High Altitude Sickness

What does mountain sickness feel like?” I asked my boyfriend before we embarked on a two-month motorbike trip in the Indian Himalayas. He is one of those types who has done the Everest trek on his own without a guide or a porter or even a decent map, and with just his 20 kg+ backpack for company, probably in flip-flops and a t-shirt. He did get sick with the altitude, but he couldn’t explain how Acute Mountain Sickness (AMS) feels, so I thought it couldn’t be so bad. I was very wrong.

What is altitude sickness ?

Altitude sickness has three forms. Mild altitude sickness is called acute mountain sickness (AMS) and is quite similar to a hangover – it causes headache, nausea, and fatigue. This is very common: some people are only slightly affected, others feel awful. However, if you have AMS, you should take this as a warning sign that you are at risk of the serious forms of altitude sickness: HAPE and HACE*. Both HAPE and HACE can be fatal within hours.

What causes altitude sickness?

Two things are certain to make altitude sickness very likely – ascending faster than 500m per day, and exercising vigourously. Physically fit individuals are not protected – even Olympic athletes get altitude sickness. Altitude sickness happens because there is less oxygen in the air that you breathe at high altitudes.

Treatment of HAPE and HACE

Immediate descent is absolutely essential.

Dexamethasone and acetazolamide should both be given, if available.

Pressure bags and oxygen gas can buy time.

This is what high altitude sickness feels like: you’re lying inside a freezing cold tent in 4200 m altitude in a place called Sarchu in the middle of nowhere between Manali in Himachal Pradesh and Leh, Ladakh. The tent is made of an old parachute and your mattress has been used by millions of random people before you, but it doesn’t matter because your head hurts so much that you can place it on the makeshift pillow (ie. pile of your dirty clothes).

It is pitch black around you and you are freezing, but you cannot sleep. Everyone else is snoring away, but you cannot because you think your head is going to explode. You cannot breath either. There isn’t enough oxygen in the air. You think you’re going to suffocate and die and nobody will notice until it’s too late.

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You haven’t been able to eat, because you are nauseous, and you have no appetite anyway. Your stomach rumbles in a funny way and you think you’re going to throw up or get diarrhoea. There are no toilets in this tent camp, and since you are in a high altitude desert in the Himalayas, there are no bushes to squat behind either. You can’t do anything except pray.

You lie there for hours until the morning comes and you realize that you haven’t slept a second, but you’re still going to have to travel the whole day over higher and higher mountain passes to reach Leh, the capital of Ladakh. You can’t turn back either, because there are high passes wherever you look. You read the pages about altitude sickness in a friend’s guidebook:

Altitude Sickness on the Manali to Leh Road

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