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Acute Mountain Sickness

Slowly make your way up the "Big Headache Mountain."

"Next, one comes to Big Headache and Little Headache Mountains, as well as Red Earth and Swelter Hills. They make a man so hot that his face turns pale, his head aches, and he begins to vomit. Even the donkeys and swine react this way."- Too Kin (c. 36 B.C.)

Too Kin was not the first to fall ill upon ascending to high altitude, but his account was the first documented report of mountain sickness. High altitude illness occurs in more than one fourth of people traveling to about 11,000 feet and more than one half of people scaling above 20,000 feet. Researchers believe that Too Kin probably crossed the Kilik Pass in the Karakoram Range, soaring at an elevation of over 15,000 feet. At such height (and at a presumably rapid ascent), the moniker “Big Headache Mountain” is understandably appropriate. 

Too Kin might have considered other nicknames for the mountain: “Lightheaded Peak”, “Nausea Ridge”, “Vomitus Summit”,  and “Great Fatigue Prominence”. He might have experienced hangover-like symptoms within 6 to 12 hours of reaching altitudes above 8000 feet, although it's also possible that he was considering monikers within an hour of arriving at the high mountain pass. We do not know for certain if he experienced fatigue, lack of appetite, lightheadedness, or other symptoms experienced by sea level dwellers who impatiently scale great heights. We can only make the assumption that he wisely did not ascend to higher elevations until the headaches, nausea, and vomiting were resolved. It may have been three or more days of rest that allowed him to continue on his journey. Had he not listened to his body, he would not have lived to tell his tale. In the absence of helicopter rescue, supplemental oxygen, and hyperbaric chambers, he probably would not have survived high altitude cerebral edema or high altitude pulmonary edema, two potentially fatal manifestations of high altitude illness.

While emergency rescue and therapies are available to modern day mountain adventurers, like Too Kin, we need to take precautions before and when reaching new heights. There are a few things we can do to prevent acute mountain sickness:

Climb slowly. 

For those who live below 5,000 feet, avoid ascending rapidly. It’s best to avoid sleeping above 9,000 on the first night. 

For destinations that are above 10,000 feet, stop at a location that’s lower for at least one full day. Do not climb more than 1,000 feet per day. If we have to climb more than 1,000 feet per day, hike to the higher altitude during the day and return to a lower elevation to sleep at night. Do not over-exert ourselves. And remember to avoid alcohol and sleeping pills

Talk to our doctors about preventative medication

For those who have had altitude sickness previously or those who must ascend quickly, consider discussing the risks and benefits of medications such as acetazolamide or dexamethasone to help with altitude acclimation.

Listen to our body and rest

Be attuned to the body’s signals of distress in high altitudes. When we experience symptoms of mountain sickness, we should rest until the symptoms have resolved. 

Know when to descend and do not hesitate to seek help

Symptoms usually improve within 24 to 48 hours. If the symptoms worsen at any point, we should descend or seek help.

Taking proper precautions, may “Big Headache Mountain” and “Little Headache Mountain” never be renamed “Fatal Swollen Brain Mountain” or “Deadly Wet Lung Mountain”.


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