Have you ever been on a hike or backpacking trip when you start to feel a shortness of breathe, fatigue, loss of coordination and/ or dizziness? You may have been experiencing acute mountain sickness (AMS). Acute mountain sickness or altitude sickness is defined as:
Mountain sickness develops when the rate of ascent into higher altitudes outpaces the body’s ability to adjust to those altitudes.
Mountain sickness generally develops at elevations higher that 8,000 feet (about 2,400 meters) above sea level and when the rate of ascent exceeds 1,000 feet (300 meters) per day.
During a recent outing with my wife and I took Pisgah highway 151 to the Blue ridge Parkway. We decided since the parkway was closed, we would hike up one of the many trails that overlooked the surrounding areas. We began to hike on the trail that was heading up Candler Knob. My wife started to experience fatigue, which we just chalked up to being a little out of shape. As time wore on, she started to get a headache and I noticed that her coordination was a little off during the times we would pause for water breaks. I made a decision that we needed to turn around and her symptoms got better. We decided to hike on the parkway to take some photos of the ice melting on the exposed rocks. Later, we wanted to go the opposite direction and ease up the parkway were some fellow hikers had mentioned another trail. We continued on for about another 20 minutes when my wife started getting the same symptoms again. On the way back to the car, we noticed a sign that said the mountain crested at 4000 feet. I knew then that my wife was having problems with the elevation, including how quickly we had driven up the highway to the ridge. We got back to the hotel and took a nap and most of the evening my wife had issues with her breathing, sounding like gurgling respirations. I just want to inform you all about this so that you do not have a negative experience when enjoying the outdoors at high altitudes.
The following actions can trigger acute mountain sickness:
Ascending too rapidly
Overexertion within 24 hours of ascent
Inadequate fluid intake
Hypothermia
Consumption of alcohol or other sedatives
Acute mountain sickness (AMS) may be associated with any combination of the following symptoms:
Fatigue
Headache
Dizziness
Insomnia
Shortness of breath during exertion
Nausea
Decreased appetite
Swelling of extremities
Social withdrawal
People with AMS often attribute their symptoms to other causes such as an uncomfortable bed, bad food, or a hangover. However, it is important to recognize that these symptoms may indicate a high altitude illness.
There are two advanced forms of AMS. They are high altitude pulmonary edema (HAPE) and high altitude cerebral edema (HACE). Both of these illness can be fatal so listed below are the signs and symptoms of both.
High altitude pulmonary edema (HAPE), an advanced form of AMS, causes following progression of symptoms:
Shortness of breath at rest
Gurgling respirations
Wet cough with frothy sputum
Possible fever
Respiratory failure
Onset of HAPE can be gradual or sudden. HAPE typically occurs after more than 1 day spent at high altitude.
High altitude cerebral edema (HACE) can begin with confusion.
A person developing HACE begins having trouble keeping up with the group.
Next, walking and coordination become impaired.
As the brain continues to swell, lethargy and then coma will develop.
If left untreated, HACE will ultimately result in death.
When should I seek medical care?
If symptoms such as headache or shortness of breath do not improve promptly with simple changes, visiting a doctor may be a helpful if descent is inconvenient and a doctor is available.
Descend immediately if shortness of breath at rest, mental confusion or lethargy, or loss of muscle coordination develops. Symptoms of most people with AMS improve by the time they reach a medical facility, which is usually located at a lower altitude.
Can I do self-care at home?
Yes, you can and here is a list of the following things you can do on your own.
Delay further ascent until symptoms improve
Rest and stay warm
Take acetaminophen (Tylenol) for headache
Do not using sleeping pills or other central nervous system depressants to treat insomnia because they can suppress breathing.
If symptoms continue, do not travel any higher.
If symptoms worsen, descend approximately 1,000-2,000 feet (300-600 meters) immediately.
How can I prevent this?
AMS is preventable. The body needs time to adjust to high altitude. Physical conditioning has no bearing on this.
For people who do not know the rate at which their bodies adjust to high altitude, the following preventive measures are recommended.
If traveling by air to a ski area above 8,250 (2,500 meters), incorporate a layover of 1-2 days at an intermediate altitude.
Avoid physical exertion for the first 24 hours.
Drink plenty of fluids, and avoid alcoholic beverages.
If mountain climbing or hiking, ascend gradually once past 8,000 feet (2,400 meters) above sea level.
Increase the sleeping altitude by no more than 1,000 feet (300 meters) per 24 hours. The mountaineer’s rule is “climb high, sleep low.” This means that on layover days, a climber can ascend to a higher elevation during the day and return to a lower sleeping elevation at night. This helps to hasten acclimatization.
Prevention of high altitude cerebral edema (HACE) is the same as for acute mountain sickness (AMS).
Information obtained from the following sources:
http://www.emedicinehealth.com/mountain_sickness/article_em.htmhttp://www.emedicinehealth.com/wilderness_altitude_sickness/article_em.htmhttp://www.annmariebrown.com/hiketips_hazards.htmlhttp://firstaid.webmd.com/mountain_sickness_treatment_firstaid.htmhttp://www.webmd.com/a-to-z-guides/wilderness-altitude-sickness
Bentley VentureTree Team
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