- HOW TO AVOID ACUTE MOUNTAIN SICKNESS (AMS) -

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• The key trekker principle of 'Climb High / Sleep Low' is closely followed on all our treks (where terrain allow). It is always best to gradually climb higher each day, then descend lower to sleep, especially once you pass above 2,500m. Following this principle allows you to gradually become accustomed to lower pressures /higher altitudes, and then recover better overnight.

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• Eats as much as you can each day to enable you to have the energy for the next days adventure. Having enough energy inside you will help move you forward, and aid effective acclimatisation prior to the final summit push, which can never be seen as easy, but there are ways of making it less hard.

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• Drink much more water than you think you need. Proper hydration helps acclimatisation dramatically. You need to drink at least three litres each day. As dehydration presents many of the same symptoms as altitude sickness, your chances of being allowed to continue are best if you stay hydrated. Don't worry about being able to relieve yourself during the trek as we will provide portable toilets for all our treks, rather than ask adventurers to venture to the established 'long drop' toilets, as sometimes they can be less than 'attractive' places to frequent!

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• 'Pole Pole' (Slowly (and steady)). You need to keep your respiration rate low enough to maintain a normal conversation. If you are panting or breathing hard and find it hard to hold a normal conversation with other trekkers / crew members you must slow down. Your guides will look to manage the pace of the trek each day, and will certainly never tell you to speed up, rather they will be trying to slow you down.

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• In short, you should look to maximise your nutrition, hydration and relaxation every day on the mountain.

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• Diamox (Acetazolamide) The general consensus of the research is that Diamox is helpful in avoiding AMS. We use it when climbing Kilimanjaro. We recommend you google Diamox and its effects yourself. Potential side-effects; Dizziness, lightheadedness, or increased urination may occur, especially during the first few days as your body adjusts to the medication. Blurred vision, dry mouth, drowsiness, loss of appetite, nausea, vomiting, diarrhea, or changes in taste may also occur. As it is a prescription drug, and you should consult with your doctor before taking it. Allergies and adverse reactions to sulfonamide medications are quite common.

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At high altitudes and low pressures, each breath takes in less oxygen, and transfers less to the blood. Blood with low levels of oxygen is said to be poorly saturated. Having slightly low oxygen saturation can lead to fatigue and feeling breathless. Severe low oxygen saturation can cause impaired mental functions, reduce your decision making ability, and have other dangerous effects. All our guides have pulse-oximeters to check your oxygen saturation daily. Alongside the use of pulse oximeters, our guides will also daily review your condition using the Lake Louise scoring system (see - NCBI or Liebert)

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​- Cerebral oedema -

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Severely reduced air pressure can cause fluid to collect in the sinuses and air cavities in the skull. Initially it presents as a mild headache, but can eventually cause disorientation, coma and even death. Cerebral oedema can present very suddenly, and is an extremely serious medical issue. With this in mind, all our guides are constantly on the look out for any changes in your character and attitude, which might indicate a susceptibility to the altitude, and the possible development of the early stages of this condition. 

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- Pulmonary oedema -

 

​This is caused by reduced air pressure in the lungs. Fluid sometimes begins to seep from the lung tissues into the air spaces of the lungs, making breathing even more difficult. This often presents like pneumonia, and is most likely to occur during sleep. With this in mind, all our guides are constantly on the look out for any changes in your character and attitude, which might indicate a susceptibility to the altitude, and the possible development of this condition. 

 

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​- How to recognise AMS -

 

​AMS does not present as a slow, gradual worsening of lesser altitude-related symptoms like breathlessness or headache. It is in fact generally a rapid, dramatic onset of symptoms that can render a person unable to walk or take care of themselves at all. Our guides are trained to recognise AMS (most are Wilderness First Responders (WFR)) and will apply the appropriate first aid. They will monitor your blood oxygen saturation and evaluate your overall acclimatisation (even by studying how much you are eating & drinking), but it is vital that you self-monitor and report your condition accurately if you notice any changes. 

 

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​- To descend or continue? -

 

​If our guides believe you health may be at risk by continuing to ascend, they will discuss the situation with you, and will agree a plan to maintain your personal health and safety. This may include requiring you to begin your descent immediately. Your guides will not make decisions without carefully considering the facts and will have your continued safety at the forefront of their thoughts and recommendations.

 

 

Other options could include descending to a lower (more oxygen-rich altitude) and await the return of any continuing trekkers, descending fully, or adding an extra day to see if your condition improves to such and extent that it is verified that it is safe for you to continue with the trek as planned.