Training for altitude

12 August 2009

Mount Kilimanjaro is the highest point in Africa and the highest freestanding mountain in the world at 5895m above sea level. Friends have told me that the views from the summit are breathtaking and well worth the effort, but the higher one goes, the thinner the air becomes. With less oxygen available in the air and your body still requiring the same amount of oxygen to sustain physical activity as it did further down the mountain, it stands to reason that the higher you go, the tougher it will become.

Altitude sickness, or Acute Mountain Sickness (AMS) is a common ailment that affects many attempting any high-altitude ascent and the higher the altitude, the greater the affect may be. There is little way of knowing if you’re prone to it unless you’ve been there, but when I did the Inca Trail a few years ago, I coped at the highest point of 4200m, so hopefully my luck holds out for Kilimanjaro. Susceptibility to AMS has no correlation to age, gender or fitness, and some reports have even indicated that young, fit men are more prone. Sounds like a lottery to me!

Initial symptoms of AMS include headaches, nausea, vomiting, breathlessness, fatigue, appetite loss, swelling of the hands and face, insomnia and giddiness. Loss of coordination, hallucinations, disorientation, loss of memory and weakness are more advanced symptoms. Symptoms need to be monitored as they could lead to pulmonary or cerebral oedema (water on the lungs or brain). Both these conditions are serious and potentially life-threatening, and the fact that people have died on Kili is reason to heed the medical advice that climbers experiencing severe symptoms must descend immediately.

Porters have constructed a “Kilimanjaro Ambulance” to assist with emergency descents. It’s a bumpy but rapid trip down as you’re strapped to a board, which is fastened atop a bicycle wheel and run down the hill with a porter in front and another behind. As Kilimanjaro is a freestanding mountain (unlike the Himalayan mountain range), one can descend to a safe altitude within a couple of hours.

Diamox tablets may assist in preventing or reducing the severity of AMS, although there are many conflicting views on whether this medication is necessary. It comes down to personal preference. Many of my friends have made it to Uhuru point without it, and one friend said that ibuprofen was great to minimise high-altitude headaches. About 80 percent of climbers reaching 4600m (Kibo Hut/Barahu area) experience appetite loss, headaches, vomiting and nausea to some extent, and the key is to know all the symptoms and monitor yourself.

Most guides will monitor you too and check for a racing pulse and the more advanced signs of AMS, so it’s wise to check that your guides are experienced when booking your trip.

Nutrition update
Prevention is always better than cure, so I’ve been reading up on the best ways to avoid or minimise the effects of AMS.

Recommendations include:
-Hydrating regularly (three to five litres a day)
-Walking slowly and setting a steady pace from day one onwards
-Adding an extra day to assist with acclimatisation
-Avoiding alcohol as this dehydrates you
-Maintaining a high-carbohydrate diet while you’re on the mountain.

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