Altitude problem

[Romero]

I have been suffering from COPD for a few years. I Moved to souther Spain (from the UK) in the hope it would improve, I have got better but my breathing has got worse. I do believe this is due to the altitude, as I unbderstand that you lose 10% of oxygen for every 1000ft you go up. I now live in the mountains 3500ft - 4000ft high. Anybody got any suggestions as to what I can do or take to improve this. Exercise is very difficult due to the breathing problem which in turn makes me very tired.

[National Jewish]

You are correct that at high altitudes the air is less dense than at sea level.  This means that you are breathing air with less oxygen in it.  To supply the necessary oxygen, your body must take in more air and so you breathe more often.  Until your body adjusts to the new altitude you may notice shortness of breath, especially with exercise.  You may also tire more easily.

The shortness of breath and tiredness should disappear as your body adjusts to the air.  In order to make up for the decreased oxygen, your body has to make more red blood cells.  Depending on your age and health this can take anywhere from 3 days to 3 weeks.  Since you have chronic obstructive pulmonary disease (COPD) your body may need a little extra help, so it is a good idea to check with your doctor.

COPD is a chronic lung disease linked with cigarette smoking and worsened by contact with industrial dusts and other toxins.  It is a disease that worsens over time.  There is relatively irreversible obstruction of airflow and actual destruction of the airsacs in the lung.  Normally the airsacs of the lung look like a bunch of grapes.  COPD causes destruction of the walls between the airsacs.  Over time these individual airsacs become one large airsac called a bullae.  When this happens there is less surface area for oxygen to get from the lungs into the blood and for carbon dioxide to get from the blood into the lungs to be exhaled.  This can reach a point where the amount of oxygen in the blood is low.  This is called hypoxemia.  This can also reach a point where the amount of carbon dioxide in the blood is high.  This is called hypercarbia or hypercapnia.  The lungs can reach the point where they cannot provide the body with enough oxygen to keep the blood level above 90%.  This increases the workload on the heart.  Over time the heart will get large and work less efficiently.  Once the heart is enlarged this cannot be reversed.

Now that you are living in the mountains at 3,500 feet to 4,000 feet high you may need oxygen.  If your oxygen level is low in your blood, you may experience symptoms such as: shortness of breath, irritability, morning headaches or ankle swelling.  Using supplemental oxygen will help to lighten the workload on your heart so it does not get large.  Oxygen therapy will also decrease your shortness of breath when you exercise so that you do not feel as tired.  Another option is to move to sea level where you may not need oxygen.

You will need to have your oxygen level in your blood checked at the altitude where you are now living.  It should be checked while you are sitting, walking, and sleeping.  Then you will know if you need to use oxygen, how much, and when.  Oximetry and arterial blood gases are used to measure the oxygen level in the blood.  One or both of these tests may be used to determine your need for oxygen therapy.  Your oxygen level may be measured as a percentage of the oxygen in your blood.  This is called the blood oxygen saturation.  Generally oxygen therapy is recommended when your blood oxygen saturation is below 90%.

An oximeter is a device that measures your blood oxygen saturation.  A small clip is placed on a finger or earlobe.  This is a simple and painless way to tell if you need oxygen.  This test may be done while you are sitting, while you are walking around the doctor’s office for a few minutes, and for a thorough evaluation while you are sleeping.

The second way of testing is the arterial blood gases (ABGs).  While this blood test is more complex, the results tell your doctor more information about how your lungs are working.  This test measures several levels including both the oxygen and carbon dioxide levels.  Usually blood is taken from a vein for blood tests.  However, for this test the blood must be taken from an artery.  Most of the time the artery in the wrist area is used.

[starion]

Have you had any testing to find out what your oxygen saturation rate is in your new home?  If your oxygen saturation rate is below 88% while sitting at rest, walking, or sleeping, in United States you would generally qualify for supplemental oxygen.  Living at a higher elevation CAN increase your need for supplemental oxygen--for example, I do not need supplemental O2 at sea level (where I live), but DO need it while walking or sleeping at 5000 feet (where my doctor is).

If your oxygen saturation rates are at or above 90% while sitting, walking and sleeping, you might benefit from a pulmonary rehabilitation program.  Ask your doctor(s) if there are any near your home.  Exercising and good breathing techniques can be helpful.  Toned muscles use O2 much more efficiently than de-conditioned muscles.

Good luck!
Aloha,
Starion

[Romero]

Thank you so much Starion for your comments and they made a great deal of sense. I will now endeavour to get a test done (not sure how, but will definately try very hard).Once again thank you very much.

[totempole889]

A related discussion, change elevation for copd was started.