So you’re going to spend some time at high altitude, climbing mountains or trekking, don’t forget to pack your Diamox before you leave home, it can save your life. Below are a few simple Q&A’s that should give you some perspective.
Q: What is considered High Altitude?
A: Medicine recognizes that high altitudes above 1,500 meters (4,900 ft) start to affect humans, as altitude increases atmospheric pressure decreases, which affects humans by reducing the partial pressure of pure oxygen. Extreme altitudes above 5,500–6,000 meters (18,000–20,000 ft) cannot be permanently tolerated. Although most people don’t experience and altitude related problems until about 3000 meters.
Q: What is Altitude Sickness and what are the symptoms?
A: Also know as AMS (Acute Mountain Sickness). Altitude sickness has three forms. Mild altitude sickness is called AMS and is similar to a hangover – it causes a headache, nausea, and fatigue. This is very common: some people are only slightly affected, others feel awful. However, if you have AMS, you should take this as a warning sign that you are at risk of the severe forms of altitude sickness HAPE and HACE both of these types of altitude sickness can be fatal within hours, always descend immediately if you are experiencing these symptoms.
Q: Who can get Altitude Sickness?
A: Anyone can, how fit you are, how much you weigh, your ethnicity or even your age has nothing to do with whom can get it and who can’t, if you follow the simple rules of climbing high and sleeping low, you will be fine. It is sensible practice to only sleep 400 meters higher than your previous evening, although you can climb as high as you like during the day, on my recent trip in the Himalaya we would have lunch at the highest point we would climb that day, after lunch a headache started and we would descend to our destination for the evening.
Q: What is Diamox?
A: Diamox also known as Acetazolamide is a medication prescribed to manage glaucoma (a condition of high eye pressure) and altitude sickness among a few other things unrelated to high altitude.
Q: What are the side-effects of Diamox?
A: According to Drugs.com side-effects include blurred vision; changes in taste; constipation; diarrhea; drowsiness; frequent urination; loss of appetite; nausea; vomiting. When I developed AMS at Everest Base Camp my only side-effect from this drug was tingling in the tips of my fingers, a day or so later my lips were also slightly tingling.
Q: When Should I take Diamox?
A: There is a big debate about this amongst people who travel through high altitude. I have talked to individuals who take Diamox at the beginning of their trip before they anywhere near developing AMS, the scary thing about this is most people I spoke with told me their doctor told them to do this so their body can get used to the medication. Yikes! My question to these people, “how do you know if you have AMS if you are taking medication to get rid of the effects of it?” Just because you don’t have symptoms of AMS doesn’t mean you don’t have it, and if you have it and don’t descend to an altitude your body can handle, or worse, you keep acceding, you will die. Yes, die. So in my option I would not take Diamox until you have the symptoms and when you do make sure you descend and follow the climb high and sleep low rule. I asked my doctor for one extra pill and took it a few weeks before my trip, purely so I knew what side-effects to expect.
Q: Can I buy Diamox in the country I’m travelling in?
A: I would say you can in the majority of destinations, but why would you? This is your LIFE. Why risk getting fake pills or something you are unsure of? Purchasing this medication in your home country ensures you will receive the correct medication and proper instructions on how to use it.
Q: What’s the worst case scenario if I get AMS and don’t take Diamox
A: If you keep ascending and ignore AMS symptoms. Death.
Q: What happens before death?
A: Once you have severe AMS and don’t immediately descend to a safe altitude the next stage is High Altitude Cerebral Edema, (HACE) the symptoms of this are: decreasing levels of consciousness including disorientation, loss of memory, hallucinations, irrational behavior and coma. In the presence of language barriers, HACE can be assessed by asking (or gesturing) for the climber to walk along a straight line.
Next, you get High Altitude Pulmonary Edema (HAPE) this is the stage just before you die. Symptoms include: Difficulty breathing at rest, cough, weakness or decreased exercise performance, chest tightness or congestion, Crackles or wheezing (while breathing) in at least one lung field, blue skin color, rapid shallow breathing.
This is a rapid process from first developing AMS to HACE to HAPE to death, no one has the exact statistic of this but, if you are a smart climber or trekker and listen to your body, you will be fine.
I hope you’ve gained some insight on AMS after reading this post. My time at high altitude gave me a lot of perspective on this subject, and after many conversations with other travellers that didn’t know much about AMS, or had miss information I felt this topic was quite relevant to my blog.
If you are trekking up to Everest be sure to drop into the Himalayan Rescue Post in Pheriche, they hold a daily 3 pm information session about AMS in the high season.