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Altitude Sickness During Trek

    Altitude sickness (also known as AMS, Acute Mountain Sickness) is a potentially fatal medical illness that can occur when you engage in physical activity at high elevations without being acclimatized to the lower pressures encountered there.

    Of course, altitude and air pressure tolerance vary greatly across individuals. People who are physically fitter have fewer problems with AMS. Even highly athletic persons can have AMS if they hike too high in too short a period or without adequately acclimatizing.

    Some persons get AMS at elevations as low as 2,400 meters (8,000 feet), but significant symptoms are uncommon below 3,700 meters (12,000 feet). The most common cause of AMS is a shortage of oxygen combined with physical exercise.

    At 5000 meters, the air pressure (and hence the amount of oxygen accessible with each breath) is just 55% of what it is at sea level. It is less than half at 6000 meters. This has a significant influence on the physiology of the body. AMS is not necessarily characterized by progressive development of the moderate altitude-related symptoms that most individuals experience, such as headache and shortness of breath. It has a quick, violent onset and can render a trekker fully incapacitated in minutes.


    What exactly is altitude sickness?

    Above 8,000 feet, altitude sickness becomes a significant concern (2,400m). Most individuals may have shortness of breath as they acclimate, but headaches, vomiting, trouble sleeping, and the development of pulmonary oedema (fluid on the lungs) are major signs of AMS.

    It's critical to acclimate slowly while trekking in Nepal, and most guides will make sure you sleep at a lower altitude than you attained that day.

    It is also critical not to become dehydrated and to pace yourself. From the first day of the walk, take it slowly, remain with the group, and rest if you're feeling ill.

    The development of pink frothy liquid around your mouth and nose, shortness when resting, severe headaches, lack of coordination, and vomiting should be recognized as AMS, and the best therapy is to descend. The only therapy for this extremely dangerous disease is to descend.




    Oxygen saturation decreased

    At high altitudes, each breath delivers less oxygen to your blood, yet increased physical activity just increases oxygen demand. Slight decreases in oxygen saturation in your blood will cause weariness and shortness of breath. Larger reductions in blood oxygen levels can impair mental function and have other negative consequences.

    Any decline below 80% is regarded as extremely severe. If your blood oxygen saturation falls below 75%, you must immediately begin your descent.


    Oedema Cerebral (HACE)

    Reduced air pressure can also cause bodily fluids to leak into your skull or even the fluid that covers your brain. This causes a minor headache at low doses. If it progresses, it might impose undue strain on the brain. If this happens, it might cause severe disorientation, coma, or death. The onset (and progression of the most severe symptoms) can be exceedingly rapid.


    Pulmonary Oedema (HAPE)

    Similarly, a loss of air pressure can cause fluid to leak into your lungs. This can cause pneumonia-like symptoms and is quite hazardous if it happens while sleeping.

    High Altitude Pulmonary Oedema can occur in the absence of other AMS symptoms and can be dangerous on its own.


    What causes altitude sickness?

    Above 8,000 feet, any journey in the Himalayas - whether in Nepal, Bhutan, India, or Pakistan - poses a risk (2,400m). Many individuals that arrive in Cusco, Peru with the intention of hiking the Inca Trail are affected. Morocco's Atlas Mountains are likewise a high-risk area. Kilimanjaro in Tanzania/Kenya is also at blame for a number of incidents. Few European Alpine resorts are higher than 8,000 feet (2,400m). However, several resorts in the United States, particularly in Colorado, are closer to 9,840 feet (3,000m).


    Prescription Medication for Altitude Sickness

    Acetazolamide, often known by the brand name Diamox, is a medication. It is used to both treat and prevents altitude sickness.

    Acetazolamide can help avoid symptoms by allowing you to acclimate to high altitudes more rapidly. You should begin taking this drug 1-2 days before traveling to a high altitude (over 2,500m/8,200ft). However, it is critical that you also follow the other measures we've outlined to ensure safe acclimatization.

    We cannot give this sense it is a prescription medication. If you want to use this medicine as a preventative measure or in the case of altitude sickness symptoms, please consult your doctor, local travel clinic, or medical expert before you go.


    AMS-treating DRUGS

     Acetozolamide is a medication (Diamox)

    1.  AMS-125mg 12 hourly prevention
    2. Mid AMS   – 250mg 12hourly
    3.  HAPE and HACE –250mg 6hourly


    It can cause tingling sensations in the fingers, lips, and toes, although this is not dangerous. It may also induce dehydration, so drink lots of fluids while taking it. Avoid if you have a sulfur medication allergy.

    • Tab. Dexamethasone(Dexona) – used in HACE – start with 8mg, the first does then take 4mg 6hourly.
    • Tab.Nifedipine –used in HAPE –10 to 20mg 6 to 8 hourly.

    It can cause severe adverse effects such as an abrupt drop in blood pressure, dizziness, flushing, and headache.


    Travel Insurance That Covers Everything

    In severe cases of altitude sickness in Nepal, your guide may feel compelled to get you to a hospital as soon as possible.

    Your coverage should cover helicopter evacuation above the highest point of your journey (for example, above 4,130m/13,600ft for Annapurna Base Camp). It's fairly uncommon for us to have to remove people by helicopter.

    We can take prompt action in the case of an emergency if you email us a copy of your insurance certificate before your journey.


    Symptoms and Diagnosis of Altitude Sickness

    AMS symptoms include nausea, shortness of breath, headache, and difficulty moving within a few hours of arriving at a high altitude. An overall sense of tiredness will sap all of the excitement you were experiencing prior to things going wrong. You may have difficulty falling asleep, dizziness, and a strong headache. You may also have a loss of coordination, difficulty walking, and a tight chest. If you develop HAPE or HACE, you may get disoriented, experience shortness of breath at rest, and be unable to move at all. The more severe your symptoms might be, the higher the altitude. If you've seen the film Everest, you'll understand what we're talking about. But those men were ascending, while we were just walking. There are several grading methods available for determining altitude sickness. Guides have been educated in these methods and have prior expertise with urgent treatment. Although many people will suffer altitude sickness symptoms, they do not have to worsen. You can do a lot to keep healthy at high altitudes if you are aware of the signs.


    How to Avoid Altitude Sickness While Trekking

    When you're out in the Himalayas, there are a few general guidelines you should follow. Your body is working hard to adjust to its new circumstances, and it will let you know when it needs to rest.


    Prepare Carefully

    Consult with your doctor around 6 months before your trip. Have a thorough physical examination and inform your practitioner about your activities. Purchase medicine that has been prescribed by your doctor. If you intend to hike with children, make sure you prepare them just as well. Do you have any medical problems that you need to be aware of? Make sure to discuss this with your doctor as well.


    Get Fit

    If you want to enjoy your trekking adventure, make every effort to get physically fit. Walk a lot and attempt to cover some height if possible. Exercise 3 to 6 hours per week with a 10kg rucksack to imitate a typical day in the Himalayas. Read on to find out what else you can do to be in shape for hiking in Nepal.


    Pay Attention to Your Body

    Your body will alert you when it requires rest. Pay close attention. Be aware of and discuss the signs of altitude sickness. Let your companions, guide, and porters know how you're feeling, and halt when your body tells you to. Don't let things deteriorate.


    Ascend High, Sleep Low

    Climb high but sleep low is an unspoken rule for hikers and climbers alike. That's why mountaineers on Everest take so long to reach the summit; they travel up and down several times before pushing for the summit. They ascend high, but sleep low. That's why you can notice a descent in the middle of your route. This is done to ensure that you acclimate slowly after tackling elevation.


    More Food

    Eat. Consume as much as you can. Even if you don't like what's on your plate, never miss a meal in a teahouse. Your body is working hard and needs a lot of carbs to go the additional mile and tolerate higher elevation. Forget about your diet and go ahead and get that extra candy bar. Trekking is a strenuous exercise that may easily burn over 4,000 calories per day. Refuel; your body will thank you.


    Hydration is essential.

    Water comes before and after eating. Then there's more water. Seriously, you'll need to increase your water consumption. This is much simpler when it's warm and you're sweating, but you must be disciplined. Drink 3 to 5 liters of water every day, plus another cup of tea. You're walking, not partying, so save the alcohol for afterward. Alcohol causes AMS not just because you are dehydrated while drinking it.


    Select the Best Itinerary

    You've been fantasizing about hiking in the Annapurna or Everest regions for years, and you've finally decided to slash your expenses and practically dash to the Base Camp. Why? Take your time. Book the 15-day trip instead of the 12-day trip and spoil yourself at Namche Bazaar. There is enough to do, and spending a longer time at the same altitude will undoubtedly aid your acclimatization.


    Keep Track of Urination

    Drinking more and being at a higher altitude will undoubtedly cause you to leak more frequently. Keep this in mind. Simply ensure that you urinate more regularly than usual. If that is not the case, this is what you should do: Hydrate.


    Insurance for Travel

    It won't save you from getting altitude sickness, but it will come in handy if you need medical help. Check with your insurance carrier to see whether you are insured when traveling and if you are protected at high altitudes. When traveling to high altitude places, insurance companies frequently need you to update your coverage.


    Don't Be Put Off by Altitude Sickness in Nepal!

    Phew-- that was a lengthy blog! But as long as you learn the basics of altitude sickness, recognize the symptoms, and follow the golden rules, you'll be OK! Remember that all deaths are avoidable.


    Please keep in mind that altitude sickness kills hikers every year. It is critical that you take this seriously. Every year, I receive dozens of emails from individuals wondering how they may shorten a trip to save money. Acclimatization days should not be eliminated in order to save money; they save lives! Ignoring altitude sickness will only result in a scribble on a piece of paper. A Chinese trekker dies from altitude sickness while trekking to Everest Base Camp. Learn more about hikers who go missing in Nepal and are frequently killed by altitude illness or exposure.


    Be aware of local preventative measures and online gurus.

    There are several internet "gurus" or "influencers" who have promoted non-scientific or quasi-scientific knowledge in recent years. Some of this includes the fact that coffee is safe to consume and that alcohol has no effect on you at altitude. Science and experience, however, tell a different narrative. Consumables that promote dehydration can and do cause headaches and make trekking more difficult. These physical disorders can cause or resemble altitude sickness. Similarly, some individuals promote consuming garlic as a native Nepali therapy for acclimatization prevention. Again, while there is some evidence that it may be beneficial, it is not a precise science.When it comes to altitude sickness avoidance, it is crucial to err on the side of caution and established facts for one's own health and safety.


    Trekking acclimatization and altitude sickness avoidance

    Drink lots of water (water). Ascend gradually. Prepare to urinate more often during the day and night. Eat frequently and in moderation. You will require extra sleep; ensure that you get it. Not during the walk, but after. Dress appropriately for a hike. High altitude frequently entails more exposure to the elements. Wear layers of appropriate warm clothes. Keep wind prevention in mind. Consider protecting yourself from the sun with UV-blocking lotion and sunglasses. Maintain as much dryness as possible on your hands, feet, and extremities. Wet footwear, socks, gloves, or caps should be avoided. Keep your hands as clean as possible at meal times to minimize food contamination and potential gastrointestinal troubles, which can lead to dehydration at altitude, among other concerns. Make a record of your pee and urination. Because of the altitude and the increased water consumption, you should be peeing more frequently than usual. One indicator that you are not drinking enough is dark urine. Drink plenty of water! Understand the signs of AMS, HACE, and HAPE not just for yourself, but also for others around you.


    Important: Make sure you have travel insurance for Nepal before you arrive and that you are protected from trekking at heights higher than the altitude you will be hitting! Check out my travel insurance advice for hiking in Nepal.


    Is it risky to go to high altitudes when pregnant?

    Because there is little knowledge of the danger of high-altitude disease during pregnancy, it is difficult to tell if traveling to a high altitude is safe for pregnant women. Some specialists advise pregnant women not to travel over 8,000 feet in elevation. If you are pregnant, consult your doctor before traveling to a high altitude.


    What about kids and high elevations?

    Children are normally safe to go to high elevations, but they are more prone to suffer high-altitude disease because their bodies have a difficult time adapting to the low oxygen levels in the air. Because a kid may not identify the symptoms of high-altitude disease, parents and other adults must keep a close eye out for any indicators of high-altitude illness in children.