Mountain Sickness

What is Mountain Sickness?

Thise of you who have experiences high altitude mountaineering, you will know there is a whole whack of things your body goes through as you as ascend into thin air. Why do lungs fill ith fluid? Why do you get heeadaches? Why do you get nauseous. And why the heck do we love to endure these hardships? I have spent more than 20 years in the mountains of the world. Hopefullky I can answer some these questions for you.

The basic cause of altitude sickness

The amount of people getting involved in mounatineering has exploded in the past decade. Things have changed since the Edmund Hilary era of climbing. New technologies and medical knowledge have increased our understanding of the cause, prevention and possible treatment of a widening spectrum of altitude sickness.

What is the basic cause then? Lack of oxygen or hypoxia is numero uno on the list. But other factors have also been included in the list.  Thousands of people either trek or climb in the various high altitude areas of the world from Kilimanjaro, the Himalayas, Andes and Elbrus in Russia. Although a majority of people will get some sort of altitude related illness, even those who go as low as 3,000m may also experience some sort of affects.

Basically there are 3 main culprits when it comes to altitude related problems:

Acute Mountain Sickness

Acute Mountain Sickness ( AMS) is the most common thing that people experience. It doesnt seem to discrimenate between genders but seems to be less common in older people than younger people. AMS is the most common of the altitude related illnessses. It affects 30% of of all people who ascend rapidly from low to even moderate altitudes which can even inlcude the Drakensberg mountains in South Africa. Acute mountain sickness is characterized by headache, nausia, diaharea dizziness, fatigie and insomnia. It can aslo disturb the water balance in tissues resulting in the swelling of hands, feet, face and winkies. These symtoms will usally dissapear in a couple of days. But you will need to have a bit of will power to overcome them. Some people get it bad. We have been on many a summit bid when someone is vomitting, poohing and falling asleep for hours. Not the most comfortable thing to experience but it is not neccessarily life theatening. The best thing to do if you are feeling really bad is to take an extra day to chill and allow your body to acclimitize.


How to prevent AMS?

The golden rule is to ascend slowly. This allows your body to acclimitize to the thinning air. The majority of climbers have resorted to acetazolamide ( Diamox) to help with the symptoms. Usually taken in 125mg doses twice a day. The side effects are minimal and include urinating a lot, dizziness and tingling fingers or toes. Being a diaretic though means you are going to have to up your intake if fluids.  Dexamethosone ( 2-5mg twice a day) minimizes symptoms once they appear but is not as good as Diamox for prevention.

High Altitude Cerebral Edema

Symptoms of Acute Mountain Sickness are due to small, reversable changes in brain chemistry and/or circulation. In some instances ( 5-10%) when these changes are dominant, the illness can esculate to a condition called High Altitude Cerebral Edema (HACE).  The symptoms are pretty obviouys although they can also be confused with pure exhaustion or dehydration. These symptoms include a staggering walk, confusion and hallucination. If not treated, the end result is a coma. When any of these symtoms appear, an urgent evacuation to a lower altitude as soon as possible is key. Although it may be pretty easy to descend Kilimanjaro in a relatively fast time, the Himalayas is another kettle of fish. HACE in the Himalayas will require helicopter evacuation. This however is not always possible as bad weather conditions may affect flying. In this case, Oxygen and intravenous dexamethosone must be administered to buy time.

High Altitude Pulmonary Edema

And then we have the HAPE, or High Altitude Pulmonary Edema. Less common than AMS but a ot more serious. This is a condition that results in the accumulation of fluid on the lungs. Pretty easy to spot. Weakness, shortness of breath, coughing and a blueish colour of the skin due to insufficient oxygenation of the blood. Crackles, gurgles and wheezes and can be heard coming from the lungs. A slight cough grows worse and soon produces frothy or sometimes bloody sputum. The pulse rate is high, they might be a slight fever and the Oxygen satuartion levels as read by an oxymeter will often relfect a reading of less than 75%. A rise in pulmonary arterial pressure that accompanies HAPE is now attribited to a deficiency of nitric oxide, a simple chemical found in our bodies. It is also believed that certain chemicals like endothelins released from the lining of the blood vessels during hypoxia contribute to both HACE and HAPE.

Men are Everest, woman are from Amadablam

Sorry guys, it seems we are more susceptable to AMS compred to the faier sex. Four times more susceptible in fact. Ouch, poor us. Migfht have to bring along an extra portion of concrete to harden up.



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