Acute Mountain Sickness Impacts on Adventures Tourist

Acute mountain sickness is an illness that can affect mountain climbers, hikers, skiers, or travelers at high altitudes, usually above 8,000 feet (2,400 meters). It is very common to experience acute mountain sickness during a Manali to Leh bike trip.

It is a negative health effect of high altitude, caused by acute exposure to low amounts of oxygen at high altitude.

CAUSES

Higher altitudes have lower levels of oxygen and decreased air pressure. When you travel in a plane, drive or hike up a mountain, or go skiing, your body may not have enough time to adjust. This can result in acute mountain sickness. Your level of exertion also plays a role. Pushing yourself to quickly hike up a mountain, for example, may cause acute mountain sickness.

SYMPTOMS

Symptoms will also depend on the speed of your climb and how hard you push (exert) yourself. Symptoms range from mild to life-threatening. They can affect the nervous system, lungs, muscles, and heart.

In most cases, symptoms are mild. Symptoms of mild to moderate acute mountain sickness may include:

Difficulty sleeping
Dizziness or light-headedness
Fatigue
Headache
Loss of appetite
Nausea or vomiting
Rapid pulse (heart rate)
Shortness of breath with exertion

Symptoms that may occur with more severe acute mountain sickness include:

Blue color to the skin (cyanosis)
Chest tightness or congestion
Confusion
Cough
Coughing up blood
Decreased consciousness or withdrawal from social interaction
Gray or pale complexion
Cannot walk in a straight line, or walk at all
Shortness of breath at rest

RISK FACTORS

Your risk of experiencing acute mountain sickness is greater if you live by or near the sea and are unaccustomed to higher altitudes. Other risk factors include:

quick movement to high altitudes
physical exertion while traveling to a higher altitude
traveling to extreme heights
a low red blood cell count due to anemia
heart or lung disease
taking medications like sleeping pills, narcotic pain relievers, or tranquilizers that can lower your breathing rate
past bouts of acute mountain sickness

If you're planning on traveling to a high elevation and have any of the above conditions or take any of the above medications, talk to your doctor about how best to avoid developing acute mountain sickness.

EXAMS AND TESTS

The health care provider will examine you and listen to your chest with a stethoscope. This may reveal sounds called crackles (rales) in the lung. Rales may be a sign of fluid in the lungs.

Tests that may be done include:

Blood tests
Brain CT scan
Chest x-ray
Electrocardiogram (ECG)

TREATMENT

Treatment for acute mountain sickness varies depending on its severity. You might be able to avoid complications by simply returning to a lower altitude. Hospitalization is necessary if your doctor determines that you have brain swelling or fluid in your lungs. You may receive oxygen if you have breathing issues.
Medications

Medications for altitude sickness include:

acetazolamide, to correct breathing problems
blood pressure medicine
lung inhalers
dexamethasone, to decrease brain swelling
aspirin, for headache relief

Other treatments
Some basic interventions may be able to treat milder conditions, including:

returning to a lower altitude
reducing your activity level
resting for at least a day before moving to a higher altitude
hydrating with water

OUTLOOK (PROGNOSIS)

Most cases are mild. Symptoms improve quickly when you climb down the mountain to a lower altitude.
Severe cases may result in death due to lung problems or brain swelling, called cerebral edema.

In remote locations, emergency evacuation may not be possible, or treatment may be delayed. This can have a negative effect on your outcome.

PREVENTION

Keys to preventing acute mountain sickness include:

Climb the mountain gradually
Stop for a day or two of rest for every 2,000 feet (600 meters) of climb above 8,000 feet (2,400 meters)
Sleep at a lower altitude when possible
Learn how to recognize early symptoms of mountain sickness
If you are traveling above 9,840 feet (3,000 meters), you should carry enough oxygen for several days.

If you plan on quickly climbing to a high altitude, ask your provider about medicines that may help.

If you are at risk for a low red blood cell count (anemia), ask your provider if an iron supplement is right for you. Anemia lowers the amount of oxygen in your blood. This makes you more likely to have mountain sickness.

While climbing:

Drink plenty of fluids
Avoid alcohol
Eat regular meals, high in carbohydrates
You should avoid high altitudes if you have heart or lung disease.

The outlook depends on the rate of descent once symptoms begin. Some individuals are more prone to developing altitude-related sickness and may not respond as well.
Be thoroughly prepared and take all the precautions before embarking on a Nepal Motorcycle Tour or Bhutan bike trip. Therefore, it's essential to plan ahead when traveling to high-altitude locations.