The further one plans to ascend, the more precautions has to be taken against mountain sickness. The most effective prevention of mountain sickness is by slow ascent and plentiful fluid-intake. Futhermore, one must make sure to descend quickly if symptoms should occur, since mountain sickness is easier treated in lower altitude than that in wich it occured. Upon the experience of milder symptoms, one should not ascen further until symptoms are absent. Above 3600 metres one should not stay overnight in altitudes above approximately 300 metres higher. One can increase your altitude by more than 300 metres, as descent occurs in time. This is because symptoms normally arise 6 -12 hours after exposure and the height at which one sleeps is most important. Every second or third day one should stay overnight at the same altitude for at least two nights.
Many mountaineers promote acclimatization by:
- Being in good physical shape before venturing towards the heights, although fitness has no direct correlation with mountain sickness.
- Avoiding to overstrain themselves.
- Being adequately dressed so that they are sure to avoid freezing
- Avoiding tobaccoe smoke, their own and that of others.
- Avoiding large amounts of alcohol.
- Making sure that ascent to more than 3600 metres happens at a slow pace. By walking instead of flying the body is easier accustomed to the changed altitude.
- Sleeping at a lower altitude than that at which they climb, whenever possible.
- Keeping track of their fluid intake.
- Following a diet that is composed of at least 75% carbohydrates when staying at high altitude.
Mountaineers who venture into zone IV often carry oxygen equipment - Some only use oxygen in emergencies. Breathing pure oxygen prevents and reduces the symptoms of mountain sickness.
Examples of the blood percentage of haemoglobin reaching a value high enough to interfere with the transportation of red blod cells through the vessels as a result of exposure to altitude have been described. The body is inadequately oxygenated, and one will experience severe freezing. The cure has been to descen to lower altitude, drink many litres of fluid each day, administrate intravenous natriumchloride, and draw blood.
Transportable pressure chambers
A brilliant invention for treating mountain sickness is the Gamow-bag, named after its inventor dr Igor Gamow. This is a transportable, lightweight pressure chamber made out of plastic. It resembles an overdimensioned sleeping bag. The patient is placed in the bag and the bag is zipped up. A plastic window makes it possible for the patient to look out. The person assisting the patient inflates the bag with a foot-pump, causing the oxygen pressure of the bag to rise. A vent hole stabilizes the pressure. Treatment inside a Gamow bag corresponds to descending 1000-1500 metres.The standard edition weighs approximately 7 kgs including the weight of the pump. Several brands and models are available.
A duo-version of the Gamow bag is also available, so that the patient can receive treatment under the increased pressure.
One should pay attention to the fact that symptoms of mountain sickness are serious warning signals of the body, although administration of pure oxygen and medicine may relieve symptoms and one thereby may be tempted to continue climbing, when one should seek down. Severe shortness of breath and coughing, when resting are signs that one should seek acclimatization at a lower altitude.
Acute Mountain sickness
When occuring in zone I, staying at this altitude and awaiting acclimatization will be secure in most cases. This may take from ½ to 4 days. One can also descend to lower altitude. A descent of only a few hundred metres will make a big difference in most cases. It is recommended to stay at a lower altitude and aquire full acclimatization before initiating another ascent. Symptoms can be relieved by administration of medicine against mountain sickness.
Moderate Mountain sickness
This condition requires instant descent to lower altitude. At least 500 metres, depending on the altitude, but preferably more. The patient requires medical treatment, in some cases administration of pure oxygen and treatment in pressure chamber, and especially plenty of fluid.
Severe Mountain sickness
The patient needs to descend immediately. At least 1,000 metres, and more if possible. Pressure chamber if available, the patient needs instant medical care.
High Altitude Pulmonary Edema - HAPE
Treated with oxygen, pressure chamber, and fast descent to as low an altitude as possible. The patient may need to be transported in a sitting posture, because the pressure in the pulmonary (lung) circulation increases by lying down. Symptoms may disappear if the patient is brought to low altitude soon after the appearence of the first symptoms. The patient needs medical attention.
High Altitude Cerebral Edema - HACE
Treated with oxygen, pressure chamber, and fast descent to as low an altitude as possible. The patient may need to be transported in recovery position. The patient needs medical attention.
Remedies that may prevent altitude related symtoms:
- Dimethylglycine (Pangamic acid) - Vitamin B-anologue that decreases the oxygen need of the body by increasing the oxygen carrying ability of the red blood cells. Dosing: 25 - 50 mg. 3 times a day, or 1 tablet (120 mg.) a day as a lozenge. Taken together with a daily supplement of vitamins and minerals. DMG has no side effects.
- Ginseng, Panax - Increases the ability of the body to cope with situations of physical and emotional stress.
- Inosine - Increases physical performance and the oxygen-uptake of the cells.
- Propolis - May relieve the bothersome cough that many are affected by in the thin air.
- Roseroot (Rhodiola rosea) is known as Hong Jing Tian in its country of origin - China. It is used by mountaineers for increasing their staying power and reducing headache provoked by altitude.
- Schisandra chinensis - Aids in the regulation of the fluid balance, prevents cough, strengthens the nervous system, relieves the irritability that often accompanies staying in high altitude, and fascilitates the adaptation to the climate.
- Temple tree, Ginkgo biloba - Strengthens the circulation, increases cerebral bloodflow, and prevents embolies. To be taken five days before climbing: 120 mg. 2 times a day.
Prescribed medication that is used in prevention and in the acute treatment of mountain sickness.
- Acetazolamid - Prescribed against glaucoma and epilepsy. Also used in the prevention of mountain sickness. Recommended dose is 125 - 250 mg. in the morning and before bedtime for 5 days. Some side effects can be seen, predominantly prickly sensations of the fingers and feet, increased diuresis and sometimes allergic reactions.
- Dexamethason - Perscribed synthetic adreno-cortical hormone. Used in the treatment of lung - and brain oedema. Available as tablets or as injections. Recommended dose: As tablets: 8 mg. right away, thereafter 4 mg. every 6 hours for the following 24 hours. Injections might be followed be side effects in the form of prickling sensation or sometimes regular pains.
- Nifedipin - Blood pressure reducing prescripted medication. Used in the treatment of pulmonary oedema. Side effects are most common with high dosage. Recommended dose: As tablets: 20 mg. taken 4 times divided over 24 hours. Not recommended for people suffering from decreased liver- or heart function.
The list is incomplete.
