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Avoiding altitude related sickness

 Poster: A snowHead
Poster: A snowHead
What measures can you take to help prevent the effects of altitude? And furthermore what are the likely symptoms one might expect to experience? The last time I was away I felt pretty awful for large parts of the trip - firstly I had real trouble sleeping, felt pretty de-hydrated, had nose bleeds, dizzy spells and had the runs almost all week. Looking back I'm wondering whether it was altitude related or whether I was just ill with food poisoning! By the way I still had a great time!

I've certainly heard that Altitude can lead to nose bleeds, dizziness and problematic sleeping etc … so anyone got suggestions for preventative measures??
Cheers
Adam
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
a quick google search brings up the following :


www.high-altitude-medicine.com/AMS.html

( amended to get the link working )


Last edited by Obviously A snowHead isn't a real person on Wed 24-11-04 18:51; edited 2 times in total
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Adam Holt, I think this has been discussed elsewhere in this site - do a quick search for the topic (also, can admin help here?).
Short of not going so high so quickly, there's not much else in the way of "preventative" measures. Restrict alcohol, caffeine, drink water, eat well, sleep as much as you can.
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There's loads of info on the web. Doing as Manda suggests pretty much sums it up although there are drugs (prescription in the UK) which apparently help. They are viewed with suspicion by some, 'though, since they can occasionally mask the symptoms of altitude sickness, with ghastly results. There are non prescription compositions around which claim to help, but they're of dubious value, I suspect.

If you do have serious symptoms (other than a persistent mild headache and an inability to sleep), lose height quickly. Things can get worse very rapidly, apparently. I wouldn't have thought that many ski resorts are high enough to cause serious altitude sickness, unless you go off moutaineering, but you never know.

I've tried chewing coca leaves to combat the effects of altitude; it did help a bit, but it's pretty unpleasant itself (the numb mouth is fine, but the taste is disgusting). Coca leaves are not widely available in many ski resorts, so far as I know - Portillo, perhaps?
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richmond,
Quote:

I've tried chewing coca leaves
The trouble is that they are a class A drug! and as you say banana ash that you have to chew them with is foul. It does switch off the appetite too, so you would save a fair bit on mountain burgers.
Manda, is right - drink water, and then drink some more, sorry to mention it but your urine should be very pale yellow or colourless, anything darker and you're not drinking enough. Avoid diuretics such as caffeine, alcohol, but Acetazolamide, prescription only - see the website above is useful if you think you may have problems at resort level (Breckenridge, Val Thorens)
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A south American traveller methinks!!! Altitude sickness is only really meant to be a problem over 2500m so you shouldn't be spending any more than a day's skiing at that level. COME DOWN if you start feeling properly ill, as richmond says, and keeping hydrated (with water, alcohol is a dyhydrant) is very important too!! You can take a drug called Acetzolamide (Diamox) 2 or 3 times daily starting 24hrs before ascent and and continuing for 48 hrs after arriving.
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Martin Nicholas wrote:
richmond,
Quote:

I've tried chewing coca leaves
The trouble is that they are a class A drug! and as you say banana ash that you have to chew them with is foul.


I'm not sure that coca leaves are class A, they don't contain cocaine, but I daresay they're illegal. It's illegal to export them from Peru, altho' legal to grow, sell and chew them there. I chewed them with some kind of crumbly stone (possibly banana ash), absolutely foul, and with bicarb, which was possibly even more disgusting, in a less crunchy, more retch inducing, kind of way.
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They do contain cocaine - that's where cocaine comes from. However, chewing/eating them is not a very efficient way of getting the drug into your bloodstream, I think stomach acid breaks down cocaine. (One of our medical snowHeads will no doubt put me right).

The stuff is in legal limbo land in Peru & Bolivia. It is illegal because the USA twists the arms of the governments to make it so, but they have to give concessions to the indigenous population who have been using it for centuries.
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Pete Horn wrote:
They do contain cocaine - that's where cocaine comes from.


I appreciate that cocaine comes form coca leaves (the clue is in the name, when you think about it), but my understanding is (or was) that cocaine itself is not present in the leaves. Mind you, having looked on the web, it seems that I may be talking cobblers.
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Adam Holt, Difficulty sleeping - might just be jet lag if you've had a long flight, or might be because of extremely low humidity in your room. Try putting a damp towel on the radiator before going to bed. The other symptoms you had might well have been at least in part raging gut rot. How high were you?
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When cocaine is absorbed from the gut it passes through the liver in the bloodstream, where it undergoes "1st pass metabolism", which breaks it down to a non-psychoactive substance. However, chewing coca leaves allows the cocaine to be absorbed directly through your mouth and throat (the buccal cavity), substances absorbed through this route do not pass through the liver before entering the bloodstream, and so remain active.
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I wish I'd had some coca leaves to chew when I was skiing in Mammoth a few years ago. The village is at 7,800 feet and the skiing up to 12,000 feet. In the ten days I was there I didn't have one good night's sleep and got a lot of headaches. The combination of jetlag and altitude really did me in, although the skiing and the snow was incredible, but I wouldn't ever go that high or far again.
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I have just come back from Everest base camp which is higher than anywhere you are likely to ski (18300').

You can get AMS (acute mountain sickness) at relatively low altitudes (8,000 - 10,000') and it can kill you so you need to be aware although at these altitudes you are more likely to just suffer the symptoms.

Certainly at higher resorts (particulary Colorado) ease off the beer for the first few days and make sure that you keep hydrated.

Most symptoms of AMS manifest themselves at night and if you do suffer we found that diamox works pretty well (it makes you pee a lot though - not good when its about minus 10C outside the tent) although you realy need to take further action quickly if the symptoms persist even with diamox.

I took ginko for about a week beforehand and throughout the trek and had no problems so its certainly worth considering if you are going to a very high resort.

Those who suffered AMS didn't suffer digestive problems so that was probably down to a bad pint or food poisoning.

Stephen.
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 You know it makes sense.
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Stephen Sadler, Theres no evidence that Ginko is better than placebo as far as I'm aware. The French are doing a serious trial into Viagra and AMS which leaves one with a wonderful mental image. Some where to attach the tricolor perhaps? Puzzled
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Yeah but placebo's a bit of a wonder drug. I avoided getting sore throats and colds for years using it. There's even evidence for it working when people know they're taking a placebo.

Quote:
The French are doing a serious trial into Viagra and AMS


So AMS is caused by too much blood to the head?
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 Poster: A snowHead
Poster: A snowHead
One of my sons is quite afffected by altitude. He had nosebleeds in Flaine (1600m), and Bell Plagne,(somewhat higher), but the worst experience with him was when we went dog-sledding near Canmore. He ended up sitting in the sled whilst his younger brother and I had all the fun mushing the dogs, and that was after being in Banff for over a week.
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richmond wrote:
Pete Horn wrote:
They do contain cocaine - that's where cocaine comes from.


I appreciate that cocaine comes form coca leaves (the clue is in the name, when you think about it), but my understanding is (or was) that cocaine itself is not present in the leaves. Mind you, having looked on the web, it seems that I may be talking cobblers.


Having looked at my 'Principles of Organic Synthesis' (a rip roaring read), I don't think coca leaves do contain cocaine, but rather cocaine precursors (which are converted into cocaine during the processing of the leaves).

Not that it matters.
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Helen Beaumont wrote:
One of my sons is quite afffected by altitude. He had nosebleeds in Flaine (1600m), and Bell Plagne,(somewhat higher), but the worst experience with him was when we went dog-sledding near Canmore. He ended up sitting in the sled whilst his younger brother and I had all the fun mushing the dogs, and that was after being in Banff for over a week.


How does he get on in 'planes? I believe that they are pressurised to about 1600m.
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My understanding is that Diamox is not particularly effective for AMS. If you are alttitude and start to get symptoms of AMS, I thought that the only treatment was to descend to a safer alttitude immediately.
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richmond, he's usually OK. Kramer, I'd heard that too, anyone had any experience on it's use?
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Martin Nicholas, Very Happy Very Happy Very Happy Very Happy Very Happy
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Having seen the affects of AMS at first hand and seeing how the trek leader dealt with it then diamox is a definite help but you still need to be careful as if symptoms persist then you can be in trouble very quickly (and if its cerebal odema then you will almost certainly be unaware that you are in trouble).

The trek leader was insistent that anyone who even started with a headache reported to him and he would then keep an eye on them and if it persisted he would start them on diamox which in our party always worked.

The problem is that once you start on diamox you have to keep taking it until you get to a lower altitude than when you started but it enabled everyone to at least see Everest even if only 9 of us got to base camp.

At those altitudes AMS is a serious consideration and it was not unsual to see 2 or 3 helicopters each morning evacuating people who had become ill during the night.

There has been a recent trial with ginko which showed a large reduction in AMS (I think it was as much as 50%) as opposed to the control group and in those on ginko the symptoms were greatly reduced.

I may have just been lucky but I was one of only two in a group of 16 who was not affected in some way.

Its certainly worth a try even if its only a placebo effect,
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richmond wrote:
Having looked at my 'Principles of Organic Synthesis' (a rip roaring read)

Shock By ROC Norman? If so, that takes me back a bit. I'm sure I've got a copy upstairs, but I haven't opened it in decades!
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laundryman, I sold all my books to !st years for beer money 20 years on and now I wish I hadnt, well for some of them anyway.
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We went to Breckenridge this March (11,000 ft). We took ginko for a week before we went and during the holiday, Also didn't drink for first 3 days. I had never been
anywhere near as high as this before and apart from getting out of breath from even a small walk we had a great time. I think if you go with a positive attitude, then things have a habit of being ok.
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Quote:
I think if you go with a positive attitude, then things have a habit of being ok.

...but not always
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Looking at the research-

A recent well conducted systematic review in a peer reviewed journal.

The summary was:-

Quote:
What is already known on this topic:-

Acute mountain sickness is a disease frequently experienced at high altitude.

Many drugs have been used to prevent acute mountain sickness.

What this study adds:-

The risk of acute mountain sickness depends directly on the ascent rate; above 4000 m, dexamethasone 8-16 mg and acetazolamide 750 mg are equally efficacious in preventing acute mountain sickness when ascent rates are higher than 500 m/day.

Contrary to widespread belief, acetazolamide 500 mg does not work.

Dexamethasone and acetazolamide are associated with specific adverse effects.

With low rates of ascent, prophylaxis is not worth while.


What this means for most skiers, is that at the alttitudes most of us ski at, diamox is probably not effective, and you run the risk of serious side effects.

The evidence for ginko biloba does not seem to be as strong. Three small studies have suggested that it may reduce the incidence and severity of AMS, however I don't think that any of them have reached statistical significance (the bare minimum standard of statistical significance needed to recommend a medication). Also it is a herbal preparation, and as such comment cannot be made on the frequency and severity of adverse effects. Also being a herbal remedy, the quality control of preperations cannot be guaranteed to be up to the standard of pharmacological preperations.

Hope that this clears things up. Very Happy
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