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All you should know about AMS before hitting LADAKH

by / Saturday, 16 April 2016 / Published in HMRA Blog

HMRA || Adventure..Best Possible

Planning a trip to Ladakh or high Himalayas?
Have you heard about AMS?
This article can be the best thing to happen to your preparation for the Ladakh road trip if you are not aware of AMS

 

HMRA || Adventure..Best Possible

Pictures and videos of Ladakh trips induce such a great excitement to see the landscape through own set of eyes to many but what if you can not appreciate the beauty in your best form even after being there!!
AMS does that to most of the people who visit Ladakh without being prepared for this acute and very common condition. Once hit, only thing a person think about is to leave Ladakh instead of capturing it’s pristine beauty through eyes and cameras.
Yes, AMS can be that bad!

 

What the hell is AMS???

AMS or Anti Mountain Sickness or Acute Mountain Sickness or Altitude sickness or Altitude bends or Soroche or Hypobaropathy is a pathological effect of high altitudes on human beings caused by travelling to 8000 feet & above in a short period of time.
As Ladakh starts from 9000 feet above sea level,you should be Aware & Alert for the symptoms of AMS as soon as you enter Ladakh region.
Ladakh is located at the altitudes ranging from 9000 to 15000 feet above sea level (civilisation). Travelling to this altitude in a short period of time can lead to deranging health condition in which most common is ALTITUDE SICKNESS.
This condition is due to low oxygen levels at high altitude & reduced air pressure mostly causing hangover like condition manifested as headache,vomiting,dizziness,shortness of breath,cough and sometimes diarrhoea.
Eventually you can safely travel upto 8000 feet in 24 hours but beyond this you should ideally ascend only 1000 feet in 24 hours to adapt to the low oxygen levels.

 

YOU CAN EVEN LOSE YOUR PRECIOUS LIFE !!

Yes it’s true, some severe forms of AMS like ‘High altitude pulmonary edema’ (HAPE) and ‘High altitude cerebral edema’ (HACE) can be life threatening as many lose their lives because of them every year after developing HAPE & HACE after travelling and sleeping at High altitudes (8000 feet & above).

Generally AMS is not a life threat until severe and takes 1-2 days to ween off with no residual effects.

Medically Altitude sickness has three forms. Mild altitude sickness is called acute mountain sickness (AMS) and is quite similar to a hangover – it causes headache, nausea, and fatigue. This is very common: some people are only slightly affected, others feel awful. However, if you have AMS, you should take this as a warning sign that you are at risk of the serious forms of altitude sickness: HAPE and HACE. Both HAPE and HACE can be fatal within hours.

HAPE

HAPE is excess fluid on the lungs, and causes breathlessness. It is never normal to feel breathless when you are resting – even on the summit of Everest. This should be taken as a sign that you have HAPE and may die soon. HAPE can also cause a fever (a high temperature) and coughing up frothy spit. HAPE and HACE often occur together.

HACE

HACE is fluid on the brain. It causes confusion, clumsiness, and stumbling. The first signs may be uncharacteristic behaviour such as laziness, excessive emotion or violence. Drowsiness and loss of consciousness occur shortly before death.

 

Treatment of HAPE and HACE

  • Immediate descent is absolutely essential
  • Dexamethasone and acetazolamide should both be given, if available
  • Pressure bags and oxygen gas can buy time

 

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How the hell I will know I am hit by AMS!!!

General symptoms of AMS include Breathlessness,Nausea,Vomiting,Fatigue/weakness,Headache And Altered Brain functioning among which Headache is the cardinal symptom simulating an ‘Alcohol Hangover’ (off course if you have experienced a alcohol hangover before, if not, ask your drunk-yard mates!)

Other symptoms include Sleeplessness/Insomnia,Stomach upset/Diarrhoea,Nose bleeding,Drowsiness And Peripheral oedema(swelling of hands,feet,face).

 

OTHER PRECAUTIONS & TIPS FOR PREPARATION

– Ascend gradually, if possible.
– Try not to go directly from low altitude to >8000 feet sleeping altitude in 1 day rather try to move 1000 feet of sleeping altitude per day, and plan an extra day for acclimatization every 3000 feet.
– Avoid alcohol or any other kind of abuse for first 48 hours of reaching high altitude, no matter how big a tanker or scorer you are, just AVOID IT.
– Do not indulge in Strenuous Exercise for first 48 hours of height exposure.
– Consider using Acetazolamide(trade name- DIAMOX) to speed up your body acclimatization to high altitude.
– Have a high altitude exposure at >8000 feet for 2 nights or more, within 30 days before the Trip, which would be useful to avoid AMS.
– If possible, carry portable Oxygen cylinders as oxygen can be life saving as far as AMS is concerned.
– And lastly add medications required for AMS to your first aid box.

 

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WHO SHOULD BE WORRIED MORE?
– As per the facts available there is no such preponderance of any individual being susceptible to the mentioned disease. Even physically very fit, or to be more dramatic, even Olympic athletes can be hit by AMS 
– But as per studies children less than 6 years and Menstruating women have more chance of developing AMS as compared to others.

 

PREVENTION & TREATMENT
– Best prevention for AMS is after realization of disease one should stop the ascending journey and descent to lower altitudes (at least 1000 feet) in case severe.
– For prophylaxis one can take acetazolamide (DIAMOX) 125mg twice a day which will speed up your acclimatization process and help in the prevention of the disease.
– For effective Treatment after AMS has occurred, DEXAMETHASONE 6mg every 6 hourly is given and ACETAZOLAMIDE 125mg thrice a day can also be used as an effective treatment.
– For headache and bodyache you can also take ASPIRIN or IBUPROFEN 50mg which will subside the aching symptoms of the disease.
– And last but not the least 2L per minute OXYGEN  will recover AMS in 1 or 2 hours.

 

HOW THE HELL TO PREPARE FOR HIGH ALTITUDES
– Start working out, running/jogging/fast walk anything.Though it is not guaranteed that a regular exercising person will not get affected by AMS but it improves your chances in a solid way.
– Detoxification is the second best thing you can do before going to high altitudes in line to get yourself prepared for AMS. Avoid alcohol, tobacco products, drugs, junk food.

 

Some Cheat Codes to plan a healthy and AMS free trip to LEH LADAKH

  • If you are doing complete circuit then start from Srinagar Side and end via Manali side 

  • If starting from Manali side, avoid night stays at Bharatpur (Baralacha La), Pang, Tso Kar and Tso Moriri

  • Avoid smoking, drinking and inhaling as much as possible, specially while initial exposure of high altitude

  • Avoid too much physical burnout, plan your kilometers per day accordingly, if you don’t have enough leaves plan your trip some time else as it is better to have a trip delayed than a trip derailed!

  • And last but not the least, shed those extra few kilos RIGHT NOW

And at last, forget everything above said except the last two paragraphs, as AMS also hits psychologically. Avoid too much reading and thinking about AMS.

Doubts/Questions/Confusions/Queries/Help Needed???
Just comment on the article and we will try to get back with best of our capability and knowledge.

HAVE A HAPPY AND AMS FREE TRIPPING IN HIGH HIMALAYAS!!! 🙂

 

***Article is written by a rider who had been hit by AMS quiet bad in the first time and then became a regular in Ladakh. Expert guidance  from a MBBS doctor from Sir JJ Hospital, Mumbai has also taken for medication suggestions***

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