Respiration trumps aspiration

BodyBasics - Health

In the mountains, watch out for mountain sickness.

Humans are, like bison, a plains-dwelling herd animal. We're not physically adapted to environments like sea, desert, outer space, or the mountains. Still, because some of us are slightly crazy, we go to unwelcoming places for fun, and call it science, sport or adventure tourism.

One of the easiest extreme environments to holiday in is the mountains. There are many ways to achieve exhilaration painfully at high altitudes, but by far the best-known is climbing. The higher you go, however "" and even 6-8,000 feet above sea level is enough for some "" the further you go from your biological comfort zone. If you go suddenly, say taking a plane from Delhi to Leh, your body may be unable to quickly adapt to the change of altitude. You may experience altitude sickness because of the reduced atmospheric pressure and shortage of oxygen.

Altitude sickness has three syndromes. Acute mountain sickness (AMS) is the commonest, and usually occurs above 9,000 feet. It feels like a hangover, with headache, fatigue, appetite loss and nausea the typical symptoms, and sets in six to 12 hours after arrival. There are also shortness of breath, a rapid pulse and possibly swelling of hands, feet and face. High-altitude cerebral oedema (HACO) is a worsened AMS, when the victim becomes lethargic, confused and unsteady, and begins to lose consciousness because of fluid pressure on brain tissue. In high-altitude pulmonary oedema (HAPO), fluid collects in the lungs, triggering breathing difficulties even at rest, and a persistent dry cough. For HACO and HAPO, both life-threatening conditions, immediate descent is the only solution.

In case you think such things are rare, researcher John A Krasney of the University of Buffalo, USA, offers numbers: "Thirteen million people go to Colorado every year to ski and 65 percent develop at least a headache. Twenty-five percent develop acute mountain sickness, and 1-2 percent develop high-altitude cerebral oedema." Think how many Indians holiday in the Himalayas, a day's drive from Delhi.

So, if you're going high, the only real safeguards are: be aware of the symptoms of AMS, HACO and HAPO; verbalise any discomfort so you can get help; don't go higher if you experience symptoms; and immediately descend if symptoms worsen at the same altitude. And say a prayer for the soldiers at Siachen.