Altitude sickness and how to prevent it

Altitude sickness happens because of low atmospheric pressure and oxygen starvation – hypoxia. Mountaineers, skiers and people somehow connected with work in the mountains are familiar with altitude sickness. Most of the world’s population lives at an altitude of up to 1000 meters; their bodies are not adapted to the high altitude conditions. Altitude sickness has several stages. It starts from headache, general fatigue and irritability. In especially acute cases, it ends with cerebral edema.

Altitude sickness appears not only because of the height, but also due to the speed of altitude gain. It means that rapid ascent from 300 meters to 3000 can cause more serious consequences than, for example, a graduate ascent from 4000 to 5500 meters. Also we need to remember that in general, the higher the worse. With height, the concentration of oxygen in the atmosphere changes not linearly, but exponentially. The salvation from this lies in acclimatization, during which you gradually adapt your body to high altitude conditions. We will talk about acclimatization separately, but now let’s focus on the altitude sickness.

Stages of altitude sickness

Altitude sickness has several stages, depending on altitude, distance from the equator, climate, the condition of the person (weight, physical shape, altitude experience, etc). Usually, a person who lives on a plain feels symptoms of altitude sickness as early as at 2000 meters. I met people from Moscow who felt nausea and headache near Lake Sevan (1900 meters). Therefore, it is important at what altitude is your permanent residence. For people from Yerevan the altitude of 3000-4000 meters is not a big difficulty. In the world there are settlements above 3000 m – Lhasa (Tibet, 3650 m), Potosí (Bolivia, 4090 m), and the highest in the world – La Rinconada (Peru, 5100 m). The body of people living at these heights differs from Yerevan residents and people living on the plain.

For people living on the plain, climbing mountains such as Azhdahak or Aragats in Armenia is recommended to be done with acclimatization. The altitude above 3000 meters is already considered to be the height where people can feel altitude sickness. Therefore, an overnight stay during ascent to Azhdahak near Lake Akna (3032 m), or Lake Kari (3200 m) in Aragats are the recommended option for tourists with no experience, or for those who live on the plains or in coastal regions. A night at this altitude will help you sleep well and calm down from the stress caused by a rapid altitude gain in one day. In case of a one-day ascent you will need to get up before dawn in Yerevan, have a long journey by car and only then start the ascent. All this negatively affects the well being of a person, believe me.

Symptoms of altitude sickness

Let’s analyze symptoms and effects of altitude sickness on the body, and then talk about prevention and treatment.

• Loss of appetite. Even after a whole day of walking, you feel nauseous just thinking about food. It is important to eat at least in small portions, to have strength and energy.
• Pulsating pain in the temples. If you feel acute pain, you should drink ibuprofen or a similar analgesic. It will not save from the altitude sickness, but will remove the pain, which irritates, doesn’t let you concentrate on work and takes away a lot of physical and psychological strength.
• Mood swings. You laugh and joke, and then you suddenly feel sad, then everything gets on your nerves and you become aggressive. Typically, people release endorphins and start to think that they are omnipotent. They start running, jumping around. Usually this euphoria fades away as quickly, and you remain exhausted. Because people in this state are not able to control themselves and can seriously injure themselves, or even fall off a cliff or into a crack of a glacier. Therefore, be sure to monitor the adequacy of your teammates.

• Insomnia. Stressful state and fatigue distract you from sleeping. In these cases you should drink sleeping pills. Don’t worry; you will be able to wake up in the morning. Good sleep is the key to success in the mountains.
• High blood pressure. Atmospheric pressure decreases, but yours remains the same. Therefore, the body goes out of balance. In any case, do not drink pills without measuring the blood pressure first, as it differs in each person.
• Loss of coordination, blurred vision, flickering black dots in front of the eyes – these are the signals that cannot be ignored.
• High temperature is normal. It means that the body is fighting. It would be worse if you didn’t have it. Nevertheless, if the temperature rises above 38.5 degrees, you should make a stop and interrupt the ascent.
• No desire to do anything. You just want to lie down and die. In no case you should fall asleep in this condition, or you may never wake up.
• Intermittent and shallow breathing, rapid heart rate.

Altitude sickness prevention

It is important to drink a lot of water and eat sweets. Do not allow dehydration. Urine must be clear. Usually all of the symptoms disappear in one day, if you do not exceed the altitude. If the situation does not get better, you need to drop the altitude. Your condition can also be negatively affected by physical fatigue, dehydration, lack of energy, injuries and loss of blood, severe cold, chronic diseases, especially diseases of the cardiovascular system and lungs. With the latter, it is not recommended to go to the mountains at all. If you have similar diseases, be sure to consult with doctors before you go to the mountains.

It is difficult to diagnose altitude sickness, since most of the symptoms are observed in other diseases. A person can simply be exhausted or have food poisoning. Therefore you need to be attentive to the health and make a conclusion, relying on all symptoms. Before the critical stage of altitude sickness when cerebral edema begins, everything is simple. You just need to drop the altitude. Many mountaineers say that at the top of Lenin Peak or Everest their consciousness was blurred, it was hard for them to breathe and talk. But as soon as they went a little bit down, they immediately began to feel better.

Remember, that alcohol and coffee, also colds, dehydration, insomnia, exhaustion contribute to the development of altitude sickness and worsen the well-being. Also, different people cope with the altitude differently. Depending on:

• gender (women are more tolerant to hypoxia),
• age (younger people tolerate hypoxia worse),
• general physical training and mental state,
• speed of the ascent,
• and the high altitude experience

The last point is especially important. The first time at a new altitude is always more difficult than the next one, even if the next one will happen in two or more years. All other things being equal, the body remembers the algorithm for adapting to altitude and it’s easier for it to acclimate.

In order to avoid the altitude sickness, the following is necessary:

• Make a proper acclimatization plan
• Choose high-quality equipment in accordance with the conditions of the mountain that you plan to climb
• Two weeks before vacation, it is advisable to take a course of vitamins
• Do not drink alcoholic beverages, even in small doses
• Learn to sleep in a tent at a high altitude. If possible, train at low altitudes. Aragats for example is a perfect option to prepare for climbing Kazbek, Ararat, Elbrus or Demavend. Overnight in a tent at an altitude of 3200-3500 meters, followed by ascent to Northern Aragats (4090 m) is a great training plan. We recommend this program for a successful and, most importantly, safe ascent to Kazbek or another 5000 m or higher peak.

What to do if altitude sickness did happen?

If symptoms are not very pronounced, then it is advisable to interrupt the ascent and camp in the nearest suitable place. If the symptoms are acute and do not go away, you need to immediately drop the altitude and descend as low as possible. After this you can repeat the attempt to climb. In most cases, altitude sickness goes away, as the body begins to acclimatize. But there are also acute conditions, when the life of a victim and the whole group is at risk. Due to such conditions, the group begins to lag behind the schedule. This condition happens at extreme high altitudes. Above 6000 meters shortness of breath, as a rule, doesn’t go away, it is difficult and sometimes impossible for a person to rest. Such ascents require an acclimatization program lasting a week or more.

In the Himalayas climbing the eight-thousanders goes relatively smooth, due to the climate and geography. If such mountains were in Caucasus or closer to the poles, then climbing them would be beyond possible. Above 8000 meters the so-called “death zone” begins. Here the “mere mortal” will not survive without an oxygen tank. The oxygen concentration in the atmosphere is only 55% of what is on the plain. Acclimatization to such altitude takes more than a month. You cannot stay at this altitude for too long, the time is very limited. In any way, the body begins to slowly die at this altitude.

Tips for altitude sickness

In acute mountain sickness there is a need for help with medicines. There are injections that mountaineers always carry with them, for example, dexamethasone. But we will not talk about this, since such an extreme is not included in our goals, and apart from the theory from smart books, we are not competent to say anything else. The Internet is full of articles and forums on this topic. We as mere mortals should just regularly train our cardio, do hypoxic workouts, i.e. cardio trainings with holding your breath or putting on a special hypoxic mask that makes breathing difficult. Such workout increases the level of hemoglobin in the blood and increases the density of capillaries, which improves blood supply to cells, thereby making us more resilient to high altitudes and frostbite.

Have a couple packs of Rehydron and ascorbic acid in your first-aid kit, drink water with isotonics, drink plenty of sweet liquids and simply follow proper acclimatization. At first, it is difficult for beginners to objectively assess their condition, due to a lack of experience. Many of them rush and do not notice the alarms that their own body sends them. Others, even with a more adequate approach, can still confuse the altitude sickness with the fatigue. Therefore, it is better for a beginner to consult a mountain guide. Most mountain accidents happen due to biased assessment of the situation and our own strength, especially on such tourist mountains as Kazbek and Elbrus.

We tried to briefly explain what altitude sickness is. Next comes a very important topic – acclimatization, which is closely related to this one.

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