Acute Mountain Sickness

These notes apply to our high altitude Tours in Ladakh and Tibet only.  Acute Mountain Sickness (AMS) is an illness that can affect mountain climbers, hikers, skiers, or travellers at high altitude (typically above 10000ft or 3050m).

Causes, Incidence and Risk Factors
AMS occurs due to a combination of reduced air pressure and lower oxygen levels at higher altitudes.  The faster you ascend to a high altitude, the more likely you are to experience AMS.  The intensity of your symptoms will also depend on the speed of your climb and how hard you push or exert yourself.

You may be more likely to experience AMS if

  • You live at or near sea level
  • You have had the illness before

Symptoms of AMS
Symptoms range from mild to life-threatening and can affect the nervous system, lungs, muscles, and heart. In most cases, the symptoms are mild.
The symptoms generally associated with mild to moderate AMS include

  • Difficulty sleeping
  • Dizziness or light-headedness
  • Fatigue
  • Headache
  • Loss of appetite
  • Nausea or vomiting
  • Rapid pulse (heart rate)
  • Shortness of breath with exertion

Symptoms generally associated with more severe AMS include

  • Bluish discoloration of the skin (cyanosis)
  • Chest tightness or congestion
  • Confusion
  • Cough
  • Coughing up blood
  • Decreased consciousness or withdrawal from social interaction
  • Gray or pale complexion
  • Inability to walk in a straight line, or to walk at all
  • Shortness of breath at rest

Treatment
Early diagnosis is important, since AMS is easier to treat in the early stages.  The responsibility is on our riders to inform us of symptoms as soon as possible, so that we can take prompt remedial action.

  • The main treatment for all forms of mountain sickness is to descend to a lower altitude as rapidly and safely as possible.  You should cease climbing if you develop symptoms
  • Acetazolamide (Diamox) may be given to help improve breathing and reduce mild symptoms. This drug can cause increased urination. Make sure you drink plenty of fluids and avoid alcohol when taking it
  • Extra oxygen should be given, if required and available
  • People with severe mountain sickness may need to be admitted to a hospital

If you have fluid in your lungs (Pulmonary Edema), treatment may include

  • Oxygen
  • A high blood pressure medicine called Nifedipine
  • A phosphodiesterase inhibitor, such as Sildenafil
  • Lung inhalers – beta agonists
  • A breathing machine in severe cases

NOTE:  The above medications are ONLY administered by a medical professional / physician

Expectations (prognosis)
Most cases are mild and symptoms improve almost immediately when you descend to a lower altitude.  In severe cases AMS can be fatal due to lung problems or brain swelling.
If a Rider has any of the following symptoms (1) severe breathing problems, (2) altered level of alertness or (3) coughing up blood, we will send them down the mountain to the nearest medical assistance as soon as possible, bearing in mind the remoteness of our location.  Again, the responsibility is on our riders to inform us of symptoms as soon as possible, so that we can take prompt remedial action.  

Prevention
Tips to preventing acute mountain sickness include

  • Increase your altitude gradually
  • Stop and rest every 500m (2000ft) above 3050m (10000ft)
  • Sleep at a lower altitudes when possible
  • Learn how to recognize early symptoms of mountain sickness
  • Report any symptoms to the Motorcycle Expeditions Representative IMMEDIATELY

While increasing altitude, it is advisable to

  • Drink plenty of fluids
  • Avoid alcohol
  • Eat regular meals, high in carbohydrates

We will carry an adequate supply of Diamox if riders suffer from AMS.  This is usually sufficient to counter the symptoms felt on our Tibet and Ladakh Tour routes.

If you are at risk of anaemia, ask your physician if an iron supplement would offer the required support and also, if your body would cope with high altitudes. Anaemia lowers the amount of oxygen in your blood.

You should avoid high altitudes if you have heart or lung disease.
When in doubt, please discuss high altitude trips with your physician first.