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Altitude Sickness

Altitude sickness occurs when a human is acutely exposed to low partial pressure of oxygen at high altitude. It normally occurs above 2400meters or 8000feet. Anyone and everyone can be affected by altitude sickness. Most people can ascend to about 2400m without difficulty.

Altitude sickness is also known as altitude illness, hypobaropathy, “the altitude bends” or soroche.

It has 3 forms.

Mild altitude sickness is also called acute mountain sickness. It is similar to having a hangover. It causes nausea, fatigue and headaches. It is very common. Some people are affected mildly while some feel awful.

If a human experiences acute mountain sickness, then there is a chance of it developing more serious forms of altitude sickness like HAPE and HACE, both of which can be fatal within hours.

Acute mountain sickness (or AMS) can lead to HAPE (or high altitude pulmonary edema). Excess fluids accumulate in the lungs. This can be life-threatening and can happen to anyone who goes above 2400m. If you experience any of the following symptoms then you may die soon

  • Difficulty in breathing or breathlessness
  • Cough
  • Weakness or decreased exercise performance
  • Chest tightness or congestion
  • Blue skin color
  • Rapid shallow breathing
  • Rapid heart rate
  • Crackles or wheezing, while breathing, in at least one lung field

In some cases, HAPE can cause a high temperature fever and coughing up frothy spit.

One of the main causes of HAPE is a shortage of oxygen which is caused by lower air pressure at high altitudes.

Acute mountain sickness can also lead to HACE (or high altitude cerebral edema). Excess fluids in the brain, leads to the swelling of the brain and this can happen because of the physiological effects of travelling at high altitude. Some of the symptoms are

  • Vomiting
  • Confusion
  • Clumsiness
  • Stumbling
  • Laziness
  • Excessive emotion
  • Excessive violence
  • Fever
  • Coordination of movement
  • Discomfort or pain in the eyes due to light exposure or by presence of actual physical sensitivity of the eyes
  • An altered mental state
  • Severe headaches
  • Hallucination in some cases
  • Stupor
  • Blurred vision
  • Paralysis

Drowsiness and loss of consciousness can occur shortly before death.

It occurs when the body fails to acclimatize while ascending to a high altitude. It also occurs because of oxygen deprivation.

Treatment of HAPE and HACE are

  • Immediate descent to lower altitudes is absolutely essential
  • Dexamethasone and acetazolamide should both be given, if available
  • Pressure bags and oxygen gas can buy time

The main causes for altitude sickness are

  • Ascending faster than 500m per day
  • Exercising vigorously at high altitudes
  • Lower levels of oxygen at high altitudes

Every one including a physically fit person such as an Olympic athlete can get altitude sickness.

To prevent high altitude sickness, one must ascend slowly. One needs to acclimatize the body properly and get used to the altitude at every level. The body can acclimatize beautifully however, it needs enough time. It could take up to a week to adapt to an altitude of 5000m.

Only one drug is currently known to prevent AMS and to be safe for this purpose: acetazolamide (diamox). It causes some minor side effects, such as tingling fingers and a funny taste in the mouth.

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There is no known cure for altitude sickness. Although these methods have been tried and it helps in reducing symptoms

  • Stay well hydrated throughout. Before you hit high altitude ensure that you have had 0.5 litres of water atleast half an hour before. Ensure that every night before going to bed, you have 0.5 litres of water.
  • Force yourself to eat even if you have slight headaches. Having slight headaches is normal.
  • Slow down and don’t force yourself to go faster.
  • Ascend slowly.
  • Go high, sleep low. You can go to a high altitude but ensure that you always sleep at lower altitudes.
  • Stay positive.
  • Enjoy the nature.
  • Breathe deeply if you go breathless.
  • While climbing stairs, go one step at a time. If you feel breathless, stop, take a minute to recover and then start climbing again. Slight breathlessness is normal.
  • Staying fit is also a key. Altitude sickness can hit even the fittest of the people, but that doesn’t mean one should not be fit. It is better to tackle altitude sickness with a fit body than an unfit body.
  • Regular pranayama exercises like simple anulom-vilom if started a couple of months before the trip to a high altitude destination can help in better breathing.
  • Simple 30mins brisk walking, if started a couple of months before the trip to a high altitude destination can also help in improving levels of fitness.
  • Ensure that you are dressed in layers. Even if you are indoors, ensure that you only take off the top most layer. The heat should never escape the body.
  • Don’t stay indoors. Be outside in the cold rather than the warm indoors. It helps in better acclimatization.
  • Some say Coca helps. Consult your homeopath.
  • Don’t drink alcohol as it tends to dehydrate the body.
  • Take the first day to acclimatize to the altitude. Take it easy. Rest for a couple of hours before you go for a short walk the moment you land at the high altitude destination.
  • Avoid caffeinated products as they tend to dehydrate.
  • Have the local food as far as possible.

Descend to a lower altitude if the symptoms get worse. Consult the doctor. Use oxygen to increase oxygen pressure. Diamox is easily available over the counter in Leh-Ladakh and Nepal. Resort to that in case of bad nausea or bad headaches.

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