Acute Mountain Sickness Or AMS - All You Need To Know As A Motorcycle Rider

Riding in the hills has a special allure for every discerning biker. Those who have been to the hills, swear by the unforgettable experience they have had, which makes some of them keep going back year after year. No matter the age, one would want to wear the badge of honour of riding to the lofty mountains at least once in their lifetime.

While riding to places like Ladakh is a unique experience, it does come with a different set of challenges. There’s bad, unpredictable weather, tattered, or non-existent roads, permissions, which are often difficult to get and several other difficulties that one may have to face. However, the one challenge that a rider must prepare for on top priority, is the phenomenon of Acute Mountain Sickness. The thin air in the mountains has the capability to wreak havoc on the health of the fittest amongst us and can turn a ride plan on its head. In this article, we will discuss Acute Mountain Sickness, or AMS at length, and tell you everything you need to know about this challenge, so that you are fully prepared to cope with it as you ride into the mountains.

What is Acute Mountain Sickness?
Adventure seekers who travel to high altitudes sometimes develop Acute Mountain Sickness or AMS. This condition is also known as altitude sickness or high-altitude pulmonary oedema. Some people can develop AMS at as low as 6,500 feet or 2,000 metres, however, in most cases, symptoms usually occur within 6 to 12 hours of arrival at altitudes above 8,000 feet or 2,400 metres above sea level. Symptoms include dizziness, nausea, headaches, weakness, and shortness of breath. Most instances of this condition are mild and heal quickly. In rare cases, however, Acute Mountain Sickness can become severe and cause complications with the lungs or brain. This makes it extremely important that you take proper precautions to avoid being hit by AMS and be prepared in case it hits you despite your best efforts.

Causes of Acute Mountain Sickness
The main cause of Acute Mountain Sickness is a rapid change in air pressure and air oxygen levels at higher elevations. For most of us low altitude dwellers, our bodies aren’t used to the relative lack of oxygen in the air at high altitudes and take some time to adapt to these tough environmental conditions. This period of getting used to a different air pressure and lesser percentage of life-giving oxygen in the air sometimes makes an individual sick, and the condition is termed as AMS. Symptoms generally manifest if you travel to a high elevation without giving your body time to adjust. Even if you are physically fit, you can still be prone to acute mountain sickness.

In addition to uneasiness and mild symptoms, high altitude and lower air pressure can sometimes lead to fluid leaking from blood vessels. Researchers don't understand exactly why this happens, but it results in fluid building up in your lungs or brain. This is a more severe symptom of AMS and should be taken very seriously. Ignoring moderate or severe symptoms of AMS can even be life-threatening in some rare cases.

Symptoms
When your body is exposed to high altitude, you may experience nausea, light-headedness, and headache. Symptoms of short-term Acute Mountain Sickness usually begin 12-24 hours after arriving at high altitude, but they ease once your body has adjusted. Mild symptoms include:

• Fatigue
• Low energy
• Dizziness
• Breathing trouble
• Insomnia
• Loss of appetite

If you realise that the once mild symptoms are worsening over time instead of getting better, you may be experiencing moderate Acute Mountain Sickness. The symptoms for moderate mountain sickness include:

• Fatigue getting worse
• Weakness
• Increased breathing trouble
• Chest congestion
• Headache
• Loss of appetite
• Nausea and vomiting
• Difficulty in doing regular physical activities

The symptoms can get even worse than this and develop into severe Acute Mountain Sickness. The symptoms for the severe AMS are similar to the moderate symptoms but the intensity is much higher. These include:

• Confusion
• Inability to walk
• Fluid build-up in lungs
• Shortness of breath even when resting

Treatment
The primary treatment for Acute Mountain Sickness is to move to a lower altitude as quickly and safely as possible. To prevent altitude sickness from escalating, do not travel higher to a higher elevation than youare already at. If symptoms are mild, staying where you are for a few days might be enough to bring your condition back to normal.

Symptoms typically improve once you adjust or descend. If they don’t, you will need some more help:

Mild AMS: Over-the-counter medicines can relieve some symptoms. Visit a physician who will prescribe medicines which could help your condition. Other symptoms will improve once your body adjusts or as you move to a lower altitude.

Moderate AMS: For minor cases, you should begin to feel better within 24 hours when you are 1,000 to 2,000 feet lower than where you were before. Within three days of this change, most symptoms should have subsided.

Severe AMS: If your symptoms are more severe, there could be lasting neurological effects such as an increased risk of being confused, seizures and coma with long-term exposure at high altitudes. You will need medical help, and your doctors will have to decide the course of treatment based on your current condition.

Prevention
The easiest and the most common way to prevent altitude sickness is through acclimatisation. This process lets your body adjust to the change in oxygen levels gradually. Ideally, you should start your climb up the mountains from moderate altitudes so that your body gets acclimated to the increasing altitude in a linear fashion. If you are taking a flight to a high-altitude location before getting aboard a motorcycle, ensure that you take complete rest for two days before you start your journey on the saddle. Make sure you don’t climb too much too fast, as that could be disastrous. Break your journey if required to give your body the requisite time to cope with the altitude change.

In case you get hit by AMS despite taking all the precautions, you can take help from medicines after consulting a physician. Medicines like acetazolamide or dexamethasone can be prescribed by a physician on an ‘as-needed’ basis, but they may also have side effects. Talk to your family physician about which medicines you should carry to tackle AMS and carry them along for emergencies. Following these steps will make your acclimatisation easier:

Understand your body: Only you know what you are feeling, so if you start feeling fatigued, weak, dizzy, or uneasy in some way, it’s wise to assume that AMS is kicking in and you need to take complete rest. If your condition doesn’t improve, it will be wise to move to a lower altitude. This is not something you deal with every day and riding through it will only make things worse. Closely observe how your body is responding to the rising altitude and continue the journey accordingly.

Take it slow: Your body needs time to adjust to the lack of oxygen in the air. Give it the time it deserves. It’s your well-being that’s at stake while climbing a mountain, so don’t take it casually. Also, remember that it’s not a race to the top. More than rushing your way up, it’s important to experience the beauty of the mountains, and falling sick will ruin that experience. Ride in intervals and take breaks so that your body can adjust as you go higher. Also, ride at a slow pace. If your altitude changes quickly, your body will not get ample time to cope. As a reference point, don’t climb higher than 1,000 metres or 3,000 feet in a day. Break your journey if your ascent is going to be higher than that number, especially if your body isn’t coping too well with the change in the altitude.

Rest: Take ample breaks. Also, when you halt for the night, make sure you get a good amount of rest. Sleep is your best friend, and it will help rejuvenate your body.

Do not overexert: Physical exertion is one of the biggest reasons why AMS symptoms get amplified. What counts as normal activity at lower altitudes takes a much bigger toll on your body at higher altitudes. Conserve your energy, keep your movements to as minimal as possible and do not overexert. Being miserly with physical effort will go a long way in keeping you safe and comfortable in the initial days, until your body adapts to the new, more challenging conditions.

Hydration is important: This is non-negotiable. You need to drink at least 3 litres of water every day. Drink plenty of water during your breaks. Carry a camel pack if possible and keep sipping on water as you ride.

No alcohol: Another non-negotiable. Alcohol dehydrates your body. At higher altitudes its effect is even more enhanced. It can also stay in your system longer and impair your judgement when riding.

Eat Well: Having a high-carb meal will help you cope with AMS quicker. Anything that has a high percentage of carbohydrates is welcome. In fact, your diet should contain at least 70% carbs. If you are on some sort of a low-carb diet, it will be advisable to stop it a few days prior to your trip.

Avoid Tobacco: High altitude affects lungs and breathing. Smoking is dangerous as it is, but it’s even more harmful at higher altitudes than at a lower elevation. It can make AMS even worse. Avoid smoking or chewing tobacco altogether.

These were some tips to prevent Acute Mountain Sickness. Of course, it’s highly recommended that you go through a thorough physical examination before taking that trip to the mountains. Make sure you prepare well and are well-informed about the challenges that await you before you begin your ride. This will equip you with all the knowledge and resources you require to keep your journey safe and enjoyable. Ride safe!