Acute Mountain Sickness

AMS (Acute Mountain Sickness) or Altitude Sickness

At sea level one can breath easily as whole atmosphere of pressure pushes in on the air. As one goes higher elevation, there is less atmospheres and hence less atmospheric pressure pushing in on the air breathed into the lungs. Our bodies experience that lack of air pressure as a lack of oxygen. Until the body has a chance to adapt such thin air pressure, one may experience symptoms of mountain sickness known as AMS. Different peoples' bodies adapt or acclimatize at different rates. These acclimatization rates are not at all related to what kind of physical shape one is in. A super fit olympic marathon runner or an obese or a young strong climber are equally likely to have symptoms of altitude sickness (AMS) at the same altitude.

SYMPTOMS of AMS – the symptoms of altitude sickness are rather vague, variable, and easy to attribute to other causes. However, when at high altitude, assume any of the following symptoms are mountain sickness until proven otherwise.

IF YOU HAVE SYMPTOMS:

1.    Rest – do not over exert yourself,

2.    Do not go higher elevation,

3.    Drink lots of fluids. Avoid alcohol,

4.    Let someone know how you are feeling,

5.    Try paracetamol for headache discomfort,

6.    Avoid any sedatives - especially sleeping pill or narcotics. These will slow your breathing and worsen your symptoms,

7.    Consider use of Acetazolamide (Diamox) to prevent or treat symptoms.

8.    If symptoms are severe or worsening, return to lower altitude.

 At the advice of physician, consider the use of other medicines such as dexamethasome every 6 hours, nifedipine 10 mg 8 hourly or oxygen.

ACETAZOLAMIDE  (DIAMOX) –
If AMS symptoms are moderate or severe, acetazolamide treatment may be beneficial. The dose is 250 mg every 12 hours. This medicine stimulates breathing and therefore helps the body get more oxygen. Acetazolamide especially helps one breath better at night and hence, helps sleep without causing any sedating effects. Possible side effects of acetazolamide include tingling (pins and needles feeling) of hands, toes, lips, increased urination, and change in taste of carborated beverages. These symptoms are merely annoyances, subside when the drug is stopped, and do not indicate allergic reaction. Travellers who have allergies to sulfa antibiotics  and have never tried acetazolamide  should not take this medicine. Acetazolamide is as sulfa derivative, there is a slight possibility of allergic cross reaction.

PREVENTION –
The best preventive measure is acclimatization that is walking steadily and gaining altitude slowly. This way the body starts adapting slowly to the thin air pressure of the high altitude.

Besides acting to treat symptoms of mountain sickness, acetazolamide can also help prevent or decrease severity of AMS symptoms before they occur.  Especially for people who have been to high altitude before and have had AMS, taking acetazolamide 24 hours before going high is very helpful in preventing altitude sickness. Drinking lots of water while taking acetazolamide is very important, since acetazolamide makes one urinate more. Most people do just fine at high altitude with nothing more than a few annoying symptoms of headache or shortness of breath with exertion. Being able to identify to know what to do about mountain sickness can help prevent serious problems.

Related Oxygen Rate at Different Altitude