Altitude Sickness (AMS) - Prevention and Treatment

Folks who have ventured above couple of thousands of feet above sea level can relate well to the term called Altitude Sickness or Acute Mountain Sickness (AMS). It is a condition which triggers as a result of lower levels of oxygen at high altitudes. Most people often ruin their precious holiday time because of altitude sickness.

 

As you travel to high altitudes, the amount of oxygen in the air you are breathing declines. Once you reach altitudes of over 8,000 feet, the oxygen levels in the air are significantly lower. It can be difficult for your body to adjust to this decreased oxygen, along with the cool and dry air, and closer proximity to the sun, all of which come with spending time at high altitudes. Fortunately, there are steps to take for both altitude sickness prevention and altitude sickness treatment.

 

Symptoms of Acute Mountain Sickness (AMS) are:

-Headache
-Loss of appetite
-Nausea
-Vomiting
-Fatigue and weakness
-Dizziness
-Restless sleep
-Shortness of breath
-Swelling of the face and hands.

 

Lungs of people living near sea level are used to high levels of oxygen in air. Once you start ascending, the Oxygen levels in the air keep on decreasing. Increased risk of high altitude sickness sets in starting from the 3,500 meter mark. The high risk or mountain zone starts from 5,500 meters. The Oxygen levels decrease significantly once you cross the 3,500 meter mark. Above 5,500 meters mark, Acute Mountain Sickness can turn into High Altitude Pulmonary Edema (HAPE) or High Altitude Cerebral Edema (HACE) which are both very serious.

 

High Altitude Pulmonary Edema (HAPE) symptoms include: serious fatigue, shortness of breath and dry cough, shortness of breath at rest, rapid and shallow breath, frothy or pink mucus possible, gurgling, rasping sound when breathing, pressure, heavy feeling in the chest, restlessness, rapid pulse, possible fever, cyanosis – blue or grey lips and indescribable lethargy.

High Altitude Cerebral Edema (HACE) symptoms include: powerful headache which doesn’t pass using painkillers, loss of coordination (ataxia), vomiting, apathy, fatigue, indifference, walks as if drunk, behavioural changes, confusion, hallucinations, cramping fits, short-term blindness and numbness or paralysis of individual body part.

 

 

Altitude Sickness Prevention

The best way to prevent altitude sickness is to allow your body to adjust to the decreased levels of oxygen in high-altitude locations, this is often referred to as acclimatization.

 

• Don’t Rush: Ascend slowly towards the top. It takes several days for your body to get used to the low levels of Oxygen in the air. A good rule of thumb is to avoid ascending more than 1,000 feet a day. If you are traveling to very high altitudes, stop at 8,000 to 9,000 feet for a few days before moving on to allow your body to adjust.
• Sleep At Lower Altitudes: Your blood levels of oxygen are the lowest when you are sleepingat a high altitude. If possible, plan your vacation so that you visit high altitudes during the day and return to lower altitudes for sleeping. For instance, book your hotel a couple of thousand feet lower than the mountain you will be skiing, biking, or climbing on during the day.
• Keep Hydrated: This is the best way to help your body adjust to high altitude. Generally the low humidity at altitude keeps the air dry, so you should drink twice as much water as you would at home.

Also keep in mind that you want to add water to your body, not deplete it. At least initially, avoid caffeine and alcohol.

• Medications: Consult your doctor before taking any AMS medications. If your doctor recommends, consider taking acetazolamide (Diamox) to help your body adjust to rapidly increasing altitudes.
• Alcohol: You should strictly consider not to consume any alcoholic beverages when at high altitudes. It dehydrates the body and lowers the internal body temperature.
• Express Yourself: If you are feeling uncomfortable or breathless, then it is always a good idea to keep your team informed about this, so that your fellow travellers can take necessary actions in case of any emergency.

 

Altitude Sickness Treatment

If you are having mild symptoms of mild altitude sickness,  you should consider not going any higher for at least next 24 to 48 hours. Most cases will improve during this time, but will help you even more if you:

• don't exercise
• drink plenty of fluid (but not alcohol)
• don't smoke
• rest until you feel better

If you do develop altitude sickness, the following treatment options may help:

• Descend: If you have mild symptoms of altitude sickness that don't disappear over the course of 24 to 48 hours, the best thing to do is descend by at least 500m (about 1,600 feet).

Don't attempt to climb again until your symptoms have completely disappeared. After two to three days, your body will have acclimatised and your symptoms should disappear.

If you have severe symptoms or your symptoms are getting worse, descend immediately by as much height as possible. This is because severe altitude sickness can be fatal if not treated quickly. Seek immediate medical help when you reach a low altitude.

• Artificial Oxygen: Increasing your oxygen intake with bottled oxygen or portable hyperbaric chambers (also known as Gamow or Certec bags) can help to temporarily improve some of the symptoms of altitude sickness.

A portable hyperbaric chamber is a bag you're zipped into, which is then pumped full of air. After one to two hours of treatment, your symptoms should improve significantly. The effect of the treatment is equivalent to descending about 2,000m (6,500 feet).

However, while oxygen treatment or the use of a hyperbaric chamber can relieve the symptoms of altitude sickness, it's not a replacement for descending to a lower altitude. You should always descend if you have severe or worsening symptoms, even if you've had oxygen treatment.

 

• Medication: Painkillers such as paracetamol, ibuprofen etc. can be used to treat mild headaches. If you're experiencing nausea or vomiting, a type of medication called an antiemetic may be useful. Promethazine is an antiemetic medicine often used by people with altitude sickness.
Research has shown that acetazolamide (Diamox) can reduce the severity of altitude sickness symptoms and can help prevent the condition. Altitude sickness can change the chemical balance of your blood. It's thought that acetazolamide helps correct this chemical imbalance. There are a number of common but minor side effects associated with acetazolamide, including numbness or tingling of the face, fingers or toes. Some people find these quite distressing, so doctors often suggest trying it at home for two days before travelling if you're likely to use it at altitude. You should always consult your doctor before deciding to any of the above mentioned medications. And again, it's not a replacement for descending to a lower altitude.

It is important to listen to your body when traveling to high-altitude locations, since altitude sickness can be serious. If you suspect that you are experiencing altitude sickness, don't go any higher until your symptoms improve and move to lower ground if your symptoms get worse.

 

Happy Travelling!