Thursday, June 29, 2006

FAQs abt High Altitude!

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Acclimatization is the process of the body adjusting to the decreased availability of oxygen at high altitudes. It is a slow process, taking place over a period of days to weeks.

High altitude is defined as:

- High Altitude: 1500 - 3500 m (5000 - 11500 ft)

- Very High Altitude: 3500 - 5500 m (11500 - 18000 ft)

- Extreme Altitude: above 5500 m


Practically speaking, however, we generally don't worry much about elevations below about 2500 m (8000 ft) since altitude illness rarely occurs lower than this.
Certain normal physiologic changes occur in every person who goes to altitude:
* Hyperventilation (breathing faster, deeper, or both)
* Shortness of breath during exertion
* Changed breathing pattern at night
* Awakening frequently at night
* Increased urination
More about An Altitude Facts....
http://www.ismmed.org/np_altitude_tutorial.htm
Normal Acclimatization
Acute Mountain Sickness
High Altitude Cerebral Edema
High Altitude Pulmonary Edema
Treating AMS
Prevention
The Golden Rules

Prevention of Altitude Illnesses more .. http://www.princeton.edu/~oa/safety/altitude.html
Prevention of altitude illnesses falls into two categories, proper acclimatization and preventive medications. Below are a few basic guidelines for proper acclimatization.
*
If possible, don't fly or drive to high altitude. Start below 10,000 feet (3,048 meters) and walk up.
* If you do fly or drive, do not over-exert yourself or move higher for the first 24 hours.
* If you go above 10,000 feet (3,048 meters), only increase your altitude by 1,000 feet (305 meters) per day and for every 3,000 feet (915 meters) of elevation gained, take a rest day.
"Climb High and sleep low." This is the maxim used by climbers. You can climb more than 1,000 feet (305 meters) in a day as long as you come back down and sleep at a lower altitude.
* If you begin to show symptoms of moderate altitude illness, don't go higher until symptoms decrease
("Don't go up until symptoms go down").
* If symptoms increase, go down, down, down!
Keep in mind that different people will acclimatize at different rates. Make sure all of your party is properly acclimatized before going higher.
* Stay properly hydrated. Acclimatization is often accompanied by fluid loss, so you need to drink lots of fluids to remain properly hydrated (at least 3-4 quarts per day). Urine output should be copious and clear.
* Take it easy; don't over-exert yourself when you first get up to altitude. Light activity during the day is better than sleeping because respiration decreases during sleep, exacerbating the symptoms.
* Avoid tobacco and alcohol and other depressant drugs including, barbiturates, tranquilizers, and sleeping pills. These depressants further decrease the respiratory drive during sleep resulting in a worsening of the symptoms.
* Eat a high carbohydrate diet (more than 70% of your calories from carbohydrates) while at altitude.
The acclimatization process is inhibited by dehydration, over-exertion, and alcohol and other depressant drugs.
Preventive Medications
Diamox (Acetazolamide) allows you to breathe faster so that you metabolize more oxygen, thereby minimizing the symptoms caused by poor oxygenation. This is especially helpful at night when respiratory drive is decreased. Since it takes a while for Diamox to have an effect, it is advisable to start taking it 24 hours before you go to altitude and continue for at least five days at higher altitude. The recommendation of the Himalayan Rescue Association Medical Clinic is 125 mg. twice a day (morning and night). (The standard dose was 250 mg., but their research showed no difference for most people with the lower dose, although some individuals may need 250 mg.) Possible side effects include tingling of the lips and finger tips, blurring of vision, and alteration of taste. These side effects may be reduced with the 125 mg. dose. Side effects subside when the drug is stopped. Contact your physician for a prescription. Since Diamox is a sulfonamide drug, people who are allergic to sulfa drugs should not take Diamox. Diamox has also been known to cause severe allergic reactions to people with no previous history of Diamox or sulfa allergies. Frank Hubbell of SOLO recommends a trial course of the drug before going to a remote location where a severe allergic reaction could prove difficult to treat.
Dexamethasone (a steroid) is a prescription drug that decreases brain and other swelling reversing the effects of AMS. Dosage is typically 4 mg twice a day for a few days starting with the ascent. This prevents most symptoms of altitude illness. It should be used with caution and only on the advice of a physician because of possible serious side effects. It may be combined with Diamox. No other medications have been proven valuable for preventing AMS.

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