Acute Mountain Sickness
Acute Mountain Sickness is the result of climbing to a higher altitude quicker than your body is able to adapt to it. Symptoms can start from around 8,000ft in some people, and in others at around 11,000 ft.
Symptoms of AMS (2)
Mild Acute Mountain Sickness:
Symptoms mild altitude sickness can be like a hangover.
•Slight loss of appetite
Provided you have no abnormal lung sounds and a good blood oxygen saturation level (SpO2), mild symptoms should normalize after some hours rest. Communication is key – your guides need to be kept up to date with how you feel, and you should not go higher whilst you still have symptoms.
•Deterioration of all the above symptoms
•Nausea and vomiting
•Shortness of breath
•Loss of appetite and inability to eat
•Very weak and lethargic
At this point, you should descend immediately to the elevation where you last felt “well”. Remaining at this lower altitude until your symptoms normalize, only then should you even consider going higher.
If you continue to climb higher with Moderate AMS, you put yourself at risk of needing to be evacuated from the mountain – and worse – you risk your life.
Traveling with a reputable operator, you will not be allowed to get to this point. If you do, then get down that mountain as fast as you are able! Spending some time in a Gamow bag (Portable Altitude Chamber) can be effective to reduce symptoms before making the descent. Under no circumstances should you climb higher after using the Gamow bag.
If you somehow managed to ignore the symptoms of moderate AMS, and have deteriorated to the point where you have Severe AMS, then your only hope for your life is to descend as quickly as possible.
•Increased shortness of breath
•Decreased coordination (ataxia)
•Inability to walk
•Hallucination and inability to communicate properly
•Increased coughing and fluid on the lungs
If you are suffering from severe AMS, it’s very possible that you will not be able to walk down the mountain and an evacuation will be necessary. You probably won’t even know how ill you actually are.
This is where you rely on your guides and team-mates. Keeping an eye on each other, noting if people have symptoms that they seem unaware of. Any reputable operator will have been monitoring your condition long before it gets to this point.
There are two devastating results of severe mountain sickness, HAPE and HACE.
High Altitude Pulmonary Edema (HAPE)
For many years, High Altitude Pulmonary Edema (3) was incorrectly diagnosed as “pneumonia” in various reports of healthy young men dying after a few days at high altitude.
In most cases, some symptoms of Acute Mountain Sickness have preceded the onset of HAPE. Though in some cases it can appear without prior symptoms.
Pulmonary Edema is where fluid builds up in and around the lungs, preventing oxygen from being absorbed and making breathing difficult.
Symptoms of HAPE include:
•Productive cough, with blood or mucus
•Gurgling lung sounds
•Blue lips from lack of oxygen
•Tight chest, difficulty breathing
•Confusion, lack of coordination
If you are at altitude and have the feeling that you may have a chest infection, assume it is HAPE until proved otherwise.
Symptoms can go from bad to worse very rapidly. Blood oxygen levels will drop, causing the brain to be starved of oxygen. This can lead to the onset of HACE. If oxygen is available it should be given, and descent should be immediate. Waiting around to “see if he/she feels better” will almost certainly result in death.
Descent is the only option, which is further made difficult as exertion can exacerbate HAPE. The shortness of breath and lack of oxygen can make the person unable to walk. For this condition, an evacuation is essential. It is important to get off the mountain and get medical attention immediately.
High Altitude Cerebral Edema (HACE)
High Altitude Cerebral Edema, characterised by a crashing headache that will not go away is the result of a buildup of fluid on and around the brain. The onset can be rapid, and once again, immediate descent is essential.
Symptoms of HACE include:
•Confusion and disorientation
•Lack of coordination
•Inability to walk
•Irrational behaviour (as though the person is drunk)
Because HACE affects the brain, the person suffering may not know how ill they really are. Treatment with oxygen and a Portable Altitude Chamber whilst preparations are made for immediate descent can help.
Nothing will treat the onset of HACE whilst remaining at altitude. The only option is to go down and seek medical attention immediately.
MOST, IF NOT ALL SYMPTOMS OF ALTITUDE SICKNESS ARE AS A RESULT OF ASCENDING TOO QUICKLY TO A HIGH ALTITUDE.
Tips to Stay Safe & Comfortable:
•Opt for a longer route, the longer the better.
•Do not use cigarettes, sleeping pills or alcohol on the mountain. If you have a headache and need to take a pain-killer, tell your guide.
•Choose an operator with robust safety procedures, well trained guides that know how to monitor you and recognize the signs of developing altitude sickness
•Communicate with your guides and fellow team-mates, do not “tough it out” if you are feeling unwell.
•Keep well hydrated, drinking 3-4 liters of water per day.
•Go slowly! This is not a race, and the slower you go, the more your body is able to acclimatize.
•For extra safety, choose an operator that carries oxygen canisters and a Portable Altitude Chamber.
•If your chosen operator does not carry a pulse oximeter, take one with you – and learn how to use it to monitor your blood oxygen levels.
•Consider using Diamox, as recommended by many operators.
Kilimanjaro Altitude and Pre-Existing Conditions
Most companies will require a medical form to be filled in prior to being accepted on a trek. This gives them the opportunity to review any current medical conditions you may have and refer you back to your doctor for final acceptance.
If you do suffer from any medical conditions, even if they are well-controlled, it’s worth going to see your doctor or healthcare professional to inquire whether or not it is safe to go to altitude.
A common one is asthma. Many people who have no current symptoms of asthma, but have suffered with it in the past can find it rears it’s head on the mountain. The combination of the dry, cold, dusty air and lack of oxygen can cause attacks.
If you rely on any medications, you should be sure to check with your doctor before attempting the climb. Also check for any interactions with your current medication if you decide to take Diamox.