Altitude Sickness
The following article was developed by reviewing various articles published on this topic. Their absolute accuracy can not be determined.
Researched and Prepared by:
Lou Sclafani
ALTITUDE or MOUNTAIN SICKNESS
Altitude or Mountain Sickness is a health issue that effects most travelers heading to higher elevations. Symptoms begin to occur in some people at an altitude of as low as 8,000 feet, but serious symptoms do not usually occur until over 12,000.
When researching altitude sickness you may come across a number of other names and related illnesses. Let’s look at what they might be called.
Acute Mountain Sickness or AMS. AMS may be sub categorized as Mild, Moderate and Severe. More severe cases are known as High Altitude Pulmonary Edema (HAPE) and
High Altitude Cerebral Edema (HACE). For now, let’s just say that HAPE and HACE are much more severe and just talk about Mild AMS and ways to prevent it and to deal with it.
The symptoms of mild AMS include Headache, Nausea & Dizziness, Loss of Appetite, Fatigue, Shortness of Breath, Disturbed Sleep and a General Feeling of Malaise. The onset of these symptoms usually start 12 to 24 hours after arrival at higher altitudes and tend to be worse at night when your respiratory drive is decreased. These symptoms begin to decrease in severity around the second or third day.
Why do we get AMS? It is difficult to determine who may be affected by AMS sine there are no specific risk factors such as age, sex, or physical condition that correlate with susceptibility. It’s strictly based on how fast you ascend not necessarily how high you ascend. While a physically fit person is no more susceptible than a less fit person, the fact that a fit person may race to the top is what makes the fit person more likely to be affected by AMS.
It’s a simple case of there being a lower barometric pressure at higher altitudes which in turn means fewer Oxygen molecules are being inhaled per breath. It’s probably not that important for the average skier to know about the % of oxygen, and measurement of air pressure in mmHg that we are talking about here, but they should be aware that the higher the altitude the worse it gets. Perhaps you have heard the term “thin air”? That’s what we’re talking about.
Since the main cause of AMS is going too high too quickly, the main way to avoid it is to ascend slowly. This will allow your body to acclimate itself to the higher elevations. That’s why mild AMS seems to go away by the third day (unless you hit the all you can eat buffet at Taco Tony’s). Being the sea level flat landers from Florida that we are, we’re probably more affected by AMS than someone who lives year round at a seemingly modest elevation of four or five thousand feet. These people are already partially acclimated but even they will need to be acclimated to even higher altitudes.
What can you do before you leave for the mountains to help prevent the effects of AMS? Here are a few suggestions:
• Stay hydrated. Drink plenty of water. 3-4 quarts of water a day are recommended. If you are just beginning to drink this much water you should start at least two weeks prior. Consumption of extra water will cause excessive trips to the rest room and your body will need to acclimate to this as well. A couple of weeks should do it. Besides the inconvenience, if you wait until you get to the mountain those extra trips to the rest room may cause dehydration as well.
• For at least 72 hours prior, avoid alcohol, coffee, soda, smoking, sleeping pills and narcotics. OK, you may not be able to cut out completely the alcohol or coffee but you should cut back. Excess consumption of alcohol and coffee promotes dehydration (bad), the carbon dioxide in soda interferes with oxygen in your bloodstream (bad), smoking makes it more difficult to get oxygen to your blood (bad) and the drugs, well the drugs are just bad. All may decrease ventilation, intensify hypoxia and make symptoms worse.
• Before the trip maintain a good work/rest cycle, avoiding excessive work hours and last minute packing.
• Avoid heavy exercises. Mild exercises are OK.
• Consult with your physician. There are a number of medications the Doctor may prescribe. These include Diamox and Dexamethasone as a preventative.
Once you have left for the mountains there are a few more things you can do:
• If possible you should tier or stage your steps to higher elevations.
• Don’t over do it. Plan on minimal activities your first day.
• Ascend in stages of about 1,000 feet per day.
Despite your pre-trip efforts you may still feel the effects of AMS. In this case there are a number of treatments that you can try.
• Drink more water. You can’t get enough! Breathing dry air at altitude greatly increases water loss and promotes dehydration. Dehydration increases the severity of AMS.
• Avoid extra salt. It’s the dehydration thing.
• Try Aspirin, Tylenol or Ibuprofen for the headache.
• Try Ginko Biloba extract for increased peripheral blood flow.
• While at a higher altitude eat a high carbohydrate diet. The heck with Atkins here. About 70% of you caloric intake should be from easily digested carbohydrates such as fruits, jams and starches (rice and pasta). Eat frequently (5 times per day)
• Return to a lower altitude.
• Seek medical treatment. A qualified physician may prescribe a number of medications and treatments that may include 100% Oxygen, Diamox (acetazolamide), Procardia (nifedipine), Decadron (dexamethasone), Compazine (prochlorperazine), Phenergan (promethazine) or Lasix (frusemide). A trip to a hyperbaric chamber or the use of a Gamow Bag may also be appropriate. These treatments though are usually reserved for more serious cases of Altitude Sickness and should only be initiated by a qualified and licensed physician. They are mentioned here only as a resource so you may discuss these options with your physician. Dosages and strengths vary from case to case. Please do not try and self medicate.
Hopefully with a few precautions and some tips on dealing with the symptoms of AMS, we can enjoy the precious little time available to us on the mountain as opposed to laying around sick in our hotel room (or worse) all week.
There are a number of articles available on the internet on this subject. A few of those are listed below. Feel free to browse through them and read about AMS for yourself.
http://www.skimag.com/skimag/fitness/article/0,12795,325797,00.html
http://www.personal.usyd.edu.au/~gerhard/pressure.html
http://www.traveldoctor.co.uk/altitude.htm
http://www.princeton.edu/~oa/safety/altitude.html
http://www.merck.com/mrkshared/mmanual/section20/chapter281/281a.jsp
http://www.medformation.com/ac/crssma.nsf/file/crs-sma-sma_altitude.sickness
http://www.emedicine.com/emerg/topic22.htm
http://www.mdtravelhealth.com/illness/altitude_sickness.html
http://www.nrel.gov/altitude.html
http://www.ciwec-clinic.com/altitude/
http://www.chclibrary.org/micromed/00036940.html.
