Every year there are thousands of trekkers who make the journey around the world for the sole purpose of finding adventure in the higher altitudes. Adventure will certainly be found, but it comes along with dangers posed by such altitudes.
One such danger is Altitude Sickness, which if ignored or left untreated can be fatal. Trekkers, especially the ones who are trekking in higher altitudes for the first time, do not seem to realize this threat as one that can lead to certain death.
Because there are thousands of people who have successfully completed many different treks without much problem, they think it's easy and do not realize the gravity of the matter. Altitude Sickness is not the same for every individual!
THE GOLDEN RULES
There are three simple rules set by Dr. David R. Shlim that trekkers must follow:
1. If you feel unwell, you have altitude sickness until proven otherwise.
2. Do not ascend further if you have symptoms of altitude sickness.
3. If you are getting worse, then descend immediately.
Another important rule is – Learn the early symptoms of altitude sickness and know when you have them. Stay alert! There may be a person in the group with symptoms of altitude sickness.
Altitude sickness may hit you when you are above 2500 m (8000 ft) from sea level. There are three kinds of altitude sickness:
1. Acute Mountain Sickness (AMS)
2. High Altitude Cerebral Edema (HACE)
3. High Altitude Pulmonary Edema (HAPE)
One often sufferers from HACE and HAPE at the same time, making things even more complicated. HAPE and HACE have similar symptoms to AMS, but getting it means one has reached critical condition.
Acute Mountain Sickness (AMS)
If you suffer from mild AMS, it will feel like a hangover. However, you would not have had any alcoholic drink, so that's out of the question. Treat these headaches as AMS until proven otherwise. Remember the mantra – Prevention is better than cure.
AMS may just feel like a hangover, but you SHOULD NOT underestimate it. If left untreated, AMS can become HACE or HAPE in just a few hours, which in turn can cause death of the person within the next few hours. AMS should be taken as a warning sign that if you are careless and ignore it, you could suffer from either HAPE or HACE or worse, both!
– Lack of sleep
The best treatment for AMS is prevention. Walk at a slow pace and do not be in a rush to climb higher up. But, in case you suffer from AMS, here's what you do –
If you have mild AMS:
– Rest and DO NOT go any higher!
If you have severe AMS:
– DESCEND! DESCEND! DESCEND!
– Take Acetazolamide (Diamox) as prescribed
– Dexamethasone as prescribed
– Use oxygen or Pressure Bags if available
HIGH ALTITUDE CEREBRAL EDEMA (HACE)
HACE is where AMS has become severe. It's very uncommon that HACE would occur without a person suffering from AMS first.
In HACE, a person's brain is filled with fluids that should not be there, obviously! The fluids just increase the pressure of the brain and squeeze it, creating complications in a well-functioning brain. The person suffering from HACE may act out of his / her character not normal for them like being lazy, showing excessive emotions or even being violent!
– Severe headaches (even painkillers do not provide any relief)
– Acting out of character
– Drowsiness and unconsciousness moments before death
HIGH ALTITUDE PULMONARY EDEMA (HAPE)
HAPE is where a person's lungs are filled with excess fluids, making it difficult to breathe. Even when resting at high altitudes, it is NOT normal to suffer from breathlessness. This should be taken as a sign of HAPE, if a person is breathless even when resting.
HAPE starts normally after spending 24 – 48 hours in new altitudes. And this one often comes without getting AMS first.
– Can not lie flat
– Breathlessness even while resting
– Excessive breathlessness compared to physical activity
HACE and HAPE TREATMENTS
The best treatment for HACE and HAPE is prevention, walk at a slow pace and do not be in a rush to climb higher up. But, in case you suffer from either HACE or HAPE or worse- both, here's what you must do:
– DESCEND! DESCEND! DESCEND!
– Carry or at least help the victim get to a lower altitude
– Take Acetazolamide (Diamox) and Dexamethasone as prescribed
– Use Oxygen or Pressure Bags if available
– Further medical follow-up
FACTORS THAT RAISE THE CHANCES FOR ALTITUDE SICKNESS
If you are not careful, your chances of getting hit with altitude sickness increases. Below are a few of the factors that are likely to raise the risk of you getting altitude sickness:
– Individual vulnerability
– Climbing faster and higher than desired altitude
– Excessive physical exertion
– Drinking less water and fluids (cause for dehydration)
– Drinking alcohol, smoking or taking sleeping pills
MEASURES TO PREVENT ALTITUDE SICKNESS
The saying “Prevention is better than cure” is more apt here than anything else. The following measures are simple and highly effective for prevention of AMS:
– Do not ascend quickly to high altitudes
– Walk at a slower pace and rest for a long period to acclimatize every 2 to 3 days
– Drink more water and fluids (avoid being dehydrated)
– Avoid alcohol, sleeping pills and smoking
– Do not carry a heavy backpack
– Look after each other
– Stay alert for the symptoms of AMS
– Never leave or send a patient to lower altitude alone
THINGS THAT ARE COMMON IN HIGH ALTITUDES
There are certain things that one may show some concern over, but are normal for higher altitudes:
– A little puffy hands and feet
– Frequent need to pee
– Lack / poor quality of sleep
– A little faster and heavier breathing
– A bit faster heartbeat
– Regular dreams in sleep
It's not that we can not trek or even live in the high altitudes, thousands of trekkers and the locals who have adapted at those altitudes have provided that. But, the thing is, for us to be able to trek in high altitudes, our bodies need to get accustomed to the environment there, which might be completely different from where came from.
For adapting to high altitudes, our bodies need to make some adjustments to how it functions and these can adjustments might be made by breathing a bit faster, peeing more frequently, heart beating a bit faster and body making more red blood cells.
Thus, there are days for acclimatization, at different points in all the trails at higher altitudes while trekking.
Acclimatization is different for every individual. Some acclimatize in just one day and some may need two or more days, so take the time your body needs to adjust to new altitudes before heading to even higher altitude than you are at now.
Even the fittest and toughest of the group can suffer from altitude sickness as there is less oxygen and less pressure in the higher altitudes.
There is certainly a great adventure that can be found while trekking. But, one should certainly not take the dangers that come along with it lightly.
Here's a safe and adventurous trek!