Mountain sickness (AMS)

Acute Mountain sickness and other Hazards:

The trails:

The trekking trails in Nepal vary from wide, road like avenues to narrow, slippery paths built out over enormous drops. In many places a fall from the trail would be fatal. one must pay attention at all times to where you are placing your feet. Be especially careful with mountain sickness not to move while looking through the view finder of your camera. Sometimes your route will become confusing, and you may take the wrong path, if you are tired, as one often is at altitude or after a long day, there is a great temptation to try to climb up or down a steep hillside to regain the correct trail. Several people have died from a long fall while trying to do this and others have been painfully injured. Re-trace your steps to find the correct path rather than moving cross country. Never trek alone. If you have no friends available with whom to trek, consider hiring a guide or Porter to trek with you.

The weather:

Nepal has the widest altitude range of any country on earth, from 60 meters in the Terrain to 8848.59 meters on the top of the world Mt Everest. Each altitude will have its own weather problems, from tropical heat to arctic cold. It is often difficult to plan for bitter cold winds and snow while walking past banana trees in the hot sun. In the main trekking seasons in the spring and fall, the weather is often stable, and even the high passes may be free of snow and relatively easy to Traverse at times. Those trekkers who encountered an easy day at altitude may spread the world that boots, and warm clothing are not required. This is a mistake! Sudden storms can occur at any time, dumping one or two meters of snow on the passes. At that point, anyone with simple running shoes will not be able to proceed and may even be stranded for a number of days. Frostbite is a constant risk if one walks in snow at high altitude.

If you trek during the winter, you must be prepared for the cold and snow. If you trek in during the monsoon you might be faced with slippery trails and difficult rivers crossing but there are much less people on the trail. You are heading into the world’s highest mountain ranges. Be prepared for changes in temperature and weather.

Final preparations:

If you are thinking about the trekking route, you will go over 4000 meters, take a warm sleeping bag, boots adequate for snow, a warm jacket, and good quality sunglasses. If you are hiking with porters, make sure they have sunglasses, warm clothing and proper shoes if they are trekking over high passes.

Since most popular trekking routes do not have medical care for most of their distance, bring an adequate first aid kit

Altitude:

The Himalaya begins where other mountain ranges leave off. Everest Base Camp is the foot of huge mountains, similarly Annapurna Base camp, round Annapurna, Manaslu Circuit, Dolpo, Upper Mustang etc … The Everest Base Camp Yet it is 1000 meters higher than the highest point in Europe. Your body can adjust these altitudes, but only if given enough time. Being in a hurry in the mountains of Nepal can be deadly! It also seems that exertion at altitude like (carrying a heavy bag pack) may predispose some people to altitude sickness. So, it may be advisable to carry a light bag pack and use a porter (they are not expensive, you can contact a porter or guide in Ascend Hikes Pvt Ltd.). Acclimatization is the word used to describe the adjustments your body makes as it ascends. You should adjust your schedule so that you average no more than 300meters per day of ascent above 3000 meters.

If you fall to allow time for acclimatization, you may develop symptoms of AMS (Acute Mountain sickness). The AMS may be mild enough to go away with a day’s rest or ignored may lead to death. All that is required to ensure a safe trek is basic awareness of AMS, and a willingness to rest or descend if you develop symptoms. As a result of the growing awareness of altitude sickness problems there is only one death from AMS in Nepal out of every 30000 trekkers. Even these deaths would be avoidable if everyone knew how to respond to AMS. There are no reliable figures for casualties among porters.

Recognizing Acute Mountain Sickness:

Acute mountain sickness AMS can develop at any altitude over 2500 meters. The early symptoms are headache, extreme fatigue, and loss of appetite. Some people became breathless at rest. AMS is the result of fluid accumulating in parts of the body. Where it does not belong, in the brain, in the lungs or both. When mild symptoms develop, it is a signal that you must stay at the altitude until symptoms have gone away. Never ascend with any symptoms of AMS! Usually within one or two days you will feel well and can continue your journey in Nepal Himalayas.

If you are resting at the same altitude and your symptoms are becoming worse, then it is necessary to descend. Worsening symptoms of altitude sickness AMS including increasing tiredness, severe headache, vomiting and loss of coordination. There are signs of high-altitude Cerebral Edema of HACE. HACE can lead to unconsciousness and death within 12 hours in progressive symptoms are ignored. Increasing shortness of breath, coughing, and tiredness are signs of High-Altitude Pulmonary Edema or HAPE. HAPE can also be rapidly fatal if ignored.

A person suffering from AMS may not have clear thinking and may have to be forced to descend. Even if someone is willing to descend, they should never be allowed to descend alone. Keep descending until the person shows some sign of improvement, usually after 300-500 meters of descent. Even if the diagnosis is not clear, but might be AMS, you should descend and you can always re ascend when the person feels better.

It is best to start descending while the person who is ill can still walk. If the person can no longer walk, a Yak or horse might be obtained. Porters can often be found to carry a sick person down. In the Emergency case, do not wait for a helicopter. If you chose to administer oxygen or medications do not delay the descent to watch for improvement.

The symptoms of acute mountain sickness:

The symptoms of acute mountain sickness typically appear within hours of ascending to higher elevations. They vary with the seriousness of your condition.

• dizziness
• Symptoms may include headache, muscle aches, and insomnia.
• Symptoms include nausea, vomiting, and irritability.
• Loss of appetite
• Symptoms may include swelling of the hands, feet, and face, rapid heartbeat, and shortness of breath when exercising and 
• Vomiting 

Major acute mountain sickness:

Significant cases of acute mountain sickness can result in more severe symptoms that affect your heart, lungs, muscles, and nervous system. For example, brain swelling can cause confusion. You may also experience shortness of breath due to fluid in your lungs.

Symptoms of severe altitude sickness could include:

• Coughing, chest congestion.
• Pale complexion and skin discoloration
• Inability to walk or loss of balance
• Social withdrawal
  If you are experiencing severe symptoms, call 911 or seek emergency medical attention right away. If you address the condition early on, it will be much easier to treat.

Who is at risk of mountain sickness?

If you live near or by the sea and are unfamiliar with higher altitudes, you are more likely to develop acute mountain sickness. Other risk factors are:

• Quick ascent to high altitudes.
• Physical exertion when traveling to higher altitudes or extreme heights.
• Possible causes of low red blood cell count include anemia and heart or lung disease.
• Medications such as sleeping pills, narcotic pain relievers, or tranquilizers can reduce breathing rate.
• Previous episodes of acute mountain sickness may also be a factor.

If you plan to travel to a high elevation and have any of the above conditions or medications, consult your doctor about how to avoid developing acute mountain sickness and consult our Ascend Hikes guides.

What are the treatments for acute mountain sickness?

The treatment for acute mountain sickness varies according to its severity. You may be able to avoid complications by simply returning to a lower elevation. If your doctor diagnoses you with brain swelling or fluid in your lungs, you will need to be admitted to the hospital. If you are having trouble breathing, you may be given some oxygen.

Treatments for altitude sickness include:

• Acetazolamide, to treat breathing problems.
• Treatment options include blood pressure medication, lung inhalers, and dexamethasone for reducing brain swelling.
• Aspirin for headache relief.

Milder conditions may be treated with simple interventions, such as:

• Return to a lower altitude.
• Reduce your activity level.
• Rest for at least a day before moving to a higher altitude and stay hydrated with water.

How can I avoid acute mountain sickness?

You can take some important precautions to reduce your risk of acute mountain sickness. Get a physical to ensure that you do not have any serious health issues. Review the symptoms of mountain sickness so that you can identify and treat them as soon as they appear. When traveling to extreme altitudes (above 10,000 feet, for example), consult your doctor about acetazolamide, a medication that can help your body adjust to high altitudes. Taking it the day before you climb and for the first day or two of your trekking can help alleviate your symptoms.

Physical fitness:

Does not prevent AMS!!!

Do not expect everyone in your party to acclimatize at the same rate. You may have to wait an extra day for some members or be prepared to split the group. Children are more susceptible to AMS. It is risky to trek to high altitude with infants. Sleeping pills, sedatives, and alcohol should not be used at altitude as they tend to decrease breathing and lead to AMS. It seems that drinking 3-4 liters of fluids per day to avoid dehydration helps in the acclimatization process.

Consider use of the drugs acetazolamide (Diamox) as one treatment for mountain sickness. Talk to your physician about its use and side effects.

In addition, other drugs are nifedipine which is used for HAPE and dexamethasone which is used for HACE. But remember not to take medicine indiscriminately.

A few more points on AMS:

The HRA does not recommend taking any drugs to try and prevent AMS for the usual trekking routed in Nepal. It is safer to rely on a planned slow ascent. You should not plan to go to higher altitude if you have heart disease, difficulty breathing at sea level or are pregnant. For other chronic medical conditions, consult your physician. Acute mountain sickness can occur when your body does not have enough time to adjust to the lower levels of oxygen and air pressure at higher altitudes. This can happen when you travel by plane, drive or hike up a mountain, or go skiing. Your level of exertion can also play a role. For instance, pushing yourself to hike up a mountain quickly can cause acute mountain sickness.

In summary, if you are not doing well at altitude, most likely have some mild symptoms of AMS. Rest at the same altitude, until you feel well. If you are getting worse at the same altitude, descend to at least the last point at which your fest well. If you are not sure of the diagnosis, err on the side of being too cautious. Remember severe altitude sickness is entirely preventable if you follow these guidelines.

Twenty years of hiking, touring, and peak climbing in the Himalayas of Nepal. Regarding our guide featuring descriptions of over a hundred distinct trekking routes in Nepal… Please get in touch with us if you are considering a tour, trek, or peak climbing in Nepal. You can view our website at www.ascendhikes.com to find your ideal adventure destination. At the conclusion of every tour and trekking schedule, there are links to the most recent tour, trekking, and climbing in addition to the complete itineraries. A growing number of them are also connected to Nepal trip, trekking, and climbing photography.
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