Acute Mountain Sickness

[Furious Doc]

Iam sure mot of you are aware of what acute maountain sickeness is...now here is the science behind all the symptoms and the treatment

WHAT IS AMS?
High altitude reduces the amount of oxygen in the air and can lead to dangerous effects on the body. Although the most serious cases are usually of mountain climbers, anyone can get mountain sickness by visiting an area of a higher altitude without adequate acclimatization
High altitudeis defined as altitudes more than 3000 meters whileextreme high altitude is altitudes more than 5800 m.Altitude related illnesses that develop shortly after ascentto high altitudes can present with either cerebral or pulmonary syndromes.

What is Acclimatization?
It is the adaptation of the body to the hypoxic conditions in high altitude i.e it refers to the change in the body's physiology to the change in the oxygen availability and atmospheric pressure.

What are the Symptoms?
The list of signs and symptoms mentioned in various sources for Mountain sickness includes the 21 symptoms listed below:
Dizziness
Headache
Drowsiness
Lethargy
Fatigue
Shortness of breath
Rapid deep breathing
Hyperventilation
Rapid pulse
Nausea
Vomiting
Exhaustion
Anxiety
Sleep disturbances or insomnia
Pulmonary edema
Difficulty breathing
Frothy sputum
Blood in sputum
Cyanosis i.e bluish discoloration of the skin
Incoordination
Coma (if untreated)

Treatment Management of AMS follows three axioms:
a) furtherascent should be avoided until the symptoms haveresolved
b)patients with no response to medicaltreatment should descend to a lower altitude
c) if and when HACO(High altitude pulmonary oedema) is suspected, patients should urgentlydescend to a lower altitude.
 Descent andsupplementary oxygen are the treatments of choice andfor severe illness, the combination provides optimaltherapy. Remarkably, a descent of only 500 to 1000 musually leads to resolution of acute mountain sicknesswhile high-altitude cerebral oedema may require furtherdescent. Simulated descent with portable hyperbaricchambers, now commonly available in remote locations,are also effective. Medical therapy becomes crucialwhen descent is not immediately possible
A small, placebo-controlled study showed that theadministration of acetazolamide reduced the severity ofsymptoms. Dexamethasone is as effective asacetazolamide and starts acting within 12 hours whileacetazolamide takes around 24 hours. Other drugswhich have been used are ibuprofen and sumatriptan.For high altitude related insomnia acetazolamide iseffective. Newer non-benzodiazepine sedatives like zolpidem, which do not depress ventilation are also effective

[nikunj_friends_25]

nice info doc...

[Furious Doc]

nice info doc...

There is more to come....

[Croc]

Thanks a ton Furious for all this info...

There is something I want to discuss here and need your expert advice.....

Last time when I visited Leh ladakh... I had a unbearable headache because of which I have take a U turn... As soon as I came down to a lower altitude my headache was vanished like it was never there.... So I take that as AMS hit...

Now this time when I went again in that direction.... I did not feel any headache.. So I was able to complete my trip this time. This time I didn't suffer any headache but as you have mentioned... Yes my breathing was deep and when I did some physical activites, the breathing becomes more deeper and faster... So was that because of the altitude of was that also the symptoms of AMS ? When I was at sarchu where Faiyaz was treated for dehydration, the doctor told me that I am doing good and I have no symptom of AMS. When I was at Sultak post... I spend a night there with army people and again they examined me for any symptom of AMS. They told me that there is no symptom of AMS however they treated for mild fever...

Now I want you to help me and find out if there was any AMS symptoms or the deep breathing and fast breathing is just a part of life at that high altitude....

[nikunj_friends_25]

that was not at all an AMS symptoms....... it happnens........ because at high altitude the density of O2 is less and when u exert u require more O2 in the blood..... which ultimately results into deep breathing......

[Sajeesh]

Last time when I visited Leh ladakh... I had a unbearable headache because of which I have take a U turn... As soon as I came down to a lower altitude my headache was vanished like it was never there.... So I take that as AMS hit...

If you would have traveled in plane, you would have noticed your ears getting blocked & you need to air-gulp (I call it gulping virtual spit) to open-up them.

This is due to the fact that air pressure is higher as you go on higher altitudes. Due to the pressure, the O2 supply to your brain is not in the correct proportion.  Moreover, the atmospheric pressure stress on your muscles and nerves.  All this leads to headache and body ache.

As such, there is no particular cure for this.....the more your visit higher altitudes; sooner you get prone to such aches.

[Furious Doc]

Thanks a ton Furious for all this info...

There is something I want to discuss here and need your expert advice.....

Last time when I visited Leh ladakh... I had a unbearable headache because of which I have take a U turn... As soon as I came down to a lower altitude my headache was vanished like it was never there.... So I take that as AMS hit...

Now this time when I went again in that direction.... I did not feel any headache.. So I was able to complete my trip this time. This time I didn't suffer any headache but as you have mentioned... Yes my breathing was deep and when I did some physical activites, the breathing becomes more deeper and faster... So was that because of the altitude of was that also the symptoms of AMS ? When I was at sarchu where Faiyaz was treated for dehydration, the doctor told me that I am doing good and I have no symptom of AMS. When I was at Sultak post... I spend a night there with army people and again they examined me for any symptom of AMS. They told me that there is no symptom of AMS however they treated for mild fever...

Now I want you to help me and find out if there was any AMS symptoms or the deep breathing and fast breathing is just a part of life at that high altitude....

What ur explaining here Mr Croc are not the symptoms of AMS..The headache ans the deep breathing is because of the drop in oxygen levels and increase in the atmospheric pressure as one ascends in altitude.
Both these factors along with the fact that due to decrease in normal oxygen consumption and the carbon-dioxide produced the the body increases which would stimulate ur respiratory centers leading to the feeling of breathlessness making you breath deeply along with increase in the rate of respiration..the unbearable headache is also due to the sudden increase in atmospheric pressure..this is basically because of slow acclimatisation i.e your body not being accustomed to that altitude
The absence of similar complaints the second time you went there due to the fact that you had already exposed ur body to that condition before due to which the second time ur body could respond better to this condition

[nikunj_friends_25]

nice info doc....

[Peaceful_Warrior]

Guys...the simple solutions to this problem.. I've learned from my last visit to Ladakh.

1. Spend 3-4 hours at Rohatang Pass...this will help u to get acclamatize...
2. Drink water as much as u can when u ride to Ladakh..!!
3. Eat-Eat-Eat, Chochlates, Energy Bars even if u dont feel hungry eat..!!

One of the Tent Owner at Bharatpur named Sonia adviced me this last time..!!

Good article Doc..!!

HTH

Cheers,
Rishi

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Acute Mountain Sickness