At high altitude (anything above 3500m/11500ft) the reduced oxygen to air ratio and reduced atmospheric pressure can cause the body to undergo some fairly unpleasant changes. The most common complaint at altitude is Acute Mountain Sickness. Less common are the complaints of pulmonary and cerebral oedema.
Acute Mountain Sickness
The name Acute Mountain Sickness (also known as AMS) is misleading. Most cases are very mild, less than 5 percent suffering from any acute form of mountain sickness.
AMS is the most common complaint on Mount Kilimanjaro, affecting nearly 90 percent of all climbers above the altitude of 3500m (11500ft). AMS occurs when the body is unable to acclimatise and suffers from a lack of oxygen. Symptoms include headaches, nausea, vomiting, diarrhoea, loss of appetite, fatigue and insomnia. Most climbers suffer from a few of these symptoms, the most common being a headache and insomnia. Unless a climber is suffering from severe AMS (a headache unresponsive to medication, constant vomiting and/or diarrhoea) there is no need to stop ascending.
AMS should be treated symptomatically. Painkillers (Paracetamol or Tylenol) should be taken for headaches, anti-diarrhoea (Imodium or Lomotil) for diarrhoea and rehydration salts for vomiting and diarrhoea. Sleeping pills should not be taken at altitude as they can prevent acclimatisation. When choosing painkillers try to avoid non-soluble aspirin as it can be abrasive on an already sensitive stomach.
Drinking alcohol whilst ascending to high altitude is not advisable. Doing so increases the chance of suffering from severe AMS.
High Altitude Oedema
Oedema (the build up of fluid in various parts of the body) is thought to be caused by a rapid ascent to altitude without allowing the body to acclimatise. There is no known medication to either prevent or cure oedema, the only preventative measure being a slow approach to altitude. There are two forms of oedema that may strike at high altitude, viz. High Altitude Cerebral Oedema and High Altitude Pulmonary Oedema.
High Altitude Cerebral Oedema (HACE) is the gathering of fluid on the brain. This causes severe headaches, hallucinations (usually denied by the sufferer), disorientation and a loss of co-ordination. It is very much akin to being drunk and suffering from a hangover at the same time!
High Altitude Pulmonary Oedema (HAPE) is the gathering of fluid on the lungs. Symptoms being extreme exhaustion, shortness of breath and rales (gurgling breath). Very often these symptoms are also accompanied by a chesty cough producing a frothy, blood tinged sputum. On lying down the sufferer feels suffocated as fluid in the lungs enters the windpipe preventing the passage of air.
Both forms of oedema are very dangerous. If suspected there is only one course of action available: immediate and rapid descent to a lower altitude. Sometimes as little as 300m (1000ft) descent can 'cure' the sufferer completely. However returning to altitude causes a relapse and is not advised under any circumstances.
Mountain medication
A complete first aid kit is always a good idea when travelling in Africa. Listed below are only a few drugs that should help combat AMS and are a must on Mount Kilimanjaro. This is by no means the definitive list on mountain medicine.
| Drug Type | For | Drug | Side Effects |
|---|---|---|---|
| Mild diuretic | Prevent or reduce symptoms of AMS | Diamox (acetazolamide)* | Dehydration, tingling in fingers & toes, change in taste, loss of apetite, drowsiness. Diamox is a sulphur drug only available on prescription. Consult your physician before use. |
| Anti-diarrhoea | Stop/prevent diarrhoea | Imodium Lomotil |
None Blurred vision, fatigue |
| Pain killers | Cure headaches, fever, mild pain | Aspirin Tylenol Paracetamol |
Stomach upsets None None |
| Rehydration Salts | Prevent dehydration, replace lost body fluids | None | |
| Throat lozenges | Cure sore throat | Thirst | |
| Sun block | Prevent sunburn | High factor (SPF 30+) sun block | None |
