HIGH ALTITUDE MOUNTAIN ILLNESS
The illness occurs when travelers are at an altitude of 3000 meters ( 10000 feet ) or more above sea level. If the traveler’s climb is gradual and not more than 3000 meters ( 10000 feet ) per day, then he/she is less likely to fall ill as the body acclimatizes and the traveller’s general health is not affected. If the ascent is done in a quick manner whether flying high altitudes or climbing a steep mountain, the traveler will develop symptoms of benign acute mountain sickness ( AMS ), such as vomiting, headaches and nausea. This could lead to malignant acute mountain sickness, there are 2 types of malignant AMS
1. In the lungs there is a fluid building up which makes one breathless, cough and lip turning blue. This is high altitude pulmonary oedema ( HAPE )
2. In the brain fluid accumulates and the traveler begins to feel drowsy, behaves abnormally and is unsteady on the feet
WHAT TREATMENT SHOULD BE GIVEN
• Immediately have the person brought down to lower altitude as soon as possible
• Medication: In a HAPE situation – Dexamethasome could be given and for HAPE effected ni fedepine could be given
• Oxygen to be given
• The person put in a Gamov bag – which is an individual presentation in a portable compression system
• Bed rest
PREVENTION OF THE ILLNESS
You should have rest days for every 3000 feet above 9000 feet during ascent. You should climb high but sleep low – should be your motto
On consultation with the family doctor one should carry prescribed medicine if one develops symptoms of AMS. The course of taking the drugs should begin a day before ascent and continued for 2 – 3 days after reaching the high elevation. There are however cases known of some people taking the drugs is understood to have suffered from AMS. Unless there is a rescue attempt where rapid ascent is necessary, it is not advisable to use prophylactic drugs.
When poorly insulated tissues of the body (eg cheek, chin, ears, nose, hands and feet) are exposed to the chill and freezing temperatures on the climb, with or without general chilling or hypotherma could result in freezing wherein frostbite occur.
Reasons for Frostbites will be due to the following factors:
• The temperature – the coldness in the atmosphere
• The degree of the chilly winds
• The area of the tissue exposed – that which has blood flow low.
If you begin to feel intense pains of the body parts that are affected then these are the first signs of frostbite. It is advisable to have the affected body part warmed. If neglected, then the area gets numb and hard to touch because it is frostbitten
• At the first signs of the frostbite, it has to be treated accordingly; you stop immediately, protect, insulate and re-warm the affected part.
• At the slightest indication of wet clothing, ensure that you change it immediately and consume a hot meal this could rectify any chances of getting a frostbite.
• Avoid touching bare metal with bare hands as this could cause instant freezing
• If affected by frostbite, the patient should be kept in a room where the temperature is warmed maintained at 21 degrees Celsius. The frostbitten area should be cleaned with an antiseptic solution as directed by the physician bandaged lightly and kept raised ( foot/hand )
• Begin on a course of antibiotics prescribed by your family physician to reduce the intensity of the pain.
• If the affected area is in a state where surgery is necessary, then it could result in amputation.
HOW TO PREVENT
• You should be careful and aware of the risk involved when the tissue is exposed to the cold – insulate yourself well.
• Keep yourself updated on the temperature and wind chill index (air temperature / wind velocity)
• Have yourself well covered and the right warm clothing worn, well fitting and in a proper layer format – leaving neck and wrist opening for water vapour from sweat can escape.
• Boots and socks should be well fitted.
• Note that socks are worn for too long will result in :
1. Becoming wet because of the sweat condensed and this could lead to chilling.
2. Holes could occur and the feet could not be well insulated, thus leading to a chill of the foot therefore reducing the blood supply to the feet and toes.
TRAVEL TIPS For DIABETIC
Travel for diabetics is possible and need to worry should be minimum, but one has to carefully plan and prepare for the trip in a relaxed manner and play safe.
HOW TO GO ABOUT THE TRIP PREPARING YOURSELF FOR IT
• It is a must to travel with your diabetic checking / insulin meter. It would not be possible to go through an “ unwell day” without the meter.
• Your insulin should always be kept in a cool place. It should be kept in a broad wide necked vacuum flask or packed in an ice pouch.
• Insulin should always be carried so as to be easily accessible to you either in your pocket or hand luggage
• It is advisable to have with you extra medicines in case your return is delayed. If the stay is for longer duration then it is preferable to carry your prescriptions.
• Your diabetes identification card should always carried by you on your travel. The reason being that it would ensure that you get proper medication in case you get an attack of severe hypoglycemia
• A letter from your doctor carried by you mentioning that you are diabetic is necessary. The customs could be explained as to why you are carrying insulin, syringes, tablets and other necessary medicines for diabetes.
VACCINATING AND INOCULATING YOURSELF
There are some countries in the world where before you enter you have to get immunized. Get this done well in advance as this makes you feel unwell after getting immunized. If this should happen then it would be easier to control your diabetes better at home and could take good care of your general health too.
WHEN TRAVELLING BY AIR
• It is recommended that you inform the airlines that your diabetic well in advance and ask them prepare meals of low calorific value for you.
• Do not allow your insulin go through the X-ray machines as it is not safe.
• In case you do not get your meals on time on the flight thus carrying eatables with you like biscuits, dried fruit and glucose tablets would be helpful
• Avoid alchohol or sweet drinks on flight – drink plenty of liquids.
YOUR INSULIN / MEDICATION DOSAGES TO BE ADJUSTED
• Intercontinental flights the time zones change therefore it is preferable to ask your doctor accordingly and have your medicines timing adjusted.
• It is important to check your blood sugar constantly and to be careful as your eating schedule changes and activity level varies on your trip, doing this will make your trip well controlled.
WHEN YOU ARE AT YOUR SCHEDULED PLACE OF STAY
• Your insulin should be kept in a cool place or preferably in your hotel room refrigerator.
• On reaching your place of travel find out where the medical pharmacies / hospitals are located nearest to your hotel.
YOUR FOOD INTAKE
Food globally is more or less similar and you can find out through travel catalogues at your place of travel before going there. Eat your meals at proper time intervals and do not eat food or drink water from places not hygienic or you feel not safe to consume