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Altitude Sickness
Kanchan Shrestha | July 26, 2017

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Altitude sickness is a common illness which happens in a person when he moves from lower elevation region to higher (generally above 3000m). But the symptoms of this illness can range from mild to fatal. Some people are slightly affected while some people feel horrible. The basic syndromes of altitude sickness is very similar to that of the hangover i.e. headache, nausea, vomiting, fatigue, etc.

Major Causes of Altitude Sickness

  • Low partial pressure of oxygen in the air at high altitude.
  • Rapid ascend, dehydration and hypothermia can worsen your condition.

Symptoms of Altitude Sickness

  • Minor symptoms

Headache, fatigue, nausea and vomiting, dizziness, shortness of breath, loss of appetite, difficulty in sleeping, increase in heart rate, face, lip and finger nails get pale – which indicates inability to transport oxygen into the blood, etc.

  • Severe symptoms

Worsening of symptoms mentioned above, persistent dry cough, breathlessness, ataxia, mental confusion (altered mental status), drowsiness, irritation, unconsciousness or even coma

Types of Altitude Sickness

  • Acute Mountain Sickness (AMS) – It is the mildest and most common form. AMS leads to symptoms like of a hangover i.e. headache, nausea, fatigue, etc.
  • High Altitude Pulmonary Edema (HAPE) – This illness occurs when fluid builds up within the lungs which make breathing extremely difficult.
  • High Altitude Cerebral Edema (HACE) – It is a severe form of altitude sickness where fluid builds up within the brain. It results in swelling of brain with fluid which ultimately leads to change in mental state like loss of co-ordination and coma.

HAPE and HACE can be fatal if not treated in time.

Make a proper decision

  • At high altitude any problem can be due to altitude sickness. So, therefore do not try to go up until you are sure that it is not because of AMS. Stay on the same altitude until the symptoms are gone or else come down if your condition gets worse.

Preventive Measures

  • Enough Acclimatization – after 2000m is very essential. 1-2 days acclimatization at an intermediate altitude is very essential.
  • Rapid ascent is highly discouraged. Do not go too fast too high.
  • Alcohol, sleeping pills and cigarettes are respiratory depressants therefore should be avoided.
  • Drink plenty of fluids and avoid beverages
  • Consume a high carbohydrate diet.
  • Do not carry heavy packs; 10-12 kg is ok.
  • Climb higher sleep lower.
  • Sleeping altitude should not be increased than 500m a day over 3000m.
  • Do leave yourself alone, unattended.

Golden Rules

  • “CLIMB HIGH and SLEEP LOW” – In the days separated for acclimatization, you can ascend to a higher elevation during the day but at night return to the lower elevation for sleeping. This helps you in acclimatization.
  • If you get mild symptoms, stop and take aspirin if condition worsens get down.
  • Do not ever travel alone.

Treatment

  • Descending is the best medicine. Do not wait for a helicopter. Come down as fast as you can.
  • Oxygen maybe helpful.
  • Medicines-

Diamox 25mg – for AMS before dinner is recommended ( it is for sleeping problem and if one feels suffocation)

Nafedipine for HAPE

Dexamethasone (Decadron, a steroid) for HACE

  • Hyperbaric bag – a Gamow bag may be helpful

If you are planning to trek to high altitude regions, then you should be aware of altitude sickness, its causes, symptoms and preventive measures.

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