Sussex Travel Clinic

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01273 749100

Worthing Clinic

01903 254774

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Sussex Travel Clinic can prescribed Diamox – call 01273 749100 or 01903 254774 to book an appointment

17/8/2017- Diamox is currently on manufacturers delay. Please call the clinic to check stock availability.

Trekking holidays in places like Nepal, Peru and climbing Kilimanjaro are becoming ever more popular amongst travellers. 30,000 people attempt to climb Kilimanjaro very year, with 6 to 8 people dying on the mountain each year. [1] Preparation before you go and following the right advice is essential.

What is Altitude Sickness?

Altitude sickness is often referred to as acute mountain sickness (AMS) and is the body’s reaction to decreases in pressure at high altitude. High altitude is classed as heights over 2.500 metres. The decrease in pressure means you take in less oxygen and this can make it more difficult to breath.

What can I do to avoid AMS?

It is difficult to predict who will get AMS; being physically fit does not prevent it. If you have previously had AMS you may get it again.

Follow the 3 golden rules. [2]:
1. If you feel unwell, you have altitude sickness until proven otherwise
2. Do not ascend further if you have symptoms of altitude sickness
3. If you are getting worse then descend immediately

Reduce your risk by:

  • Avoiding climbing too quickly.
  • Avoid flying directly to high altitudes.
  • Spend a few days getting used to altitude before you go above 3,000 metres.
  • Make sure you climb gradually and do not sleep more 300 to 500 metres higher than
    you did the previous night.
  • Do not get dehydrated.
  • Regular rest days are important– a full day of complete rest every three days is best.
  • If any signs of AMS develop, do not go any higher until you have fully recovered.
    Make sure you have adequate travel insurance that covers you for your climb and
    medical evacuation should you need it.

Am I at risk of developing altitude sickness?

It is difficult to predict the susceptibility of a traveller to AMS, and physically fit travellers are not necessarily at lower risk. The best indicator of how altitude will affect a traveller is previous experience at altitude, but even this may be unreliable.
Rapid ascent without a period of acclimatisation puts a traveller at higher risk. e.g. In a study 84% of trekkers who flew directly to 3,860m were affected by AMS [3].

Can AMS be treated?

If you rest and do not climb any higher symptoms of AMS usually improve in a few hours or days. DO NOT climb any higher.
Taking over the counter medication such as paracetamol may help with headaches and anti-sickness drugs like promethazine will help nausea and vomiting. Keep hydrated by drinking plenty of clear fluids and avoid alcohol. If you do develop AMS make sure you do not venture off on your own as you could develop more serious symptoms at any time.
If  symptoms get worse or do not improve you MUST rapidly go (or be taken) to a lower altitude (at least 500 to 1,000 metres).
You should NEVER leave anyone with AMS on their own – they can become very ill very quickly.
Acetazolamide (Diamox®) can be prescribed to try and prevent AMS. Diamox reduces the headache of AMS and increases blood oxygenation at high altitude by altering the body’s acid- base balance. Diamox should be taken 24 hours before arrival at high altitude and continued for 2 days once the highest altitude is reached. A trial course of 250mgs per day for 2 days is recommended before going to a remote location where a severe allergic reaction could prove difficult to treat if it occurred.
Diamox is not suitable for everyone. Your nurse will make a risk assessment to see if it is suitable for use.

How does Diamox work?

Put simply Diamox works by forcing the kidneys to excrete bicarbonate the base form of carbon dioxide. It speeds up the acclimatisation process and stimulates breathing during the night and lessens the symptoms of AMS.

 

References

1. http://www.mtkilimanjarologue.com/planning/random/mt-kilimanjaro-how- dangerous-is-it-really.html
2. http://www.altitude.org/altitude_sickness.php#golden_rules
4. http://ismm.org/tl_files/archive/1999/January/ISMM%20News%201%201999%20How%20fast%20is%20too%20fast.pdf

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