Char Dhaam Yatra: Preventing acute mountain sickness

Health Care 118 Comments
  1. Slow ascent is the best prevention.
  2. If one lives below 5,000 feet (1,500 m), one should avoid ascending rapidly. On the first night, avoid sleeping above 9,000 feet (2,800 m).
  3. Between 5000–10,000 feet have a night halt.
  4. If one is planning to travel above 9,800 feet (3,000 meters) one should not ascend more than 1,600 feet (500 meters) per day.
  5. One should take a full day rest for every 3,200 feet (1,000 meters) ascent.
  6. On rest day one should not ascend higher or over–exert.
  7. For better adjustment one should climb high and sleep low. One should hike to a higher altitude during the day and return to a lower elevation to sleep at night.
  8. One should not over–exert during the first few days at altitude.
  9. One should not consume alcohol and sleeping pills, especially in the first two days.
  10. If one stays at elevations above 4,900 feet (1,500 meters) in the weeks before one ascends may allow one to ascend faster.
  11. If one drinks caffeine (coffee, tea, soda) regularly, he or she should not stop drinking it before or during the trip. Caffeine is safe at high altitudes, and stopping it suddenly can cause symptoms similar to AMS (Acute mountain sickness).
  12. One should be more careful if he or she has had acute mountain illness or another high altitude illness previously.
  13. Preventive drugs are given if one has had high altitude illness previously or wants to ascend quickly.
  14. The drug is acetazolamide to be started a day before the ascent and to be continued for 48 hours or until one reaches the highest point of the trip.
  15. Acetazolamide can temporarily cause carbonated drinks to taste unpleasant.
  16. Other side effects can include the need to urinate more frequently, numbness or tingling in the hands or feet, nausea, drowsiness, or blurry vision.
  17. Acetazolamide is not recommended for pregnant women.
  18. Acetazolamide is a sulfa medicine, but many people with a sulfa allergy can take acetazolamide without a problem.
  19. Dexamethasone is a steroid that may be recommended as a preventive treatment if one is allergic to acetazolamide.
  20. Taking aspirin or ibuprofen can help to prevent the headache that often occurs with AMS.
  21. If one intends to ascend quickly, one can start taking aspirin or ibuprofen before the ascent or take on developing headache.
  22. If one had high altitude pulmonary edema in last visit or wants to ascend quickly to altitudes above 8,200 feet (2,500 meters), one may also take nifedipine (commonly used to treat high blood pressure), dexamethasone, or acetazolamide to prevent lung swelling.

Dr KK Aggarwal

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