What is altitude sickness?
Altitude sickness occurs when you cannot get enough oxygen from the air at high
altitudes. This causes symptoms such as a headache, loss of appetite, and trouble sleeping.
It happens most often when people who are not used to high altitudes go quickly
from lower altitudes to
8000 ft (2438 m) or higher. For
example, you may get a headache when you drive over a high mountain pass, hike
to a high altitude, or arrive at a mountain resort.
Mild altitude sickness is common. In the United States, more than 20% of people visiting the western mountains get it.1 Experts do not know who will get it and who will not. Being male or female and your fitness level play no role in whether you get altitude sickness.
What causes altitude sickness?
Air is "thinner" at
high altitudes. When you go too high too fast, your body cannot get as much
oxygen as it needs. This causes the headache and other symptoms of altitude
sickness. As your body gets used to the altitude, the symptoms go away. 
What are the symptoms?
The symptoms of altitude sickness include:- A headache, which is usually throbbing. It gets worse during the night and when you wake up.
- Not feeling like eating.
- Feeling sick to your stomach. You may vomit.
- Feeling weak and lazy. In severe cases, you do not have the energy to eat, dress yourself, or do anything.
- Waking up during the night and not sleeping well.
- Feeling dizzy.
Altitude sickness can affect your lungs and brain. When this happens, symptoms include being confused, not being able to walk straight (ataxia), feeling faint, and having blue or gray lips or fingernails. When you breathe, you may hear a sound like a paper bag being crumpled. These symptoms mean the condition is severe. It may be deadly.
If you are going on a high-altitude trek, learn about altitude sickness, its symptoms, and how to treat it. Look out for other people in your group. You can learn more about altitude sickness at the International Society for Mountain Medicine website at www.ismmed.org.
Treating altitude sickness
If you have symptoms of mild altitude sickness, you should not go any higher for at least 24 to 48 hours.
Most cases will improve during this time, but it may help if you:
Do not attempt to climb again until your symptoms have completely disappeared. After two to three days, your body will have acclimatised and your symptoms should disappear.
If you have severe symptoms or your symptoms are getting worse, descend immediately by as much as possible. This is because severe altitude sickness can be fatal if not treated quickly. Once you reach a low altitude, you should seek medical help immediately.
A portable hyperbaric chamber is a bag you are zipped inside, which is then pumped full of air. After about two hours of treatment your symptoms should improve significantly. The effect of the treatment is equivalent to descending 2,000m (6,500 feet).
However, while oxygen treatment can relieve the symptoms of altitude sickness, it is not a replacement for descending to a lower altitude. You should always descend if you have severe or worsening symptoms, even if you've had oxygen treatment.
Altitude sickness can change the chemical balance of your blood and acetazolamide helps correct this chemical imbalance.
However, acetazolamide is not licensed in the UK for the treatment or prevention of altitude sickness and it is only available on prescription. Your GP may consider prescribing acetazolamide if they think it might be helpful, so you should talk to them about the possibility of using it before you travel.
There are a number of common but minor side effects associated with this medication, including numbness or tingling of the face, fingers or toes.
Dexamethasone is a strong steroid that reduces swelling of the brain. It's usually taken as a tablet several times a day.
The medication is particularly useful for "buying time" until it is safe to make a descent. For example, it can be used during the night to relieve symptoms when making a descent is not possible or may be dangerous. Symptoms usually start to improve within about six hours.
Dexamethasone can cause side effects such as stomach upset, difficulty sleeping (insomnia) and mood changes.
As with acetazolamide, you should talk to your GP about the option of taking dexamethasone before you travel.
The drug decreases the narrowing of the artery that supplies blood to the lungs, helping to reduce chest tightness and ease breathing. It's usually taken as a tablet at six- to eight-hour intervals.
Nifedipine can cause a sudden drop in blood pressure, so it is important not to get up too quickly from a lying or sitting position if you take it.
Most cases will improve during this time, but it may help if you:
- do not exercise
- drink plenty of fluid (but not alcohol)
- do not smoke
- rest until you feel better
Descending to a lower altitude
If you have mild symptoms of altitude sickness that do not go away over 24 to 48 hours, the best thing to do is descend by at least 500m (about 1,600 feet).Do not attempt to climb again until your symptoms have completely disappeared. After two to three days, your body will have acclimatised and your symptoms should disappear.
If you have severe symptoms or your symptoms are getting worse, descend immediately by as much as possible. This is because severe altitude sickness can be fatal if not treated quickly. Once you reach a low altitude, you should seek medical help immediately.
Oxygen treatment
Increasing your oxygen intake with bottled oxygen or portable hyperbaric chambers (also known as Gamow or Certec bags) can help temporarily improve some of the symptoms of altitude sickness.A portable hyperbaric chamber is a bag you are zipped inside, which is then pumped full of air. After about two hours of treatment your symptoms should improve significantly. The effect of the treatment is equivalent to descending 2,000m (6,500 feet).
However, while oxygen treatment can relieve the symptoms of altitude sickness, it is not a replacement for descending to a lower altitude. You should always descend if you have severe or worsening symptoms, even if you've had oxygen treatment.
Medication
Painkillers
Painkillers, such as paracetamol or ibuprofen, can be used to treat mild headaches caused by altitude sickness.Anti-sickness medication
If you are experiencing nausea or vomiting, a type of medication called an anti-emetic may be useful. Promethazine is an anti-emetic medicine often used by people with altitude sickness.Acetazolamide
Studies have shown that acetazolamide can help reduce the severity of altitude sickness symptoms, and can also help prevent the condition.Altitude sickness can change the chemical balance of your blood and acetazolamide helps correct this chemical imbalance.
However, acetazolamide is not licensed in the UK for the treatment or prevention of altitude sickness and it is only available on prescription. Your GP may consider prescribing acetazolamide if they think it might be helpful, so you should talk to them about the possibility of using it before you travel.
There are a number of common but minor side effects associated with this medication, including numbness or tingling of the face, fingers or toes.
Dexamethasone
Dexamethasone can be very useful for treating severe complications of altitude sickness, such as high altitude cerebral oedema (HACE).Dexamethasone is a strong steroid that reduces swelling of the brain. It's usually taken as a tablet several times a day.
The medication is particularly useful for "buying time" until it is safe to make a descent. For example, it can be used during the night to relieve symptoms when making a descent is not possible or may be dangerous. Symptoms usually start to improve within about six hours.
Dexamethasone can cause side effects such as stomach upset, difficulty sleeping (insomnia) and mood changes.
As with acetazolamide, you should talk to your GP about the option of taking dexamethasone before you travel.
Nifedipine
Nifedipine is often used to treat high blood pressure, but it can also be useful in treating high altitude pulmonary oedema (see complications of altitude sickness for more information).The drug decreases the narrowing of the artery that supplies blood to the lungs, helping to reduce chest tightness and ease breathing. It's usually taken as a tablet at six- to eight-hour intervals.
Nifedipine can cause a sudden drop in blood pressure, so it is important not to get up too quickly from a lying or sitting position if you take it.
Magazine
Nepal Travel and Tour Pvt. Ltd
Bhaktapur,
Nepal
email:
info@magazinenepal.com
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