SUMMARY OF THE SYMPTOMS, DIAGNOSIS AND PREVENTION/CURE OF THE
ALTITUDE SICKNESS IS EXPLAINED PRIOR.
Kilimanjaro climb is exhilarating and fun-filled adventure, there
are many dangers associated with high altitude climbing. Although
the information below will help you plan and prepare for your
Kilimanjaro or Meru climb, it is not a substitute for high altitude
medical training or experience. You must be extremely cautious
during your climb and inform the guide and others in the group of
any altitude sickness you experience. Classic Tours advices the
Tourists/climbers to climb slowly slowly (pole pole) and drink
enough water.
Altitude: Kilimanjaro and Meru
Altitude affects people differently and there are no specific
factors such as age, sex, or physical condition that correlate with
the susceptibility to altitude sickness. Most people can hike to
2,438 meters (8,000 feet) with minimal affect. If this is your first
trip at altitude, it is important to be extremely cautious when
hiking either Kenya, Meru Kilimanjaro. Altitude is commonly given
three rankings of high, very high, and extremely high. The lower and
upper boundaries of these ranks are shown in the table below.
|
High |
2,500 to 4,000 meters |
8,000 to 13,000 feet |
Adaptation sufficient |
|
Very High |
4,000 to 5,500 meters |
13,000 to 18,000 feet |
Adaptation not sufficient; acclimatization necessary. |
|
Extremely High |
Over 5,500 meters |
Over 18,000 feet |
Acclimatization not possible; deterioration. |
The summit of Kilimanjaro, 5895 meters (19,340 feet), falls in the
extremely high category and proper precautions should be taken to
mitigate the risks of high altitude hiking. The highest camps of
Kilimanjaro, Barafu and Kibo, fall in the very high category of
altitude and hikers could experience severe signs of altitude
sickness at these camps. Although Horombo hut and Baranco Camp are
often viewed as an acclimatization hike for Kilimanjaro, its peak,
4,566 meters (14,990 feet), falls in the very high altitude category
and hikers can also experience severe altitude sickness while hiking
Meru.
What is Altitude Sickness?
Symptoms associated with altitude sickness result from the body's
inability to adjust to lower levels of oxygen in the blood. At sea
level, the concentration of oxygen is about 21% and the barometric
pressure averages 760 mmHg. As altitude increases, oxygen
concentration remains the same but the number of oxygen molecules
per breath is reduced due to lower barometric pressure. At 3,658
meters (12,000 feet), barometric pressure decreases to 483 mmHg,
resulting in roughly 40% fewer oxygen molecules per breath. In order
to increase oxygen levels in the blood, your body responds by
breathing faster. Although oxygen levels increase, sea level
concentrations cannot be reached. The body must adjust to having
less oxygen. This adjustment is called acclimatization. At
elevations above 5,500 meters, acclimatization is not possible and
the body begins to deteriorate.
Acclimatization
The main cause of altitude sickness is going too high too fast.
Given enough time, your body will adapt to the decrease in oxygen at
a specific altitude. This process is known as acclimatization and
generally takes one to three days at any given altitude. Upon
climbing to a higher elevation, the body must readjust to the new
altitude again over a period of one to three days.
FROM THE CLASSIC TOURS & SAFARIS LTD
When Climbing Mount Kilimanjaro, in 5 days trip you can’t get
acclimatization day. It is better you plan a six days trip so that
this one day extra is used for acclimatization. Acclimatization
day is used to climb high and descend down to a certain point not
far from the desired altitude. However, most reasonably fit climbers
of age up to 78 years make up to the Roof of Africa ( 5895m)
Kilimanjaro top in 5 days, and this is possible through Marangu
route.
In order to cope with decreased oxygen levels, the body reacts in
the following ways:
•Respiration frequency and depth increases
•Pressure in pulmonary arteries is increased, "forcing" blood into
portions of the lung which are normally not used during sea level
breathing.
•Additional red blood cells are produced to carry oxygen
•Enzymes are produced to facilitate the transfer of oxygen from
hemoglobin to body tissues.
It is imperative that hikers be aware of symptoms of Acute Mountain
Sickness during Kilimanjaro, Kenya and Meru trips and that they
communicate with the guide regularly regarding their condition. It
is very important to rest and not ascend further if experiencing
severe symptoms of AMS.
Acute Mountain Sickness (AMS)
Acute Mountain Sickness is common at high altitudes and 75% of
people experience some symptoms over 3,000 meters (9,842 feet). The
severity of AMS depends on several factors including rate of ascent,
elevation, and individual susceptibility. Symptoms usually begin
between 12 and 24 hours after reaching altitude and decrease in
severity by the third day.
Mild AMS symptoms
include: headache, nausea and dizziness, loss of appetite, fatigue,
shortness of breath, and inability to sleep.
As long as the symptoms are mild, hikers can continue to climb at a
moderate rate. All symptoms of AMS should be communicated to the
head guide and progress reports should be given daily.
Moderate AMS symptoms
include: severe headache, nausea and vomiting, increased weakness
and fatigue, shortness of breath, and decreased coordination.
Although the hiker may be able to continue walking on their own
while experiencing moderate symptoms of AMS, normal activity becomes
more and more difficult as the hiker gains altitude. At this stage,
only medicine and descent can reverse the symptoms of AMS. Even a
minor descent of only 300 meters will result in a significant
improvement. All symptoms of moderate AMS should be communicated to
the guide at which point the guide will make a decision whether or
not to evacuate. Depending on symptoms, the climber may be told to
walk a straight line. If he or she is not able to walk a straight
line on their own, immediate descent is required.
Severe AMS symptoms
include: increased shortness of breath, loss of ability to walk,
decreasing mental awareness, and fluid buildup in lungs.
Severe AMS can only be treated by immediate descent to lower
altitudes.
Other Severe Altitude-Related Illnesses
Two other severe forms of altitude sickness may result from failure
to descend to lower altitudes. These include High Altitude Pulmonary
Edema (HAPE) and High Altitude Cerebral Edema (HACE). Although these
happen less frequently, they usually result from fast ascents among
people who are not properly acclimatized. The lack of oxygen in the
body causes a leakage of fluid through the capillary walls into
either the lungs or brain.
High Altitude Pulmonary Edema (HAPE)
HAPE results from fluid buildup in the lungs and can prevent
effective oxygen exchange. Impaired cerebral function, cyanosis, and
death may result in severe cases of HAPE. Symptoms of HAPE include:
shortness of breath even at rest; fatigue and weakness; feeling of
impending suffocation or drowning; grunting or gurgling sounds when
breathing; persistent cough which brings up white, watery, or frothy
fluid; confusion and irrational behavior. In cases of HAPE,
immediate descent is necessary. Patients should be evacuated to a
medical facility for follow-up treatment.
High Altitude Cerebral Edema (HACE)
HACE is the result of swelling of brain tissue from fluid leakage.
Symptoms include the following: headache; loss of coordination
(ataxia); weakness; decreasing levels of consciousness including,
disorientation, loss of memory, hallucinations, blindness, and coma.
HACE generally occurs after a week or more at high altitude. Severe
instances can lead to death if not treated quickly and immediate
descent is a necessary life-saving measure. Follow-up care must be
sought at a medical facility following HACE.
Preventing Altitude Sickness
There are two ways to prevent altitude-related illness: proper
acclimatization and preventative medicines. These recommendations
are written specifically for climbing Mounts Meru and Kilimanjaro in
Tanzania and may not be applicable to other high mountains.
•Tell guide your AMS symptoms and keep him as well as the other
group members informed of your progress.
•Climb high and sleep low. It is recommended that you acclimate
during the day by climbing to high elevations and then descending to
sleep.
•If you begin to show symptoms of moderate altitude illness, don't
go higher until symptoms decrease.
•If symptoms become severe, descend.
•Stay properly hydrated. Acclimatization is often accompanied by
fluid loss, so you need to drink lots of fluids to remain properly
hydrated (at least 4-6 liters per day). Urine should be clear.
•Don't over-exert yourself at altitude. Light activity during the
day is better than sleeping because respiration decreases during
sleep, exacerbating the symptoms.
•Avoid tobacco and alcohol and other depressant drugs including,
barbiturates, tranquilizers, and sleeping pills. Depressants further
decrease the rate of respiration during sleep resulting in a
worsening of the symptoms.
•Eat a high calorie diet of which 70% is carbohydrates.
Preventative Medications
Diamox (Acetazolamide): Diamox is a drug that allows you to
breathe faster so that you metabolize more oxygen. Although gradual
ascent is recommended as opposed to Diamox, the drug does help to
avert symptoms of Altitude Mountain Sickness. Because it takes a
while for Diamox to have an effect, it is advisable to start taking
it 24 hours before you go to altitude and continue for at least five
days at higher altitude. The recommended dose is between 125 mg and
250 mg twice daily starting one to two days before the trek and
continuing for three days once the highest altitude is reached.
Possible side effects include tingling of the lips and finger tips,
excessive urination, blurring of vision, and alteration of taste.
Contact your physician for a prescription. Since Diamox is a
sulfonamide drug, people who are allergic to sulfa drugs should not
take Diamox. Diamox has also been known to cause severe allergic
reactions to people with no previous history of Diamox or sulfa
allergies. (There are other medications that may be taken to prevent
altitude sickness. You must ask your doctor if they are right for
you.)
Other Medications
Ibuprofen relieves altitude induced headache.
Nifedipine rapidly decreases pulmonary artery pressure and
also seems able to decrease the narrowing in the pulmonary artery
caused by low oxygen levels, thereby improving oxygen transfer. It
can therefore be used to treat HAPO, though unfortunately its
effectiveness is not anywhere as dramatic that of dexamethasone in
HACO. The dosage is 20mg of long acting nifedipine, six to eight
hourly.
Frusemide may clear the lungs of water in HAPO and reverse
the suppression of urine brought on by altitude. However, Frusemide
can also lead to collapse from low volume shock if the victim is
already dehydrated. Treatment dosage is 120mg daily.
Apart from
these Symptoms and knowledge on these medicines which help to cure
or reduce the adverse Mountain Sickness, Experience is also
important.
Below are
important things to consider when climbers want a Success.( With
Classic)
(i)
Knowledgeable, Experienced and devoted Mountain Guides.
(ii)
Control the path or speed of Climb-Climb slowly slowly.
It means climb
and breath. In Swahili they say Pole pole.
(iii)
Food that is needed for Mountaineers is Special, it includes
Energy meals,
ask for this Food Formula.
(iv)
Enough Water
(v)
Much more experiences are discovered everyday, ask for more!
Now in your
next African Holiday, don’t forget to include Mount
Kilimanjaro.
Classic Tours
and Safaris Ltd is glad to arrange your Travel Plan
