High Altitude Sickness

High altitude sickness

High altitude sickness is often known as acute mountain sickness (A.M.S.) in general and may occur when people ascend too quickly, normally in altitudes of over 3000 m. Most people will feel some effect of altitude, shortness of breath, and possibly lightheadedness, which is fairly common. Acute mountain sickness is very different and normally involves a severe headache, sickness, and loss of awareness. In almost every potential case, there are enough warning signs to take appropriate action.

Our expert and trained guides will advise you about any health requirements and also altitude sickness while you are trekking, so you should not worry about it. We do, however, recommend you get advice from your travel doctor or health advisor before you leave. The following information gives you an idea about high altitude sickness and how to minimize its effects

There are three stages of altitude sickness and symptoms.

1. Normal AMS Symptoms – Should expect but not worry
The following are the normal altitude symptoms that you should expect, but not be worried about. Every trekker will experience some or all of these, no matter how slowly they ascend.

• Periods of sleeplessness.
• Occasional loss of appetite.
• Periodic breathing.
• The need to rest/catch your breath frequently while trekking, especially above 3500 meters.
• Runny nose.
• Increasing urination while moving to/at higher altitudes (a good sign)

2. Mild AMS Symptoms: Don’t go higher
Many trekkers in the high valleys of the Himalaya get mild AMS. Admit or acknowledge that you are having symptoms. You need to have only one of the following symptoms to have altitude sickness.

• Mild headache
• Nausea
• Dizziness
• Weakness
• Sleeplessness
• Dry, raspy cough
• Fatigue/Tired
• Loss of appetite
• Runny nose
• Hard to breathe

What to do if a mild symptom doesn’t go away?
If mild symptoms develop while walking, stop, have a rest, drink plenty of water, and take 125-250 mg Diamox. Diamox generally takes one to four hours to begin alleviating symptoms.

If symptoms partially go away but are still annoying, it is safe to take another 250 mg Diamox 6-8 hours later.

If mild symptoms continue getting worse, try descending for a few hours, which may be more beneficial than staying at the same altitude. Going higher will definitely make it worse.

3. Serious AMS Symptoms: Immediate descent

• Persistent, severe headache.
• Persistent vomiting.
• Ataxia (loss of coordination, an inability to walk in a straight line, making the sufferer look drunk)
• Losing consciousness (inability to stay awake or understand instructions)
• Mental confusion or hallucinations.
• Liquid sounds in the lungs.
• Very persistent, sometimes watery, cough.
• Difficulty breathing.
• Rapid breathing or feeling breathless at rest.
• Coughing up clear fluid, pink phlegm, or blood (a very bad sign).
• Severe lethargy/fatigue.
• Marked blueness of face and lips.
• High resting heartbeat (over 130 beats per minute)
• Mild symptoms are rapidly getting worse.
• Dangerous cases of AMS (Acute Mountain Sickness)

Dangerous Cases of AMS

High Altitude Cerebral Edema (HACE)
This is a buildup of fluid around the brain. In most cases, the first five symptoms are on the mild and severe lists previously. Coma from HACE can lead to unconsciousness and death within 12 hours from the onset of symptoms but normally takes 1-2 days to develop. At the first sign of ataxia, begin treatment with medication, oxygen, and descent. Usually, 4 to 8 mg of dexamethasone is given as a first dose, then 4mg every six hours, Diamox every 12 hours, and 2-4 liters/minute of oxygen. Descent is necessary, but a PAC (portable altitude chamber) bag will often be used first if available.

High Altitude Pulmonary Edema (HAPE)
This is an accumulation of fluid in the lungs and is very serious. It is responsible for all the other mild and serious symptoms, and it is often accompanied by a mild fever. By far the treatment is oxygen at 4 liters a minute, but using PAC (portable altitude chamber) bag treatment is a good substitute. If there is no PAC bag or oxygen, then descent will be life-saving. HAPE can lead to unconsciousness and death very quickly.

Tips for prevention of Acute Mountain Sickness (AMS)

• Allow sufficient time for acclimatization (after 3000 meters).
• Don’t make a rapid ascent. Don’t go too far too fast.
• No alcohol, sleeping pills, or smoking.
• Drink more fluid, 3-4 Liters a day, clean water, boiled or treated, tea, coffee, soup/juice, etc.
• Climb high and sleep low.
• Do not trek/travel alone; take a guide/porter.
• Follow the advice from your guide, hotel, local, and guidebook.
• Descent if mild symptoms rapidly get worse.
• Never leave or descent sick person alone.
• Avoid getting cold.
• Take an easy and comfortable trekking route even if its longer.

First Aid Kit
This is the basic list to cover the more common ailments that affect trekkers. Climbing groups, expeditions, and trekkers going to isolated areas will need a more comprehensive kit.

• Bandage for sprains
• Plasters/Band-aids
• Iodine or water filter (optional)
• Moleskin/Second skin – for blisters
• Antiseptic ointment for cuts
• Anti-bacterial throat lozenges (with antiseptic)
• Aspirin/Paracetamol—general painkiller
• Oral rehydration salts
• A broad-spectrum antibiotic (norfloxacin or ciprofloxacin)
• Anti-diarrhea medication (antibiotic)
• Diarrhea stopper (Imodium – optional)
• Antibiotic for Giardia or similar microbes or bacteria
• Diamox 250/500mg (for altitude sickness)
• Sterile Syringe set (anti-AIDS precaution)
• Gel hand cleaner.