Acute Mountain Sickness (AMS)
For travelers and trekkers, while taking a trip in Nepal, the most important question arises is about Acute Mountain Sickness (AMS) or commonly known as Altitude Sickness. This condition is caused due to continuous gain of altitude without proper acclimatization. As the altitude increases, the level of oxygen gradually decreases in the air causing the body severe complications on the respiratory, circulatory, and nervous functionalities.
Nepal is home to some of the world’s finest and high elevated regions, especially ideal for trekking, hiking, and mountaineering expeditions, some more popular destinations being Everest, Annapurna, Dhawalagiri, Manaslu, and others. Most of these regions fall in the High altitude and Very High Altitude categories.
Normally the regions below 2700 meters are less likely to cause you AMS; however, once you are exceeding the altitude limit then the chances of Altitude Sickness is imminent which may cause mild AMS symptoms. Beyond 4000 meters, there is a huge probability of one getting some severe Acute Mountain Sickness and might need emergency medical assistance.
Types of Acute Mountain Sickness
High Altitude Cerebral Edema (HACE): In this condition, the brain starts swelling with fluids, either by retention of fluid or by the penetration of fluid into the Brain-Blood Barrier. The main cause of this condition is the low oxygen levels in the brain while gaining altitude rapidly. The symptoms may include disorientation, lethargy, vomiting, fever, lack of voluntary control of muscles, sensitivity to light, rapid heartbeat, nose bleeding, and fatigue.
High Altitude Pulmonary Edema (HAPE): This condition occurs when the fluid starts accumulating in the air pockets of the lungs disrupting the proper exchange of gases leading to failure of lung functionality. The symptoms include shortness of breath at rest, tight congested chest, fatigue, rapid heartbeat, rapid breathing, crackles (in the lung during respiration), and the skin starts turning blueish color.
Symptoms for Acute Mountain Sickness may vary depending on different conditions including age, Body Mass Index, general health, blood pressure, lung capacity, pace(of altitude gain), dehydration, food intake, and experience in higher altitudes.
Prevention for Acute Mountain Sickness
Acute Mountain Sickness is a very serious issue and is to be understood clearly before going for a high-altitude adventure in Nepal. While prevention is better than cure, proper preparation is recommended before taking the trip. Exercises and techniques for improving one’s respiratory and circulatory functions should be undertaken as preventive measures which will indeed help you.
Yoga and Meditation can be a great preventive measures, as they help one’s body and mind to be organized. Other activities like jogging, cardio, Zumba, swimming, cycling, and other sports that make you sweat are also useful. Vertex Holiday recommends that one should start these measures at least a couple of weeks prior to the departure of the trip.
Acclimatization is a highly effective measure for the prevention of AMS and is added to the trekking itineraries, just to make sure that your body can cope with the change in the environment. A slow gradual ascent should be properly maintained, while in the higher altitude regions (above 3000m), a day is dedicated as an acclimatization day after every four to five days of hiking.
During this leisure day, you can hike to at least 300 or 400 meters higher altitude and retrace back for the nights’ rest. It help’s your body and mind to familiarize yourself with the environment. Heavy exercises and mental stress should be avoided during the trip, instead of meditation and breathing exercises can be helpful.
Food and beverages can also help prevent AMS, therefore water and soups should be included in the diet. Carbohydrates, fruits, and vegetables should be taken in adequate quantity. If you prefer non-veg products, then it is wiser to give up on them at least for the trip. This helps your body for proper digestion and reduces stress. Smoking, Alcohol, and taking sleeping pills are highly discouraged.
Treatment for Acute Mountain Sickness
Once you feel the mild symptoms of any of them described above, then you must inform your guide or leader of the trip and take a break for at least 30 minutes. Keeping the body hydrated is very important, so make sure to drink enough water. If possible Portable Hyperbaric Chamber (Gamow Bag) and Supplemental Oxygen should be used.
However, if the situation starts worsening: proper medical attention may be needed. If the pain persists, then the best solution is to descent slowly to lower altitudes. Even though prescribing medications to the clients suffering AMS is risky, the comprehensive First Aid Kit carried out by our staff will include medicines like Paracetamol, Ibuprofen, Dexamethasone, and Acetazolamide (Diamox): only to be used if necessary.
In more severe cases of AMS, descending at least 500 to 1000 meters might be helpful. However, if the situation doesn’t improve for 24 hours then immediate evacuation using Helicopter services for the purpose of hospitalization might be needed. Therefore proper comprehensive Medical and Travel Insurance covering any possible hazards is recommended.
What is Acclimatization and how can it help?
Acclimatization during a trekking or mountaineering trip refers to leisure time after a certain altitude gain. Mostly, itineraries of adventure holiday packages have Acclimatization day tailored to it, normally in between 4 to 5 days’ hiking in altitude higher than 3000 meters above sea level. This day is dedicated for your body to adapt to the newfound environment as well as explore the local surrounding.
As one gains altitude gradually, the amount of oxygen entering your body declines and you’ll start noticing that your body responding to the situation in odd behavior like shortening of breath and rising heartbeat. Due to the thinner air, the level of oxygen starts depleting and the production of Red Blood Cells starts to increase. So, in that case, acclimatization helps your body adapt to the environment and produce essential enzymes to speed up the process of transferring oxygen to the cells.
Unlike people from Sherpa, Rai, and other mountainous tribes: tourists and trekkers from low altitude countries have a body less familiar with the harsh conditions. Therefore, acclimatization plays an important role in forging your body to cope with low oxygen conditions in the Himalayas. However, if it is your first time trekking or hiking in Nepal: then it is probably a wiser decision to take short beginner-level trekking trips in the lower altitudes rather than higher elevations.
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