What is Acute Mountain Sickness or AMS?
When you think of trekking in the Himalayas then generally you will be trekking above 2800 metres or 9200 feet where it is common for Trekkers to experience some adverse health effects due to the High Altitude – regardless of your age, gender and fitness. It even happened to Sir Edmund Hillary. These ill effects are generally described as Acute Mountain Sickness (AMS) or Altitude Sickness and Nausea, Dizziness, Headache are common symptoms of the same.
Altitude sickness or Acute Mountain Sickness is the reaction of the body adjusting to decreasing amounts of oxygen. Normally, the higher the altitude, the less oxygen available for the body to carry on normal functions. Altitude sickness most commonly occurs from above 2,800 metres (9,200ft) but this is different for everyone – there is simply no way of knowing your own susceptibility prior to being at altitude thus it is vital you monitor your own health. Symptoms may be mild and subside/go away after a day’s rest, or if it is ignored it could lead to death.
What causes Acute Mountain Sickness?
Before your Trek in Himalayas
Some pre-existing medical conditions are known to severely worsen at high altitude and be difficult to adequately treat on the ground, leading to more serious consequences. It is imperative that you discuss your pre-existing medical condition/s with your doctor. We understand certain medications are reported to aid acclimatizing to high altitude. Please discuss these options with your doctor.
During your Trek:
Normally human body takes around 24 hours to acclimatize for 500 meters gain in altitude but sometimes we gain more altitude due to paucity of time or lack of good camp ground then we get the symptoms of AMS. While our trek leaders have basic first aid training and are aware of the closest medical facilities, it is very important that you are aware of the cause and effects of trekking at altitude, monitor your health and seek assistance accordingly.
What are the symptoms of Acute Mountain Sickness or AMS?
Symptoms can appear within 1-2 hours although most often appear 6-10 hours after ascent and generally subside in 1-2 days as the body adjusts to altitude. They may reappear as you continue to go higher. Symptoms usually occur gradually & can be one or a combination of the following:
- Loss of appetite
- Disturbed sleep or drowsiness
- Swelling of hands, feet & face
If the body is unable to adjust to altitude these symptoms will persist and, if they are left untreated, altitude sickness may progress to High Altitude Cerebral Edema (HACE) or High Altitude Pulmonary Edema (HAPE). Both can be fatal if ignored.
Symptoms of HAPE (fluid in the lungs):
- A dry cough, developing to a wet one with blood-tinged discharge or saliva.
- Tightness in the chest & blueness/darkness of face, lips & tongue
- Low fever up to 38°C/100°F
- Severe fatigue, progressing to coma
HAPE can occasionally develop without the usual symptoms of AMS – a telltale sign is breathing does not return to normal when at rest, it remains shallow, rapid and panting even after an extended period of inactivity, often accompanied by a cough.
Symptoms of HACE (fluid in the brain):
- Severe headache symptoms not relieved by painkillers or lying down
- Confusion, disorientation & drowsiness
- Loss of balance or coordination
- Blurred or double vision/retinal hemorrhage
Gamow Bag is used in treatment of acute mountain sickness (AMS) by artificially creating atomosphere of lower altitudes and this is done by increasing air pressure around the patient in a closed chamber. Gamow Bag can simulates descent of as much as 7,000 feet, thus relieving AMS symptoms.
Who is at risk for acute mountain sickness?
Although AMS can happen to any one but following will have the higher probability
- Quick gain in Altitude
- Physical Exertion
- Heart or Lung disease
- Low count of Red Blood cells
- Medications like Sleeping Pills, Narcotics etc
- Liquor & Smoking
- Previous Case of AMS
How to avoid Acute Mountain Sickness?
Certain medical conditions (such as respiratory disease) or medications (such as sleeping pills) can increase the risk of altitude sickness – it is important that you inform your trek leader of any medical conditions or medications before ascending to altitude.
You can help your body to acclimatize and avoid altitude sickness by:
- Drinking plenty of water – at least 4 liters per day on top of other forms of fluids such as tea or soups
- Avoiding alcohol, tobacco and substances that can interfere with good delivery of oxygen to the body or cause dehydration.
- Eating small, frequent meals high in carbohydrates.
- Taking it easy or have a regular break. Walk at a slower pace than you would at sea level and avoid over-exertion.
Treatment of Acute Mountain Sickness (AMS)
Most Trekkers are able to successfully acclimatize by following the previously mentioned guidelines. However, there are instances where medical treatment is required. Ultimately, the best treatment for acute altitude sickness is to descend to a lower altitude. There may be times when your trek leader makes the decision that you or a member of your group is at risk of serious altitude sickness and for safety insists that you cannot ascend further – please respect that they are within their rights to do so and are making that decision in the best interests of your health and well-being.
Lake Louis Scale
We recommend you to keep track of altitude related symptoms you may experience by completing the below chart from the first day you experience any altitude sickness symptoms. If you are experiencing any altitude sickness symptoms, we encourage you to discuss them with your leader straight away so you both can follow your acclimatization progress. However, should you rate the severity of any symptoms at 7 or more, or the symptoms continue/worsen after the initial 1-2 days, please inform your trek leader without delay, so that we can seek the advice of a trained medical professional if necessary.
Everyone will have a different perception of the severity of their symptoms, the key is to personally assess whether your symptoms are improving or worsening. A rough guide would be:
1 = Very minor symptoms that are causing no discomfort 5 = Moderate discomfort 10 = Extreme discomfort