This summer, as part of my RN to BSN program with UCCS, I needed to complete a public health course with clinical. I decided on an unusual path by joining the team of pediatrician and public health activist, Dr. Ebert-Santos.

Dr. Ebert-Santos has been the primary care giver for my two boys, now 8 and 4 years old, since birth. I would venture to say that Dr. Chris, as we call her, is known by most families in Summit County. Not only are we a mountain community but we are a community committed to growing in mindful ways. A lot of thought goes into how we operate our community events and care for our families. Dr. Ebert-Santos has been very active on more community issues than I can address here. But, let’s include water quality, health insurance/coverage initiatives, and pretty much every community health walk for a cause, healthy community eating and garden initiatives, bike to work week, trail maintenance…you get the picture. For these reasons, I finagled my way into her office this summer.

Our community is one of the healthiest in the nation according to national statistics. We are one of the lowest on obesity, adult diabetes, and hypertension. For this reason, along with the beauty of the Rocky Mountains, we have a lot more people moving here than ever before. “Summit County has recently exceeded a permanent resident population of 30,000. This is a 28.7% increase in full-time residents since 2000” (Summit County Colorado, 2017).

One major health issue that Dr. Ebert-Santos is bringing to light with her current research shows that high altitude kids are often born at lower birth weights, catching up on the national growth charts within the first few years. These babies are not unhealthy by high altitude standards. The problem is that statewide and nationally, we have yet to set standards specific to high altitude children. Dr. Ebert-Santos is making a big push to address this.

Dr. Ebert-Santos is also the doctor most likely to check your newborn for wellness and release them home, safe and sound, following birth. Many of our mountain babies go home with an infant oxygen tank that you will see parents wearing as backpacks. Dr. Ebert-Santos has been collecting and analyzing data on high altitude kids for years now. At higher altitudes, we have lower air pressure and that means decreased bioavailable oxygen. While many people are aware that acute mountain sickness and high altitude pulmonary edema (HAPE) are potential obstacles to overcome when travelling up into the Rockies, many people do not know that our resident children, who haven’t even travelled down from altitude and back up, are also prone to these illnesses. High altitude pulmonary edema in children living at altitude can follow the sort of respiratory infections that kids are prone to catching as they make their way through school while their immune systems are developing. This is often entirely treatable with oxygen alone.

The problem Dr. Ebert-Santos has identified is that, assuming residents are acclimated and therefore unlikely to have HAPE, kids here are often diagnosed with pneumonia instead of HAPE. Treatment of pneumonia often involves a hospital stay with antibiotics and other medications on board. Dr. Ebert-Santos sees dozens of children each year who have what she would like others in the medical community to recognize as Mountain Resident HAPE. With proper diagnosis, these children can be treated with oxygen and improve within a matter of days. Awaiting recovery from pneumonia when there is no pneumonia present can be detrimental to children.

Dr. Ebert-Santos will have her research published this year in the Journal of High Altitude Medicine and Biology. I had the fortunate experience of working this summer, with Dr. Ebert-Santos and her dedicated team, to create a public health message relevant to her work. Office manager Meaghan Zeigler, who has a master’s in public health, was invaluable to my education there.  I was happy to find that our local oxygen companies were ready to join in this effort to educate the public. Big thanks to Summit Oxygen Inc. in Frisco, AlpinAire in Breckenridge, and AeroCare in Silverthorne! Below you can see the acronym I created to help high altitude families recognize the signs and symptoms of high altitude illnesses, including HAPE and Mountain Resident HAPE.

Stay safe and keep breathing Summit County!

Juli Joyce, RN


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