Altitude Sickness/Preparation

Since you will be traveling by bus the elevation change from the ~1400 ft at Salzburg to ~3000 ft at Castelrotto (?) should be gradual and perhaps less of a shock to your system.

Have you discussed this with your MD for recommended strategy to avoid or minimize adverse reactions?

Happy travels

I don't think you will really be staying that high in the Alps. Chamonix will be the highest place you will sleep. That is 3400 feet above sea level. That is about the same as Rapid City, South Dakota or Lubbock, Texas. No where near someplace like the mile-high city of Denver.

3000 ft asl is not very high. Standard atmospheric pressure at 3000 fasl is about 13.2 psia, 90% of standard pressure at sea level. Pressure at 1500 ft asl is 13.9 psia, 95% of sea level. The difference between pressure at 1500 and 3000 ft asl is not very significant.

First, the cause and effect of altitude sickness is not well understood. You could go to a high altitude four times with no problem and be very sick the fifth time. Why??? Who knows. This, of course, assumes you have no problems with your lungs. One of the best things to do is to stay well hydrated and avoid alcohol. You do not have enough red blood cells to carry the oxygen needed so drinking water helps in the manufacture of additional cells. It is a problem of not getting enough oxygen to the brain. IF you have some lung/breathing issues then see you doctor. There are medications that are helpful. And finally I don't think the altitude you going to will be a problem either. We live a 6,200 feet but when family visit there can be problems especially if we travel into the mountains. I think you will be fine.

Second, every had a problem on a long plane flight? Most airplanes are pressurized at about 8,000 feet or less. And newer planes are closer to 5,000 ft.

PS Tom, people can experience altitude sickness well below 10,000 feet. It can start closer to 5 and 6,000 feet.

There is medication one can take to help reduce the chance of altitude sickness, but the travel clinic I got it from gave it to me only to cover the time I would be above 8000 feet (and the day before). I'm not sure you could get it for 3000 feet. Both my husband and I are migraine sufferers--especially him--and we were fine with this medication, although we did tire and get out of breath a bit more easily.

My understanding is that, if you don't gain more than 1000 feet per day, you should be all right, even without medication, at high elevations. Are you approaching that altitude gradually, or flying directly to that altitude?

If you are concerned, do take it a bit easier at first, if you can.

We are also going on the Alpine tour in August . We did both the GAS tour and The Best of Switzerland tour. I never got altitude sick on The GAS even when we went to the top of the Schilthorn .. on Best of Switzerland tour one day we were driving to a cheese farm and we had the option of getting off the bus and hiking the rest of the way to the top. My husband and I thought what a great idea so we did. The hill was pretty steep and the bus driver let us off maybe a third of the way up. I suddenly could not move forward or walk but tiny little steps without deep deep breaths.. I kept insisting it was because we started on the hill and not gradually... I did finally make it to the top and the aroma of the cheese making only made me feel worst. I went outside and got some fresh air and just rested against the side of the barn...my husband insists it was altitude sickness... I am not 100% sure it was altitude sickness but is wasnot nice... it never happened again..I been told DRINK DRINK water... which I normally do...but that I had not drank very much prior to the hike up the hill.....
In preparation for the Alpine we are hiking four miles a day four days a week and 8 miles three days. Unless it is raining... We have started to add in hills... the hills are killers in the beginning..
Hope you have a wonderful trip..We can wait..

I live at sea level and go to 4,500ft above sea level to visit family 3 or 5 times a year. I avoid alcohol, and drink more water than normal. I find I don't have as much stamina for aerobic activity (fast walking!) and when I do drink, it hits me faster.

Do check with your doctor. Don't depend only on the kindness of the internet.

Do check with your health provider, but off the top of my head the places often visited by tourists where altitude sickness (which is different from mere breathlessness, the latter being pretty normal above 7,000 feet) would be a concern for most people without specific conditions are Aiguille du Midi above Chamonix, Klein Matterhorn above Zermatt and Jungfraujoch above Wengen. All above 11,000 feet. These are skippable mountain excursions. I don't know any of them is part of the My Way trip, and you are always free to do something else at lower elevations.

AMS is typically only a serious issue above 4000 metres but some people do develop some symptoms at heights as low as 2500 metres (uncommon).

We had a guy die a day ahead of us on our trek to EBC but that was at 5000 metres. One of our crew had to turn around from the same lodge in the morning after waking with pulmonary oedema. He and a porter returned to 4500 metres and he stabilised and then down to 3500 next day recovered quickly. Another of our crew developed cerebral oedama at 5400 metres. He was able to stabilise at 5200 metres and once back to 4500 metres recovered well. Both would have deteriorated and died without descending.
In the Alps there are some opportunities to reach heights between 3000 and 3500 metres via mechanical means. This would probably mean a rapid unacclimatised ascent. This could lead to some basic AMS type symptoms, most likely a headache. It would be extraordinarily unlikely you would develop any major issues.
The treatment for AMS is simple. DESCEND!! So if you did feel very unwell then arrange to go back down to a lower altitude as soon as practical. A drop back to 2000 metres would be quite sufficient.
Given your migraine Hx it might be worth discussing with your Dr about using Diamox if you are doing a rapid ascent.
I can't imagine a RS tour is having you stay at an altitude much above 1500 metres. There is no real issue at such height.

As the others have noted, unless you take an excursion to the top of a mountain, none of the locations are likely to be high enough to cause altitude sickness.

And let me throw in my cards here... I'm a family physician with training in flight medicine. We only give preventative medications in the following circumstances:

1) Someone with a history of altitude sickness whose occupation requires them to periodically ascend.

2) Someone with a history of altitude sickness who absolutely insists on high-mountain climbing.

I would never prescribe preventative medications in someone without a history, because the medications are not completely effective and may actually mask the symptoms in someone who was unfamiliar with the syndrome. Most important is that if you start to feel unwell to immediately descend. Altitude sickness can be fatal if it is not immediately remedied, and the easiest and most effective remedy is to quickly descend.

Prior acclimatization is usually recommended for extended stays at altitude, but that probably isn't possible for you, and as noted, most of the locations on the tours are not high enough to induce the sickness.

And finally... um, look at the group photos of the Rick Steves tours. These aren't exactly the most fit or adventurous souls out there...

We needed preventive medication for our trip to Cuzco and Macchu Pichu. But that is a much higher elevation than your trip. Have you ever flown through Denver? What sort of elevations have you visited before? It is not wise to get medical advice from non-physicians. You should see your internist or family physician, or whomever diagnosed your migraines. You did get ... a diagnosis, didn't you?

Caveat... Tim mentioned another situation where preventative acetazolamide might be warranted. Travel to locations like Machu Pichu, where immediate evacuation is not possible. This is not the case in the Alps, where a quick cable car, funicular or rack rail descent is usually readily available.

Interesting thing Tom. 3 of our 12 EBC crew were using Diamox. One of those 3 was the one who developed HAPE at 5000 metres.

The cabin on an airline typically "levels off" at 6,000 feet when you fly. Since that's the biggest change, people get ear problems, if they're going to have them, within 15 minutes after takeoff or before landing. Do you have problems on airlines? If not, most places are lower than 6,000 feet.

Maybe I missed it here but caffeine (as long as you stay hydrated) is supposed to help. I haven't had an issue with altitude to date but haven't been much over 10,000 feet.

All right, I give up. What the heck is "EBC"?

Stay hydrated for one. When we went to Cuzco we had no problem and it’s at 11,150ft. Macchu Picchu is much lower at 7,972 ft and no problem either. Quito, at 9375 wasn’t an issue for the first 4 days, but when we took the teleferico to the 13,270 mountaintop (5 mi Ute ride), my wife did get some altitude sickness. To answer your question, there are plenty of recommendations online if you do a simple search.

Sam EBC = Everest Base Camp.

A few others mentioned it, but stay hydrated and avoid alcohol. Like Frank, I live at around 6,000ft (in fact he's only about an hour up the road from me!) Friends who visit us from sea level tend to be a little more out of breath going up a flight of stairs, and might have a slight headache at this altitude, but it's usually short lived. Unless you have underlying health issues, a 3,000ft elevation shouldn't cause you any trouble. Enjoy!

michelle,

You've received lots of good advice in this thread, but it would be a good idea to check with your health care provider on whether the altitudes on that tour will cause any problems with any of your existing conditions. Is a change in altitude likely to trigger a migraine episode?

You likely won't have too many problems in Salzburg, the Dolomites or Füssen as the altitudes are not that extreme and you'll have a few days to adjust. The two stops where you may have some issues are the Lauterbrunnen Valley and Chamonix. Some thoughts.....

• Lauterbrunnen Valley - the town of Lauterbrunnen is at 802M / 2630 ft. so you should be able to tolerate that quite well. Mürren is not that much higher so that too shouldn't be a problem. You may have issues visiting the Schilthorn which is at 3050M / 10,000 ft. but you may be fine with a short visit. I've never had any problems spending several hours at the top of the Schilthorn, exploring the displays in the building and having a fine meal in the revolving restaurant. The Jungfraujoch is a different story however, as it's at an elevation of about 3466M / 11,370 feet (the connected Sphinx Observatory is slightly higher at 11,716 ft.). I didn't have any serious problems spending a few hours there, but noticed that things like climbing stairs took a lot more effort, so I had to pace myself accordingly.
• Chamonix - you shouldn't have any issues in the town of Chamonix, even though it's at an altitude of 1035M / 3395 ft. It's relatively flat and you can wander about at your own speed. However if you're planning on visiting the Aguille du Midi or taking the Panoramic Mont Blanc cable car over to Pointe Helbronner (Italy), you very well could have problems especially if you spend more than a few hours at that altitude. The Aguille du Midi is at an elevation of 3842M / 12,605 ft. and you won't have time to acclimatize to the elevation before you arrive there. If you're planning to visit that, it would be a good idea to talk that over with your doctor. You may be fine with a short visit of an hour or two, but you'll need to be prepared to leave quickly on the next cable car if you have problems.

As the very informative post from Tom mentioned, medications may not be the best choice in this situation. As with most medications, Acetazolamide (Diamox) may have adverse side effects, and may interact with other medications that you're taking. Your family doctor or other health professionals will be the best ones to assess that.

Good luck and Gute Reise!

As others have said, it is best to seek medical advice from your healthcare provider.

Thanks all for your thoughtful answers to Michelle's questions. We will be locking this thread.