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No hurling. You can prevent or diminish altitude
sickenss -which tipìcally occurs above 8000 feet- if you follow this
advice:
Rest Up. Get at least two 8 hours nights of sleep, and make sure you are
well hydrated before you start; you can also aclimitize by spending 3
days at high altitude.
Don't race, climb slower than your normal walking pace. If you need to
rest after ascending only 20 yards, your are flirting with exhaustion
and need to dial it back.
Dig deeper. When your legs turn to stone or you feel nauseous, we
suggest presure breathing: 'Take a deep breath, then force air out
through pursed lips like you're blowing out a candle. Do this 3 to 4
times a minute; vigorous respiration pushes more oxygen from the lungs
into the bloodstream.
Hit the bottle. Some studies show that the herbal remedy COCA tea (inca
leaf tea) helps increase red blood cells (drink it a lot)
Some drugs that contain acetazolamide (such a Diamox) can prevent or
alliviate some forms of altitude sickness, but be aware if side effects
such as numbness and frecuent urination. See a doctor for prescription
and dosage information.
Treat early Altitude sickness typically starts with nausea, lethargy,
headache, irritability. and/or loss of appetite.We suggest immediate
action: slow your pace, hydrate, practice presure breathing - or just
take a rest. If your condition doesn't improve, there's one simple,
surefire solution-descend.
Fact and Advice:
What is meant by high altitude? Some "formal" medical definitions:
High Altitude: 1500 - 3500 m (5000 - 11500 ft)
Very High Altitude: 3500 - 5500 m (11500 – 18000 ft)
Extreme Altitude: above 5500 m
Practically speaking, however, we generally don't worry much about
elevations below 2500 m (8000 ft) since altitude illness rarely occurs
lower than this. Acclimatization is the process of the body adjusting to
the decreasing availability of oxygen- by increasing the amount of red
bloods cells-. It is a slow process, taking place over a period of days
or even weeks.
Physiologic changes due to altitude:
Changed breathing pattern at night
Awakening frequently at night
Weird dreams
Hyperventilation (breathing fast)
Shortness of breath during exertion
Increased urination
TYPES OF ALTITUDE SICKNESS
Acute Mountain Sickness (AMS)
This is the most common of all types of altitude sickness. When
acclimatization lags significantly behind ascent, various symptoms
occur. Acute Mountain Sickness (AMS) represents the body's intolerance
of the hypoxic (low oxygen) environment at one's current elevation.
Who can get AMS? Anyone who goes to altitude. It is primarily
related to rate of ascent. No way has been found to predict who is
likely to get sick at altitude.
Mountain rule 1
* It is OK to get altitude illness. It is not OK to die from it.
Don't violate this rule! Anybody can get AMS , there is no prevalence
based on age, gender, physical fitness, or previous altitude experience.
If you know what to do you should be able to avoid the severe,
life-threatening forms.
Mountain rule 2
* Any illness at altitude is altitude illness until proven otherwise .
Recognizing AMS . I n the context of a recent ascent, a headache , with
any one or more of the following s ymptoms above 2500 meters (8000 feet)
qualifies you for the
Diagnosis of AMS:
Loss of appetite, nausea, or vomiting
Fatigue or weakness
Dizziness or light-headedness
Ear ringing
Difficulty sleeping, insomnia
Confusion, hallucinations
Staggering gait
It is remarkable how many people mistakenly believe that a headache at
altitude is "normal" when it is actually AMS. Be willing to admit that
you have altitude illness .
How to Avoid AMS
The key to avoiding AMS is a rational ascent that gives your body time
to acclimatize. People acclimatize at different rates, so no absolute
statements are possible, but in general, the following recommendations
will keep most people from getting AMS:
At altitudes above 3000 meters (10,000 feet), your sleeping elevation
should not increase more than 500 meters (1500 feet) per night, and
every 1000 meters (3000 feet) you should spend a second night at the
same elevation.
PERUVIAN SACRED strongly recommends you spending 3 to 4 nights at a high
elevation city above 3000 meters in order to minimize the possible
effects of the AMS speacially before undertaking the Inca Trail to Machu
Picchu or any other andean trek in/around Cusco.
What To Do If You Have AMS
We emphasize : DO NOT ASCEND ANY HIGHER.
Mountain rule 3
* Never ascend with symptoms of AMS.
It is always OK to descend, you will get better faster.
Severe Types of Altitude Sickness
High Altitude Cerebral Edema (HACE)
AMS is a spectrum of illness, from mild to life-threatening. At the
"severely ill" end of this spectrum is High Altitude Cerebral Edema;
this is when the brain swells and ceases to function properly.
Obviously, this is a Bad Thing to have happen to you.
HACE, once present, can progress rapidly, and can be fatal in a matter
of a few hours. Persons with this illness are often confused, and may
not recognize that they are ill.
The main symptom of HACE is a change in the ability to think. There may
be confusion, hallucinations, changes in behavior, or lethargy. However,
it is probably easier to recognize a characteristic loss of coordination
that is called ataxia . This is a staggering walk that is identical to
the way a person walks when very intoxicated on alcohol.
To test for this abnormal walk, have the sick person do a straight line
walk (in medical speak this is called the "tandem gait test"). Be fair:
do this on level ground, take off their backpack, and don't have them
try it in big heavy boots. Draw a straight line on the ground, or have
them follow a crack in the teahouse floor. Have them walk along the
line, placing one foot immediately in front of the other, so that the
heel of the forward foot is right in front of the toes behind. Try this
yourself. You should be able to do it without difficulty. If they
struggle to stay on the line (the high-wire balancing act), can't stay
on it, or fall down, they fail the test and should be presumed to have
HACE .
The treatment is immediate descent . This is of the utmost urgency, and
cannot wait until morning (unfortunately, HACE often strikes at night).
Delay may be fatal. The moment this is recognized is the moment to start
organizing flashlights, helpers, porters, whatever is necessary to get
this person down. How far down? At least to the last elevation at which
they woke up in the morning with no symptoms of AMS. Bearing in mind
that the vast majority of cases of HACE occur in persons who ascend with
symptoms of AMS, this is likely to be the elevation the person slept at
two nights previous. If you are uncertain, 500-1000 meters descent is a
good starting point.
People with HACE usually survive if they descend soon enough and far
enough, and usually recover completely. The staggering gait may persist
for days after descent. If recovery has been complete, and there are no
symptoms, cautious re-ascent is acceptable.
High Altitude Pulmonary Edema (HAPE)
Another form of severe altitude illness is High Altitude Pulmonary
Edema, or fluid in the lungs. Though it often occurs with AMS, it is not
felt to be related and the classic signs of AMS may be absent. Symptoms
of HAPE include any of the following:
Extreme fatigue
Breathlessness at rest
Cough, possibly productive of frothy or pink sputum
Gurgling or rattling breaths
Chest tightness, fullness, or congestion
Blue or gray lips or fingernails
The treatment for HAPE is the same as for HACE: immediate descent . As
with HACE, it is of the utmost urgency; delay may be fatal . The same
rules apply for how far as well: to the last elevation where the victim
felt well upon awakening.
Whereas HACE descent is complicated by confusion and staggering on the
part of the victim, HAPE descent is complicated by extreme fatigue and
possibly also due to confusion (due to inability to get enough oxygen to
the brain). HAPE frequently occurs at night, and may worsen with
exertion.
HAPE resolves rapidly with descent, and one or two days of rest at a
lower elevation may be adequate for complete recovery. As with AMS, once
the symptoms have fully resolved, cautious re-ascent is acceptable.
It is common for persons with severe HAPE to then also develop HACE due
to the extremely low levels of oxygen in their blood (equivalent to a
continued rapid ascent).
Mountain rule 4
* If you are getting worse, go down at once.
DO NOT WAIT UNTIL MORNING. Descend at least to the elevation where you
last felt well when you woke up.
Mountain rule 5
* Never leave someone with AMS alone.
People sick with AMS can get worse, and may need help descending, or may
not recognize that they are getting sicker.
Things to Avoid
Respiratory depression (the slowing down of breathing) can be caused by
various medications, and may be a problem at altitude. The following
medications can do this, and should never be used by someone who has
symptoms of altitude illness (these may be safe in non-ill persons,
although this remains controversial):
Alcohol
Sleeping pills (acetazolamide is the sleeping tablet of choice at
altitude)
Narcotic pain medications in more than modest doses
How to recognize high altitude headaches:
Trekkers always wonder about how to tell if a headache is due to
altitude . Altitude headaches are usually nasty, persistent, and
frequently there are other symptoms of AMS; they tend to be frontal (but
may be anywhere), and may worsen with bending over. However, there are
other causes of headaches, and you can try a simple
diagnostic/therapeutic test. Dehydration is a common cause of headache
at altitude. Drink one liter of fluid, and take some acetaminophen or
one of the other analgesics listed above. If the headache TOTALLY
resolves (and you have no other symptoms of AMS) it is very unlikely to
have been due to AMS.
The main treatment of AMS is rest, fluids, and mild analgesics:
acetaminophen (paracetamol), aspirin, or ibuprofen. These medications
will not cover up worsening symptoms. Descent is always an option, and
recovery will be quite rapid...
Other recommendations to help your body acclimatise are :
Avoid over-exerting yourself when you first arrive (however, some gentle
activity during the day is better than sleeping)
Eat lots of carbohydrates
Drink lots of fluids (water no beer)
Avoid cigarettes and alcohol
Avoid taking sleeping pills
Drink coca (ancient traditional leaf) tea
Take Diamox (consult your Dr first). |
