What to expect in High Altitude?
During your trekking and other adventure which involves high altitude walks above 3,000 m especially on Everest base camp or within Everest region, including other adventurous destinations that involves high passes above 5,000 m. All altitude gain in high hills and mountains of Nepal is taken from level of the sea and then as landscapes changes from sub-tropical to cooler alpine zone of above 1,500 m to 2,800 m high extending towards 3,000 m and even higher all the to the tips and summit of the peaks.
In Nepal with world highest mountains altitude variation and elevation of the country ranges from 60 m above sea level to the highest point on earth, Mt. Everest at 8,848 m, all within a distance of 150 km resulting into climatic changes from Sub-tropical-alpine to Arctic zone of temperatures and landscapes. Where trekkers and adventurer including mountaineers needs to adjust with certain heights having rest days for acclimatization, as higher elevation where you encounter thin air and lack of oxygen, where your body and physical must adopt with the situations, going slowly, sleeping well and drinking lot of fluid each day on your walking hours.
Never ever take alcoholic drinks that might hamper or confuse with AMS (Acute Mountain Sickness) as both symptoms is quite similar. Well it is all right on the way down and when you feel at your energetic best.
Altitude Sickness Information:
Altitude Sickness mostly occurs while trekking or climbing high peaks and major mountains could be from above 4,000 to higher 6,000 to 8,000 m where the level of O2 (Oxygen is at lowest). The sickness due to high elevation gain known as AMS (Acute Mountain Sickness) High Altitude Sickness known as Acute Mountain Sickness (A.M.S.) mainly happens when trekkers and climbers ascend at fast speed or quickly normally AMS takes place above 3,000 meter high for some people. Where the victims has to descend to lower areas and rest till relived and then try going higher slowly with acclimatization days in between before reaching one’s final destination at high above.For this reasons Tramping Himalaya Adventures allocates experienced and well trained guides who have gone several times training with medical course including symptoms of AMS, one might have consults with your family doctor before signing up the trips that includes high altitude walks, and suggest you with ideas providing you with medical list and advice.
01: Normal AMS Symptoms – might occur but not a Big Deal.
Normal Altitude Sickness Symptoms that one might encounter sometimes no matter how much precaution is taken, most of the trekker will experience sometimes. Not getting enough sound sleep than normal 5-6 hrs of deep sleep, loss of appetite, nightmare, shortness of breathiness, these are the symptoms might occur above 2,600 m and higher elevations. On some occasion one might get frequent runny nose and dizziness, not enough of urine these are severe case either descend-descend and descend for more critical case requires immediate evacuation by any means quick transportation if Helicopter is not available, due to weather and other problem and landing field.
02: On Mild AMS Symptoms – NEVER TRY TO ASCEND:
While many trekkers and adventurer booked the holiday involving high passes and altitude even though how fir you are? Might catch mild AMS due to this reason should take care and descend or rest drinking plenty of fluid, water-tea and soups and taking deep breathe. Get acclimatize with rest days where you can hike higher up for short while and then sleeping at low elevation which helps with acclimatization, that is why we have designed the itinerary days in Everest or any other trips that involves high altitude walks.
Severe Case of AMS: High Altitude Cerebral Edema (HACE)
A build-up of water or in the brain, in most cases the first symptoms gets mild and then grows severe. Might lead to HACE might lead to unconsciousness are death within several hours from the onset of symptoms, but normally it takes few days to develop the symptoms of HACE. The first sign of ataxia begin treatment with medication, oxygen and descent. Usually 4 to 8mg of dexamethasone is given as a first does, then 4mg every six hours, Diamox every 12 hours and 2-4 litres /minute oxygen. Descent is necessary but a PAC (portable altitude chamber) bag will often be used first if available.
High Altitude Pulmonary Edema (HAPE)
A buildup of fluid or water in the lungs and get very serious, one should be careful with this serious symptoms and it is often accompanied by a mild fever. By far the treatment is oxygen at 4 liters a minute but using PAC (portable altitude chamber) bag treatment is a good substitute. If there is no PAC bag or oxygen then descent will be lifesaving. HAPE can lead to unconsciousness are death very quick.
Prevention of Altitude Illnesses
Prevention of altitude illnesses falls into two categories, proper acclimatization and preventive medications. Below are a few basic guidelines for proper acclimatization. f possible, don’t fly or drive to high altitude. Start with slow elevation taking easy pace before heading higher up towards 10,000 feet or 3,048 meters above. If you do fly or drive, do not over-exert yourself or move higher for the first 24 hours. Best way to deal with high altitude is climb high and then sleep low. This is the normal and important routine used by climbers and mountaineers
Preventive Medications:
However it is not best to take the medication on AMS, but to be careful taking safety measures walking at slow pace with much rest as well with proper acclimatization days before reaching higher ground. Some might be recommended with certain medication like Diamox which is widely used to speed up with acclimatization, it is always safer to take advice from the doctors, trek leader or well-trained local guides regarding this matter of taking medications. Diamox medically known as ‘Acetazolamide’ allows you to breathe faster so that you metabolize more oxygen, thereby minimizing the symptoms caused by poor oxygenation. Most helpful at night when respiratory decrease, might take while for Diamox to work and gets it effect, it is advisable to start taking 24 hours before plan to trek higher up continue for at least five days at higher altitude. The recommendation of the Himalayan Rescue Association Medical Clinic is 125 mg. twice a day (morning and night). (The standard dose was 250 mg). The other medication for severe case is Dexamethasone a steroid) a prescribed drug that decreases brain and other swelling reversing the effects of AMS. Dosage is typically 4 mg twice a day for a few days starting with the ascent. This prevents most symptoms of altitude illness. It should be used with caution and only on the advice of a physician because of possible serious side effects. It may be combined with Diamox. No other medications have been proven valuable for preventing AMS.
A Comprehensive Medial and First Aid Kit:
This is the basic list to cover the more common ailments that affect trekkers. Climbing groups, expeditions and trekkers going to isolated areas will need a more comprehensive kit. Bandage for sprains, Plasters / Band-Aids, Iodine or water filter (optional), Moleskin/Second skin – for blisters, Antiseptic ointment for cuts, Anti-bacterial throat lozenges (with antiseptic), Aspirin or Paracetamol (general painkiller), Oral rehydration salts, Broad-spectrum antibiotic (norfloxacin or ciprofloxin), Anti-diarrhoea medication (antibiotic), Diarrhea stopper (Imodium – optional), Antibiotic for Guardia or similar microbe or bacteria, Diamox 250/500mg (for altitude sickness), Sterile Syringe set (anti-AIDS precaution), Gel hand cleaner.
These are the basic comprehensive medical and first aid kit that we always carry throughout the trek and climb in every trips, and we also recommend you to bring your own personal first aid kit as well with an advice from your doctors before departing for Nepal
