Dr. Eric Anderson, a charter diplomat of the American Board of Family Practice and a former president of the New Hampshire Academy of Family Physicians, is a regular contributor to Travel Tips 'n' Tales. He is widely traveled and published, having written a travel health column for Travel 50 & Beyond and a weekly online column, Ask The Doctor, for The New York Times Syndicate.

Dr. Anderson invites you to send your questions regarding travel health issues to ericmd@lorrypatton.com

Question: My friend and I are training to mountain bike Haleakala, Maui late this year. This is an appealing ride because one can go from sea level to 10 Kft on a paved road in under 40 miles. I've spent a lot of time at the summit observatory and climbed (on foot) to 14.5 Kft, but I had problems with the altitude. I talked to my doctor about supplemental oxygen. He did not seem enthusiastic.

Can you talk about the proper use of oxygen, in particular how to recognize and avoid problems with its use? I've gone on O2 at the observatory; it's an interesting experience - as you breathe it in, all the instrumentation LED's grow brighter!

Answer: Sounds like you guys are going to have fun.

Although there's no harm in it, supplemental oxygen would be an unusual approach for otherwise healthy tourists going to high places in the United States. A local mountaineering store might have some suggestions for you or maybe a local medical supply house sells small units. Going to an industrial supply house isn't a good idea as industrial oxygen has moisture in it that can freeze and clog a valve at cold high temperatures. When I was flying a lot in small aircraft, I bought a cannister of oxygen for a cross-country over the Rockies flight from a company called Sporty's, which now has a website at http://www.sportys.com/shoppilot/ (Telephone 800-LIFT OFF). Sporty's sold me a small round cylinder with 30 minutes' supply O2 for less than $100 but when I go to website today I find the units are much more expensive.

Most experts, however, feel the approach to the problem of moderate altitude is not using oxygen but having knowledge: learning about altitude sickness, knowing the standard medication is the sulpha drug, acetylazoleamide (Diamox), and being aware that the standard treatment is to get down at least a thousand feet lower if one starts to feel ill as if with the flu.

Early altitude sickness produces symptoms of general unwellness with fatigue, headache and nausea being common. Patients ignoring those symptoms go on to vomiting, breathlessness and swelling of the face and extremities. They become restless and unable to sleep.

Tourists at higher altitudes should drink more fluid but avoid alcohol because alcohol compounds the problem; they should not be too busy or active till they have gotten used to the altitude. We used to say to hikers, "Take two days to eight[thousand feet] then one day for every one [thousand feet]". But now, for example, if you are flying in the Andes you can go from sea level to uncomfortable heights in just a few hours. That's a strain.

Most persons tolerate 8,000 ft easily, hence that choice for aircraft pressurization. A lot of people can handle 10,000 ft if the ascent to that level is gradual and there is no sudden physical exertion at that height. A few young people can manage 12,000 ft. Being able to tackle 14,500 ft would be rare for average people. (I'm not talking about mountaineers in training for Everest.)

NOTE: Lorry Patton's Travel Tips 'n' Tales would like to remind you to always consult with your personal physician before following any medical advice and to please read the Travel Tips 'n' Tales "Terms of Use" found on the bottom of each page of this website. Dr. Anderson's opinions are not necessarily the opinions of Lorry Patton or Travel Tips 'n' Tales.