Acute Mountain Sickness in Ladakh

Acute Mountain Sickness

Ada yang tahu tak apa itu Acute Mountain Sickness atau biasanya kita sebut AMS?

Bila kita tengok gambar-gambar Ladakh rasanya semua rasa nak pergi. Tempat yang cantik siapa yang taknak pergi kan? Tapi…tapi…kita memang nak seronok ke sana tapi dalam masa yang sama kita kena ada beberapa precautions atau langkah-langkah berjaga-jaga yang patut kita titikberatkan supaya AMS ini tak menyerang kita. Kalau yang pergi sendiri tu kena la rajin-rajin study pasal AMS ni, tapi kalau yang pergi dengan shizentrip takpe jangan risau, insyaAllah kami akan sentiasa mengingatkan apa yang “do and don’t” di sana nanti.

AMS ni adalah satu illness/sickness yang akan rasa sekiranya anda pergi ke kawasan altitude tinggi. Anda mungkin akan rasa mild AMS atau mungkin lebih berat bergantung kepada badan masing-masing. Dalam banyak kali saya pergi ke Ladakh, dan apa yang saya perhatikan saya tak pasti AMS ni akan menyerang siapa. Maksudnya adakah AMS akan menyerang bergantung kepada faktor umur, faktor kesihatan, faktor cuaca atau faktor lain. Adakah ikut nasib? Kalau bernasib baik tak kena AMS. Sebab itulah kita sukar nak jangka siapa akan kena dan siapa yang tak kena. Apa-apa pon, kita harap semua tak kena so kita boleh enjoy sepanjang trip. Yang penting kita sentiasa jaga-jaga dan ikut cakap “group leader”. (^ . ^ )

Altitude can be categorized into the following scales —

§  High (8,000 – 12,000 feet [2,438 – 3,658 meters])

§  Very High (12,000 – 18,000 feet [3,658 – 5,487 meters])

§  Extremely High (18,000+ feet [5,500+ meters])

Leh iaitu city di Ladakh beraltitude lebih 11,000 feet dan kita akan pergi ke Khardungla Top, altitude lebih 18,000 feet. Oleh yang demikian, sepanjang trip Ladakh ini kita akan sampai di altitude dalam range high hingga extremely high. Jangan risau, shizentrip dah susun itinerary perjalanan supaya possibility untuk anda diserang AMS ini kurang.

 Ini serba sedikit tentang AMS yang saya dapat dari website devilonwheels, sila baca ye:

Generally, people can go up to 8000 feet without much problems of mountain sickness. As you start to increase altitude, the barometric pressure starts to decrease which reduces the Oxygen intake per breath. Now, in order to compensate for the less Oxygen intake, your body need to increase the breathing rate. Although the increased breathing rate does increase the Oxygen level in the blood but it does not take the Oxygen level to the same level as required by the body while you are at home doing some activity. By spending proper amount of time at such altitude your body will adapt to such changes in Oxygen levels and this process is called as acclimatization. Always keep in mind that different people will acclimatize at different rates.

Acute mountain sickness (AMS) is caused above the altitudes of 10,000 Feet or 3,048 Mtrs to majority of people. Higher is the elevation and rate of ascent, more will be the effects of AMS. Hence, do not try to directly go or stay at very high altitudes directly.

Symptoms of Acute Mountain Sickness (AMS)

AMS Symptoms	AMS Level	Possible Cure
Headache, dizziness, fatigue, shortness of breath, loss of appetite, nausea, disturbed sleep, and a general feeling of malaise	Mild	Medication or Descend
Decreased coordination (ataxia), Severe headache (not relieved by medicine), other mild level symptoms with increased affect	Moderate	Advanced Medication or Descend  about 305-610 Mtrs
Inability to walk, decreasing mental status, and fluid build-up in the lungs	Severe	Immediate Descend about 610-1,220 Mtrs

Tanda-tanda biasa kalau rasa AMS, buat apa-apa je pon dah penat. Cakap sikit je termengah-mengah. Itu memang tanda-tanda biasa. Kita akan rasa pening-pening juga. Tapi kalau pening sampai dah rasa macam belakang tengkorak kena pegang sila beritahu group leader.

Tips for Better Acclimatization

1)      Increase the altitude gradually – shizentrip dah buat itinerary perjalanan di mana kita akan naik altitude secara sedikit demi sedikit.

2)      Keep your body properly hydrated - Do take plenty of intake of water with ORS or fluids like milk tea, juice, soup (garlic one will do wonders). If possible, take ORS soluted water or ORS – L tetra packs with you to replenish the lost nutrients immediately. Also, garlic flavored water ( keep garlic in water bottles) will help much more than drinking plain water which shall be avoided. This will help keep the oxygen level to normal in the body. You should avoid too much black tea or coffee as well…

Sila minum air banyak-banyak sebab air dapat bagi oksigen. Di ladakh memang kurang oksigen, di tempat altitude tinggi oksigen kurang. Tambah-tambah pulak Ladakh adalah cold dessert, mana ada pokok sangat. Chai (milk tea) atau ginger tea juga boleh membantu. Tapi jangan minum air banyak sangat sampai overhydration , nanti muntah pulak.       
              

3)      Avoid sleeping at high altitudes - As sleeping decrease the respiratory drive of our body.  Kami akan remind anda di tempat-tempat yang anda sepatutnya jangan tidur.

4)      Avoid over exertion - Do not over exert your body with any unnecessary physical activity which may lead you pump more breath. Ini juga sangat penting, biasanya bila kita tengok tempat cantik kita akan overexcited. Bila overexcited kita akan lari sana sini, pergerakan yang menggunakan tenaga. Ini perlu dielakkan, anda perlu sentiasa RELAX, RELAX DAN RELAX.

5)      Avoid tobacco and smoking and alcohol and other depressant drugs.

6)      Keep your body warm - Keep your body warm with woolens and do not let it cool. Make sure your clothes are always dry. Kalau rasa sejuk, jangan tahan, kena pakai baju tebal-tebal. Bila badan sejuk ini juga akan menarik AMS datang.

7)      Eat lots of Carbohydrates - Eat a high carbohydrate diet (more than 70% of your calories from carbohydrates) while at altitude. Kena paksa diri untuk isi perut kosong juga walaupun tak lapar.

8)      Sleep in upright position, if possible - Try to lay down or sleep by resting your back against the wall. If you cannot sleep in such mode then do not flatten your head on the bed rather place a bag below your head and then one or two pillows and then sleep in such a posture. It will help you keep your head much lighter.

9)      Carry preventive medicines for AMS - Do take preventive AMS medicines along with you on the trip but only after consultation with your doctor or physician because the AMS medicines may lead to some side effects too. Kita dinasihatkan untuk consume DIAMOX, pil boleh dibeli di sana kalau tak jumpa di sini.

10)  Carry Small Oxygen Kit - If possible, you may also carry a oxygen cylinder to counter the AMS symptoms. Oxygen intake will help you incase of any emergency and will spare you more time to descend to lower altitudes as soon as possible.

11)  Immediately descend, if symptoms increase - Last but not the least, if the AMS symptoms start to increase then you should consider immediate descend. This is the only cure in some conditions when the symptoms have reached moderate levels and are not decreasing.