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Task Force won't let altitude bring team down

U.S. Navy Dr.(Capt.) Peter Amato (left), deployed from Westover Air Force Base, Mass., and Air Force Dr. (Capt). Ronald Khoury, deployed from Nellis AFB, Nev., assist a patient with a severe cut wound, June 6.  The doctors are in the mountainous region of Ayacucho, Peru participating in New Horizons - Peru 2008, a U.S. Southern Command- sponsored humanitarian mission set on improving the quality of life of underprivileged Peruvians.

U.S. Navy Dr.(Capt.) Peter Amato (left), deployed from Westover Air Force Base, Mass., and Air Force Dr. (Capt). Ronald Khoury, deployed from Nellis AFB, Nev., assist a patient with a severe cut wound, June 6. The doctors are in the mountainous region of Ayacucho, Peru participating in New Horizons - Peru 2008, a U.S. Southern Command- sponsored humanitarian mission set on improving the quality of life of underprivileged Peruvians.

HUAMANGA, Peru -- The air is a bit thin up here in the mountainous region of Ayacucho, Peru, where U.S. Air Force, Army, Navy and Marine servicemembers are participating in New Horizons - Peru 2008, a humanitarian mission set on improving the quality of life of underprivileged Peruvians. 

The altitude in Huamanga is more than 9,000 feet above sea level; almost double the elevation of Denver, Colo. - not something many servicemembers are used to experiencing -- especially while working at completing heavy-duty construction projects. Whenever military members are ill, service doctors are known for patching up military members prior to the next mission. High in the Andean mountains, their task is to keep them from losing their breath -- literally. 

As is common with most people traveling to extreme altitudes (approximately 8,000 feet and above), difficulty breathing, fatigue, and insomnia may develop. These are likely symptoms of acute mountain sickness, a pathological condition caused by exposure to low air pressure (usually outdoors at high altitudes). 

More than 15 of the almost 300 servicemembers participating in New Horizons Peru have already experienced extreme AMS symptoms, enough to warrant medical attention. 
To combat medical issues possibly preventing a successful mission, the task force brought a robust medical team ready for the challenges of working at extreme altitudes.
The New Horizons medical team has maintained a proactive approach to caring for task force personnel affected by AMS by watching for symptoms and encouraging commanders to practice the same vigilance. Doctors have also offered circumstantial considerations and tips to leadership. 

"An individual's starting point, by the very nature of it, increases or decreases the possibility of developing altitude sickness," said Navy Dr.(Captain) Peter Amato, the New Horizons - Peru senior medical doctor, and a reservist assigned to 4th Marine Air Wing at Westover Air Reserve Base, Mass. "Individuals traveling from the oxygen-rich environment of the California coast will have a greater chance of developing altitude sickness than someone traveling from the Rocky Mountains of Colorado where there is less oxygen at higher altitudes." 

To prevent, or reduce the impact of AMS the doctor prescribes, first and foremost, good health. Acute mountain sickness tends to exacerbate health problems and increases the possibility of someone developing the sickness. Someone with heart disease, or lung related health issues like asthma, or sleep apnea, and are having complications with their condition in their baseline environment should be screened by a doctor before traveling to extreme altitudes. Medics here in Peru have advised doctors at home stations that are sending personnel to support the New Horizons project to screen those individuals for extreme altitude suitability. 

Physical fitness is another variable in determining whether or not an individual develops AMS as active servicemembers are better able to endure low air pressure environments. However, being fit does not make an individual invincible to extreme altitudes. 

"We have a military member participating in the exercise who recently ran a 26-mile marathon, and in spite of the conditioning that requires, was so limited by the environmental effect of the altitude that she could only run one and half miles the first few days," said Air Force Dr. (Capt). Ronald Khoury, Task Force New Horizons - Peru medical commander, assigned to Nellis Air Force Base, Nev. "So being fit does not protect people from the effects of the high altitude. However, if they slowly increase their activity levels, in due time they will likely return to normal activity levels." 

The time needed for an individual to adjust to changing altitudes varies, but studies suggest one to two weeks according to Dr. Khoury. Slowly increasing your activities and paying attention to how your body respondes to high altitude environments is the best defense, added the doctor. Therefore, New Horizons Peru medics are advising task force members to pace themselves and return to their physical training routines gradually. 

One of the treatments doctors have used for those patients who suffer from AMS has been pure oxygen or O2 consumption. This treatment required a dual effort from both the medical team, as well as the task force contracting officer who went to great lengths in locating oxygen tanks for the task force medical team. 

"Master Sgt. Vincent Pfoser and Staff Sgt. Luis Cibrian (the New Horizons contracting team) were able to obtain a local source of medical grade oxygen which solved a critical need given our environment," said Dr. Khoury. "That allowed us to return participants to the mission without requiring evacuation." 

The medical team will be on the ground throughout the duration of the New Horizons event to care for the more than 990 servicemembers rotating through the encampment, ensuring mission accomplishment regardless of the unique Peruvian environment. 

Maj. Matt Joganich, the Task Force New Horizons - Peru commander, quipped, "The altitude definitely presents challenges, but we won't let it get us down." 

For more information about New Horizons - Peru visit: www.12af.acc.af.mil/library/newhorizons.asp

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