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Altitude Sickness

Altitude sickness is the major problem when you are trekking in Nepal. And it is really necessary for you to study the causes, symptoms and treatment of the attitude sickness before trekking and climbing in Nepal. Average of three peoples per year dies due to the Altitude sickness.

While trekking and climbing in Nepal it is necessary to adjust your schedule for trekking in above 3,000 meters. It is better if you climb no more than 400 meters per day when you are climbing above 3,000 meters. If you fail to allow time for adaptation, you may develop the symptoms of Acute Mountain Sickness (AMS). You can easily care it with a day’s rest or if ignored can lead to death. So before trekking in Nepal especially in higher altitude, basic awareness of AMS is necessary for safe trek.

Altitude Sickness:

It occurs when travels or trekker has been unable to adaptive to place to place where they have climbed.  As altitude increases, the level of oxygen decreases (only half of oxygen is noted above 5000m in Everest Base Camp and Annapurna Circuit). During the trekking, trekkers will feel that their breathing increases with decrease in oxygen. If they continue trekking without taking a rest, they might be victim of Altitude Sickness. Altitude Sickness happens when fluid collects in cell around the body as the result of failure to acclimatize. More deadly result can be happen when fluid builds subsequently in the lungs and brain.

Symptoms:

The major symptoms of Altitude Sickness in Nepal are nausea, irritability, headache, a dry cough and in more severe cases cough up a pink frothy substance and lose balance as though drunk.

Prevention:

As we know prevention is better than cure and it is necessary for you to give time to acclimatize your body as you climb. When you visit to high altitudes during your trip to Nepal, you should spend 2 – 3 nights at the place. During this period you can enjoy with local peoples knowing their living style, cultures, visiting local place of attraction and resting. This will give enough time to you to acclimatize your body. Whenever you fell the slightest of Altitude sickness symptoms, then you should stop at that point and take rest until these have passed.

Treatment:

If somehow you suffered from Altitude Sickness, then it is necessary for you to stop trekking and take a time to acclimatize your body. If you still did not recover with Altitude Sickness after taking long rest, you must need to visit local medical post or return back to Kathmandu with emergency rescue services. So it is recommended having adequate travel insurance during your trip to Nepal.

 Three ways to avoid dying due to Altitude Sickness:

  1. Recognize the early symptoms of altitude sickness when you have them, and note that you might be the only person suffering with Altitude sickness in a group.
  2. Never ascend to the new altitude for rest when you have symptoms of Altitude Sickness.
  3. Descend to the lower altitude, if you are getting worst with the Altitude Sickness at the same altitude.

Normal Acute Mountain Symptoms:

Following are the symptoms for normal acute mountain sickness that you should expect during your trekking in Nepal. Most of the trekkers will experience some or all of the given symptoms, no matter how slow they climb.

  • Periods of sleeplessness.
  • Need more sleep than normal often 10 hrs or more.
  • Occasionally loss of appetite.
  • Vivid, wild dreams at around 2500 – 3800 meters in altitude.
  • Periodic breathings.
  • Need to rest your breath frequently while trekking above 3500 meters.
  • Runny nose.
  • Dizziness and increase in urination while moving to higher altitudes (this is good sign).

Mild Acute Mountain Sickness Symptoms:

Following are the symptoms of mild acute mountain sickness. You may expect any one of the following symptoms to be getting altitude sickness.

  • Mild headache
  • Nausea dizziness
  • Weakness
  • Sleeplessness
  • Dry Raspy cough
  • Tired and fatigue
  • Loss of appetite
  • Hard to breath
  • Runny nose

Dangerous Acute Mountain Sickness:

There are commonly two case of dangerous acute mountain sickness. These altitude sickness causes to the brain and lung of the trekkers.

The first High Altitude Cerebral Edema (HACE) builds up fluid around the brain and expects the first five symptoms of mild and severe sickness. Normally, takes 1-2 days to build this sickness to the trekker leading to coma and unconsciousness and ultimately to the death within 12 hours.

At first sign, treatment is done with medication, oxygen and descent. For this 4 – 8 mg of DexaMethasone is given as a first dose to victims and then 4 mg every six hours, then Diamox every 12 hours and 2 -4 lit/min oxygen. Descent is necessary but a portable altitude chamber bag will often be used first if available.

The second High Altitude Pulmonary Edema (HAPE) is an accumulation of fluid in lungs and is very serious altitude sickness. This sickness can lead unconsciousness and death very quickly. By far only treatment available is oxygen at 4 lit/min but portable altitude chamber bag treatment can be good substitute. If both is not available then descent can be a lifesaving.

Prevention of Acute Mountain Sickness (AMS):

  • Allow sufficient time for acclimatization above 3000 meters.
  • Never make rapid climb
  • Never use alcohol, sleeping pills and smoke
  • Drink as much possible fluids at least 3-4 liters a day, clean water-boiled or tea, coffee, soup, juice etc.
  • Try to be in group while trekking and take guide or porters along with.
  • Always follow the advice from guide, hotel, local people and guide book.
  • Descent if mild symptoms getting worse
  • Avoid getting cold.
  • Take easy and comfortable trekking routes

First Aid Kit:

Following are the essential ailments that afflict trekkers. These things are necessary to carry along with while trekking to higher altitude zone. Trekking with groups, expeditions and trekking to isolated area will require more comprehensive kit.

  • Bandage for sprains
  • Plasters/Band aids
  • Iodine capsules (Optional)
  • Aspirins/Paracetamol
  • Anti-bacterial throat lozenges with antiseptic
  • Moleskin/Second skin
  • Antibiotic for diarrhea
  • Oral rehydration salts (norfloxacin or ciprofloxin)
  • Diamox 250/500 mg
  • Gel hand cleaner

Diamox is generally useful for mild to moderate AMS.

Dosage: One 250 mg tablet two or three times a day

Dexamethasone is a very potent steroid used in HACE temporarily to facilitate descent. This drug improves the symptoms but does not help acclimatization. It is not recommended to ascend while still taking this drug even if one is symptom free.

Dosage: 4 mg every 6 hours.

Nifedipine is useful in HAPE by lowering pressure in the pulmonary blood vessels and thereby decreasing fluid in the lungs. This drug also lowers blood pressure. Sildenafil (Viagra) is increasingly being used in treating HAPE.

Oxygen is very useful particularly for HAPE.