How to handle Acute Mountain Sickness
One of the several things that you need to consider while preparing yourself for a trip to Spiti valley is the chance of suffering from acute mountain sickness. To be quite honest; this doesn’t really get pondered upon so much with Spiti as it does in case of Ladakh. The fact however still remains that a trip here means you will be traveling to altitude that you probably have never been to. You are bringing your body to a climate that it is not really accustomed to. The sudden change in elevation mixed with low oxygen level sometimes may cause your body to experience acute mountain sickness in Spiti valley. In this article, I will provide some information on what acute mountain sickness is, its causes and symptoms and how you can handle it better to ensure an enjoyable and hassle free trip.
Before I go any further in this article; I would like to mention that I am not a doctor or a medical professional. I have no knowledge of medicine or any illnesses and have no experience in the field at all. What I am adding here is purely my own research; based on my own personal experience or information that I gathered from the web. While the information below suffices for most travelers, I highly recommend a visit to a doctor if there is any medical condition involved. If you are an Asthma patient, a heart patient or any other medical history; please just do not go by my word and consult a doctor.
I have been to Spiti valley multiple times and quite frankly, have never experienced altitude sickness there. But then for someone who travels around the hills a lot; this is not something unusual. On the other hand, for someone who is visiting Spiti valley first time, there is a high chance that you may feel discomfort at several places during the trip.
Where will you suffer from AMS can differ for each individual but It can be assumed that for most of the people, it is the height of 10,000 ft or above that can lead to altitude sickness. Your most chances are at Batal, Chandratal, Kunzum Pass, Kaza and Nako. Please be advised that these places are located at highest altitude in this region where most people feel the symptoms but you may suffer from mountain sickness at other places as well.
A trip to Spiti valley is mostly done in form of a circuit; and what I call as the traditional way of doing this circuit is to start from Shimla and Manali. If you too have planned the journey in the same manner; it is rare that you will suffer from AMS anywhere during the trip. However for someone traveling from Manali towards Spiti; chances of altitude sickness are quite high. Reason for this I will explain further in the article. Let me start by explaining what AMS is, what its symptoms are, what causes it, where will you have the highest chance of suffering from it; followed by a few tips on how you can handle it better.
Acute Mountain Sickness in Spiti
Depending on the symptoms, Altitude sickness can be of three types.
Acute Mountain Sickness (AMS): AMS is the mildest, most common type of altitude sickness. caused by reduced air pressure and lower oxygen levels. Symptoms include difficulty in sleeping, dizziness, fatigue, headache, loss of appetite, nausea or vomiting, rapid heart rate, and shortness of breath.
High-Altitude Pulmonary Edema (HAPE): HAPE is a more serious condition of altitude sickness, symptoms include shortness of breath (even while resting), persistent coughing, exercise intolerance, coughing up pink, frothy spit (indication of fluid in the lungs).
High-Altitude Cerebral Edema (HACE): HACE, another and even more serious condition of altitude sickness, causes difficulty when walking, severe lethargy and a loss of focus. HACE and HAPE are rare and if not treated on time can be even fatal.
Cause of Acute Mountain Sickness in Spiti
Acute Mountain Sickness is a direct result of exposure to lower percentage of oxygen at high altitudes. As altitude increases, level of Oxygen present in the air starts to get lower. In order to accommodate for low oxygen per breath, our body increases the breathing rate and this is the reason why we start to huff and puff so easily in mountains. The process of a human body getting accustomed to low oxygen and adapting to the new environment is called acclimatization. When there is ample time for this process and our body is not undergoing a stress, there will not be any symptoms at all. However, as it happens in case of a trip to Spiti, the gain in altitude continues to happen over a period of 3-4 days and at a faster rate than our bodies can adapt to. This is what can trigger altitude sickness.
Symptoms of Acute Mountain Sickness in Spiti
While AMS falls under the category of nonspecific symptoms, in most cases they are the same of that of high fever. Your body temperature will suddenly rise followed by severe headache, chest pain, vomiting, lack of sleep, fatigue, nausea, loss of appetite and difficulty in breathing. Most people will suffer AMS when the increase in altitude is in a matter of a few hours or a day; but some people may suffer it for first few days even if the process is gradual.
These symptoms, ranging from mild to life-threatening, will also depend on the speed of your climb and how hard you exert yourself. If mild then they will gradually subside after a couple of days at high altitude but sometimes it can even lead to high altitude pulmonary edema, which is the worst condition of AMS and can be fatal. Some of the severe symptoms, affecting nervous system, lungs, muscles, and heart are blue color to the skin, gray or pale complexion, chest tightness or congestion, confusion, coughing up blood, decreased consciousness, withdrawal from social interaction, shortness of breath even while resting or unable to walk at all. Severe cases may result in death due to lung problems or brain swelling, called cerebral edema.
How to Handle Acute Mountain Sickness in Spiti
Once it happens, only two things will help. The first is to give your body ample time to adapt and for the symptoms to subside. If this however doesn’t help, the only other way is to get to a lower altitude as fast as you can. Apart from these two, below are a few other tips that can be of help.
Slow gain in altitude
Time is the key to altitude sickness, both before and after you start feeling the symptoms. As a rule of the thumb, stop for a day at every 2,000 feet (600 meters) of climb above 8,000 feet (2,400 meters). You really got to give your body ample time to acclimatize and need to plan your journey in a way that the altitude gain happens gradually. As compared to Manali Leh highway, Srinagar to Leh route is at a lower altitude and the ascent is gradual. You slowly get to high altitude as you travel across the highway and your body adapts better.
Start the journey Shimla and end at Manali. This is beneficial due in two ways. First, as you travel from Shimla and approach Spiti, altitude increases gradually, giving enough time to your body to adapt. Shimla is at 2000 meters, Narkanda at 2700, Sarahan at 2300 and Chitkul at 3400, so the rise in altitude is slow, spread over a few days, In comparison. If you start the journey from Manali, altitude increases all of a sudden. One day you are at Manali, at a height of 2000 meters, and the very next day you reach Chandratal at a height of 4300 meters, more than double. Secondly, travelling from Shimla means that you do not have to acquire a permit to cross Rohtang Pass which you will have to if you travel from Manali.
Avoid Smoking & Alcohol consumption
I know, this is easier said than done but it definitely helps. Even at several of the high altitude passes, you will find boards put up by Indian Army advising people not to smoke at such heights. Also stay away from any sleeping pills or anti-depressant medicines.
Avoid turning the heater on
If traveling in a Car, you will be tempted to turn on the car heater in the cold atmosphere of Spiti. Avoid doing so or even if you did turn on the heater, do not keep it at full blower or full heat. In the closed atmosphere of a Car, using a heater at its full capacity may trigger the symptoms of AMS.
Sleeping Habits
While you need to ensure that your body is getting proper sleep, you also need to avoid spending a night at a place where you are already suffering from AMS. If you start feeling the symptoms, then break the journey immediately rather than continuing to an even higher place. Ensure that you are sleeping with your head on a pillow and not without it. Avoid sleeping during day at all. If you are feeling symptoms of AMS, try sleeping in an upright position, with your back against the wall.
Eating & Drinking Habits
Keep yourself hydrated. Drink plenty of water and ensure that your diet has lot of carbohydrates in it. At the same time, you need to make sure that you are not over hydrating yourself. Do not force yourself or someone else to drink water if they are not thirsty. This can happen specially with children. Over hydrating or forced drinking can lead to vomit or worse; can trigger cerebral edema (symptoms being confusion, weakness, seizures or coma). Avoid drinking too much coffee or tea and eating heavy, fatty, junk foods. Try having small meals rather than heavy ones; inclusive of food that is easily digestible.
Do not exert yourself
Keep your body relaxed, try to walk slowly and do not exert yourself with any unnecessary activities that will leave you panting.
Medicines for Acute Mountain Sickness in Spiti
There are several medicines available in the market for high altitude sickness. What they do is make your body breath faster than the usual rate and hence try to compensate for the low amount of oxygen. However even these medicine are a precautionary measure and not a cure. They become useless once you start feeling the symptoms and should be taken as a precaution to avoid symptoms.
Acetazolamide, also known as Diamox, is the preferred medicine. It helps your body get used to higher altitudes more quickly, and reduces minor symptoms. Take a dose of Diamox a day before you climb, and then for the next 1 to 2 days. It is highly advised to consult your doctor before taking Diamox as it has several side effects like nausea, drowsiness, tingling like sensation in the body and frequent urination. PLEASE CONSULT YOUR DOCTOR BEFORE TAKING THE MEDICINE, specially if you are allergic to something.
If you are experiencing symptoms of mild AMS, the first step is to rest at the same altitude. Usually symptoms resolve with rest and painkillers within 24 hours. If symptoms do not resolve or if symptoms become worse, move down (descend). It is common that even a short descent and rest will improve symptoms significantly. It may still be possible to climb up again (re-ascend) if you have recovered and your schedule allows for this.
If you are at risk for a low red blood cell count (anemia), ask your provider if an iron supplement is right for you. Anemia lowers the amount of oxygen in your blood. This makes you more likely to have mountain sickness.
Home Remedies for Acute Mountain Sickness in Spiti
Apart from Diamox, there are some natural home remedies known to help with mountain sickness. These are some general daily use things and I will recommend that you pack these a little as well.
Ginger / Ginger Water
Ginger can prove to be one of the best remedies for altitude sickness. Chewing on some raw ginger can also combat nausea, dizziness, and vomiting at high altitudes. What you can also do is to consume it mixed with water. Peel the ginger, grind it to extract the juice and mix it (1 tbsp) in 1 glass of water. Consume it in the morning before you start climbing up and then again midway if you begin feeling dizzy or nauseous.
Garlic
Garlic is known for two things, both of which can be helpful while experiencing AMS. First is that it thins the blood and enhances the circulation. Second is that it helps the body use oxygen more efficiently; which reduces breathlessness at a high altitude place like Spiti. All you need to do is to peel off 2-3 garlic cloves and start chewing on them.
Clove
Clove is another natural home remedy that helps the body to be more efficient while using oxygen.
Lavender Oil
Lavender Oil is known to contain sedative effects that can soothe the mind and decrease restlessness; help reduce headaches and stomach discomfort which are some of the symptoms of AMS. Just apply 2 to 4 drops of lavender oil on your head for a headache or inhale the lavender oil to reduce nausea and dizziness.
Manali to Spiti
Chances of suffering from Spiti are highest when traveling from Manali to Spiti valley; as I also previously stated in the article. A lot of people do it mostly when they are short on time. If you too are planning a trip this way then ensure that you first reach Kaza from Manali; and do not break the journey at Chandratal. Primary reason behind this is that Chandratal is pretty much in the middle of nowhere. If your situation worsens at night; you will be in trouble with nowhere to go to. At least with Kaza, you have the option of getting medical help. You can cover Chandratal on your way back to Manali. Your body would have acclimatized better and you will feel better.
Conclusion
Once again, the only sure-shot cure of AMS is to get to a lower altitude. An oxygen tank can help as well if you continue to have breathing problem. If your condition worsens, please rush to a hospital. In case of a heart patient, it is best to avoid this journey and not take the risk. Try planning from Shimla to Spiti if possible; if not then ensure that you head straight to Kaza from Manali and stay there until you do not feel any symptoms at all.
I hope the information above regarding Acute mountain sickness in Spiti valley was helpful. If you have any further questions, please feel free to ask in the comments section below or at our Forum; and I will be glad to answer.Start writing your post here.
You can send your trip images and videos to add in this blog.
