AMS- Acute Mountain Sickness. What is it?
Imagine yourself on a lovely trek across the Himalayas when all of a sudden your buddy complains of a headache and feels a bit lightheaded. He doesn't feel like eating anything when you go to your café. Sounds recognisable? He might have AMS, also known as acute mountain sickness. One of the most frequent dangers that trekkers encounter while trekking at high elevations is AMS. This is the deterioration of health brought on by an increase in altitude and often happens at elevations exceeding 2500 metres.
Why does this occur? As one ascends, the air becomes less dense, lowering the amount of oxygen that is taken in by the lungs with each breath. Because the body does not have enough time to adapt to the decreased oxygen level, AMS develops. Mild AMS is a typical occurrence, and the symptoms are typically simple to recognise.
What does the term ‘High-Altitude’ refer to?
Are you anticipating your forthcoming Himalayan trek? Thinking to avoid trekking since it might make you sick with acute mountain sickness? There are a few things you can do to lessen your risk of becoming sick, even though it is extremely usual to acquire AMS at high elevations if you are not well-acclimatised.
What is it, first of all? Any elevation over 8,000 feet is regarded as high altitude. In other words, oxygen molecules are more distributed at this altitude when air pressure starts to drop significantly. What does this imply? It indicates that less oxygen is getting to your lungs with each breath you take. The body responds by breathing more forcefully. Additionally, rapid breathing during ascending causes your blood carbon dioxide levels to increase. Your body experiences a decline when the accumulation of carbon dioxide exceeds what it can handle. Therefore, if you were inhaling 200 oxygen molecules each breath at lower altitudes, at higher altitudes you will only be breathing 100 to 150 oxygen molecules per breath. You need to raise your breathing rate, or ventilation, to receive the same amount of oxygen that you are used to inhaling.
Dehydration, a lack of appetite, and other hypoxic symptoms are all caused by the body's reduced ability to absorb oxygen and the increased expulsion of carbon dioxide from the body.
Therefore, you must be aware of the physical changes that altitude causes and you plan your trek diligently.
The human body is a marvel of design. Despite the surroundings changing, it doesn't take long to adjust to the new setting. Acclimatization is the process by which our bodies become accustomed to and adapt to high altitudes, but to make the acclimatisation process as good as possible, you must adhere to high-altitude trekking whilst taking things at your own time without rushing.
Symptoms of AMS
Mild AMS
Severe AMS
Acute mountain sickness (AMS) is the most common form of altitude sickness. 75% of persons will experience minor symptoms at altitudes more than 10,000 feet.
The symptoms of AMS can take many different forms. How rapidly and vigorously you exhaust yourself while climbing the mountain, as well as any additional accompanying preconditions you may have, will all have a significant impact on the intensity of the symptoms you encounter (e.g., coming from sea level, having pre-existing lung conditions, etc.).
In most cases, symptoms begin as quite minor ones. The optimum time to catch them and take them back to lower elevations is now. However, the more time that passes, the worsening of the symptoms and the severity of the AMS's adverse effects are likely to increase.
Mild AMS: You experience in the initial 1 to 3 days spent at a specific altitude. Typically, symptoms appear 12 to 24 hours after arriving at altitude. You can go about your daily activities despite symptoms like a mild headache and tiredness. After a few days, as your body adjusts, symptoms go better. As your body adjusts, you can probably continue to be at your present height. When trekking, it's crucial to let your trekking companions know right away if you start to feel sick. A person usually suffers mostly from gastrointestinal symptoms.
The following is a list of the most typical Mild AMS symptoms:
A feeling of faintness or dizziness
Fatigue
Headache
Insomnia
Lethargy
reduced appetite
muscle pain
nausea or diarrhoea
quick heartbeat
breathing difficulty
hands, feet, or facial swelling
Severe AMS: If you have severe AMS, you could feel out of breath even when at rest. It might be challenging to walk. You must seek medical attention right away by descending to a lower altitude. Acute mountain sickness that is severe can impact your heart, lungs, muscles, and the neurological system and result in more severe symptoms. For instance, brain enlargement may cause disorientation in certain people. Additionally, having fluid in your lungs may cause you to experience breathing difficulties.
A rapid descent to lower elevations of 2,000–4,000 feet is necessary for severe AMS (610-1,220 meters).
The following is a list of the most Severe AMS symptoms:
chest congestion when coughing
Skin discolouration and a bare complexion
incapacity to walk or unsteadiness
social exclusion
If you are suffering from any of these severe symptoms, you must share the Trek leader immediately and to get emergency help right away. If you take care of the issue before it becomes worse, it will be much simpler to treat.
Who is at risk for AMS?
Acute mountain sickness may affect anyone. Your risk does not appear to be affected by your age, sex, or overall health. You could be more vulnerable if you:
Have a lung or heart condition: If at all feasible, your doctor may advise avoiding high altitudes.
Are Expecting: Before visiting a high-altitude area, consult with your physician if you are trekking during your pregnancy.
Live at a low elevation: Your body is far less used to higher elevations, thus you are more likely to have symptoms. Know the signs of altitude sickness and how to cure it if you're planning a vacation to a high-altitude area.
Previously experienced altitude sickness: Before your next vacation, discuss prevention and treatment with your clinician.
A low red blood cell count due to anaemia.
Using drugs that might slow down your breathing, such as tranquillizers, sleeping pills, or narcotic painkillers.
Prevention of AMS
While trekking or visiting high-altitude areas, there are several precautions you may use to minimise your risk of getting AMS or prevent any serious symptoms.
Know your Trek Itinerary Well: Even while spontaneous travel and trekking plans with a group of friends may thrill us, it is vitally essential to know your trek itinerary and the highest point of your journey before you set off on your adventure. This is significant for both your physical trip preparation as well as your understanding of the trek's acclimatisation plan and pace of height increase.
Stay Fit: Your risk of developing acute mountain sickness decreases as your level of fitness increases. An easy illustration of this is that if you stay vigilant during the trek, you will be able to breathe regularly and your body will receive the oxygen it requires. There is therefore a very high probability that you won't have any symptoms, particularly headaches. On the other hand, if you are constantly weary and gasping for air, your body is unable to absorb the oxygen it requires, which will likely result in a headache at the end of the day.
Acclimatization: When travelling to a high-altitude area, it's important to include a buffer day. It offers your body the time and rests it needs to acclimatise to the challenging weather and altitude change. This becomes even more crucial if you're flying to northern areas because you'll be gaining a lot of elevation in a short period, which is sure to make you feel nauseous. Additionally, if at all feasible, spend the night in the closest low-altitude location because the risk of AMS rises as the temperature drops at night.
Eat frequently: One of the signs of AMS is fatigue. This is because when we travel, we often consume less food and, even when we do, it is unhealthier stuff that makes us feel bloated. Food that is unplanned and unhealthy should always be avoided. When your diet is healthy, eating on schedule offers your body the energy it needs and helps to keep your body temperature stable. Hot soup, eggs, energy bars, and other light meals are the best choices.
Gradually increase altitude: One of the numerous reasons why our body reacts adversely to an abrupt increase in altitude is that it doesn't have enough time to adjust to the environment. Planning your schedule while keeping in mind that you need to climb gradually and shouldn't be in a haste to go forward can help you prevent this.
Maintain Body Temperature: This is crucial because, as you ascend in altitude, the temperature lowers significantly. If you can't keep your body temperature steady, your risk of acquiring AMS also rises. Wearing at least three to four layers of warm clothes is advisable to keep your body as warm as possible.
Keep Yourself Hydrated: Drinking enough water is the simplest and frequently overlooked approach to prevent AMS. Being hydrated is the apparent way to avoid AMS because it is well-known that drinking water helps our body keep the level of oxygen in our blood cells at a healthy level. You need to avoid coffee as much as you can and consume water at regular intervals.
Diagnosis of AMS
It's most probable altitude sickness if you get a headache and at least one additional symptom within 24 to 48 hours of ascending to a higher level. A more seasoned climber may be able to identify altitude sickness symptoms while you're ascending and direct you to medical assistance.
A medical professional will inquire about your symptoms, routine, and surroundings if you have severe altitude sickness. The doctor could examine you physically, including listening to your chest.
To determine whether you have any fluid in your chest, you might require a chest X-ray. To check for brain fluid in serious situations, your doctor may request a brain MRI or CT scan.
How is AMS Treated?
Moving as fast and safely to a lower height is the primary therapy for altitude sickness. Avoid going any higher, at the very least. Staying at your existing altitudes for a few days can be sufficient to alleviate moderate problems.
Various therapies are dependent on how severe the symptoms are:
Mild altitude sickness: Over-the-counter medications can ease headaches. Once your body adjusts or you relocate to a lower altitude, other symptoms will subside.
Moderate altitude sickness: Once you are 1,000–2,000 feet lower than you were, your symptoms should subside in 24 hours. You should feel entire well in three days.
HACE, HAPE, and severe altitude sickness: If you exhibit severe symptoms, you need to be transferred right away to a location that is no higher than 4,000 feet in elevation.
You could require dexamethasone, a steroid that aids in reducing swelling in the brain if you have fluid in the brain (HACE). Sometimes doctors will recommend dexamethasone as a preventative medicine.
You could require oxygen, medicine, a lung inhaler, or, in extreme circumstances, a respirator if you have fluid in the lungs (HAPE).
Acetazolamide, which speeds up your breathing so you inhale more oxygen, may be prescribed by a doctor if you need to take in more oxygen. The medication lessens the effects of altitude sickness and helps your body adapt to the higher level more quickly.
Reach a healthcare professional as soon as you can. You might need to be hospitalised.
Medication: here are various medications that can be used to treat AMS based on a Doctor’s prescription and recommendation. They include:
Ibrufen
Dispirin, for headache relief and
Diamox
Dexamethasone, only in extreme cases
Before taking any medicine for AMS, it is advisable to speak with a medical professional or specialist. Before travelling to the mountains, we advise having a complete medical examination.
The long-term outlook of AMS
After returning to lower elevations, the majority of people can swiftly recover from a minor episode of acute mountain sickness. Symptoms usually go away after a few hours, although they might continue for two days. However, problems can cause swelling in the brain and lungs, which might end in a coma or death if your condition is severe and you have limited access to care. When going to high-altitude regions, it is crucial to prepare ahead of time.
Does altitude sickness have any long-term effects?
Altitude sickness has no long-term detrimental consequences if you take precautions and descend to a lower level when you get symptoms. You will feel better in a few days. As soon as you feel better, you can keep ascending to greater altitudes as long as you do it cautiously and gently.
Can high altitude illness lead to death?
Altitude sickness occasionally poses a life-threatening concern. You run the danger of experiencing problems like a coma or perhaps passing away if you have HAPE or HACE. Get help as soon as you can to lower your risk.
Can you get rid of altitude sickness?
Temporary altitude sickness is common. You'll feel better as soon as you descend to a lower elevation. Make careful to move slowly to allow your body to adapt when you start your ascent again (or on your subsequent climb).
TYPE OF AMS
There are two more dangerous but less common severe kinds of altitude sickness. Both have the potential to be fatal. You must descend right away to obtain medical attention for:
HAPE- High-altitude pulmonary oedema, or HAPE, causes the lungs to swell with extra fluid, which makes breathing difficult even while at rest. You experience extreme exhaustion, weakness, and maybe a sense of suffocation.
You can overlook the unique HAPE symptoms if you're not paying attention.
You should be able to catch two things: cough and shortness of breath.
You may occasionally cough up an extremely dry cough if you have HAPE.
Next, take note of your navigation of the campground. It is a loud warning signal if your breathing is laboured or your actions are clumsy. You can even become aware of your shallow breathing while seated. Anything will make you drained. There is a constant sense of weariness.
These are HAPE's early phases. You must identify HAPE during this time and initiate treatment right away.
HACE- High-altitude cerebral edema, or HACE, is characterised by an accumulation of fluid on the brain that results in swelling. You may act violently, get disoriented, or lack coordination.
You'll almost always get a severe headache with HACE (because HACE is a swelling of the brain). Daily tasks like putting on a jacket or just zipping up your tent will be challenging for you. Additionally, you can speak irrationally and come out as confused and bewildered to others. You could consistently forget stuff.
Additionally, you can still feel dizzy and nauseous.
These are all signs of HACE. It implies that fluid is building up inside your brain and causing oedema.
Like HAPE, there is no known cure for HACE. What you can do is stop it from accelerating and getting deadly. The only method to escape a HACE is to drop and rapidly reduce altitude.
Therefore, it's crucial to take action before it worsens.
Enjoy Trekking. But be safe!
Depending on the severity, altitude sickness symptoms can be painful or even fatal. You may, however, avoid this problem with some planning and safety measures. With careful preparation and acclimation, it may be avoided. Any journey should be carefully planned, and you should be informed of the closest hospitals and emergency numbers. The easiest approach to stop it is to move more slowly and give your body time to adjust. Do not continue if you start to get symptoms at a high altitude. Return to a lower height to give your body time to acclimatise before proceeding slowly and cautiously upward.
Everyone's body responds differently to high altitudes, making it difficult to forecast how yours will. Avoiding rapid ascents to high altitudes and being prepared with the aforementioned advice are your greatest lines of defence against altitude sickness.
Writer & Trek Expert
Apurvi Manek
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