Everyone going to altitude is potentially at risk. Altitude sickness or Acute Mountrain Sickness (AMS) is a very real problem that kills people every year. Many people feel somewhat off colour if they travel directly by plane or train from sea level to altitudes above 3500m (11500 feet).
Most problems occur between 8000 to 13000ft (13000 – 18000 is usually only reached by serious climbers) 80 – 90% of travellers will develop AMS if they ascend too rapidly to 5000m (16400ft). Acute Mountain Sickness is a result of the depleted level of oxygen at altitude. As you ascend there is less oxygen available in the air to breathe, this places strain on the body. Given time the body can adjust to these depleted levels.
Prevention
The fit and healthy may be more at risk of developing AMS. If either traveller ascends too quickly due to fitness levels or flying into destinations AMS may develop as inadequate time has been allowed for the body to acclimatise.
Reputable tour companies will be aware of AMS – listen to their advice – tragedies have occurred when people have pushed on regardless
Familiarise yourself with signs and symptoms
The question of ‘how high how fast’ – is difficult to answer because of individual responses however – healthy people under 65 years may travel rapidly to altitudes up to 3500m though some people will develop mild symptoms of AMS. Above this height the speed of further height gain should be gradual.
Spending a few days – a week before ascending further is sensible. If any symptoms of AMS persist you should descend and seek medical attention.
Acute Mountain Sickness is usually a self-limiting condition without serious long-term consequences.
Malignant AMS: This is a severe form of Altitude Sickness that could be potentially fatal if not treated correctly.
It is not possible to predict who will develop Altitude Sickness. Patients with heart disease, lung disease, high blood pressure, and the elderly should seek specialist advice if they plan trips above 4000m.
Signs and Symptoms
Headache
Fatigue
Nausea
Loss of appetite
Difficulty sleeping
Un-due breathlessness on exertion
Sensation of the heart pounding
1. Pulmonary
Caused by fluid building up in the lungs – the symptoms are:
Severe breathlessness after exercise or even at rest (this can come on in a matter of minutes)
Coughing – with white or frothy pink sputum
Blueness of the lips
2. Cerebral
Caused by fluid building up in the brain the symptoms are:
Headache (sometimes with double vision)
Unsteadiness on the feet
Unusual behaviour/drowsiness which may lead to coma
Treatment
Drugs and oxygen have little part to play in the treatment. The best treatment is to descend. The sufferer may be irrational and not in a position to help themselves. They must be brought down AS SOON AS POSSIBLE. Even 1000ft can help. Descent by 2000-3000ft can bring rapid relief. DO NOT WAIT FOR A HELICOPTER. DIAMOX (Acetazolamide) – this drug reduces fluid retention and can help prevent AMS. It must be started at least 3 days before ascent. In a dose of one 250mg tablets twice daily. Side effects include nausea and tingling in the fingers.