What is High Altitude?
Mountain medicine recognizes three altitude regions that reflect the lowered amount of oxygen in the atmosphere. High Altitude ranges from 1500 to 3500 meters or 49211 to 11483 feet, Very High Altitude is within 3500 to 5500 meters, and Extreme Altitude goes above 5500 meters.
An increasing number of people are traveling to new heights and altitudes every now and then. In this case, we mean trekkers and hikers. A small percentage of them are affected by altitude illness, which increases as they ascend. Though most cases of altitude illness are self-limiting, some cases can become life threatening and one should be aware of the symptoms and ways to prevent it.
What is High Altitude Sickness?
High Altitude Sickness, abbreviated HAS, (HAI – High Altitude Illness) include sleep disorders and periodic breathing, thromboembolism or blood clot in the blood vessels, acute hypoxia or reduced oxygen saturation, cerebrovascular syndromes like stroke and infarcts, peripheral edema, AMS or acute mountain sickness, HAPE or high-altitude pulmonary edema and HACE or high-altitude cerebral edema.
Keep an emergency contact number with you. The doctor will pick up the signs and advise medication. It is good to have these pills handy.
Medicines and corresponding illnesses:
It is advisable to descend when altitude illness occurs. If that can’t be done immediately, here are some common medicines in relation to the illnesses, which you can carry along.
– AMS or Acute Mountain Sickness:
The symptoms of AMS are usually mild and transient, while the condition could be life threatening if not attended to. They include a headache, lethargy, nausea, vomiting, loss of appetite, gastrointestinal upset, dizziness, and disruption of the sleep cycle. In severe cases, it leads to increased fluid retention, decreased urine output and increased intracranial tension.
What to pop: Diuretics like acetazolamide and furosemide, dexamethasone(steroid), ibuprofen (pain killer) for headaches, acetaminophen (analgesic for mild headaches), stemetil (prochlorperazine) for nausea and vomiting.
– HAPE or High Altitude Pulmonary Edema:
The earliest symptoms in addition to those of AMS include a persistent cough, fatigue, weakness, shortness of breath on exertion and the signs of AMS (a headache, anorexia). In later stages, the person complains of a dry cough, central and peripheral cyanosis, increased heart rate and increased respiratory rate at rest. The more life threatening condition of HAPE includes the production of pink frothy sputum, shortness of breath at rest and persistent coughing.
What to pop: Medications in the early stages include morphine to reduce breathlessness, improve oxygenation and reduce the heart and respiratory rates, furosemide (diuretic), nifedipine (reduces pulmonary vascular resistance) and nitric oxide inhalation. High-flow oxygen, if available, and delivered by face mask or nasal cannula can be lifesaving.
– HACE or High-Altitude Cerebral Edema:
HACE is usually recognized when a person with AMS or HAPE develops symptoms of encephalopathy. To make it clear, nonspecific symptoms include headaches, nausea, and vomiting; while specific symptoms include difficulty in walking (ataxia), mental status changes, altered level of consciousness (altered higher mental function). He/she usually experiences confusion, drowsiness, stupor and coma or fatigue, besides cyanosis (bluish) skin color, hallucinations, cranial nerve palsy, paralysis, epilepsy, retinal hemorrhages and focal neurologic signs.
What to pop: In this case, it’s not just about popping a pill, but establishing a secure airway and draining the urinary bladder if needed. Other management components include intubation and hyperventilation, and careful use of diuretics such as furosemide (B III).
– High altitude adjustment:
While the first three were more life-threatening, minor adjustments to high altitudes require one’s attention too. The specific altitude medications are more highly recommended for rapid travel (i.e. by plane) to very high altitude (3500m-5500 meters or 11,483-18,045 feet) and may not be required for travel to lower elevations.
What to pop: You must get medications that help the body adjust to high altitudes, such as acetazolamide (Diamox) and dexamethasone. Other supplements include gingko balboa.
1. Stomach issues: Mild stomach aches, indigestion, and gastritis are common and can be dealt with by having Gelusil, stirring a fruit-salt like ENO in water, popping a Lomotil in case of diarrhea etc.
2. Additional medicines: Analgesics and antipyretics like paracetamol can be kept handy to keep fever and aches at bay. Allegra and cetirizine work well for allergies and cold. You could carry Zantac for heartburn, asthma inhaler if you have difficulties in breathing, antibiotic pills, and lotions for topical application.
3. First-Aid Kit: It is imperative to carry a well-equipped first-aid kit with an anti-fungal cream, antiseptic lotion, Dettol, band-aid, cotton, iodine tablets, crepe bandage etc.
**Disclaimer: The illnesses listed above could have different manifestations in different people. The treatment and medications vary from person to person. Although some pills have been listed above, please remember that these are not to be taken without checking with a doctor. You MUST consult a doctor at all times. This post does not replace the medical advice and prescription by a doctor. We do not hold liability to any of these recommendations.