Resolved question:
Hi,
I am a healthy 30 year old woman in my 9th week of pregnancy with my first child.
I have no history of health problems, no ongoing medical condition, not taking any medication, never had surgery, no allergies, I am a healthy weight and non-smoker, who regularly exercises and eats well. On this basis I was hoping to have a healthy pregnancy.
All my blood tests have come back as normal and a scan last week showed the baby is 2cm long, with a good heartbeat, and the ob gyn said everything is as it should be.
However, my problem is that I am living at high altitude - 2,800m above sea level - in Quito, Ecuador. I am originally from the UK and spent the first 28 years old patientof my life at sea level. I have lived here for two years old patientnow and never had real problems with the altitude until I got pregnant. I would travel away a lot for work, both inside the country at lower altitude and abroad, and only get a mild headache and sometimes light heart palpitations on the first day back in Quito.
Now, however, I feel absolutely terrible all the time that I am at altitude. I had to travel outside the city (lower altitude) at the weekend, and felt much better all weekend with lots of energy and I was able to eat. However as soon as I got back Sunday night a terrible headache started, I could not stop vomiting and also had uncontrollable diarrhoea. My heart was beating like crazy and rushing in my ears. Everything I ate came back up. I couldn't sleep due to the heart pounding and headache, and nausea. My vision was blurry and I felt dizzy. I also had terrible wind and felt my stomach bloat out like a balloon, which was terribly painful especially as I had not been able to keep any food down.
It is now Wednesday evening and the headache, palpitations and blurry visions is not much better. I have eaten and kept food down, but still feel constantly nauseous and can only eat very small, plain portions such as a piece of bread or plain rice. Which worries me that I am not getting enough nutrients and varied diet for the baby.
I had two doctors appointments here since Monday, but do not feel like I was taken seriously at all regarding the altitude sickness. I told them my vision was blurry and they could see that I could hardly walk, and they did not seem concerned at all. I have read online that this is a serious cause for concern, and now two days later I am frightened because it has not gone away. Both doctors told me I probably had a stomach infection from something I ate, which was causing the diarrhoea. I just KNEW it was the altitude and not that. Sure enough they both sent off for blood and stool sample tests, which came back normal. But then they basically said "you don't have an infection, your baby is fine, you are fine" and sent me away with instructions to drink lots of fluids.
I know that local doctors in Quito really don't seem to believe in the severity of altitude sickness. People who were born and grew up here do not even feel the effects of altitude, and I am probably the first European woman who did not grow up in high altitude that either of these doctors have ever treated. They have been very good with general pregnancy care, but whenever I try to tell them how bad I feel from the altitude, they just laugh it off and tell me that I will have become acclimatised by now, after living here for 2 years. They don't seem to believe me that I WAS acclimatised, but something seems to have gone wrong now I am pregnant meaning I have become more sensitive to the altitude or it is affecting me more for some reason.
Please, please help me - how can I get the doctors here to take me seriously? I have read online that altitude sickness can get very serious and that blurry vision is something to worry about. I am just not getting answers here locally, and I want to know whether I and my baby really are in danger? And even if not, what can I do to stop feeling so awful all the time? I cannot work, can barely eat, feel weak and exhausted all the time, my heart is always pounding like crazy even at rest, and exercise is an impossibility - despite both doctors telling me I should still exercise regularly! They just didn't believe me that walking up two flights of stairs to my apartment makes me feel like I'm having a stroke. Two months ago before the pregnancy I was at the gym 3 times a week, and it is so depressing now to feel so ill all the time, not to mention frightening.
I would be so very grateful for any advice you can give me.
Also please could you tell me whether it would be better to try and stay at this level of altitude all the time, in the hope that I will eventually acclimatise, or would it be better to try and spend some time at a lower level at the weekends? My partner has even talked about moving house to one of the valleys outside Quito, at a 500m lower altitude, but it would then mean I would have to travel up into Quito every day to go to work - which I don't know whether that would be worse.
I really just need some professional medical advice on what I can do to handle this, and whether based on the symptoms above I really have cause for concern or not?
Thanks so much in advance,
Rachel
Submitted:
4 Days
Category:
OBGYN
Hello Rachel,
Thanks for posting your query at DoctorSpring.com
I have gone through your question in detail.
There is almost no doubt in my mind that you are suffering from High altitude sickness.
You mentioned that even while non pregnant, you would have mild symptoms.
Pregnancy interferes with your acclimatization process, and some women who are pregnant might not acclimatize at all .
Yes, your symptoms are worrisome, and the ONLY treatment for them is descent to a lower altitude.
Most of the drugs used for altitude sickness are prophylactic ( for somebody intending a short term visit ) and most of them cannot be used in pregnancy.
In fact, there is no drug that you can use long term throughout your pregnancy to help with this condition, without affecting your baby.
The ONLY solution is descent to a lower altitude, lower than 1500 m.
You can try asking the local doctors to read up some stuff - I can provide a few links -
http://www.summitpost.org/pregnancy-and-altitude/286351
http://www.babymed.com/daily-living/high-altitude-elevation-during-pregnancy-and-complications
Beyond this, there is no point trying to convince them, as your baby is at risk anyway, and so are you, because you seem to have a severe variant of altitude sickness right now.
Staying at a lower altitude and coming up everyday will make you more prone to the illness, you might have it every time you climb up.
And staying where you are , in the hope of getting acclimatized, puts your baby at grave risk, as you already know.
Yes, you have a cause of concern, and something needs to be done immediately.
The only solution I can put forth is to somehow descend to a lower altitude for the course of the pregnancy, and stay there.
I know it might be a momentous decision in terms of your life and work, but then , you have to prioritize, and go ahead, knowing that it is the only safe option for you.
HOpe my answer helps you.
PLease feel free to discuss further.