HIGH ANXIETY: Preventing Mountain Sickness
The ARS Sojourner
I was experiencing a form of altitude illness called acute mountain sickness (AMS). Many ARS members have mentioned having similar symptoms while hiking.
Altitude illness ranges from mild acclimatization problems to potentially fatal accumulations of fluid in the lungs or brain.
Many people say AMS feels like a hangover. The most common complaint is headache, usually worse the morning after ascent. Other signs are weakness, fainting, inability to sleep, poor appetite, nausea, dizziness, shortness of breath, reduced urination and vomiting.
Headache that becomes incapacitating or doesn't go away after two days is a bad sign. Loss of coordination, severe agitation, and noisy, labored breathing are signs of life-threatening illness.
About one fourth of those who travel to moderate elevations (6,000 to 9,500 feet) develop AMS and almost 60 percent of those who climb higher than 10,000 feet.
Rapid accent and large elevation changes cause greater illness. Those who live at elevations below 3,000 feet are three times mores likely to get AMS than those who live at higher elevations.
There is an inverse relationship of AMS to age. Children and young people are more susceptible to AMS than older folks.
Women, obese people, and those with lung disease or who are in poor physical condition are at greater risk.
How can AMS be avoided? Give your body time to adjust to changes in elevation. Slow accent, moderation of activity, eating lightly, and drinking lots of water will help. Drinking alcohol can make things worse.
It's good to be physically fit. Activity at low altitude does not prevent AMS, but strength might be lifesaving in an emergency.
AMS is best treated by descending to a lower elevation. Sometimes breathing oxygen or treatment with strong cortisone-like steroids is needed.
Ibuprofen (Motrin) may be better for the headache of AMS than aspirin.
Acetazolamide (Diamox) is a prescription drug often used to prevent or treat mountain sickness. It probably works by regulating acid-base balance and preventing accumulation of fluids in the brain.
Of course, before taking any medication it is important to consult your own doctor.
People who often get AMS are sometimes directed by their physician to take a 125 mg Diamox tablet the first night at altitude, and then 2 tablets daily for 3 or 4 days.
Diamox is not for people who are allergic to sulfa medicines, and may increase sensitivity to the sun.
In any case, talk to your doctor if you feel you need medication for preventing mountain sickness.
AMS can ruin an outing to the mountains. Watch carefully for symptoms in yourself and your companions.
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Dr. Bob Armstrong, N7XJ, a practicing physician living in Manti, UT, is an avid QRPer, outdoorsman and a contributing editor to The ARS Sojourner. barmstrong@mail.manti.com