Acclimatization and Acute Mountain Sickness (AMS)

We all love going to Snow clad mountains at higher altitudes. But, we have to be careful so that we can avoid Acute Mountain Sickness.

Ladakh is located at the altitudes ranging from 9,000 to 15,000 feet above sea level. Traveling to this altitude in a short time can lead to acute health problems. Acute mountain sickness is commonly manifested as headache and vomiting. Other symptoms include breathlessness, sleeplessness and cough. The risk of high altitude illness depends on how quickly one ascends to high altitude. The recommendation is that one can safely ascend from sea level to 8,000 feet above sea level in 24 hours. Beyond this one should not ascend more than 1,000 feet (about 300 meters) in 24 hours. But, in practice this is difficult to follow. Traveling by road is therefore, considered safer which gives ample time for the body to get adjusted to altitude. Return by plane to lower altitudes is no problem.

There are many centers around Ladakh providing health care facilities. Major centers are the district hospitals of Leh and Kargil. Other hospitals are sub-district Hospitals at Drass, Diskit (Ph. 01982-220045), Khalsi, Padum and Primary Health centers around Ladakh. The army has many centers and major hospitals around Ladakh and emergency services are provided freely.

The best cure is either to acclimatize properly or descend. However, effects of mild AMS can be cured by taking some preventive AMS medicines like headache pain relief or Diamox with proper consultation and prescription with your doctor or physician prior to the start of the trip. Diamox is a sulfa drug and does have side effects including allergies. Hence, Diamox shall only be taken after proper prescription by your doctor or physician. Diamox can also be helpful in case a person suffer from periodic loss of breath, which especially occurs in the night while sleeping.

Incase, you feel the person is suffering badly then ask him to walk in a straight line by placing toe to toe. If the person is not able to walk in a straight line i.e. he is suffering with ataxia. IMMEDIATELY DESCEND.

Tips for Better Acclimatization
Below are few tips that will certainly help you in better acclimatization:

Keep your body properly hydrated
Do take plenty of intake of water with ORS or fluids like milk tea, juice, soup (garlic one will do wonders). If possible, take ORS soluted water or ORS. Also, garlic flavored water ( keep garlic in water bottles) will help much more than drinking plain water which should be avoided. This will help keep the oxygen level to normal in the body. You should avoid too much black tea or coffee as well.

Avoid over hydration 
Forcing children to drink when they are not thirsty : at best they will vomit (which will force you to descend), at worst they´ll start to develop cerebral edema – either only from water intoxication , or as a mixed result from this and altitude sickness. Too much water is harmful and can dilute your body’s sodium levels (hyponatremia) causing weakness, confusion, seizures, and coma.”

Avoid sleeping at high altitudes
As sleeping decrease the respiratory drive of our body, it is recommended that one shall hike to high altitudes in the day but should always come back to by the evening to sleep at lower altitude.

Avoid over-exertion
Do not over exert your body with any unnecessary physical activity which may lead you pump more breath.

Avoid tobacco and smoking and alcohol and other depressant drugs
Avoid tobacco and smoking and alcohol and other depressant drugs including, barbiturates, tranquilizers, and sleeping pills. These depressants further decrease the respiratory drive during sleep resulting in a worsening of the symptoms.

Keep your body warm
Keep your body warm with woolens and do not let it cool. Make sure your clothes are always dry.

Eat lots of Carbohydrates
Eat a high carbohydrate diet (more than 70% of your calories from carbohydrates) while at altitude.

Avoid sleep during the day
Try not to sleep during the day and keep yourself involved in some light activity during the day. Respiration decreases during sleep which further exacerbate the symptoms.

Sleep in upright position, if possible
Try to lay down or sleep by resting your back against the wall. If you cannot sleep in such mode then do not flatten your head on the bed rather place a bag below your head and then one or two pillows and then sleep in such a posture. It will help you keep your head much lighter.

Carry preventive medicines for AMS
Do take preventive AMS medicines along with you on the trip but only after consultation with your doctor or physician because the AMS medicines may lead to some side effects too. If you are not sure about any allergy with these medicines then try them one or two week before you plan the trip. Check to see if there are any allergic effects and decide.

Carry Small Oxygen Kit
If possible, you may also carry a oxygen cylinder to counter the AMS symptoms. It will certainly help as a supplement but do take proper consultation from your doctor for the intake amount of oxygen, before the trip. Oxygen intake will help you incase of any emergency and will spare you more time to descend to lower altitudes as soon as possible.

Immediately descend, if symptoms increase
Last but not the least, if the AMS symptoms start to increase then you should consider immediate descend. This is the only cure in some conditions when the symptoms have reached moderate levels and are not decreasing.

Taking baby or kid to high altitude?
Many a times when you want to travel to high altitudes, you may likely to worry for your kid or baby or infant. Well, personally I suggest you travel with kid or infant atleast 8-12 months old. However, studies suggest its safe to travel with an infant more than 3 months old IFF he/she is not born prematurely or do not suffer from any illness. NEVER travel with a baby less than 3 months old.