Altitude Mountain Sickness (AMS)
Specially, in trekking in Himalaya there are problems of Altitude Sickness (AMS). Our bodies have the ability to adjust to higher altitudes if given enough time. This process of adaptation is called acclimatization. Altitude illnesses observed in Nepal include acute mountain sickness (AMS), High Altitude Pulmonary Edema (HAPE), the presence of fluid in the lungs. High Altitude Cerebral Edema (HACE), swelling of the brain. And High Altitude Retinal Hemorrhage (HARH), bleeding in the retina of the eye.
Most people trekking to high altitudes experience one or more mild symptoms of altitude illness.
- Loss of appetite
- Mild shortness of breath with minimal exertion
- Sleep disturbance (difficulty sleeping
- Dizziness or light-headed-ness
- Mild weakness
- Slight swelling of hand and face
Never ascent to sleep if you have mild symptoms. Symptomatic treatment with medicines may be helpful. If there is no improvement after a few hours or after a night’s rest, or there is worsening, descend on foot to below the altitude where symptoms first occurred. Then ascent at a more gradual rate can be considered after getting better.
Serious symptoms of altitude illness are a grave matter:
- Inability to recover from shortness of breath with rest
- Delirium, confusion, and coma
- Loss of coordination, staggering
- Severe, persistent headache
- Rapid heart rate after resting – 110 or more per minute
- Wet, bubbly breathing
- Severe coughing spasms that limit activity
- Coughing up pinkish or rust-colored sputum
- Blueness of face and lips
- Low urine output – less than a pint (500 ml) daily
- Persistent vomiting
- Gross fatigue or extreme lassitude
If any of this symptom, he/she should descend immediately on the back of a porter, or animal to avoid undue exertion. Descend to below the altitude at which any symptoms of altitude illness first occurred.
Prevention of AMS: Drink lots of fluid without alcohol (per day 4/5 Lt). Learn about mountain sickness. Walking slowly. Never ascend to sleep at new altitude with any symptoms of AMS. Not leave sick people along. Descend if your symptoms are getting worse while resting at the same altitude. Use Gamow Bag if possible and know to use. Taking “Diamox” has been shown to be beneficial in helping the acclimatization process especially if flying to altitudes. The dose is 125 mg by mouth two or three times a day, begun 2 or 3 days before flight. For more information please ask your personal doctor or a book “Altitude Illness: Prevention and Treatment” by Stephen Bezruchka.
The vast majority of diseases that plague the travelers in Nepal are transmitted by food or water contaminated by infected human or animal feces. You should assume that all water and uncooked foods in Nepal are contaminated. It is recommend that you can drink enough boiling water during trekking or can use the filtering or bottled water or use iodine tablets. Thoroughly cooked foods can be considered safe, but only if are eaten soon after cooking. Fruits and vegetable are eaten uncooked must be washed and peeled under sanitary condition. Milk should always be hearted just to the boiling point and allowed to cool before drinking, unless it is known to be already pasteurized. For alcoholic drinks, Rakshi – local wine, we call fire water is safety because it has been boiled. Local beer or call CHhang or Jaar, unless the water from which it is made is known to be pure, it is possible to get sick from. The Tomba (Tibetan beer) is party safe if the water is enough boiled.
In case of an animal bite, treat by washing the site immediately soup and water as well as adulate solution of salt and water. Wash and irrigate the wound for 30 minutes or more. In animal experiments inoculating of a wound with rabies virus has shown washing alone to be effective in preventing clinical rabies. Those who had rabies vaccine before coming Nepal face less risk than others but should get post exposure inoculation as well, although they do not need rabies immune globulin. Leeches, abundant during the monsoon in the forests an attracted to byproducts of respiration and drop onto you as you pass under them, pick up them off as soon as they latch on. When you feel much localized cool sensation anywhere on your skin, stop immediately and investigate. In Nepal Malaria transmission is limited to the lowland Tari area. There is no risk of Malaria in Kathmandu, Pokhara or any of the main trekking areas. The risk in the Terai is very low and travelers traversing the area for one or two days do not need malaria prophylaxis. There is no risk of malaria for visitors going to Chitwan National Park.
Foot care, strains, sprains and sahib’s knee
Well-fitting boots or shoes and proper socks are a must to prevent foot problems. Tape, moleskin, or mole foam tends to spread friction over a larger area and reduce local shear stress between layers of the skin. When you feel a tender or hot on the skin while walking, stop and investigate. Put a generous piece of moleskin, foam, or adhesive tape over the area. The best method is to place moleskin and cover that material with a piece of smooth adhesive tape. Don’t remove it for server days; otherwise, you may pull some skin off with it. Treatment for strains and sprains is similar. Ice or cool the affected part, and elevate and compress the injured area. Compress with adhesive tape or an elastic bandage. Severe injuries with require rest for a few days. For strains in the bulky muscles of the thigh, there may be little you can do except to lighten the load and ease up on the amount of ground to be covered. This advice applies to sprains as well. Take pain medicine. Individuals with preexisting knee or ankle problems should strengthen the muscles that pull across the joint by doing isometric exercises before they trek. Those with a tendency to ankle sprains should wear sturdy, over the ankle boots and do exercises to strengthen their peroneal muscles. Others prone to knee injuries should word on their quadriceps muscles. Those with knee problems will be better off wearing footwear with shock absorbency in the heel. Consider using ski pole to lessen the impact on knee and hips.