Acute Mountain Sickness - A Common Condition When Climbing

AMS

At high altitudes, it is common to experience acute mountain sickness (AMS). Approximately three-quarters of individuals at elevations above 3,000 metres can expect to encounter mild symptoms. The occurrence of altitude sickness depends on various factors, including elevation, rate of ascent, and individual susceptibility. During the normal process of acclimatisation, many people may experience mild symptoms of altitude sickness. It is important to understand that the mild discomfort accompanying this adaptation is considered normal and acceptable.

Typically, symptoms of AMS begin to manifest 12-24 hours after reaching high altitude and gradually decrease in severity by the third day. Mild AMS symptoms include headache, dizziness, fatigue, shortness of breath, loss of appetite, nausea, disturbed sleep, and a general sense of unease. These symptoms often intensify at night when respiratory drive is reduced.

Mild altitude sickness does not significantly hinder normal activities, and the symptoms generally resolve within 2-4 days as the body acclimatises. As long as the symptoms remain mild and merely bothersome, it is usually safe to continue ascending at a moderate pace. However, it is crucial to promptly communicate any signs of altitude sickness to the expedition leader or lead guide while hiking.

Altitude sickness is considered a neurological issue resulting from changes in the central nervous system. It can be viewed as a mild form of High Altitude Cerebral Edema. The only effective remedies are acclimatisation or descending to lower altitudes. While ibuprofen may alleviate symptoms of mild AMS, it is important to note that reducing symptoms does not cure the underlying problem or address its cause. If symptoms of mild AMS worsen, it may indicate early signs of:

Moderate AMS

Moderate AMS is characterised by severe, persistent headaches that do not respond to medication, along with symptoms such as nausea, vomiting, increasing weakness and fatigue, shortness of breath, and decreased coordination (ataxia). Engaging in normal activities becomes challenging, although the affected person may still be capable of walking independently. At this stage, the only effective solution is to descend. Even a descent of a hundred metres can provide relief, but noticeable improvement is typically observed with a descent of 300-500 metres.

Spending twenty-four hours at a lower altitude will lead to significant improvements in the individual's condition. It is important for the person to remain at the lower altitude until their symptoms have subsided. Once symptoms have resolved, it indicates that the person has acclimatised to that particular altitude and can resume ascending.

A reliable test for moderate AMS involves walking in a straight line, heel to toe, similar to a sobriety test. If a person exhibits ataxia and cannot walk in a straight line, it is a clear indication that immediate descent is necessary. It is crucial for the individual to descend before the ataxia progresses to the point where they can no longer walk independently. In the event that such a condition arises in a team member, despite all precautions, our staff is trained in rapid evacuation techniques. We can ensure the team member is safely transported to a secure location within hours, regardless of their position on the mountain.

Severe AMS

This condition presents itself as an increase in the severity of the aforementioned symptoms, including:

  • shortness of breath at rest
    • inability to walk
      • decreasing mental status
        • fluid build-up in the lungs

          Severe AMS requires immediate descent to lower altitudes of around 1,000 metres.

          There are two more serious types of altitude illness known as High Altitude Cerebral Edema (HACE) and High Altitude Pulmonary Edema (HAPE). These conditions occur less frequently, particularly among individuals who have undergone proper acclimatisation. However, when they do happen, it is often due to inexperienced individuals ascending too rapidly or staying at high altitudes for extended periods. The reduced oxygen levels lead to fluid leakage through the walls of the capillaries, either in the lungs or the brain.

          High Altitude Pulmonary Edema (HAPE)

          HAPE occurs when fluid accumulates in the lungs, hindering the efficient exchange of oxygen. As the condition worsens, the oxygen levels in the bloodstream decrease, potentially causing cyanosis, impaired brain function, and even fatality.

          Symptoms of HAPE

          • shortness of breath even at rest & tightness in the chest
            • marked fatigue & weakness
              • feeling of impending suffocation at night
                • persistent cough bringing up white, watery, or frothy fluid.

                  Confusion, and irrational behaviour are signs that insufficient oxygen is reaching the brain. In cases of HAPE, immediate descent to below 2,000m altitude is a necessary life-saving measure. Anyone suffering from HAPE must be evacuated to a medical facility for proper follow-up treatment.

                  High Altitude Cerebral Edema (HACE)

                  HACE is the result of swelling of brain tissue from fluid leakage. Symptoms can include:

                  • headache
                    • loss of coordination (ataxia) weakness
                      • decreasing levels of consciousness
                        • disorientation
                          • loss of memory
                            • hallucinations
                              • psychotic behaviour
                                • coma

                                  It generally occurs after a week or more at high altitude. Severe instances can lead to death if not treated quickly. Immediate descent to 1,000m altitude is a necessary life-saving measure. Anyone suffering from HACE must be evacuated to a medical facility for proper follow-up treatment.

                                  MOEV 801
                                  April 2024

                                  On arrival at Tribhuvan International Airport in Kathmandu, once you've passed through Immigration and retrieved your luggage, please look out for your Team Mount Everest driver carrying a placard with your name who will transfer you to Hotel Buddy for overnight on bed and breakfast basis.

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                                  SESH 1501
                                  March 2024

                                  Day 01: Arrive in Kathmandu

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                                  SESH 801
                                  March 2024

                                  On arrival at Tribhuvan International Airport in Kathmandu, once you've passed through Immigration and retrieved your luggage, please look out for your Team Mount Everest driver carrying a placard with your name who will transfer you to Hotel Buddy for overnight on bed and breakfast basis.

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                                  SESH 1601
                                  February 2024

                                  On arrival at Tribhuvan International Airport in Kathmandu, once you've passed through Immigration and retrieved your luggage, please look out for your Team Mount Everest driver carrying a placard with your name who will transfer you to Hotel Buddy for overnight on bed and breakfast basis.

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                                  SESH 1001
                                  February 2024

                                  On arrival at Tribhuvan International Airport in Kathmandu, once you've passed through Immigration and retrieved your luggage, please look out for your Team Mount Everest driver carrying a placard with your name who will transfer you to Hotel Buddy for overnight on bed and breakfast basis.

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                                  IRPR 1401
                                  December 2023

                                  On arrival at Tribhuvan International Airport in Kathmandu, once you've passed through Immigration and retrieved your luggage, please look out for your Team Mount Everest driver carrying a placard with your name who will transfer you to Hotel Buddy in Kathmandu for overnight on bed and breakfast basis.

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                                  JORE 1401
                                  December 2023

                                  Day 1: On arrival at Tribhuvan International Airport in Kathmandu, once you've passed through Immigration and retrieved your luggage, please look out for your Team Mount Everest driver carrying a placard with your name who will transfer you to Hotel Buddy for overnight on bed and breakfast basis.

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                                  On arrival at Tribhuvan International Airport in Kathmandu, once you've passed through Immigration and retrieved your luggage, please look out for your Team Mount Everest driver carrying a placard with your name who will transfer you to Kathmandu Marriott Hotel for overnight on bed and breakfast basis.

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                                  Once you have cleared Immigration and collected your baggage upon arrival at Kathmandu's Tribhuvan International Airport, please keep an eye out for a Team Mount Everest driver holding a sign with your name. The driver will transport you to Hotel Buddy in Kathmandu, where you will spend the night on a bed and breakfast basis.

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                                  Assuming climbers are able to obtain competitive flight fares all the way into Tribhuvan International Airport (KTM) this is almost always the best means of reaching us and getting into position to begin your climb or safari. During the process of booking with us we will request your flight details and will sENd one of our drivers to meet your flight. Our driver will usually be wearing a black Team Mount Everest T-Shirt and carrying a placard with the name of the main correspondent representing your climb group.

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                                  A BMI (Body Mass Index) calculator is a tool used to estimate an individual's body fatness based on their height and weight. It provides a numerical value that indicates whether a person is underweight, normal weight, overweight, or obese. The BMI calculation is based on the principle that a person's weight should be proportionate to their height. To use a BMI calculator, you input your weight and height, and the calculator calculates your BMI by dividing your weight in kilograms by the square of your height in metres. The resulting BMI value is then compared to standard ranges to determine the person's weight category. While BMI is a useful screening tool, it doesn't directly measure body fat percentage or consider factors such as muscle mass or distribution of fat. It serves as a starting point for assessing an individual's weight status and can be a helpful tool in monitoring overall health and weight management.

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                                  We don’t operate out of Kathmandu, but when we collect you we ask you to sign a declaration and conditions of participation. Let us know if you wish us to email this to you.

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