Here, halfway between sea and sky, our relationship with the air is complicated.
For visitors, breathing the thinner air in paradise can trigger acute mountain sickness (AMS): headaches, fatigue, and insomnia. Because the air pressure in Breckenridge (at 9,600 feet) is roughly three-quarters of what it is at sea level, you breathe faster to satisfy oxygen-starved lungs. Your heart works harder to pump more oxygenated blood to your brain. So whether you’re skiing bumps, climbing a flight of stairs, or just sitting on the floor in a yoga pose, you’re more likely to become winded. But as your body adjusts to the altitude—taking anywhere from a day to a week—these acute effects generally wear off (more severe cases are remedied by breathing pure oxygen at night, delivered in tanks to hotel rooms). Spend the whole winter here with more red blood cells coursing through your veins, and you might feel like a superhero when you move back down to sea level and run a mile. Settle in Summit for good, and the statistics show you’re bound to be thinner and healthier than the rest of the population.
“We have a lower incidence of cancer and heart disease up here,” says Christine Ebert-Santos, a Frisco pediatrician who studies the impact of altitude on residents. “And we’re just generally healthier.”
Need a second opinion? The 2012 Summit County Health Assessment ranked Summit as the fifth-healthiest county in the state, noting that while heart disease and cancer may be the leading causes of death here, the rates of each, and illness and injury in general, are considerably lower in Summit than in the state as a whole.
“This could be partially due to the slightly younger age of county residents,” the report posits, “but [it] may also be due to the generally healthy lifestyle of many county residents compared to others in the state.”
Lately, though, a growing number of medical professionals are noticing small cracks in the rosy picture of healthy life at high altitude—generally defined as being above 2,400 meters (about 8,000 feet) in elevation. And they’re seeing it in an unexpected place: the invisible, thin air.
“It’s not that simple, that we acclimatize and we all are OK,” says Dr. Warren Johnson, a cardiologist in Frisco.
The negative effects of locals suffering from oxygen deficiency can be subtle, he says, and difficult to diagnose. But for certain young, sick, and older residents who should be acclimated to the altitude, Johnson and Ebert-Santos prescribe a treatment that’s typically reserved for tourists suffering from AMS: monitoring blood-oxygen levels and sipping 02 from a cannula at night. It’s a new approach to high-altitude medicine, one that begins with an understanding of what happens to the human body over decades in the thin air.
Though infant mortality is no higher at altitude than at sea level, doctors say, pregnant women are slightly more likely to develop high blood pressure and other complications, and babies born at altitude tend to be smaller than babies born at elevation, with one Colorado study finding that birth weight declined by an average of 3.5 ounces per 3,300 feet of elevation. Ebert-Santos says that, compared to babies at sea level, infants in her practice are more likely to be smaller, with a percentage of those born at altitude “not on the growth chart,” but notes that most catch up to the norm within two years.
As they mature, mountain kids tend to be healthier, likely because they’re more active than their sea-level peers. However, illnesses that might clear up quickly at sea level can linger here. Ebert-Santos notes that children with chest colds in her practice are more
lethargic, and their oxygen levels are
One winter, Breckenridge resident Randall Howard brought his 15-year-old daughter, Emma, to see Dr. Ebert-Santos for labored breathing and a cough that just wouldn’t go away. After checking the girl’s blood-oxygen level, which was abnormally low, Ebert-Santos suspected that over time, the high-altitude thin air had exacted a toll, pulling fluid into the girl’s lungs. This life-threatening condition, called high-altitude pulmonary edema (HAPE), is more commonly seen in visitors from sea level (although it’s rare even with them: HAPE typically affects only 1 out of every 10,000 Colorado skiers). The good news is the condition is treatable and quickly improves with oxygen. Breathing oxygen 24-7, Emma got better, an indication that living at altitude had, in fact, made a local kid who should have been acclimated, very sick. Ebert-Santos presented this case as an example of Mountain Resident HAPE, with other findings about how living at altitude impacts local children, to the American Thoracic Society’s International Conference this spring. Her conclusion: more epidemiological research is needed to document illnesses in populations at altitude.
Like children, older adults sometimes have weaker lungs, and often face special challenges.
A few years ago, when longtime Breckenridge resident Hans Wurster felt a few “chest tweaks” while sleeping, the 78-year-old former ski patroller went to see Dr. Johnson, who diagnosed him with pulmonary hypertension, the result of lungs having to work harder to suck oxygen from the air. As a result, Ebert-Santos and Johnson have begun advising older full-time residents like Wurster to monitor blood-oxygen levels at night and, if low, to sleep with oxygen (both physicians sleep with oxygen to control high blood pressure). Wurster now owns an oxygen concentrator, which delivers a never-ending supply of oxygen at night. “I’m trying to stay here as long as I can,” Wurster says. “You don’t want to have to move to Arizona.”
But many seniors dream of retiring to the Rockies; the County Health Assessment expects Summit’s over-65 population to swell by more than 250 percent by 2030. And that demographic, as Wurster’s case demonstrates, may be especially vulnerable to the deleterious impacts of high-altitude living. The good news is that local doctors like Johnson and Ebert-Santos are helping figure out which negative effects are short-lived, which last a lifetime, and what can be done to live with them.
If you live here and are thinking about having kids or retiring here, remember that you’re still more likely to be healthy if you live at high altitude than not.
But, if you’re a little bit older, or a little bit sicker, you might try thinking of—and treating—yourself as if you were a 1958 Porsche. If it’s been well maintained, a vintage Porsche can run just fine at 9,000 feet. But your engine will run even better at altitude if you adjust the carburetor, and let in a little more air.