ACUTE MOUNTAIN SICKNESS (AMS)

One such preparation which is mostly ignored while planning a trip to high altitude regions like LADAKH, ZANSKAR & SPITI valley is our vulnerability to Acute Mountain Sickness (commonly termed as AMS). While there no reports which suggest that a FIT / HEALTHY /An athletic built person is less vulnerable to AMS, many people are mistaken by this myth. You may be a Marathon runner OR would be spending hours in Gymnasium OR would have made numerous trips in high altitude regions. Keep this in mind, that all the above doesn’t qualify you to ignore AMS.

Unfortunately, some of the most experienced people who had been advising others on AMS also have been fatally affected. Often AMS OR symptoms of AMS are misunderstood as travel fatigue, stress OR exhaustion & are inadvertently ignored. Most importantly, detection and acceptance of early symptoms of AMS has always helped people to undertake corrective actions. Personally, I have travelled several times to high altitude regions and have never experienced AMS, but I have seen people affected by AMS.

Every body would have a different tendency to handle high altitude & would react differently in higher altitudes, depending on its age, fitness, immunity, existing health issues etc..

HIGH ALTITUDE CLASSIFICATION

High Altitude                     :- 8,000 – 12,000 feet (2,500 – 3,600 meters)

Very High Altitude             :- 12,000 – 18,000 feet (3,600 – 5,500 meters)

Extremely High Altitude    :- 18,000 feet plus (5,500+ meters)

WHAT IS ACUTE MOUNTAIN SICKNESS

At higher altitudes, the concentration of Oxygen in the atmosphere decreases. However, the body needs the same amount of oxygen to perform a certain task. This disparity in the demand & supply of oxygen results in an increase in the breathing rate to facilitate additional intake of oxygen. Thus, you tend to exhaust faster at high altitudes than you would at normal sea levels while doing some physically assertive jobs. It may be just a brisk walk on a street OR may be a hike uphill.

Resultantly, we experience shortness of breath, fatigue, nausea, vomiting, headache, disorientation etc.. These are symptoms of AMS. Depending on the gravity of the symptoms, it is classified whether it is a MILD, MODERATE or SEVERE type. AMS is usually experienced at altitudes of 9,000-10,000 feet above mean sea level.

WHAT CAUSES ALTITUDE SICKNESS

  1. Fast ascend to a high altitude region. Most commonly affected people are those who fly to high altitudes like LEH.
  2. Continuing ascend at higher altitudes, without proper acclimatization.

ACCLIMATIZATION

A major reason of AMS is ascending very fast to a high altitude. The body requires some time to adapt itself to the depletion in the oxygen levels at a certain altitude. This adaptation time is called as acclimatization. For eg. If you fly to Leh which is at 11,500 feet, you would be required to spend about 1-3 days at that altitude before you proceed higher.

A thumb rule is to spend one night after every 3000 feet of ascend beyond 10,000 feet. The time enables your body to allow it to operate with decreased oxygen.

Prevention of Altitude Illnesses

Prevention of altitude illnesses falls into two categories, proper acclimatization and preventive medications. Below are a few basic guidelines for proper acclimatization.

  • If you do fly or drive to 10,000 plus feet, do not over exert yourself or move higher for the first 24-48 hours. Symtoms like shortness of breath, early exhaustion, fatigue, nausea, vomiting etc are very common.
  • Different people would acclimatize at different rates, depending on a host of the individual physical factors.
  • Gradually increase in the altitude by 1000 feet per day & after an ascend of 3000 feet, take a day’s rest.
  • Climbers often resort to “Climb High and sleep low” technique. Even if you reach high altitude, make sure you descend to sleep. For eg. High altitude passes like Khardung La, Chang La, Penzi La are at 14,000 plus altitudes. You may spend the day at such places, but return at lower levels to sleep.
  • In case any symptoms of altitude sickness persists, do not go higher till the symptoms recede.
  • If symptoms aggravate, then descend immediately.
  • At high altitudes, you would experience frequent dehydration & dry throat. Stay properly hydrated. You can use ELECTRAL powder OR ORS to help revive the lost salts. Urine should be clear.
  • Do not engage yourself in any physical activity on reaching high altitudes. Exertion inhibits acclimatization.
  • Avoid alcohol, tobacco and other anti-depressant, anti-anxiolytic & sleep drugs They further decrease the respiratory drive during sleep resulting in a worsening of the symptoms.
  • Eat a high carbohydrate diet (more than 70% of your calories from carbohydrates) while at altitude.

AMS Preventive Medications

     A friend of mine with a medical background & an experience in high altitude treks had recommended a remedy, which I follow during all my trips. Every morning along with breakfast during the trip, I take a spoonful of CHAWANPRASH & a glass full of hot milk with turmeric powder.  I am not sure whether it worked or not, but fortunately, I never came across symptoms of AMS. Probably, it also may be due to my gradual acclimatization, since I always start my journey on my bike from the Srinagar Leh highway.

     Do consult your doctor before you carry any medication. Although, I am not a doctor to recommend any particular drug, Diamox tablets are used as preventive as well as curative purpose. Diamox being a sulfa drug, please consult your doctor for the dosage & its tolerance in case of sulfa sensitive people. Diamox increase the respiratory rate due to which intake of oxygen increases.

     Post medication, if the symptoms still persists, then descending would be the only solution.

     Consult a physician / hospital at the nearest location for immediate medical assistance.

TO SUMMARIZE

In this article, I have tried to elaborate on a possible threat / health hazard which tourists may likely face during a trip to Ladakh in the eventuality of improper / no acclimatization. Friends remember that prevention is always better than cure. Hence please take all precautions to ensure that you remain safe & your trip remains etched in your memory as a joyful experience. 

Please feel free to share your experiences on this subject in the comments section below.I would like you to give me a feedback if you think any improvements in the information provided can be done.