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Attitude Sickness

Many people are concerned about altitude sickness. This problem, often known as Acute Mountain Sickness (AMS) is a particularly important medical consideration while trekking in Nepal and Tibet. Altitude illness rarely occurs lower than 2800 meters (9520ft ) and only minor symptoms occur below 3000 meters (9,800ft). AMS occurs when the body does not adapt well to less oxygen at higher altitudes. At 18,000 ft (5490m), there is one half the oxygen available as at sea level; on top of Mount Everest, only one third. The body tries to adapt to less oxygen by increasing the rate and depth of breathing, as well as the heart rate. Individual susceptibility to altitude sickness seems to be genetically determined

 

Altitude sickness, also known as acute mountain sickness (AMS), is a common condition that can occur when ascending to high altitudes too quickly. In severe cases, it can lead to more serious conditions like high altitude pulmonary edema (HAPE) and high altitude cerebral edema (HACE). Here’s some information on altitude sickness, HAPE, and HACE, including symptoms, prevention measures, and medications to consider:

1. Altitude Sickness (AMS):
– Symptoms:
– Headache (often the first symptom)
– Fatigue and weakness
– Dizziness or lightheadedness
– Nausea or vomiting
– Loss of appetite
– Shortness of breath
– Difficulty sleeping
– Swelling of hands, feet, or face
– Rapid heartbeat
– Prevention Measures and Measures to Take:
– Gradual Acclimatization: Ascend gradually, allowing your body time to adjust to the changing altitudes.
– Hydration: Drink plenty of fluids, mainly water, to stay hydrated.
– Proper Nutrition: Maintain a balanced diet, eat small, frequent meals high in carbohydrates.
– Rest and Pace: Take regular rest breaks, avoid overexertion, and maintain a steady pace.
– Avoid Smoking, Alcohol, and Sedatives: Smoking, excessive alcohol consumption, and sedatives can worsen symptoms.
– Descend if Symptoms Worsen: Descend to a lower altitude if symptoms worsen.

2. High Altitude Pulmonary Edema (HAPE):
– Symptoms:
– Severe shortness of breath, even at rest
– Persistent cough, possibly with pink or frothy sputum
– Weakness and fatigue
– Chest tightness or congestion
– Rapid heartbeat
– Bluish coloration of lips or nails (cyanosis)
– Prevention Measures and Measures to Take:
– All the prevention measures for altitude sickness (AMS) listed above.
– Ascend gradually and avoid rapid ascent.
– Be aware of personal susceptibility to HAPE, as it can be hereditary.
– Descend immediately if symptoms of HAPE develop.

3. High Altitude Cerebral Edema (HACE):
– Symptoms:
– Severe headache that does not respond to painkillers
– Confusion, disorientation, or loss of coordination
– Nausea and vomiting
– Fatigue and weakness
– Seizures
– Loss of consciousness
– Prevention Measures and Measures to Take:
– All the prevention measures for altitude sickness (AMS) listed above.
– Ascend gradually and avoid rapid ascent.
– Descend immediately if symptoms of HACE develop.

Medications to Consider:
1. Acetazolamide (Diamox):
– Acetazolamide is a medication that can help prevent and alleviate symptoms of altitude sickness. Consult with a healthcare professional for dosage and potential side effects.

2. Nifedipine:
– Nifedipine is a medication that can be considered for preventing and treating HAPE. Consult with a healthcare professional for dosage and potential side effects.

It’s important to note that altitude sickness, HAPE, and HACE can be serious conditions, and severe cases may require immediate medical attention. If you experience severe symptoms or symptoms that worsen despite preventive measures, it’s crucial to descend to a lower altitude and seek medical assistance.

Always consult with a healthcare professional before taking any medications, and discuss any pre-existing medical conditions that may affect your ability to tolerate high altitudes. Additionally, it’s essential to plan your ascent carefully, follow the guidance of experienced guides, and be aware of any altitude-related risks associated with your trekking route.

 

What happens to the body during altitude illness?

During high altitude illness, the body experiences various physiological changes and challenges due to the decreased oxygen levels and reduced air pressure at higher altitudes. Here’s an overview of what happens to the body during high altitude illness:

1. Altitude Sickness (Acute Mountain Sickness – AMS):
– The body experiences a decrease in oxygen saturation in the blood due to lower oxygen availability at higher altitudes.
– The reduced oxygen levels trigger physiological responses, including increased breathing rate (hyperventilation) and increased heart rate (tachycardia), in an attempt to compensate for the lower oxygen levels.
– The body undergoes fluid shifts, resulting in increased urine production and increased fluid loss through respiration, which can lead to dehydration.
– The brain’s blood vessels may dilate, causing headaches, nausea, and other symptoms associated with altitude sickness.

2. High Altitude Pulmonary Edema (HAPE):
– In HAPE, the body’s response to low oxygen levels leads to constriction of blood vessels in the lungs, resulting in increased pressure in the pulmonary arteries.
– The increased pressure causes fluid leakage from the blood vessels into the lung tissues, leading to pulmonary edema (fluid accumulation in the lungs).
– This can cause shortness of breath, coughing, chest tightness, and difficulty in breathing.

3. High Altitude Cerebral Edema (HACE):
– In HACE, the body’s response to low oxygen levels may lead to the swelling of brain tissues.
– The brain’s blood vessels may dilate, causing increased blood flow and pressure in the brain.
– The increased pressure can result in neurological symptoms, such as severe headache, confusion, loss of coordination, and, in severe cases, loss of consciousness and coma.

These conditions can occur when ascending to high altitudes too quickly without proper acclimatization. It’s important to note that individuals respond differently to high altitude, and the severity of symptoms can vary. Some people may be more susceptible to altitude illness than others.

The key to managing high altitude illness is gradual acclimatization, allowing the body time to adjust to the changing altitude. It is crucial to ascend slowly, stay well-hydrated, maintain a balanced diet, and be aware of any symptoms that may indicate the onset of altitude sickness, HAPE, or HACE. Descending to lower altitudes is the primary treatment for severe cases of high altitude illness.

If you plan to travel to high altitudes, it’s advisable to consult with a healthcare professional and seek guidance from experienced trekking guides who can provide you with the necessary information and support to ensure a safe and enjoyable experience.

Prevention of Altitude Illness:

Preventing altitude illness is crucial to ensure a safe and enjoyable experience when traveling to high-altitude destinations. Here are some key preventive measures to consider:

1. Gradual Acclimatization:
– Ascend gradually to allow your body time to adapt to the changing altitude. Avoid rapid ascents, particularly when climbing above 3,000 meters (9,800 feet).
– If possible, plan rest days during your ascent to allow your body to adjust and acclimatize to the altitude.

2. Hydration:
– Stay well-hydrated by drinking plenty of fluids, mainly water. Dehydration can increase the risk and severity of altitude illness.
– Avoid excessive alcohol consumption as it can contribute to dehydration and worsen altitude symptoms.

3. Proper Nutrition:
– Maintain a balanced diet and eat small, frequent meals that are high in carbohydrates. Adequate nutrition helps support your body’s energy levels and overall well-being at high altitudes.

4. Slow and Steady Pace:
– Ascend at a slow and steady pace, especially when climbing to higher altitudes. Avoid rushing and overexertion, as this can increase the risk of altitude illness.
– Listen to your body and rest when needed during the ascent. Pay attention to any early symptoms of altitude illness and communicate them with your travel companions and guides.

5. Medications:
– Consider discussing the use of medication with your healthcare professional. Acetazolamide (Diamox) is a common medication used to prevent and alleviate symptoms of altitude sickness. It helps stimulate breathing and aids in acclimatization. However, it should be taken under medical supervision and as directed.

6. Avoid Alcohol and Sedatives:
– Alcohol and sedatives can depress the respiratory system and worsen altitude illness symptoms. It’s advisable to avoid or minimize their consumption while at high altitudes.

7. Adequate Rest and Sleep:
– Ensure you get sufficient rest and sleep during your trek. Proper rest allows your body to recover and adapt to the altitude.

8. Know the Symptoms:
– Educate yourself about the symptoms of altitude illness, including acute mountain sickness (AMS), high altitude pulmonary edema (HAPE), and high altitude cerebral edema (HACE). Recognize the signs and symptoms, and take appropriate action if they occur.

9. Listen to Local Guides and Experts:
– Seek guidance from experienced trekking guides who are familiar with the region and altitude-related risks. They can provide valuable advice and monitor your well-being throughout the journey.

Remember, prevention is key, and it’s essential to prioritize your health and safety when traveling to high-altitude destinations. If symptoms of altitude illness persist or worsen despite preventive measures, it’s important to descend to a lower altitude and seek medical attention promptly.

 

First Aid Medical Kit:

When traveling to high-altitude destinations, it’s important to be prepared for potential altitude-related illnesses and other medical concerns that may arise. Here’s a list of additional items to consider including in your first aid medical kit for high-altitude travel:

1. Altitude Sickness Medications:
– Acetazolamide (Diamox): Consult with a healthcare professional to determine if it’s appropriate for you to carry and use acetazolamide for prevention or treatment of altitude sickness.
– Nifedipine: Another medication that may be prescribed for prevention or treatment of high altitude pulmonary edema (HAPE). Consult with a healthcare professional for guidance.

2. Oximeter:
– An oximeter measures blood oxygen levels and can be useful for monitoring your oxygen saturation at high altitudes. This can help identify potential oxygen deficiency or the need for medical attention.

3. Prescription Medications:
– If you have any personal prescription medications, ensure you have an adequate supply for your entire trip, including any additional days in case of unexpected delays.

4. Dexamethasone:
– Dexamethasone is a prescription medication that may be used in emergency situations for the treatment of severe altitude sickness, particularly high altitude cerebral edema (HACE). It should only be administered under medical supervision.

5. Insect Bite Treatment:
– Insect repellent (with a high DEET concentration) to prevent mosquito bites, which can transmit diseases like malaria or dengue fever.
– Antihistamine cream or oral antihistamines for relief from insect bites or allergic reactions.

6. Sun Protection:
– Sunscreen with a high SPF to protect your skin from the intense sun at higher altitudes.
– Lip balm with SPF to protect your lips from sunburn and dryness.
– Wide-brimmed hat and sunglasses for additional sun protection.

7. Additional Supplies:
– Extra supply of blister pads or moleskin to prevent and treat blisters that may occur during long hikes or treks.
– Oral rehydration salts or electrolyte packets to replenish fluids and minerals in case of dehydration.
– Over-the-counter pain relievers like acetaminophen or ibuprofen for headaches or muscle aches.
– Anti-diarrheal medication and rehydration solutions for digestive issues.
– Antibiotic ointment for wound care and prevention of infection.
– Disposable medical gloves.
– Sterile saline solution or eye drops for eye irritation due to dryness or dust.
– Medical tape and bandages suitable for high-altitude conditions.

Remember to familiarize yourself with the proper usage and potential side effects of any medications before your trip. It’s also important to consult with a healthcare professional or travel medicine specialist to ensure that the items in your first aid medical kit are appropriate for your specific needs and medical history. Additionally, follow the general preventive measures for altitude sickness mentioned earlier in this conversation.

 

Equipments : Sphygmomanometer (Blood pressure Instrument) / Stethoscope / Scissors/ Syringes (20 ml, 10 ml) / Thermometer / Tongue blades / Hot water bottle / Matchbox /Pen light / Pen and writing pad / Splints / cervical collar/ Bandages & Dressings : Sterile gauge pads (large and small) / Band aids / Triangular / Bandages / Elastic Bandages (3, 4 and 6 inches) / Adhesive Tapes / Eye pads / Cotton roll (large and small) / Q-tips / Safety pins / Medications

 

NOTE: All our guides trained at the High Altitude Medical Training Center. All Our staff is very experienced in dealing with the effects of higher altitudes. As they are natives of Nepal, they easily acclimatize and therefore can care for their clients. They are equipped with necessary medical supplies and will assist you with basic first aid treatment. We design our tours to ensure clients are ready for high altitude, and arrange alternative itineraries for those at risk

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