Altitude Sickness

Introduction
Altitude sickness is a general condition which occurs after climbing a high altitude too fast. The decline in atmospheric pressure makes breathing difficult because one is not capable to breath in sufficient oxygen.

Alternative Names
High altitude cerebral edema; Altitude anoxia; Altitude sickness; Mountain sickness; High altitude pulmonary edema.

Symptoms
Usually cases are mild and symptoms may comprise of:

In exceptional cases, altitude sickness can result in build up of fluid either on lungs or brain. These are very serious conditions and require immediate medical attention. Symptoms of severe altitude sickness are:

  • Blue color to the skin (cyanosis)
  • Chest tightness or congestion
  • aggravated breathlessness
  • coughing up pink, frothy liquid
  • difficulty in walking
  • confusion resulting in unconsciousness

Causes
Acute mountain sickness is a result of decrease in air pressure and lower oxygen levels at high altitudes.

Mild forms of altitude sickness occur at heights of over 2,500m (8,000 feet) and more severe symptoms of altitude sickness tend to occur at 3,600m (about 12,000 feet) and more.

It can affect anyone irrespective of age, sex or physical fitness. While some people get affected, others may be less vulnerable. It can occur at any point in life.

In order to avoid altitude sickness, it is better to avoid venturing higher if you exhibit any of the above symptoms. Avoid climbing for 24-48 hours. One can start climbing once relieved of symptoms. In case symptoms worsen, it is advisable to descend to distance of 500m and get medical assistance.

Acute mountain sickness which affects trekkers, hikers, and skiers occurs mostly above 8,000 feet (2,400 meters).

Diagnosis
The doctor or nurse may conduct physical examination to check sounds called crackles (rales) in the lung. Rales may be an indicator of fluid in the lungs.

Blood tests, Brain CT scan, Chest x-ray and Electrocardiogram (ECG) may be performed to ascertain the severity of condition.

Treatment
Timely diagnosis is important. Mountain sickness in the initial stages is easier to treat.

Best way to combat it is by descending to lower altitude as quickly as possible. However, one must stop climbing after developing symptoms.

Extreme severity can lead to Coma, accumulation of fluid in the lungs (pulmonary edema), swelling of the brain (cerebral edema) that can cause seizures, or damage to the nervous system.

  • Acetazolamide (Diamox) is administered to help one breathe better and reduce mild symptoms. Keeping hydrated and avoiding alcohol is of utmost importance. If the patient has fluid in lungs (pulmonary edema) treatment may include medicines to increase blood flow to lungs and inhalers to unblock airways.
  • Dexamethasone (Decadron) may help reduce swelling in the brain (cerebral edema).
  • Using portable hyperbaric chambers can help during bad weather when climbing down the mountain gets impossible.

Providing extra oxygen is essential. People with severe mountain sickness may need to be admitted to a hospital.

The best way to prevent this ailment is by giving your body time to adjust with ascending height. Ascending slowly provides body enough time to acclimatise to the change in height. One should remain hydrated and avoid alcohol. Taking break for rest and sleep at regular intervals is a must. Eating a high carbohydrate diet is very helpful. Those with anemia should taken suitable Iron supplements from doctor.

Natural Remedies
Ginkgo is helpful for asthamatic patients. Milk Thistle is useful for those with liver complaints.

Antioxidant supplements such as Vitamin C, Vitamin E, alpha lipoic Acid, Selenium, N-acetyl-cysteine, l-glutamine strengthen the system to combat altitude sickness. Adaptogenic herbs comprising of Ginseng, Siberian Ginseng, Ashwagandha, Reishi mushrooms are also advised by naturopaths for their varied benefits.

Homeopathic Remedies
Homeopathic medicines that have been suggested for altitude sickness are Arsenicum alba, Glonine, and Calcarea carbonica. Another remedy is homeopathic coca derived from coca leaves, which also produces cocaine. The Peruveans are known to use these leaves to gain stamina while ascending heights of mountains. The homeopathic medicine is made available in diluted form, but is controversial due to its origin.

Reference
1. McKenna DJ, Jones K, Hughes K. Efficacy, safety, and use of Ginkgo biloba in clinical and preclinical applications. Altern Ther Health Med 2001; 7(5):70-86, 88-90

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