According to the baseline for Acute Mountain Sickness (AMS) , I have had SEVERE AMS (score of 6+ on the Lake Louise Scoring System; worldwide medically accepted diagnosis guidelines and definition of AMS created at Lake Louise Convention) the last two times I have been to Dartsendo/Kangding (KD)... and no surprise. High Altitude begins at 1500m, though it is rare for symptoms to surface prior to 2500m*. I flew into one of the highest airports in the world at >4200m/13400ft, my first night in a tiny village outside of KD was spent at 3800m (12500ft), and the remaining nights in Dartsendo/KD at 2500m/8300ft. All stays that follow the first visit begin in KD— including last month and this current trip—which lies at 2550m/9150ft. My lodgings lie at 2544m/8346ft, but the nearby trails take me up beyond 3000m/9842ft. Each of my three visits to KD have been spent staying at the following, which I give 5 stars and highly recommend! Kangding GuoZhuang Nam Wu Hao Boutique Inn https://www.booking.com/hotel/cn/kang-ding-guo-zhuang-nan-wu-hao-jing-pin-min-su.html?label=gen173nr-1FCAEoggJCAlhYSDNYBGh1iAEDmAExuAEHyAEM2AEB6AEB-AECkgIBeagCAw;sid=1545cd94aea521feb52d4a53258a050b;sb_price_type=total;type=total& Book here: https://www.booking.com/s/34_6/yogaun82 The definition of AMS/altitude sickness is predicated on symptoms categorized in 5 areas: headache, gastrointestinal distress, fatigue/weakness, dizziness, and difficulty sleeping*. A link to the scoring system is found at the end of this post. The end-all is the headache: if you’ve got one after ascending above 2500m (and you don’t usually get headaches), you’ve got AMS. It takes 1-3 days to acclimitaze and it doesn’t matter how “fit” you are. AMS is not life-threatening, unless you are so high you also get HACE and HAPE, which calls for immediate descent, unless you want to die. No joke! You can’t really prevent the need to acclimatize—your body must adjust to higher elevations and it does so in some pretty astounding homeostatic mechanisms that involve acid-base balance, increased kidney activity, increased respiration, and so on.* The symptoms are what you can (possibly) prevent or reduce. Take ibuprofin a few hours before ascent and then regularly to minimize the vise that is seemingly sqeezing your head, drink 5-6L of water each day, take it easy the first few days after ascent, drink a lot of water before your trip and the day of, and don’t drink any alcohol. After suffering two really rough bouts of AMS that literally kept me in bed for a day each time, I found some things that helped —on my third try! 1. Rhodiola Rosea is an herb used by many cultures across Asia and Russia for elevation sickness; start taking it 1 week before ascent. 2. Ibuprofin - I started taking this the day of my flight, I took another at bedtime, another upon waking in the middle of the night (several litres of water did that!), and upon awakening. On my second day at 2600m/8400 ft. I am very fatigued, but hydrated and no headache! 3. The pharmacist at my local Chinese pharmacy recommended “American Ginseng” root (Panax Ginseng) To help with the fatigue and elevation adjustment. I started drinking that each day as a tea prior to my departure. 4. Acetozolamide is a prescription drug which relieves the symptoms of AMS while your body adjusts. For some reason, this is unavailable in Chengdu (apparently, Chinese do not get AMS so do not take this) and so my Doc has to order it from Hong Kong, which will take a week, and so I couldn’t get it in time. 5. AMS depends on sleeping elevation, so day hike at higher elevations, and return to a lower elevation to sleep. I re-ordered my entire 3 week trip based on altitude gains so that I would be increasing slowly. 6. Don’t increase sleeping elevation more than 500m per night. I had no idea how seriously ill I was, or how dangerous altitude sickness, technically called Acute Mountain Sickness (AMS) could be! Actually, not quite accurate. I absolutely knew how terrible I felt! Of course I have read the stories of all who die summitting mountains, with or without oxygen. I just did not realize to what degree I had severe AMS on my last few visits to Kham, until I began researching altitude sickness and prevention. Now I know so much more after visiting multiple mountaineering and medical research websites: medical prevention, physical prevention, fluid intake, do's and don'ts, and cure (there is only 1- descend!!). The information and stats are quite interesting (at least to minds with scientific bents, like mine). Select “Read More” to the right As I mentioned, I was pretty darn sick on my first two visits to Kangding. My first stay in a tiny pit stop village 40k or so west was at 3800m. I had such a horrific headache that I couldn’t sleep. although I arrived before noon, I never ate anything beyond a few dehydrated veggies and nuts late in the evening, because I had absolutely no appetite. I knew if I ate nothing, I’d feel even worse the following day. I was also extremely tired the day of arrival and even more so the next day. I managed to walk around and explore the surrounding area a bit, but stayed level to the road, avoiding mountains. My second incident of AMS made me sit up and take notice, and was also frightening. This time, I didn’t have any symptoms until day 3. I arrived and felt fine on day one; eating and sleeping normally. I awoke day two and felt fine, awaking early. I went on an accidentally extended day hike and believe I became unknowingly dehydrated and famished. I drank about 1-1.5L during the hike, but didn’t have much to eat during the 7 hours. I drank quite a lot of water on the return, but it was too late, a headache claimed me and worsened through the evening and night—ruining chances for restful sleep. I did however, eat a hearty bowl of yak noodles directly upon our return, and had a very long and very hot shower after dinner, then went immediately— exhausted—to rest a very short while before sleep. The frightening part was awakening the next day having slept well beyond 12 hours, and through my 6am alarm. (I learned WHY I didn’t sleep well after much research into AMS!). I also slept very fitfully and awoke feeling unrested and worn out. My entire body was also swollen—I couldn’t remove my ring, and my face looked like an overblown balloon... I could even see how swollen my eyes were by simply looking downward! I felt absolutely awful; add to that sunburned as well (higher altitude = stronger UV rays. This go round, I have sunscreen and a hat!). I literally did not want to show my face, and stayed in y room drinking large quantities of tea and water until well after 10am, when I was forced to leave my room to eat breakfast! I was glad the other guests had departed for their hikes! Throughout the day, I had very little energy, but was determined to explore KD a bit; museums, Himalayan Coffee, and the bus station. My motivation ended when I found the museum closed due to the Dragon Boat Holiday, and I returned to Himalayan Coffee to rest and eat sugar and drink caffeine. I was up for a bit of exploring then, walking to the bus station and discovering the location of Tashi Yongen, the Tibetan restaurant which I would return to for dinner a bit later. I am curious as to whether my history as a SCUBA diver affects my tendency to get AMS. That’s an interesting research topic on which I have not found any data published, as of yet. One of the predicting factors for AMS is if you have experienced it previously; if you’ve had AMS in the past, you are more than likely going to suffer again. I recall back in 2013, when I moved from Key West, 0m at sea level, to the mountains of North Carolina. Me and BF-at-the-time were driving over the mountains. Over a high pass, I developed an acute and severe headache that brought tears. It diminished a few hours later, when we descended. That was my first taste of AMS, though I didn’t realize it until later. Without a doubt, now I know and accept I am going to get AMS whenever I head west to Kham and begin ascending in KD and elsewhere. On this trip, I’ll be higher than 4200m—that’s almost 14,000 feet!— so I am taking all the precautions! On Day 2 of my current trip, I am fatigued and have little energy, but I have no headache and I’ve been drinking gallons of tea and water. Tomorrow I should be at 100% Note: all measurements are rounded up or down to nearest 50-100 meters/feet.
*References: https://www.ultimatekilimanjaro.com/Lake-Louise-AMS-Questionnaire.htm http://ismm.org/normal-acclimatization/ http://www.altitudemedicine.org/physiology/ https://wwwnc.cdc.gov/travel/yellowbook/2018/the-pre-travel-consultation/altitude-illness
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