Acute Mountain Sickness and Treatment

An altitude over 3,000 meters (9,843 feet) is usually defined as high altitude. Since most places in Tibet are higher than this level, Acute Mountain Sickness (AMS), also called Altitude Sickness is the biggest health risk to tourists in Tibet. AMS is common at high altitudes due to the decreasing availability of oxygen. Most people will experience differing degrees of symptoms at high elevation. The occurrence of AMS is dependent on the altitude, the ascent rate and individual physical condition. Symptoms of AMS include headache, nausea, dizziness, fatigue, shortness of breath, loss of appetite and disturbed sleep. Most people will experience one or more AMS symptoms upon their arrival in Tibet. The symptoms will usually gradually decrease in severity during acclimatization. Mild AMS usually will not interfere with mild activity.

However AMS can be very serious, with the most serious symptoms being High Altitude Pulmonary Edema (HAPE) and High Altitude Cerebral Edema (HACE), which can be fatal. Symptoms of HAPE include weakness, shortness of breath, even at rest, impending suffocation at night, and a persistent productive cough with white, watery, or frothy fluid. Symptoms of HPCE may include headache, ataxia, weakness, hallucinations, psychotic behavior, coma and loss of memory. Both approach and strike at night and can be fatal! Immediate descent is the surest treatment.

Before visiting Tibet, get as fit and healthy as possible, both physically and psychologically. Visitors having record of heart, lung, other organ problems or anemia should consult their doctor before making the decision to visit Tibet.

AMS can be lessened or avoided with proper acclimatization, which will also ease and reduce AMS symptoms. A gradual ascent will allow your body to acclimatize to higher altitudes and the decreased oxygen supply. Go no higher 300 - 400 hundred meters (984 - 1,312 feet) daily and have a rest after each 1,000 meter (3280 feet) ascent. Medication also helps to prevent AMS. Mild AMS symptoms can be treated with proper medication. If medication does not relieve the symptoms, go to hospital or evacuate immediately to safe altitude!

The following precautions may help to prevent or lessen the effects of AMS:

1.Since fluid loss usually accompanies the acclimatization process, drink plenty of fluids (3 - 4 litres daily at least) and eat carbohydrate food to keep the body properly hydrated;

2.Do not over exert and only partake in light activity immediate after your arrival;

3.Don't smoke, drink alcohol or take other depressants such as tranquilizers and sleeping pills. These will depress the respiratory drive and limit oxygen intake. Always keep in mind the following rules which will ensure a smooth and enjoyable trip to Tibet:

4.Any sickness at high altitude is AMS until proven otherwise; · Never go higher with symptoms of AMS;

5.It is significant that you report any symptoms of AMS immediately to other group members in the trip.