Trekking isn’t just about altitude it is also about Attitude.
Of all the seminars today – the one on altitude medicine was the most interesting. When you think about it – a lot of the real fascinating places in the world are not exactly at sea level.
There are the low mountains – NE US, the Alps, Northern Scandinavia, Southern Argentina and Chile. Then there are those higher places which are jumping off points – Nepal for the Himalayas , Cuzco (Peru), Quito (Ecuador), La Paz (Bolivia). Places that large numbers of people live and work which leaves tourists (not just Western but Korean, Chinese and Japanese) with the idea that altitude really isn’t a big deal.
For example – in a mountain climbing population in Nepal the incidence of AMS (acute mountain sickness) was 42%. And these were those who hiked up the mountain, not those who were delivered there by air. On the Lukla to Pheriche the incidence increased to 60%. If there are no rest days and as the rate of ascent increases – the incidence goes up…. Including extra time at 3450 meters, and 14000 feet – decrease to 35-43%. Mt Everest is the highest point, 8380 meters that people walk to. It can be done without oxygen.
AMS – acute mountain sickness – just your basic headache nausea, tired and weakness
HACE – High Altitude Cerebral Edema (think the worst hangover – ever)
HAPE – High Altitude Pulmonary Edema
Dealing with these extremely likely and potentially fatal diseases is like pre-medicating for seasickness. It is not the same as malaria. Taking medication is mostly for comfort, to stave off symptoms and not have one’s trip wrecked. The critical information includes – an honest evaluation (been at altitude before, and what happened, what is the itinerary & what are the options for descending rapidly). The second two above are fatal diseases and death without descent.
Factiods: 15/100000 died trekking in the 1980s. 1/40 who have attempted the Everest Climg died (2900/100,000). In contrast – the Sherpas die not from climbing but from accidents. Westerners die from altitude and injury. 40% of trekkers are organized groups but 80% of deaths occur are in organized groups.
Itinerary Truths – published schedules are averages, and will not prevent all AMS. its ok to get altitude illness – its just not ok to die from it!
#1 – learn to recognize the early sx and be willing to admit that you have them
#2 – never ascend to sleep with any sx of altitude
#3 – descend if symptons are worse while resting at the same altitude.
and now you know as much as the rest of us…