By Tonia Twichell
(May 2014) Thanks to improved access and technology, the most far-flung places
on Earth are open to travelers with enough money and determination for
adventure travel. But returning from those icy mountaintops, deep waters
and dense jungles, intrepid, but unprepared, tourists can bring back
ailments that are as difficult to diagnose as they can be to treat.
CU Travel, Expedition and Altitude Medicine (TEAM) clinic, which opened
in January, is designed to provide care and expertise for travelers
before, during and after travel.
“The vast majority of travel
clinics around the country deal almost exclusively with preparation
against infectious disease, mainly vaccination and some prophylactic
antibiotics,” says Richard Zane, MD, chair of the Department of
Emergency Medicine. “But preparation should also look at the
environment: Are you going to a place with extreme temperatures or
altitude? Will you be in a place that has a lack of access to health
care? If so, how do you plan on getting health care if you need it?
There’s a second and third level of planning that are rarely addressed.”
travelers who historically avoided exotic locales—seniors, children,
pregnant women, people with asthma and other health conditions—are now
more likely to travel.
“It’s not like 100 years ago when people
would usually stay in the same environment all their lives,” Zane says.
“In less than a day you can go from sea level to Everest or from Denver
to a cruise in the middle of the Mediterranean.”
An early consultation can make a difference between life or death.
already know that if they’re going to a place where there is malaria
they should prepare for malaria, but this goes a step further,” Zane
says. “If you are already on certain medications and you’re going to a
place with extreme heat, how will that disease be affected by the
potential physiologic stressors of travel, chronic disease and a very
different environment – heat, cold, altitude, humidity, etc.?”
care physicians don’t always know to ask for a travel history when a
patient presents symptoms, plus they often don’t have the most
up-to-date information about planning for a trip.
“For the most
part, you can’t just go to an internist and say ‘I’m going to Africa,’”
Jay Lemery, MD, associate professor of emergency medicine, says.
“They’re not prepared for that. So there’s a real role for us to play.”
clinic housed at University of Colorado Hospital Outpatient Pavilion
incorporated an altitude clinic that has for years been the go-to place
for advice on preventing and treating altitude related hypoxia. The
altitude clinic has a hyperbaric chamber—the only one in civilian
use—where experts can measure a patient’s response to altitude before
climbing to a mountaintop. Though in Colorado, there’s another option.
get people in who say ‘I have COPD, and I want to go to the Andes,’”
Tracy Cushing, MD, assistant professor of emergency medicine, says. “A
lot of times I’ll say ‘Why don’t you take a trek around Breckenridge and
we’ll see how you do at 12,000 feet?’”