Content

• To step
• Part 1 of 2: Preventing altitude sickness
• Part 2 of 2: Recognizing the symptoms
• Warnings

If you travel to an area that is high up, such as the mountains, there are many changes that can affect you. These include the cold, low humidity, increased UV radiation, lower air pressure and reduced oxygen saturation. Altitude sickness is the body's response to low air pressure and reduced oxygen levels, and it usually occurs at altitudes above 2500 meters. If you know you are traveling to high places, follow a few simple steps to avoid altitude sickness.

To step

Part 1 of 2: Preventing altitude sickness

1. Ascend slowly. If you are going to a high place, you should go there slowly. It usually takes your body three to five days to get used to altitudes above 2500 meters before you can continue. To keep an eye on this, especially if you are somewhere where the altitude is not indicated, you can buy an altimeter or a watch with an altimeter so that you know how high you are. You can buy these devices on the internet or at a mountain sports store.
   • There are a few things you shouldn't do. Never climb more than 2,700 meters in one day. Do not sleep more than 300 to 600 meters higher at night than the night before. Always acclimatize an extra day for every 1000 meters you have ascended.
2. Rest. Another way to combat altitude sickness is to get plenty of rest. Your sleep rhythm may have changed due to a long journey. This makes you tired and dehydrated, which increases the risk of altitude sickness. Before climbing, you should rest for one or two days so that you can get used to your new environment and sleep rhythm, especially if you have crossed a few time zones.
   • In addition, rest for the first one or two days if you are trying to get used to your new altitude for three to five days before exploring the area.
3. Take drug prophylaxis. Before you go on a journey that involves ascending to great heights, you can take preventive medication for altitude sickness. Make an appointment with your doctor so he / she can prescribe your prophylaxis before you leave. Discuss your medical history and explain that you will ascend to altitudes greater than 2,500 meters. If you are not allergic to it, your doctor can prescribe acetazolamide for you.
   • This drug is used to prevent and treat altitude sickness. Acetazolamide is a diuretic that makes you urinate more, and it improves the ventilation of the airways so that the body can absorb more oxygen.
   • Take 125 mg twice a day, as directed, from the first day of your trip, until two days after you reach the highest point.
4. Try dexamethasone. If your doctor doesn't want to prescribe acetazolamide, or if you are allergic to it, there are other options. You can take a drug such as dexamethasone, which is a steroid. Research has shown that this drug can reduce the occurrence and severity of acute altitude sickness.
   • Take this medicine as prescribed, usually 4 mg every 6 to 12 hours, from the day before your trip until you are fully accustomed to the highest point.
   • 600 mg of ibuprofen every 8 hours can also help prevent acute altitude sickness.
   • Ginkgo biloba has been studied as a treatment and prevention of altitude sickness, but results have been mixed, so its use is not recommended.
5. Get your red blood cells tested. Before you travel, you can have your red blood cell count checked. Make an appointment with your doctor before you leave. If it turns out that you have anemia or too few red blood cells, your doctor may recommend that you correct this before you travel. This is very important because oxygen is transported through your body via your red blood cells to your tissues and organs, so they are vital.
   • There can be many causes for low red blood cells, but the most common is iron deficiency. Vitamin B deficiency can also lead to too few red blood cells. If the levels are too low, your doctor may recommend that you take iron or vitamin B supplements.
6. Buy coca leaves. If you are going to Central or South America to climb mountains, you can buy coca leaves while you are there. Although illegal in the Netherlands, the local residents of Central and South America use it to prevent altitude sickness. If you travel to these areas, you can buy the leaves and chew them or make a tea.
   • Know that even one cup of coca tea will give you a positive result on a drug test. Coca is a stimulant, and research has shown that it induces biochemical changes that improve physical performance at high altitudes.
7. Drink lots of water. Dehydration makes it harder for your body to adapt to new heights. Drink two to three liters of water before starting your journey. Take an extra liter of water with you when you go climbing. Make sure you drink enough when you go back down.
   • Do not drink alcohol for the first 48 hours of your trip. Alcohol is suppressive and can slow down your breathing and cause dehydration.
   • Also, don't drink products with caffeine, such as energy drinks and cola. Caffeine can lead to dehydration of your muscles.
8. Eat the right things. There are certain foods you should eat in preparation for your trip to prevent altitude sickness. A high-carbohydrate diet has been shown to relieve acute symptoms of altitude sickness and improve mood and performance. Other research has shown that the carbohydrates also improve the oxygen saturation of the blood. A diet high in carbohydrates is thought to improve energy balance. So eat a lot of carbohydrates before and during acclimatization.
   • You can do this by eating a lot of pasta, bread, fruit and potatoes.
   • In addition, you should avoid too much salt. Too much salt dehydrates your body. Look for foods that have little or no salt added.
   • It can be good to work on your stamina and fitness before climbing a mountain. However, research has not shown that a good condition can prevent altitude sickness.

Part 2 of 2: Recognizing the symptoms

1. Learn about the different types. There are 3 types of altitude sickness: acute altitude sickness, high altitude cerebral edema and high altitude pulmonary edema.
   • Acute altitude sickness is caused by reduced air pressure and oxygen content.
   • High altitude brain edema is a serious progression of acute altitude sickness caused by swelling of the brain and the leakage of dilated veins in the brain.
   • High altitude pulmonary edema can occur in conjunction with cerebral edema, or separately after acute altitude sickness, or it can develop above 2500 meters after one to four days. It is caused by swelling due to fluid leaking into the lungs due to the high pressure and contraction of the blood vessels.
2. Recognize the signs of acute altitude sickness. Acute altitude sickness is relatively common in certain parts of the world. About 25% of all travelers who go above 2500 meters in Colorado, 50% of the travelers in the Himalayas and 85% of the travelers on Mount Everest are affected. There are all kinds of symptoms that can indicate acute altitude sickness.
   • These include headaches at the new altitude within two to 12 hours, difficulty getting to sleep or staying asleep, dizziness, fatigue, light-headedness, higher heart rate, shortness of breath while walking, and nausea or vomiting.
3. Recognize the signs of high altitude cerebral edema. Since brain edema is a serious extension of altitude sickness, you first get symptoms of the latter. If the condition worsens, you will also develop other symptoms. These include ataxia, which means that you can no longer walk straight, or a tendency to stagger when you walk. You may also experience an altered mental state, which can manifest as drowsiness, confusion, difficulty speaking, impaired memory, or difficulty moving, thinking, and concentrating.
   • You can also pass out or go into a coma.
   • In contrast to acute altitude sickness, high altitude cerebral edema is rare. It affects only 0.1 to 4% of people who climb.
4. Watch for signs of high altitude pulmonary edema. Since this can be an extension of cerebral edema, you will likely develop symptoms of acute altitude sickness and cerebral edema first. However, as it can also develop on its own, if it is a standalone condition, keep an eye out for the following symptoms. You may experience shortness of breath while not exercising. You may also feel pain or tightness in the chest, wheeze when you exhale, breathe faster and have a higher heart rate, feel faint and cough.
   • You may also notice physical changes, such as cyanosis, where your mouth and fingers turn dark or blue.
   • Like cerebral edema, pulmonary edema is relatively rare due to high altitude; it occurs in 0.1 to 4% of climbers.
5. Treat the symptoms. Even if you've tried to prevent altitude sickness, you can still get it. If so, you have to be careful not to make it worse. If you get acute altitude sickness, wait 12 hours to see if the symptoms improve. Immediately try to descend at least 1,000 meters if you don't feel better after 12 hours. If you can't get down, try to get an oxygen treatment within a few hours. Then reassess the symptoms to see if things are getting better.
   • If you experience symptoms of brain or pulmonary edema, descend immediately with minimal effort so that the symptoms do not get worse. Check regularly to see if the symptoms improve.
   • If descending is not possible due to weather or other reasons, try to get oxygen to get more oxygen into your blood. Put the mask on your face and attach the hose to the valve on the oxygen tank. Open the oxygen tap. You can also be placed in a portable hyperbaric chamber. If it is available, if the symptoms are not too severe and you are responding well to treatment, you may not need to descend. These lightweight devices are usually taken by rescue teams. If you have a phone with you, you can call a rescue team, provide your location and wait for them to arrive.
6. Take medicine in an emergency. There are medicines that you can get from your doctor to take in an emergency. For acute altitude sickness, you can take acetazolamide or dexamethasone. You can take dexamethasone for the treatment of brain edema. Take the pills as soon as possible and swallow them with water.
   • Your doctor can also give you a medicine for pulmonary edema, as a prophylaxis or treatment. There is some research showing that certain medications can reduce the risk of high altitude pulmonary edema if taken 24 hours before traveling. These include nifedipine, salmeterol, phosphodiesterase 5 inhibitors and sildenafil.

Warnings

• If you feel symptoms of altitude sickness coming on, don't continue your ascent, especially to spend the night higher.
• Descend if symptoms get worse or don't go away while you rest.
• If you have certain illnesses, your condition may worsen if you are at a high altitude. You may need to get a good check-up by your doctor before your trip to make sure it is safe to go. These conditions are, for example, cardiac arrhythmias, COPD, heart failure, vascular diseases, high blood pressure, diabetes and sickle cell disease. You are also more at risk of getting sick if you take heavy painkillers, which slows breathing.
• Pregnant women should not sleep at altitudes above 3500 meters.