Climb high & sleep low to keep AMS at bay
May 10 2012
Arjun Vajpai gave up his expeditions to climb Cho Oyu (8,201 metres) and Shishapangma (8,027 metres) one after the other, due to AMS
On May 7, he decided to give up his twin expeditions for the time being after coming down with acute mountain sickness (AMS) while at Camp II (7,200 metres) on Cho Oyu. He was on his summit push at the time. He descended to advanced base camp and was given medical aid. He was advised not to go back up again but to return to base camp and then Kathmandu for further treatment. Some reports said he had lost sensation along the left of his body and would come straight to New Delhi’s All-India Institute of Medical Sciences for treatment.
Vajpai has been climbing at high altitude since Everest, becoming the youngest mountaineer in the world to climb eight-thousanders Lhotse (8,516 metres) and Manaslu (8,163 metres) in 2011. However, though previous – and consistent – exposure to high altitude trains the body to adapt faster to the lower oxygen content in the air, very young climbers are more vulnerable to AMS. In mountaineering circles, climbers below the age of 25 are advised to gain altitude slowly. This is because the bone marrow cells do not mature fully until the age of 25, after which they can work at optimum output to manufacture red blood corpuscles – the process of acclimatisation.
The other golden rule to keep AMS at bay is the “climb high, sleep low” practice. This means that you gain height by doing a ferry or recce to a higher camp site and then descend to the camp you are currently occupying. The body is exposed to lower atmospheric oxygen content at the higher site and begins the work of producing more red blood cells to cope. The process is afoot physiologically, even though you have returned to the richer air of the lower camp.
Though slow acclimatisation is a factor, the actual medical causes of AMS are not known. The symptoms include headache, nausea, vomiting and lethargy. In mild cases, climbers stay put at the camp and ingest fluid, which is essential because the body is making more blood and requires liquid for the plasma. In severe cases, descent is necessary. Ascent is forbidden because it can lead to complications such as fluid in the lungs or brain, which are fatal. Vajpai appears to have suffered complications severe enough to force him to return home rapidly.
For Indians, Vajpai’s setback comes after the glorious opening of this year’s season with the success on Annapurna by Basanta Singha Roy and Debasish Biswas. In another unfortunate incident, at Everest Base Camp, 33-year-old Ramesh Gulave of Pune suffered a stroke because of a blood clot in the brain. He was rushed to Kathmandu and then to Pune where he died in hospital. Gulave was part of an eight-member team from Pune that is attempting Everest this season.