altitude_sickness_symptoms_and_prevention

What Exactly Is Altitude Sickness?

Altitude sickness—also called acute mountain sickness (AMS)—is the body’s reaction to **reduced air pressure and lower oxygen levels** above 2,400 m (8,000 ft). The higher you climb, the less oxygen each breath delivers, forcing your heart, lungs, and brain to work harder. If the ascent is too rapid, the body cannot adjust quickly enough, and symptoms appear. ---

How Do I Know I Have AMS? Early Warning Signs

**Mild AMS** feels like a bad hangover: - Throbbing headache that worsens at night - Nausea or vomiting - Fatigue despite adequate rest - Dizziness when standing up quickly - Disturbed sleep or frequent waking **Moderate to severe AMS** adds: - Persistent dry cough - Shortness of breath at rest - Loss of coordination (ataxia) - Swelling in hands, feet, or face Ask yourself: “Do I feel worse today than yesterday at this elevation?” If the answer is yes, **descend immediately**. ---

Can Altitude Sickness Become Life-Threatening?

Yes. Two dangerous complications can develop within hours: - **High-Altitude Cerebral Edema (HACE):** Brain swelling leading to confusion, hallucinations, and coma. - **High-Altitude Pulmonary Edema (HAPE):** Fluid in the lungs causing frothy sputum, chest tightness, and blue lips. Both require **urgent descent and supplemental oxygen**. Waiting to “see if it passes” can be fatal. ---

Who Is Most at Risk?

- **Rapid ascenders** (e.g., flying from sea level to Lhasa) - People with **previous AMS episodes** - Individuals with **heart or lung disease** - **Young, fit males**—they often ignore early symptoms and climb faster - **Sleeping at high altitude** without acclimatization days Even Sherpas can suffer AMS if they ascend too quickly after time at sea level. ---

How Can I Prevent Altitude Sickness Before I Leave Home?

1. **Pre-acclimatize:** Spend 2–3 nights at 2,000–2,500 m if possible. 2. **Cardio training:** Boost aerobic capacity, but avoid overtraining that leaves you fatigued. 3. **Consult a doctor:** Ask about **acetazolamide (Diamox)**—125 mg twice daily, starting one day before ascent. 4. **Plan a flexible itinerary:** Build in rest days every 600–900 m of elevation gain. 5. **Pack a pulse oximeter:** Spot-check oxygen saturation; readings below 85 % at rest warrant attention. ---

On the Mountain: Daily Habits That Lower Risk

- **Climb high, sleep low:** Trek to a higher elevation during the day, descend to sleep. - **Hydrate aggressively:** 4–5 L of water daily; pale urine is the goal. - **Avoid alcohol and sedatives:** Both depress breathing and worsen hypoxia. - **Eat carbs:** Simple sugars and starches require less oxygen to metabolize. - **Monitor each other:** Use the “buddy system” to watch for personality changes or unsteady gait. ---

Does Diamox Really Work? Dosage and Side Effects

Diamox speeds up acclimatization by **increasing ventilation and blood pH**. - Standard dose: 125–250 mg twice daily, beginning 24 h before ascent. - Common side effects: Tingling fingers, carbonated drinks taste flat, increased urination. - **Not a substitute for gradual ascent**—you can still get AMS while on Diamox. - Contraindications: Sulfa allergy, kidney disease, pregnancy. ---

What If Symptoms Appear? Step-by-Step Response

1. **Stop ascending** until symptoms resolve. 2. **Rest, hydrate, and take ibuprofen** for headache. 3. **Administer oxygen** from a canister or concentrator if available. 4. **Descend 300–500 m** if symptoms persist or worsen. 5. **Evacuate immediately** if ataxia, confusion, or frothy sputum develop. ---

Portable Hyperbaric Chambers: Do They Replace Descent?

A **Gamow bag** mimics descent by increasing air pressure inside the chamber. It buys time—usually 2–4 hours—until evacuation is possible. It is **not a cure**; descent remains the definitive treatment. ---

Children and Altitude: Special Considerations

- Children under two have **immature ventilatory responses** and should avoid sleeping above 3,000 m. - Older kids can follow adult guidelines, but **watch for irritability or loss of appetite**—their verbal skills may be limited. - Bring familiar snacks; calorie intake often drops at altitude. ---

Altitude Myths Debunked

- **“I’m fit, so I won’t get AMS.”** Fitness does not protect against AMS; rate of ascent does. - **“Caffeine causes dehydration.”** Moderate coffee intake is safe and may even help ventilation. - **“Local remedies like coca leaves cure AMS.”** They may ease symptoms but do not speed acclimatization. - **“Sleeping pills help you rest.”** Benzodiazepines suppress breathing and can trigger HAPE. ---

Post-Trek: When Can I Fly Home?

Wait **at least 24 hours after descending** before boarding a long-haul flight. Residual fluid shifts can worsen jet-lag fatigue and mask lingering AMS. Use the time to rehydrate, eat iron-rich foods, and monitor for recurring headaches. ---

Key Takeaway Checklist

- **Ascend slowly:** No more than 300–500 m net elevation gain per day above 3,000 m. - **Listen to your body:** Headache + nausea = stop and reassess. - **Carry a first-aid kit:** Include Diamox, ibuprofen, oral rehydration salts, and a pulse oximeter. - **Never ascend to sleep at a higher elevation while symptomatic.** - **Descent is the best medicine.**