Trekking At Altitude
To maximise the experience, naturally some forward planning and preparation are necessary for ultimate enjoyment. No, we're not just talking about booking cheap flights in advance and doing some background reading. The pleasure of trekking in the world's highest mountains cannot be underestimated. However, neither can the dangers as inadequate levels of fitness and underestimating the risk of mountain sickness may spoil what should be an exhilarating journey.
Most experienced trekkers will be aware of the pitfalls of poor preparation and inadequate or poorly maintained equipment. For the purposes of this article I will be concentrating on individual fitness levels and reference to medications for altitude illness.
For people of very basic or novice fitness at least three months should be devoted to building endurance and strength. Walking volumes should be gradually increased over many weeks by increasing distances by about 10% each week from a comfortable starting point for the individual. Naturally any pre-existing medical conditions necessitate a clearance from one's personal physician. Rest days are essential in any fitness programme in order for the body to recover from a progressive overload.
As cardiovascular fitness improves strength work comes into play and a visit to a gym to see a personal trainer to learn some lower body strength work is advised. These may be quite simple such as lunges, step ups and stair repeats as well as some stretching routines. Supervision is encouraged initially to learn correct technique and avoid any injury that may delay progress. Aim for peak fitness about two weeks prior to the trek so that a tapering phase is introduced as it is important not to be in a recovery phase while departing on the journey. Hydration and nutrition issues are also important so it is advisable to incorporate the same nutrition and fluid regime on training days that you will experience on the actual trek to make sure that you are used to the various foods and fluids. experiment with various items that will be available at your destination. Attention to physical fitness preparation will lessen the risk of injury while trekking, and heighten the pleasure of the experience and improve recovery ability.
Acute mountain illness occurs commonly at altitudes above 3000 metres and causes severe headaches, exhaustion and shortness of breadth. More serious consequences are pulmonary and cerebral oedema (fluid in the lung and brain).
Several drugs are available to combat and lessen the symptoms ...
Diamox is a sulpha based drug and allows you to breathe deeper and faster and especially helpful at night. Naturally it cannot be taken be taken by those with a sulpha allergy and can cause tingling and alters the taste of beer and other carbonated drinks. It can also cause peripheral tingling.
Dexamethasone is a steroid drug that decreases brain and other swelling, reversing the effects of mountain sickness.
Nifedipine is a popular blood pressure drug that decreases pulmonary artery pressure thus preventing pulmonary oedema (fluid on the lungs). Believe it or not Viagra works in a very similar way and is possibly more effective but the cost can be prohibitive as it has to be taken three times per day!
Other alternative or natural remedies such has Ginko Biloba are still controversial as to their effectiveness.
Hydration is also a key issue at altitude as is keeping warm and packing appropriately is essential to avoid hypothermia. "Climb high and sleep low" is the mantra of climbers and most treks are designed to follow these principals. Tobacco and alcohol also exacerbate the symptoms of mountain sickness. Diet should consist of a roughly 70% carbohydrate content at altitude. For more detailed personal advice re altitude medical issues consultation with a physician experienced in mountain medicine is advised.
... prepared by Dr. Cormac Carey Travel Medicine Alliance Toowoomba
