Acute Mountain Sickness - A Common Condition When Climbing
AMS, or acute mountain sickness is common at high altitudes. At elevations over 3,000m three quarters of people can expect to suffer mild symptoms. The occurrence of altitude sickness is dependent upon several factors, such as elevation, rate of ascent, and the individualβs susceptibility. Many people experience mild altitude sickness during the normal acclimatization process. The mild discomfort that accompanies this adaptation should be considered normal and acceptable.
Symptoms usually start 12-24 hours after arrival at altitude and begin to decrease in severity about the third day. The symptoms of mild AMS are headache, dizziness, fatigue, shortness of breath, loss of appetite, nausea, disturbed sleep, and a general feeling of malaise. Symptoms tend to be especially bad at night when respiratory drive is decreased.
Mild altitude sickness does not interfere with normal activity and symptoms generally subside within 2-4 days as the body acclimatizes. As long as symptoms are mild, and only a nuisance, ascent can continue at a moderate rate. When hiking, it is essential that you communicate any symptoms of altitude sickness immediately to the expedition leader or lead guide.
Altitude sickness is considered to be a neurological problem caused by changes in the central nervous system. It is basically a very mild form of High Altitude Cerebral Edema. The only cure is acclimatization or else descent. Symptoms of mild AMS can be alleviated with Ibuprofen but keep in mind that reducing the symptoms is not curing the problem or treating the cause.If symptoms of mild AMS worsen, the climber may be exhibiting early signs of:
Moderate AMS
Moderate AMS includes severe headache that is not relieved by medication, nausea and vomiting, increasing weakness and fatigue, shortness of breath, and decreased coordination (ataxia). Normal activity is difficult, although the person may still be able to walk on their own. At this stage only descent can reverse the problem. Descending even a hundred meters may help and definite improvement will be seen with a descent of 300-500 meters.
Twenty-four hours at the lower altitude will result in significant improvements. The person should remain at lower altitude until symptoms have subsided. At this point, the person has become acclimatized to that altitude and can begin ascending again.
The best test for moderate AMS is to walk in a straight line, heel to toe. Just like a sobriety test, a person with ataxia will be unable to walk in a straight line. This is a clear indication that immediate descent is required. It is important that the person descends before the ataxia reaches the point where they can no longer walk on their own. If, despite all careful preparations, such a condition should develop in a team member our staff are trained in rapid evacuation techniques. The team member will be carried to a location of complete safety within hours, from any point on the mountain.
Severe AMS
This condition presents itself as an increase in the severity of the aforementioned symptoms, including:
- shortness of breath at rest
- inability to walk
- decreasing mental status
- fluid build-up in the lungs
Severe AMS requires immediate descent to lower altitudes of around 1,000 meters.
There are two other severe forms of altitude illness, High Altitude Cerebral Edema (HACE) and High Altitude Pulmonary Edema (HAPE). Both of these happen less frequently, especially to those who are properly acclimatized. When they do occur, it is often because inexperienced people may go too high too fast, or else may go very high and stay there. The lack of oxygen results in leakage of fluid through the capillary walls into either the lungs or the brain.
High Altitude Pulmonary Edema (HAPE)
HAPE results from fluid build-up in the lungs. The fluid in the lungs prevents effective oxygen exchange. As the condition becomes more severe, the level of oxygen in the bloodstream decreases, and this can lead to cyanosis, impaired cerebral function, and death.
Symptoms of HAPE
- shortness of breath even at rest & tightness in the chest
- marked fatigue & weakness
- feeling of impending suffocation at night
- persistent cough bringing up white, watery, or frothy fluid.
Confusion, and irrational behavior are signs that insufficient oxygen is reaching the brain. In cases of HAPE, immediate descent to below 2,000m altitude is a necessary life-saving measure. Anyone suffering from HAPE must be evacuated to a medical facility for proper follow-up treatment.
High Altitude Cerebral Edema (HACE)
HACE is the result of swelling of brain tissue from fluid leakage. Symptoms can include:
- headache
- loss of coordination (ataxia)
- weakness
- decreasing levels of consciousness
- disorientation
- loss of memory
- hallucinations
- psychotic behaviour
- coma
It generally occurs after a week or more at high altitude. Severe instances can lead to death if not treated quickly. Immediate descent to 1,000m altitude is a necessary life-saving measure. Anyone suffering from HACE must be evacuated to a medical facility for proper follow-up treatment.
Many people spend a lot of time and money training and equipping themselves for a Kilimanjaro climb, only to fail in their objective of reaching the summit. Failure is avoidable and we really want trekkers to understand how to prevent it.
As from March 2021, PCR testing (or rather, sample-taking) is now available at Seronera and Ndutu airstrips in the Serengeti. This facility has been implemented to prevent clients having to either curtail their safaris or dissect their safaris with a journey to Arusha or, more recently, Karatu (FAME Hospital), mid-safari - so as to satisfy the "less than 72 hours old" validity rule that most airlines are required to enforce.
Arusha Pedal Series club aims to organise a group ride three times a week - on Mondays, Wednesdays or Thursdays, and Saturdays. All keen cyclists are welcome to join.
We read widely divergent estimates of deaths on Kilimanjaro, but how dangerous is it really? In this post we share our own experience of the dangers.
First of all - you can definitely still climb Kilimanjaro during COVID-19! There is absolutely no impediment within Tanzania. Issues only potentially arise with your own country's rules.
Although there is no requirement to have a PCR test for COVID in order to enter Tanzania, many climbers are nonetheless required by their airline to show evidence of a negative COVID test before boarding the flight home.
This following information is provided to reassure prospective climbers that there is a straightforward way to enjoy the incredible tourism and adventurous opportunities that Tanzania offers, while ensuring that returning home afterwards is stress-free.
Kilimanjaroβs Western Breach is a beautiful and breathtaking place but represents the most risk-associated assault route to Kilimanjaroβs summit, of the four options currently sanctioned by Tanzania National Parks.
I think the question of how much it costs to climb Kilimanjaro is a little like asking, how much it costs to buy 'a car'! Apart from the obvious question of how many people you want the car to carry and whether you want it to have offroad capability, there are more subtle considerations.
Kilimanjaro has been climbed from the park gates to the summit in a little over just 5 hours, and yet the Royal Geographical Society suggests that trekkers should not spend less than 10 days reaching the summit? So, how long does it usually take and what is safe?
While we've assisted people in their 70s, a 5 year old, amputees, and quadriplegics to the summit, and while in theory, pretty much everyone could climb Kilimanjaro, nonetheless, many people have told us that climbing Kilimajaro is the hardest thing they've ever done in their lives - and some of these people have been professional athletes (rugby players).
