Conquering Altitude Sickness: Understanding, Preventing and Treating the Effects of High Altitude

Trekking in the Himalayas can be an unforgettable experience, but it can also be dangerous if you’re not properly prepared for the altitude. Acute Mountain Sickness (AMS) is a condition that can occur at high altitudes, typically above 8,000 feet (2,500 meters). It is caused by the lower air pressure and lack of oxygen at high altitudes. Symptoms include headache, fatigue, shortness of breath, nausea, and insomnia. In severe cases, it can lead to fluid buildup in the lungs or brain, which can be fatal if not treated promptly. 

Which leads us to HAPE (High Altitude Pulmonary Edema) and HACE (High Altitude Cerebral Edema), both are serious forms of altitude sickness that can occur at high elevations.HAPE is a condition in which fluid builds up in the lungs, making it difficult to breathe. Symptoms include shortness of breath, a cough that produces frothy sputum, chest tightness, and rapid breathing. HAPE can be fatal if not treated promptly.

HACE is a condition in which fluid builds up in the brain, causing swelling and pressure on the brain. Symptoms include headache, confusion, difficulty walking, and loss of coordination. HACE can also be fatal if not treated promptly. Both HAPE and HACE are considered medical emergencies and require immediate descent to lower elevations and medical attention. It is important to note that these conditions can occur even if the person did not have symptoms of Acute Mountain Sickness(AMS) before.

Here are some tips to help you prevent AMS while trekking in the Himalayas:

1. Acclimatize: The key to preventing AMS is to give your body time to adjust to the change in altitude. Plan your trek so that you have at least a couple of days to acclimatize before attempting to reach higher elevations. Wilderness Medical Society (WMS) recommends that with travel above 3000 m, individuals should not increase their sleeping elevation by more than 500 m per day and should include a rest day (ie, no ascent to higher sleeping elevation) every 3 to 4 d. The increase in sleeping elevation should be less than 500 m for any given day of a trip (Luks et al., 2019). This allows the body to acclimatize and reduces the risk of developing symptoms of AMS. It’s also important to note that individual factors such as age, fitness level, and pre-existing health conditions can affect a person’s ability to acclimatize, so it’s important to consult with a doctor or trekking guide with experience in high altitude medicine before planning your trek.
2. Hydrate: Staying hydrated is essential for preventing AMS. Be sure to drink plenty of water and avoid alcohol and caffeine, which can dehydrate you.
3. Pace Yourself: It’s important to take it slow and not try to ascend too quickly. This will give your body time to adjust to the altitude and reduce the risk of developing symptoms.
4. Watch for Symptoms: Be aware of the symptoms of AMS and if you begin to experience them, descend to a lower elevation as soon as possible.
5. Consult a Professional: Consult with a trekking guide or a doctor with experience in high altitude medicine before planning your trek. They can provide you with advice and tips on how to stay safe and prevent AMS and other forms of altitude sickness. There are several medications that can be used to treat AMS, HAPE and HACE:
   • Acetazolamide (brand name Diamox) is a medication that can be used to prevent and treat AMS by increasing the excretion of bicarbonate and allowing the body to better adapt to the lower levels of oxygen at higher altitudes.
   • Nifedipine (Procardia) is a medication that can help to prevent and treat HAPE by dilating the blood vessels in the lungs, which allows for better blood flow and oxygenation.
   • Dexamethasone (Decadron) is a steroid medication that can help to reduce inflammation and swelling in the brain, making it useful in the treatment of HACE.

It’s important to note that these medications should only be used under the guidance of a medical professional, and should not be used as a substitute for proper acclimatization and other preventive measures such as ascending slowly, staying hydrated, avoiding alcohol, and watching for symptoms of AMS.

By following these tips, you can reduce your risk of AMS and enjoy a safe and memorable trek in the Himalayas. Remember to always listen to your body and never push yourself beyond your limits. Happy trekking!

Himalayan Adventure Labs (HAL) places a strong emphasis on the safety and well-being of our clients. To ensure that we provide the highest level of care, all of our guides are certified in Wilderness First Aid and/or Wilderness First Responder. This training equips our guides with the knowledge and skills needed to handle any medical emergencies that may arise in the wilderness. Additionally, we have access to a remote doctor who specializes in wilderness medicine. This allows us to provide prompt and expert medical advice and support, even in the most remote locations. 

References

Luks, A. M., Auerbach, P. S., Freer, L., Grissom, C. K., Keyes, L. E., McIntosh, S. E., Rodway, G. W., Schoene, R. B., Zafren, K., & Hackett, P. H. (2019). Wilderness Medical Society Clinical Practice Guidelines for the prevention and treatment of acute altitude illness: 2019 update. Wilderness & Environmental Medicine, 30(4). https://doi.org/10.1016/j.wem.2019.04.006