Denver is known as the Mile High City. For those that are by the shore, a mile high sounds like A Walk In the Clouds. In reality, Denver is the bunny hill compared to some of the popular tourist destinations in Colorado.

Breckenridge is just 80 miles due west. But that journey is mostly on an incline. The base of the Breck mountains is around 9,000 feet high and the peaks are closer to 13,000 feet above sea level, versus the paltry 5,280 feet in Denver. Keystone is a resort just 20 minutes away from Breckenridge, with night skiing. The altitude is just a smidgeon lower than Breck.

Vail is just a bit northwest of Breck, with an altitude of 8,000 in the town, and 11,500 on some slopes. Aspen, a three-hour drive west from Colorado Springs, features a summit elevation of 12,500 feet.

Pikes Peak and Longs Peak, both part of the Rocky Mountain National Park, are at altitudes of more than 14,000 feet, earning them spots in the 14ers club. There are arguably five dozen spots in Colorado that rise tall enough for the 14ers club. This makes Colorado the state with the most high-altitude destinations. Sounds nice, unless you get hit with HAPE or HACE, severe forms of altitude sickness.

The National Institute of Health warns that acute mountain sickness is an illness that can affect mountain climbers, hikers, skiers, or even sedentary travelers when they trek beyond 8,000 feet (2,400 meters). For those wanting to get high in the mountains of Colorado, it’s important to understand altitude sickness, and how to prevent it, or manage it. (For getting high using legal recreational marijuana in Colorado, read my prior post.)

About one in four people that go to high elevations will be hit with some sort of altitude sickness. Just because you’ve done fine in the past, doesn’t mean you won’t feel the pinch on another trip. Most will experience mild altitude sickness, which can include fatigue, difficulty in breathing, insomnia, headaches, and nausea or vomiting. Acute altitude sickness includes pulmonary edema (HAPE) and cerebral edema (HACE), the second of which can be fatal.

The effects of mountain sickness may seem random, but there are ways to minimize the effects or prevent them altogether. Following are five tips for Getting High in Colorado.

1. Hydrate. There’s not much humidity in the air here. Since it’s colder, you don’t notice the physical exertion as much and may not feel the sweat. You’re actually breathing faster at high altitudes, and losing water through your exhalations. Drink at least twice as much as you’d normally choose. Water or drinks with electrolytes are best. Do NOT consume caffeinated beverages like soda, coffee, or tea which dehydrate you more.
2. Skip the booze. Avoid all alcohol to protect yourself against the effects of mountain sickness. There are a number of reasons to say no to even beer or wine. Your body doesn’t process alcohol the same at high altitudes. Alcohol depresses breathing, and when you’re body is struggling for oxygen in thin air, alcohol is a bummer. At high altitudes, your equilibrium may also be off-kilter, and we know what happens to your balance when you drink. Alcohol dilates your blood vessels, lowers your blood pressure, slowing down the oxygenation that you sorely need in the mountains.
3. Eat like a bird. Yes, you may want to splurge in a fancy restaurant, eat that extra piece of pizza, or enjoy a five-course meal. But, unless you’re used to living in very high altitudes, graze lightly. The difference between a light meal and a heavy one can help to keep you active in the mountains, rather than stuck in bed digesting your food, or worse. Since you need more liquids, go for the soups. Limit salt and oil, and choose carbs over red meats which are harder to break down. Your digestion will move more slowly here, so don’t make it work overtime.
4. Take it slow. Ideally, spend the first night in Denver, or another location below 8,000 feet. Your body actually needs several days to adjust to the altitude. The slower the better. Don’t hit the slopes or pack in too much activity your first day. Let your body acclimate. Don’t feel rushed to get in as much skiing, snowboarding, hiking or even dancing during your vacation. It’s better to take it slow and enjoy your activities, rather than spend one day overexerting yourself, and the rest of your vacation feeling the consequences.
5. Rest. Listen to your body. Take frequent breaks. Sit still. Read a book. Play cards. Spend some time on your laptop. Go back down the hill to a lower altitude. Do not sleep near the peaks. Choose your home base closer to sea level. The difference between an altitude of 8,000 feet and 12,000 feet is significant, especially when you’re sleeping.

Finally, people with pre-existing conditions will need to pay even more attention to the above. Those with CVD, asthma, or diabetes, in particular, may want to consult their family doctor for additional advice before they depart for the Rockies.