue.
Each year, according to the study, some 7 million people who travel to U.S.
elevations over about 6,500 feet will suffer acute mountain sickness severe
enough to limit activity.
The condition is common, for example, among skiers who head to the mountains
of Colorado. "Suddenly, rather than going out and skiing hard and enjoying time
on the slopes," Harris says, "they're moping around with headache and nausea,
and suddenly their very expensive trip is being wasted."
In the double-blind study, Harris and colleagues surveyed hikers arriving at
a Nepal camp and enrolled 74 who had symptoms of high-altitude headache. (The
researchers excluded those who had a history of chronic headaches, migraines or
allergy to ibuprofen or acetaminophen.)
Of the 74 patients, 39 received ibuprofen and 35 got acetaminophen, and all
the patients took surveys measuring headache symptoms and severity before taking
the medications and 30, 60 and 120 minutes after taking them.
Both groups reported a similar decrease in headache pain during the two-hour
study period as well as slightly decreased levels of nausea.
None of the patients suffered a rare and sometimes dangerous complication of
acute mountain sickness that can cause edema -- a buildup of fluid -- in the
lungs or brain. Harris stresses people in high altitudes shouldn't continue to
ascend if they suffer symptoms such as worsening headaches, shortness of breath
and confusion.
For Harris, the three months of research in 1999 provided a chance to pursue
two passions: high-altitude hiking and medicine. His outdoor laboratory of sorts afforded spectacular views of Mount Everest, an ancient rhododendron forest where the white and pink flowering plants grow 20 to 30 feet tall, and a deep valley where the river slices through the mountains. "It's gorgeous," he says. "You've got Everest at 29,028 feet, you got the Khumbu Glacier coming from the South Col into the valley. Where it melts, the river starts and gives birth to wild white water rolling down the middle of the valley. It's a spectacular spot." And, he adds, not a bad place to do scientific research either. |
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