What is AMS?
Acute Mountain Sickness also called Altitude Motion Sickness or Mountain Sickness is a symptom that can strike if you walk or climb to a higher altitude too quickly. Trekkers, hikers, skiers and adventurers are some who can suffer from AMS. It occurs at about 8000 feet or 2400 meters above sea level. In most cases of altitude sickness it is mild and heals quickly. However in rare cases, it can become severe and causes complications with the lungs or brain.
What causes AMS?
Basically the main causes of AMS are high altitudes and lower levels of oxygen and air pressure. In little technical language the pressure of the air that surrounds you is called barometric pressure, so when you go to a high altitude, this pressure drops and the oxygen level also decreases and causes AMS. Your level of exertion also plays a role here, pushing yourself to quickly to trek a mountain may lead to mountain sickness.
If you live in a place which is located in a high altitude region, then your body gets used to that. But in case you are traveling to a place and trekking or walking to a high altitude region, in that case your body will need some time to adjust to the change in the pressure.
Types of AMS?
There are three types of Acute Mountain Sickness:
- Acute Motion Sickness – It is the mildest and most common form of AMS. It will heal quickly as well. Some common symptoms are headache, dizziness, nausea.
- High Altitude Pulmonary Edema – Abbreviated as HAPE, it is a buildup of fluids in the lungs that is dangerous and life threatening.
- High Altitude Cerebral Edema – Abbreviated as HACE, is the most severe form of altitude sickness and happens when there’s fluid in the brain. It is again severe and life threatening. You will need to seek medical attention as soon as possible.
Symptoms of AMS?
The symptoms of Acute Mountain Sickness appear within hours of moving to a higher altitude. Some of the common mild symptoms are:
- Problem in breathing while walking
- Loss of appetite
- Muscle aches
- Swelling of hands, feet and face
These AMS symptoms usually come within 12 to 24 hours of reaching a high altitude but do get better within a day or two since your body adjusts to the change in the altitude.
In some cases you might feel few of the moderate altitude sickness problems and these symptoms will be more intense and will not improve with the medication. Now this is a sign that you should stop and search for a doctor because the condition might get worse. Sometimes mild sickness can lead to severe mountain sickness and can affect your lungs, brain and nervous system. Some of the symptoms for severe form of altitude sickness like HAPE or HACE are:
- Lack of balance or difficulty in walking
- Chest congestion
- Skin discoloration
- Confusion due to brain swelling
- Shortness of breath even at rest
- Cough with white or pink frothy substance
In case of severe symptoms you will need medical attention as soon as possible. You can avoid these severe issues by taking precautions and giving attention if you feel any of the above mild symptoms.
Treatment of AMS?
Treatment of acute mountain sickness can vary depending upon the severity. If you get any symptoms associated with altitude sickness within a day or two of change in altitude, you can avoid complications by simply returning to a lower altitude. If you know the symptoms of acute mountain sickness, it will help in seeking the treatment early while the condition is mild. Medical attention or a doctor will be necessary in case severe one or if you have brain swelling or fluid in your lungs. Doctor will need to take an MRI or a CT scan of your brain to check for fluid or an X-ray of your chest. You might require oxygen in case you are having breathing issues.
There are few medications which you should always carry in your first aid box while preparing for your trek. We have already mentioned to make a checklist for all the necessary items required including first aid.
Few medications for acute mountain sickness includes:
- Acetazolamide (correct breathing problems)
- Blood pressure medicine
- Dexamethasone (decrease brain swelling)
- Aspirin (for headache relief)
- Lung inhaler
We can also take few basic measurements to deal with acute mountain sickness, including:
- Returning to a lower altitude
- Reduce the level of activity
- Hydrate properly with water
- Resting before moving to a higher altitude (can vary from one day to two days)
Preventions for AMS?
You can surely take some important preventive steps to reduce the changes of acute mountain sickness. The best way is through acclimatization, which means you let your body get used to the changes in altitude or air pressure before your travel to high altitudes. You can also study and learn about the symptoms, in case the mountain sickness occurs, you can treat it quickly. When you are trekking to a high altitude make sure you climb gradually, it helps your lungs to get more air and allows your blood cells to carry oxygen to different parts of your body. Moreover before climbing to an altitude of let’s say 10,000 feet make sure you consult your doctor about acetazolamide. It is a medication which eases your body’s adjustment to high altitudes. Taking the medicine before the day of your summit or during the initial days of your trek can lessen the symptoms of acute mountain sickness.
Here are a few things you can do to prevent yourself from acute mountain sickness.
Whenever you are going on your next trek which is above 10,000 feet, make sure you climb slowly. Since your body is not used to the high altitude and low air pressure, hence it will take atleast a day or two(or maybe three) in order to get used to these changes. Avoid climbing to high altitudes on the first of your trek. Rather, go up higher each day, make stop to rest and then continue again the next day. Climb at a pace which is comfortable for you. Do not get influenced by others, walking fast or pushing your body in an activity that is too strenuous, may lead to mountain sickness.
In addition, my personal advice would be to walk slow and make necessary stops whenever required during the trek. Do not rush, it’s not a race. Even if you are the last one to reach in your group, you won’t lose out on anything. You can also make some plans for your group before heading out in the wild. You can do something like, you will cover upto 1,000-1,200 feet each day and will take a proper day rest after 3,000-3,500 feet before you go higher. This will make your trek easy and also everyone will be able to enjoy it without any worries about mountain sickness, although there can be some exceptions because at the end everybody’s body is different and has different capabilities.
The mountain sickness usually gets worse at night when you are sleeping. You should climb high and sleep low. If you are trekking let’s say 1,000 feet during the day, at night return to a lower altitude to sleep. This will let you have a sound sleep and you won’t have any problem while breathing.
There was an incident which took place during the trek of Indrahar Pass. I went there with a group and just before our last night of summit while we were sleeping, two of our trek mates got struck with the sickness and informed us that they were not able to breathe properly. We actually climbed and placed our camps without thinking about the effects of altitude sickness. It was too dark but someone we managed by asking them to take some fresh air and asking them to drink water sip by sip. It helped but the situation was really tough at 2 at night.
Usually as we say medication should not be given ahead of time but however it is opposite in case of trekking. You will need to take this medicine two days before your trip and before the day of your summit. In case of mountain sickness problems, acetazolamide is the medicine which can help in preventing altitude sickness.
Acetazolamide is the former brand name of Diamox and typically used to treat glaucoma. But because of its work, it can also help in mountain sickness. But before taking the medicine, make sure you have a prescription from your doctor. Although use of this medicine is no surety that you won’t suffer from altitude sickness. In case you do feel the symptoms, getting yourself to lower altitude is the only effective treatment.Always know how to identify the first signs of altitude sickness and immediately move down if you feel these symptoms.
Keeping your body hydrated is very essential. Not only on normal days but also when you are doing any exercise or for that matter trekking. Water is very essential for the body. Staying hydrated is very important in preventing altitude sickness. You need to drink water regularly during your entire trek. Keep a daily target on the trek to drink a minimum of 3-4litres of water. Always carry your own water bottle in your backpack and make it a habit of filling it whenever you get a chance or water sources. Carrying a bottle might add load to the backpack but is certainly worth loading, do not rely on others. I myself have a habit of carrying a 1 litre bottle for each trek and by carrying my own I can sip water whenever I stop for a break during the trek.
During your normal routine, we are educated to eat carbs in a limit because it is the main reason for increase in weight and yes fat too adds to it. But it is again the opposite during the trek. We should eat a lot of carbs during the trek and less protein. Protein takes more time to break down plus uses more energy. On the contrary, carbs can be easily broken down and supply more energy to the body for performing various activities. At high altitudes we need more calories so always pack plenty of healthy snacks including whole grain. About 70% of your calories will come from carbs during the trek.
It is always a good option to avoid certain things which can harm your body and alcohol is one of them. Although alcohol taken in a certain quantity does benefit. However whenever you are on trek please avoid alcohol, cigarettes, tobacco and medications like sleeping pills. These things can make the situation worse. If you want to have a drink then wait for atleast 48hours and give your body some time to adjust to the altitude before adding alcohol to the list.
Above were some of the measures which you can take to prevent acute mountain sickness to a certain level. However it is very hard to predict exactly how your body will react to high altitudes. As a beginner and unknown about your own capabilities my suggestion would be to not to climb too fast and be prepared by practicing the tips included above. In case of any existing medical condition like heart problems, diabetes or asthma, always consult your physician or doctor before trekking to high altitudes. These existing problems can lead to more complications if you happen to get acute mountain sickness. Be ready for the challenge but face it wisely.
HAPPY TREKKING TO ALL.