Acclimatization is not equal to 55 tablets of Diamox plus 20 liters of oxygen!

Ritvij Kumar

Last updated: 14-05-2016

Fresh air and thus Oxygen has become so scarce on plains that people have begun to get scared without even going into the mountains. High levels of PM 2.5 and PM 10 in the city air has deposited carbon films on the logical abilities and people are experiencing AMS (Acute Mountain Sickness) symptoms at an altitude of 200 mts, 100 mts or even lesser!

Was just kidding. Don’t worry! There is no sickness in the air, love may be ;)

I was just reacting to the scare of AMS that I am coming across these days. Sometime back I published an article on Mountain Illnesses in which I also covered AMS and remedies but I think somewhere people still focus more on problems and less on solutions. So, in this article, I am going to talk more about my beliefs and less about norms, procedures, science, etc. Please refer to the earlier article for details.

I should highlight here that some of the things that I am writing here are purely my beliefs and cannot really be confirmed as prescriptions from the “Modern Science”.

1. Getting Sick in my mind! Please help..

Don’t you think we should first do our bit and try not to get sick and wait for a problem or symptom to appear before asking for help? Fear is normal and so is anxiety but getting too scared kills your risk appetite and adventure is not a field for those who do not have any risk appetite. In fact, it is something where you gain some appetite and take it back to the life. Now, please don’t kill me for asking you to take risks with health and even more dangerously “Mountain Sickness”. I am just asking you to relax and let your body adapt because stress is a huge factor for non-acclimatization and everyone ignores it. If normal things don’t work, only then think of the cure. 

2. Are you asking me to be less informed in the age of information?

No! I am not. Please read the offer document carefully before investing! Reading and understanding are good and we all must get informed but when we stay informed, it cannot be taken as ill-informed through hearsay. If you read from credible sources, they would never scare you. Hospitals (or institutions with similar intent) are never credible when it comes to such information because they are running a business of scaring people!

3. Prevention or cure?

We all have heard it many times that Prevention is better than Cure but what is in vogue these days is “Let’s get sick without symptoms and start turning cure into prevention”. Prevention for AMS is acclimatization and that happens internally. Just like the tablets prescribed for high blood pressure only suppress the symptoms and are not a cure by any stretch of the imagination. Yes, I am talking about “Diamox”. It is not some sort of elixir that keeps your RBCs young.  It is an effective short-term measure that helps us managing AMS situations, and fortunately, that is all about it! 

4. Should I start my course of “Diamox” for better acclimatization 15, 20, 25 or god knows how many days in advance?

No! Acclimatization will not happen without altitude. Your body has to naturally understand thin air and start producing more RBCs to compensate for the same. High altitude starts from 9000 feet and till 12000 feet, we call it Stage 1. Spending 4 to 6 days and following some basic principles like climbing high & camping low, plenty of fluids and active schedule (don’t be lethargic in mountains) would help you acclimatize. Specific procedures are prescribed by leading mountaineering institutes in India for acclimatization. I am producing that at the end of this article but that is a bit idealistic, normally some deviations for short treks are also acceptable. 

5. Do we need oximeters?

Maybe but not definitively. Oximeters are like machines showing your temperature, blood pressure, etc. that simply give a reading of one particular indicator. In itself, it would never mean anything. There are people whose mercury would always touch 99 degrees so should she keep eating paracetamols every day? Of course not. AMS is best judged by symptoms and low oxygen level in your oximeter (if read by the victim) would only create panic and would not help at all! We never take chances against AMS in the high altitude areas. Whenever in doubt, we assume AMS. Then would a normal oximeter rating along with symptoms of AMS stop me from taking remedies? No! So, what’s the point? Still, if you are one of those who like documentation or are pursuing research on related areas, you can keep the records up. Doesn’t really harm either! 

6. How many liters of O2 should I gulp from the cylinders every day?

Again an effective short-term measure gave the status of “Hanuman”. Frankly, think. How many cylinders can you carry? And is it correct to complete treks on cylinders? I personally have reservations against using cylinders at any time but usage in Deterioration / Death zone (altitudes higher than 6000 mts, where acclimatization is not possible) is still understandable but cylinders should not be the norm for normal treks. 

I am already sorry for offending or hurting some precious sentiments but as I said in the beginning, this is my personal opinion! 

Acclimatization Procedure 

This is the ideal acclimatization procedure and is designed considering that ascent is continuous. Adjustments would be made in this schedule basis the target height to be achieved. For instance, if one is going to a trek where the max altitude is 11500 feet, then even the complete schedule of stage 1 would not be realistically applicable.

  1. Stage 1 (9000 to 12000 ft) : 4 to 6 days
    1. Day 1 & 2: Rest more with Short walks, less climb
    2. Day 3 & 4: 2 to 3 Kms hikes without load. Less steep climb
    3. Day 5 & 6: 5 or more Kms walk with load and gain of 300 mts of altitude
  2. Stage 2 (12000 to 15000 ft) : 4 days
    1. Day 1 & 2: 1.5 to 2 Kms walk without load, no steep climbing
    2. Day 3 & 4 : 3 Kms hike without load, 300 mts climb without load
    3. Day 5 & 6 : 3 to 5 Kms walk with load and gain of 300 mts of altitude
  3. Stage 3 (15000 to 18000 ft): 4 days: Same steps as prescribed in point #2.
  4. Stage 4 (18000 to 26000 ft): Known as Deteriorating Zone. No acclimatization happens here so we spend as less time as possible in this zone.
  5. Stage 5 (> 18000 ft): Known as Death Zone. Your cells are dying here and you need to come back without losing all of them. However, the opportunity to enter this zone is not freely available and it would be the craze inside you that would save you here.

Ritvij Kumar

A nature lover, "argumentative" person, I work as a Partner at Bikat Adventures and love to explore. Read more

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