Altitude Sickness Tips

By Dr Nitin Thapa, MD

 High Altitude Illness: How to avoid it and How to treat it

Every year millions of people go to the mountains for backpacking, skiing, mountain climbing and other activities. If you’re planning a trip to altitudes over 8000feet/2500metre, before you go, talk with your doctor about high-altitude illness, or mountain sickness as it is often called.

 

What causes high- altitude illness?

The low amount of oxygen in the air at high altitudes causes high-altitude illness. The amount of oxygen in the air goes down as you climb higher about sea level and becomes very low at altitudes above 8000feet/2500meter. If you travel to a high altitude, you may feel ill because the air has less oxygen in it. If you stay at a high altitude for a long time, your body gets used to the low oxygen level, and you don’t get sick from it.

There are three main types of high-altitude illness:

  • Acute Mountain Sickness (also called AMS)
  • High-Altitude Pulmonary Edema (also called HAPE), which affects the lungs, and
  • High-Altitude Cerebral Edema (also called HACE), which affects the brain.

These illnesses can be serious, but they can also be prevented.

 

How can I prevent high-altitude sickness?

You can do two important things to prevent high-altitude sickness:

  • Take your time traveling to higher altitude and
  • Sleep at an altitude that is lower than the altitude you were in during the day. For example, if you track at an elevation of 10000 feet during the day, sleep the night before and the night after at an elevation of 8500feet
  • When you travel to a high altitude, your body will begin adjusting right away to the amount of oxygen in the air, but it takes several days for your body to adjust completely. If you’re healthy, you can probably go safely from sea level to an altitude of 8000 feet in a few days. But when you reach an altitude above 8000 feet, don’t go up faster than 1000 feet per day. The closer you live to sea level, the more time your body will need to get used to a high altitude. Plan your trip so your body has time to get used to the high-altitude before you start your physical activity.

Guideline for acclimatization:

Above 2500m-300m ascent per day with a rest day every third or fourth day.

Above 3500m-150m ascent per day with a rest day every third or fourth day.

Spend two nights at the same altitude for every 600m gained above 3500m

The daily ascent recommended is the difference between sleeping locations, you may go higher during the day. [Measures: 1meter =3.28feets, *C = 5/9 (*F-32)]

 

How do I know if I am getting a high- altitude sickness?

Some of the fist signs of high-altitude illness are headache, lightheadness, weakness, trouble sleeping and an upset stomach. If you have these symptoms, stop going up to a higher altitude or go back down to a lower altitude until your symptoms go away. More severe symptoms include difficulty breathing while you are resting, coughing, confusion and inability to walk in a straight line. If you get these symptoms, go to a lower altitude right away and get help from a doctor.

 

 

What should I do if I get high-altitude sickness?

The best treatment for any of three high-altitude illnesses is to go down to a lower altitude right away. But if you have only mild symptoms you may be able to stay at that altitude and let your body adjust. If you do this don’t exercise at all, just rest until you feel better.

If you have severe symptoms, go down 1,500 to 2,000 feet right away to see if your symptoms get better. Keep going down until your symptoms go away completely.

A medicine called acetazolamide  (brand name Diamox) can be used to treat high- altitude illness. When you talk with your doctor about your upcoming trip, ask about getting a prescription for this medicine to take with you in case you get mountain sickness. If you start to have symptoms of high-altitude illness, you can take 125 to 250mg of the medicine by mouth twice a day.

“ Don’t ignore signs of high-altitude illness. People can die of high-altitude Illness if they don’t recognize the signs or if they don’t believe their illness is caused by the high-altitude. When you have signs of high-altitude illness, don’t go to a higher altitude until you feel better and your symptoms have completely gone away.”

 

Is it safe to go to a high altitude if I have a chronic illness like heart disease or lung disease?

It might be safe. The answer depends on the type of chronic illness you have and how severe it is. Most people with chronic illnesses such as heart or lung disease can safely spend time altitude if their disease is under good control. People with coronary artery disease, mild emphysema or high blood pressure aren’t at greater risk of high-altitude illness than people without these diseases. They also don’t risk making their disease worse by traveling to a high altitude. Being overweight does not increase the risk of getting high-altitude illness.

But some diseases make going to a high altitude very dangerous. People with sickle cell anemia shouldn’t go to a high altitude. A high altitude is also dangerous in people with severe, such as chronic obstructive pulmonary disease (COPD) and sever emphysema, and in people with severe heart disease. If you have a chronic disease, ask your doctor if it’s safe for you to travel to a high altitude.

 

Is going to a high altitude dangerous during pregnancy?

There isn’t much information about the risk of high-altitude illness during pregnancy, so it’s hard to say to if going to a high altitude is safe for pregnant women. Some experts recommend that pregnant women not travel to an altitude above 8,000 feet. If you’re pregnant, ask your doctor for advice before you travel to a high altitude.

 

What about children and high altitudes?

It’s usually safe for children to go to high altitudes, but they’re more likely to get high-altitude illness because their bodies have a hard time adjusting to the low oxygen in the air. A child may not be able to recognize the symptoms of high-altitude illness, so parents and other adults must carefully watch for any signs of high-altitude illness in children.

 

Drugs used to treat AMS.

  1. Tab. Acetozolamide(Diamox) a) prevention of AMS-125mg 12 hourly

b) Mid AMS   – 250mg 12hourly

c) HAPE and HACE –250mg 6hourly

It can produce feeling of tingling in fingers, lips and toes, this is not serious. It may also cause dehydration so drink plenty of fluid while on this medicine. Avoid in sulphur drug allergy

 

  1. Tab. Dexamethasone(Dexona) – used in HACE – start with 8mg, the first does then take 4mg 6hourly.
  2. Tab.Nifedipine –used in HAPE –10 to 20mg 6 to 8 hourly.

It can have serious side effects: sudden fall in blood pressure, dizziness, flushing and headache.

 

“This handout provides a general overview on this topic and may not apply to everyone. To find out if this handout applies to you and to get more information on this subject, talk to your Doctor.” — By Dr Nitin Thapa, MD

 

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