Altitude Mountain Sickness

When you ascend too quickly over 3000 meters altitude, you might be affected by Altitude Mountain Sickness (AMS) or not. But you can have a minimal risk of this sickness by acclimatizing in a village. Shortness of breath, lightheadedness, headache, sickness, and loss of awareness are the symptoms of altitude mountain sickness.

You will be advised on any health issues, including altitude mountain sickness, before leaving for a trek. Apart from having advises from the guide and manager ofAce Holidays, please also get an advise from your doctor in your country. Very much Ace Holidays believes in your safety; therefore, it asks you to submit your insurance paper in the meeting, just before the trek. The following information provided to you by Ace Holidays is helpful in minimizing the effects of altitude mountain sickness.

There are three stages of altitude mountain sickness, and their symptoms are given below.

1. Normal AMS Symptoms – Should expect but not worry.

Following are the normal altitude symptoms that you should expect, but do not worry.

• Period of sleeplessness.
• Need more sleep than normal (often 10 hours or more)
• Occasional loss of appetite.
• Vivid, wild dreams especially at around 2500-3800 meters.

• 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)
• Dizziness.

2. Mild AMS Symptoms – NEVER GO HIGHER

Many trekkers in the high valleys of the Himalaya get mild AMS. Some may have only one of the following symptoms.
• Mild headache.
• Nausea
• Dizziness.
• Weakness.
• Sleeplessness.
• Dry Raspy cough.
• Fatigue/Tired.
• Loss of appetite.
• Runny nose.
• Hard to breath.

What to do if a mild symptom doesn’t go way?

• If you find mild symptoms developing while walking, stop and relax (with your head out of the sun) and drink some fluid. Drink frequently.

• If mild symptoms develop while walking, stop, have a rest, drink some water and take 125-250 mg Diamox. Diamox becomes effective after half an hour and works for 2 to 4 hours.

• If symptoms develop in the evening, take 125-250 mg Diamox and drink plenty of water again.

• 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 get worst, try descending for a few hours, which may be more beneficial than staying at the same altitude. Going higher will worsen the symptom.

3. Serious AMS Symptoms – IMMEDIATE DESCENT

• Persistent severe headache.
• Persistent vomiting.
• Ataxia (loss of co-ordination, 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 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 rapidly getting worse

Dangerous cases of AMS

High Altitude Cerebral Edema (HACE)

This is a build-up of fluid around the brain. In most cases, the first five symptoms of the mild and serious are likely to occur. Coma from HACE can lead to unconsciousness and death within 12 hours from the onset of symptoms. At the first sign of Ataxia, you must begin treatment with medication, oxygen, and by descending. Usually 4 to 8 mg of dexamethasone is given as a first dose, then 4 mg every six hours, Diamox every 12 hours and 2-4 litres /minute oxygen. Descent is necessary, but a PAC (portable altitude chamber) bag will often be used at 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 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.

Prevention of Acute Mountain Sickness (AMS)

• Allow sufficient time for acclimatization (After 3000 meters).
• Don’t make rapid Ascent. Don’t go too far too fast.
• No Alcohol, Sleeping pills and 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 guide/porter.
• Follow the advice from your guide, hotel, local, guide book.
• Descend if mild symptoms get worst.
• Never leave or descend with a sick person
• Avoid getting cold.
• Take an easy and comfortable trekking route even if it is longer.

First Aid Kit

This is the basic list to cover the more common ailments that affect trekkers. Climbing groups, expedition groups, 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
• Broad-spectrum antibiotic (norfloxacin or ciprofloxin)
• Anti-diarrhoea medication (antibiotic)
• Diarrhoea stopper (Imodium – optional)
• Antibiotic for Guardia or similar microbe or bacteria
• Diamox 250/500mg (for altitude sickness)
• Sterile Syringe set (anti-AIDS precaution)
• Gel hand cleaner.

Please Note: Your guide will also carry the first aid kit bag. However, Ace Holidays still recommends you to bring your personal first aid kit bag. All the guides, porters, and staffs of Ace Holidays carry GSM, CDMA, and cell phones during the treks. While trekking in a a remote area, they carry a satellite phone.