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Main \\ Outdoor Activities \\ Mountains \\ Mountaineering \\ Who can go trekking? \\
  Altitude Sickness (AMS)

AMS Symptoms


Headache
Nausea
Vomiting
Loss of appetite
Dizziness
Sleep Disturbance


At 5000m the air pressure is half that of sea level, with a corresponding reduction in the amount of oxygen. To be able to cope with this lack of oxygen your body starts to create more oxygen carrying red blood cells. Your heart rate will increase, and you will breath faster and deeper - try measuring your resting heart rate when at altitude - you may be surprised! (At Lobuche mine was 108, and I was fairly well acclimatised!). If you ascend faster than your body can acclimatise you will start to develop symptoms of Acute Mountain Sickness (AMS). A headache being the most common, others are nausea, vomiting, fatigue, loss of appetite dizziness and sleep disturbances.


The most extreme cases of altitude sickness result in High Altitude Pulmonary Oedema (HAPE) or High Altitude Cerebral Oedema (HACE). Both of these can come on very quickly (usually after symptoms of mild AMS), and can be life threatening if not treated immediately. If any symptoms of HACE or HAPE are present then you should immediately descend.


Symptoms of HACE:


Worsening headache
Loss of co-ordination
Altered behaviour
Hallucination
Disorientation
Confusion
Increasing drowsiness progressing to coma


Symptoms of HAPE:


Difficulty in breathing
Reduced exercise tolerance
Cough (dry at first then bubbly, perhaps with blood stained sputum)


But the good news is that for most people all of this is preventable by acclimatising, and this is done by slow gradual ascent.


Acclimatisation Schedule


Ascent Rate
Take 2-3 days to reach 3000m. Above 3000m, 300m / day. Take a rest day every 3 days (or 1000m)



The most important thing to remember is that the best way to acclimatise is to ascend slowly and gradually. The common wisdom is that you should take 2-3 days to reach 3000m - If flying in to above this height remember to take extra acclimatisation days. Once above 3000m, you should sleep no more than 300m above you last nights altitude, and take a rest day every 3 days (or 1000m). The key thing to note is that these are sleeping heights - there is no problem climbing higher, in fact it can be beneficial, but you must drop back down to sleep. Mountaineers always say - "Climb High, Sleep Low" - remember this!


If at any time you get symptoms of AMS you should not climb higher until they are gone. If they persist then you should descend to below the height where they first started. Only start to climb again when they have gone.


At times it can be difficult to stick exactly to this schedule, as villages aren't always conveniently placed for acclimatising, so you should think of the 300m as an average. If you do 600m in a day then consider taking a rest day. The most important thing is to not ascend if you have symptom of AMS. In general if you are feeling fine then you are probably acclimatising fine - people acclimatise at different rates and so any suggested schedule can only be an average.


Other tips


At altitude, and when working hard you will tend to become dehydrated quite quickly so it is very important to drink lots of water. It has been suggested that drinking lots of water can also help in your acclimatisation as it helps to carry the excess of CO2 from your body.


Finally, don't become paranoid about AMS. As long as you are careful, take note of what your body is telling you (watch for the symptoms) and act on it, then you will have no problems.

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