Basics On AMS / Altitude Sickness

There is so much written on this subject that I could fill many pages or at least screens.  Instead, I will list some facts to give you an idea of what it is.

1. Acute Mountain Sickness (AMS) is also referred to as Altitude Sickness.
   .
2. Acute Mountain Sickness (AMS) is caused by a lack of oxygen as you gain altitude.  This does not mean there is less oxygen at altitude.  Air composition is the same at sea level as it is at the top of Mt Kilimanjaro, that is 20% oxygen and 80% nitrogen.
   
   What differs as you gain altitude is the atmospheric pressure which drops by about a 10th for every 1,000 metres of altitude.  The air pressure at the top of Mt Kilimanjaro is approximately 40% lower than that at sea level.  As there is less pressure, it is harder to fill your lungs.  By the time you reach the summit - in comparison to sea level, you are only getting about half as much air and so oxygen into your system for each breath you take.
   .
3. Our bodies react to the lack of oxygen and unconsciously we will breath deeper and faster to gather in the oxygen, our blood will thicken and our hearts beat faster.  As a result, our vital organs will receive the amounts of oxygen they require to function.
   
   Whilst we start breathing deeper and faster as soon as there is less oxygen getting in, the following processes take a few days to get going.  Sadly, many routes up Kili only last 3-4 days and those are the routes that have the highest rate of clients getting AMS....and that's one reason I'm taking the 9 day route, so I acclimatise slowly and hopefully dont get the dreaded Altitude Sickness - fingers crossed X
   .
4. There are three levels of AMS - Mild Altitude Sickness - Moderate Altitude Sickness - Severe Altitude Sickness.  On Kilimanjaro, most people will be effected by the Mid to Moderate levels of AMS.
   
   At the Mild level, most symptoms can be overcome by resting and not climbing higher, drinking lots of water and taking normal headache pain killers.  Once the symptoms go, your climb can continue.
   
   At the Moderate level, more care is taken in monitoring the person and making sure they don't get worse and develop Severe AMS.  It the proper care is taken, as above, there are good chances the person will get better and can continue to climb.
   
   At the Severe Level, this is much more serious and climbers should descend immediately and their climb can not resume.  Even if the person develops Severe AMS in the middle of the night, they must be taken down the mountain immediately to rapidly get them to lower levels with higher oxygen pressure.
   .
5. Symptoms of AMS - individual suffers may get some or all of the following;
   
   Mild AMS
   Similar to a severe hangover ....most of us will know that feeling :( 
   * a thumping headache and nausea
   * trouble sleeping - light and intermittent
   * lack of appetite
   * should be able to recover and keep climbing
   
   Moderate AMS
   This is more serious and should be monitored carefully
   * the thumping headache will be worse than ever and normal headache painkillers won't work
   * the nausea will turn into vomiting
   * the person will be constantly out of breath even when resting
   * for the person to recover and keep climbing, they will need an extended period of rest.
      This is only possible if the illness occurs at the end of the day or on a scheduled rest day.
      If not they may have to descend as the climbing schedule can not be adjusted.
   
   Severe AMSThere are no options at this level, the person simply has to descend immediately and quickly.
   * lack of coordination and balance - known as ataxia...mmm I get that way on a bad Meniere's Disease day - I  had better warn my guide of that  :) 
   * mental confusion...sounds like me again
   * slurred or incoherent speech...only when I'm drunk
   * an inability to stay awake
   * gurgling/liquid sounds from the lungs
   * persistent watery cough and possibly coughing up blood
   * blueness around the face and lips
   * lack of consciousness
   * elevated heart rate
   The above are either symptoms of HACO (HACE) and/or HAPO (HAPE)
   
   HACO / HACE - High Altitude Cerebral Oedema / Edema
   This is a build up of fluid around the brain and is very serious.   If not treated, and the patient stays at the same altitude, death can occur within 24 hours, if the person keeps ascending death can occur in less time.
   
   HAPO / HAPE - High Altitude Pulmonary Oedema / EdemaThis is the build up of fluid around the lungs and is just as serious.  The only sensible option is to descend quickly