Addressing high altitude travel concerns
February 4, 2023 9:01 AM   Subscribe

We have concerns about traveling to a high altitude Colorado town for a wedding. One traveler is prone to nausea and migraines. We are both anxious about the drive through the mountains. I am looking for feedback on how concerned we should really be and how to prepare to stay calm, safe and healthy.

A friend is getting married in April in a high elevation town in Colorado. I am thrilled for them and was excited to attend when they announced a few weeks ago. However, I've since learned the wedding will be in a resort town about a 2.5 hour drive from Denver. (I incorrectly had assumed the wedding would be in the West coast city where the couple lives.)
I planned to attend with another friend who is now very anxious about the trip due to the travel involved and the elevation. After a 4.5 hour flight we will need to take a 2.5 hour shuttle from Denver. My friend is concerned because they are prone to getting sick in the car, even at normal altitudes. They also deal with migraines, often brought on by travel. I am also a feeling a bit anxious about this trip. I generally have safety concerns about long drives and can feel very hemmed in on transportation like a shuttle.

But we want to push through and celebrate this occasion.

I'd welcome any feedback that might help us allay concerns and any tips on how to cope with anxiety about the shuttle ride, prevent car sickness and head off migraines and stomach distress. Please note that we do not feel comfortable driving a car in the mountains so the shuttle is the only transport option. We can probably land in Denver one day early before traveling to the resort but do not have any more time to acclimate to the altitude. We've read up about hydration and neither of us drinks alcohol. Neither of us have been to an high altitude higher than 4,000'.

Any suggestions for planning and coping are appreciated. I'd also welcome feedback if our concerns may be overblown. Thank you.
posted by fies to Travel & Transportation (30 answers total) 1 user marked this as a favorite
 
If you go to a travel clinic you can get pills.for altitude sickness. You take one before you land and then every 12 hours or something like that. That's one problem solved.
posted by If only I had a penguin... at 9:12 AM on February 4, 2023 [9 favorites]


How high is the altitude where the wedding will be?

As you've already learned, stay hydrated. You've also learned about acclimating, which is good. If you have a way to do a day trip to a higher elevation the day before you go up to altitude, such as taking a tram to the top of a ski mountain, that can help. "Climb high, sleep low" is the best way to acclimatize.

If that's not possible, see if you can get a prescription for Diamox, which is used to prevent altitude sickness.

If the town is only 8000 feet or so, you should be ok, aside from feeling a little winded at first. Higher than that and you might start feeling the altitude.

I can't help with the driving sickness, though maybe mention it to your driver. They've very likely dealt with many sick passengers in the past and will know the best way to handle it.
posted by bondcliff at 9:13 AM on February 4, 2023 [5 favorites]


As a lifelong sea-level resident with family in the rockies, your concerns do sound overblown to me but there are ways to mitigate your concerns. When I travel to 5-6k feet elevation I only notice that I'm a little more tired, but it varies person to person.

It is common to get travel meds for elevation when going to even higher elevation cities in the Andes (over 8-10k feet). One you take in advance of travel and every day (diamox), and one is for emergencies. You could visit your doctor ahead of time and see if they will write you a script. Perhaps mention what town you are going to, as it varies.

Staying one night in Denver will certainly help, as will bringing hydration aids like Liquid IV or Gatorade.

For the transportation, can you afford to split a private car that will make more stops? If not at least alert the shuttle driver that you are prone to motion sickness, they will likely sit you in the front near a window and check in on you during the travel.
posted by Narrow Harbor at 9:18 AM on February 4, 2023 [5 favorites]


I also recommend a night in Denver to get started on acclimation. I went from sea level in Portland, Maine to Evergreen, CO for a week. Mostly, I was exhausted because of the reduced oxygen in the air. When I got home, I felt so fit! 2nding Narrow Harbor's response.
posted by theora55 at 9:50 AM on February 4, 2023


Migraineur who lived in Bogota (elevation 8,661 ft) here.

Hydration, rest, and sun protection are all key. I was diligent about sunscreen and often wore a hat, even on cloudy days. The sun really beats down at high altitude, which would aggravate my migraines.
posted by champers at 9:54 AM on February 4, 2023 [1 favorite]


Flying in to Denver and taking a shuttle to somewhere in the mountains is very common, I've done it twice for ski trips. The trip will be beautiful but also kind of slow and boring, it takes that long because the traffic tends to be really slow through the one main road over the mountains. You'll probably stop once at a touristy gas station. I definitely recommend staying the night in Denver as that will help a lot.

The first time I went somewhere at high elevation (a ski trip in Lake Tahoe), I couldn't sleep the night and got horrible headaches because I actually tried to go skiing the same day we drove up, which was a very bad idea. I also didn't get enough water and got a bit sunburned, which is a really bad combination. The second time I went up was better because I gave myself a day to acclimatize before skiing and didn't get dehydrated, but I still got some headaches.

Every other time I've gone to high elevation it's been totally fine, and a big part of that for me was CBD oil. CBD helps me in 3 ways, it opens up the lungs to get more oxygen in, reduces my anxiety, and helps me sleep. You can of course get real THC weed easily in Colorado, but the CBD is more important here (and wouldn't have the mental effects of THC that your friend may not want). You can get it legally before you travel so your friend could test it out before hand to figure out a dose that makes sense. There aren't a lot of scientific studies about CBD and altitude sickness, but the ones that exist are encouraging and there's a lot of anecdotal evidence saying it helps people.
posted by JZig at 10:17 AM on February 4, 2023


They sell medication for travel sickness. Bonus is a lot of this can make you drowsy so you‘ll sleep on the shuttle.
posted by koahiatamadl at 10:19 AM on February 4, 2023


Response by poster: Thank you for the feedback so far. Sorry I didn't specify that the altitude we are traveling to is a bit over 9,000'.
posted by fies at 10:20 AM on February 4, 2023


I am prone to car sickness and have taken dramamine effectively for some super windy mountain roads.

I also think the drive from Denver to the resort (even if elevation is above 9,000 and closer to 10,000 feet) might help with acclimating as you will be going up in elevation steadily over a few hours. I visited the Mauna Kea visitor center (9,200 ft) several times by car, driving from sea level to that elevation, and felt like the loooong drive from Hilo helped me, I felt normal when we arrived. Whereas when I flew directly into Cusco (11,100 ft) from sea level, I felt woozy and winded.
posted by spamandkimchi at 10:20 AM on February 4, 2023 [2 favorites]


I've had that exact migraine. Your concerns are not unfounded. Good advice above.
posted by Dashy at 10:25 AM on February 4, 2023 [2 favorites]


I have really bad motion sickness, made worse in long-distance buses and shuttles, and the only thing that helps is scopolamine patches. These are available (by appointment) at some CVS Minute Clinics, though they're not usually covered by insurance, so your friend would want to check on the cost. Also, they need to be applied behind the ear, 12-24 hours in advance, so it's a thing they'd want to obtain in advance.
posted by unknowncommand at 10:26 AM on February 4, 2023 [2 favorites]


I've resorted to carrying a "recreational oxygen" canister when I'm going to be at altitude -- you can find them easily on Amazon or other shopping sites if you use that search term, and lots of outdoor-gear stores like REI carry them. It helps quite a bit more than I thought it would.
posted by erst at 10:32 AM on February 4, 2023


Neither of us have been to an high altitude higher than 4,000'...
Have you flown much in the past? If it helps allay any of your anxiety about being at high altitude, keep in mind that flying on a commercial jet you will have experienced cabin pressure equivalent to about 6000'-8000'.

A few hours on the plane isn't enough to acclimatize but it will get you started, and spending the first night in Denver while staying well-hydrated and well-rested will help a lot more.

If you do get a low-dosage Diamox prescription, it's even more vital that you stay well-hydrated since it's a diuretic. I'd also recommend doing a trial run with it before your trip if possible (definitely check with your doctor about this first) so you can determine if you'll suffer any side effects -- some of which can mimic altitude sickness, ironically.
posted by theory at 10:39 AM on February 4, 2023 [1 favorite]


Response by poster: I don't mean to threadsit but just want to answer two recent questions. Unfortunately it doesn't look like we can afford a private driver. The only options we have seen run around $1100. If folks know of any cheaper reputable options, I'd welcome suggestions. (We wouldn't do an uber/lyft.) We have both flown a lot, including 16+ hour flights. Thanks.
posted by fies at 10:46 AM on February 4, 2023


Other people have given good advice, so the only thing I want to add is that my migraines are much more likely to happen when my triggers are compounded - so, travel, stress, dehydration, illness, food triggers - any single one is probably okay, but when I compound them, it's a doozy. So anything you can do to minimize the other migraine triggers might be a good idea.
posted by Ms Vegetable at 10:56 AM on February 4, 2023 [1 favorite]


First of all, sounds like you already doing this but for anyone else checking in the future "what will be best for traveling with a person who gets migraines" -- everyone's migraines are different so talk to them about suggestions here and what options are preferable.

Denver the night before of course, but try to reach Denver as early in the day as you can without messing up your sleep schedule by getting up horribly early for a flight. Don't go see the sights in Denver, just rest and hydrate. Consider if the person who gets migraines would be more comfortable with their own hotel room or not, or what you could do to make them more comfortable if needed. Last time I got a migraine when sharing a motel room my roommate woke around 6 am, too early for tourist options to be open, but my roommate took her laptop to the lobby of the motel 6 we were in and got her work done there which was very helpful.

I like to have hot tea if I have a migraine, having a travel kettle and teabags packed is very useful. Travel oxygen can be helpful for migraines and altitude, I'm not sure if it's allowed to have with for air travel but it's commonly available at Walgreens. Usually marketed for hangovers so it might be with those items, although I've also seen it on a display near the front of the store in a Walgreens located at over 6000 feet elevation.

For choosing where to stay in Denver, you might want to think about reducing your time on the shuttle the next day - or perhaps increasing it if it's helpful to be on the same shuttle vehicle for a while before reaching the mountains. The Denver airport is quite some distance East of the city, there's probably going to be at least an hour of very much not being in the mountains if you take the shuttle directly from the airport, longer if the shuttle is making stops on the way.

Unfortunately it doesn't look like we can afford a private driver.

Do you have any way to reach other people going to the wedding? Other guests might be renting cars in Denver and be very interested in getting some help with their own rental car costs while getting to know another guest on the drive. Although in addition to other possible downsides, a large shuttle vehicle will probably feel less "twisty" on smaller mountain roads.

Some other possibilities might be Greyhound or Amtrak if routes go through your destination, either from Denver as an alternative to the shuttle or possibly from your original city if air travel itself causes more migraine issues. Also many mountain towns in Colorado have commercial flights available if that's helpful, it can be a relatively expensive flight to get to these smaller towns but something to check.
posted by yohko at 11:46 AM on February 4, 2023


I went from Atlanta to Denver to Brekenridge about 20 years ago and I don’t think your anxiety is misplaced. Altitude sickness sucks and so you should do everything you can to avoid it. I strongly agree with flying in a day early (we didn’t do that on my trip), stay hydrated, avoid alcohol, and get a good nights sleep before the shuttle ride. Talk you your doctor about the meds folks have mentioned including those for nausea, motion sickness and altitude sickness.

If your friend gets to the resort and starts feeling ill (I woke up in the middle of the night with a brutal headache and nausea) and meds aren’t helping then I’d consider heading to urgent care. My friend went on a very exciting Colorado ski trip with a bunch of friends…she started not feeling well pretty quickly and they were trying all sort of things like going to those IV therapy/spa places to get her rehydrated and give her fancy oxygen. These visits ended up being made daily because she just felt awful for like 4 days. Finally they went to the ER and she ended up with her own oxygen tank for the rest of the trip.

Basically, not everyone adapts to high altitudes so do what you can to prepare and be ready to get medical help if it doesn’t work.
posted by victoriab at 11:48 AM on February 4, 2023 [1 favorite]


If you decide to travel with oxygen on the plane then definitely check the requirements with the airline as far in advance as possible. It might limit the flights you can take and there is some required paperwork.
posted by victoriab at 12:04 PM on February 4, 2023


Check out the route you’ll be following from Denver as well.

Denver’s 5,000+ and Aspen's a little under 8,000, but if you go from Denver to Aspen via Independence pass — a very scenic drive, by the way — you will hit 12,000, and I’ve known a number of Denverites who got sick ascending that pass.

Diamox is a carbonic anhydrase inhibitor, and I believe the accepted mechanism through which it prevents altitude sickness is by lowering the amount of carbon dioxide which is dissolved in your cerebrospinal fluid, so it couldn’t hurt to limit the amount of CO2 available to the enzyme in your blood by, say, walking around and breathing deeply before you get on the bus, and I would guess avoiding carbonated drinks might also help.
posted by jamjam at 2:35 PM on February 4, 2023


I ran into some altitude sickness when I was in Jackson Hole last year. Ibuprofen took care of it in short order.
posted by TrialByMedia at 5:31 PM on February 4, 2023


I went on holiday to Peru a few years back and was at fairly high altitude. Had long flights from the UK. The local guide’s advice to travellers was: get enough sleep, avoid alcohol, avoid heavy meals and instead have more frequent lighter meals. I wasn’t sure what to expect, having heard stories from friends being very unwell, but the only real difference I noted was shortness of breath. Otherwise I was ok, as was the rest of the group.
posted by ElasticParrot at 5:42 PM on February 4, 2023


If you have flown in an airplane, you are likely fine. Most airplanes pressurize at 8,000 ft altitude.
posted by sanka at 6:44 PM on February 4, 2023


A pressurization of 8000' is the mandated maximum:
FAA regulations in the U.S. mandate that under normal operating conditions, the cabin altitude may not exceed this limit at the maximum operating altitude of the aircraft.[10] This mandatory maximum cabin altitude does not eliminate all physiological problems; passengers with conditions such as pneumothorax are advised not to fly until fully healed, and people suffering from a cold or other infection may still experience pain in the ears and sinuses.
but is not the normal for cabin pressurization:
The cabin altitude of the Boeing 767 is typically about 7,000 ft (2,100 m) when cruising at 37,000 ft (11,000 m).[11] This is typical for older jet airliners. A design goal for many, but not all, newer aircraft is to provide a lower cabin altitude than older designs. This can be beneficial for passenger comfort.[12] For example, the Bombardier Global Express business jet can provide a cabin altitude of 4,500 ft (1,400 m) when cruising at 41,000 ft (12,000 m).[13][14][15] The Emivest SJ30 business jet can provide a sea-level cabin altitude when cruising at 41,000 ft (12,000 m).[16][17][unreliable source?] One study of eight flights in Airbus A380 aircraft found a median cabin pressure altitude of 6,128 ft (1,868 m), and 65 flights in Boeing 747-400 aircraft found a median cabin pressure altitude of 5,159 ft (1,572 m).[18]
posted by jamjam at 7:10 PM on February 4, 2023 [1 favorite]


FWIW I think it can be hard to predict one's tolerances* for altitude. I am a native flatlander, but I have visited a certain high elevation town (H.E.T.) several times before without incident. However, I was surprised that sleeping at H.E.T.'s altitude + 2000 feet was a bit much for me. An additional 2000 feet is not "that" much, right? I was able to acclimate in a day or two, but in retrospect, I would have been happier sleeping at the relatively lower elevation of H.E.T.

*I'm speaking more about you in this case. It seems reasonably likely to me that your traveling companion will be affected by traveling/ altitude.

The semi good news is that if others will be drinking at the wedding, most of their hangover remedies will be of use to you as well (either as "prevention" or "cure").
posted by oceano at 3:48 AM on February 5, 2023


nthing getting the altitude sickness drug if you don't know your reaction to sleeping at altitude, as it can be very unpredictable.

My spouse gets almost no impact from altitude -- even at 11k ft. I, who am at a similar fitness level, get marked altitude impact at anything above probably 5kft (even spending a few nights in Denver gives me a high resting heart rate), interrupting my sleep and making physical activity as mundane as going up a flight of stairs a bit of a trial.

We did some skiing last year where we slept at around 8-9k ft and spent the day up-and-down to 12k ft. At a travel clinic, I was prescribed generic diamox and started taking it the day before. It was night-and-day compared to our last trip to CO where we had a similar altitude profile and I was winded getting to the 2nd floor of our rental condo. Highly recommended.
posted by chiefthe at 6:58 AM on February 5, 2023


Oh, and a piece of general advice for being at altitude: Do not take a single step downhill. Do not under any circumstances end up downhill of the car. Of you got out to stretch your legs and acclimate? What a beautiful lake, let's get a picture? NO. STOP. Do not step downhill. I don't care how pretty the path is. I don't care how much you loved that hat that blew of your head. If you have to walk uphill to pee and it's going to get all over you, bring extra toilet paper. Do not step downhill.

If your car is driving uphill and gets a flat tire in the rear and you're just going to walk from the front door to the rear tire and trunk to change it? No. Do a U-turn or a 3 point turn so when you get out of the car you're walking uphill to the rear tire. (Ok, this one might be a little extreme).

Seriously, do not walk downhill. This has been a public service announcement.
posted by If only I had a penguin... at 8:56 AM on February 5, 2023


I am so confused by that do-not-walk-downhill comment! But altitude truly does affect everyone differently. I lived for many years in Summit County (think Breckenridge) at 9000’ plus. The only advice I gave visitors was to start doubling their hydration about three days before traveling, and maintain that while you are there.

With your concerns, I absolutely do recommend that you take advantage of the option to arrive in Denver a day early. It sounds like the shuttle option does not really suit your needs, and having no control over when and where you stop might be troubling. I’m not sure what kind of fears you have about driving in the mountains, but if you’re going to a place like Breckenridge, it’s freeway nearly all the way (though you can make it more exciting than that if you want to). Might you reconsider the car rental idea? Alternatively, Amtrak is a really nice idea, depending on its timing and access to your actual destination. Best of luck to you, and I hope you have an amazing time!
posted by AnOrigamiLife at 12:34 PM on February 5, 2023


You didn’t specify where exactly you’re going to, so this suggestion might not help, but the state of Colorado has a bus system that travels throughout the state and might be able to use it: Bustang. The Pegasus bus goes along the I70 corridor, which will get you to Breckenridge or Vail or Avon, and the Bustang west route travels the interstate as well but goes further west, including to Glenwood Springs (close to Aspen). There’s an Outrider bus that can get you to Telluride. The Snowstang runs through May and goes to a lot of other ski towns/resorts.

Also, you can fly directly to Aspen, if that’s where you are going.
posted by heurtebise at 3:49 PM on February 5, 2023


I am so confused by that do-not-walk-downhill comment!

If you get out of the car you can walk quite a ways downhill quite easily, even if you are not acclimated to the altitude and out of shape. However, you are now downhill from the car and you can't get back to the car without walking uphill, which will not be nearly as easy and may leave you feeling like you might as well be on the moon with no oxygen tank. Trust me, I have some great pictures of my by a beautiful lake at 4000m in the Andes, but god they were not worth it.
posted by If only I had a penguin... at 3:57 PM on February 5, 2023


Altitude effects everyone differently and being in great shape is no preventative measure. As someone who lives at 800 feet above sea level and has visited Breckenridge, CO (the resort town you are likely going to that is 9000+ feet above sea level), the biggest thing that altitude does to me is mess with my sleeping. So be kind to yourself.

One thing that hasn't been mentioned is the air is a lot drier. If your accommodations has a humidifier, use it. Drink when thirsty. Lotion up your skin that you know in prone to dryness.
posted by mmascolino at 7:52 AM on February 6, 2023 [1 favorite]


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