Mountains serve as a weekend getaway for several people.
From Western Ghats to the Great Himalayas, there is something available in many parts of the country for you to go running to. While hills and mountains may vary in their height, the altitude change will still have significant physiological effects on your body. These effects may be from mild to, not to jump the gun, but...life threatening, which is why it’s best to be prepared before leaving the plains.
‘The Body Needs to Adapt’
Dr Rahul Gupta, Director and Head, Department of Neurosurgery, Fortis Hospital Noida, underlines that high altitudes mean low oxygen pressure. This, in turn, means that the body has to adapt to less oxygen in the air in its breathing.
It takes a minimum of 24 hours or longer (the latter is advised by health experts), to get acclimatized to this consequent low oxygen circulation in the blood.
Experts also suggest that you don’t have to worry about too extreme changes in your body for up to an altitude of about 8,000 feet or 2,500 metres.
To put things in perspective, here is the altitude of some mountainous and hilly regions of the country most frequented by tourists:
- Manali, Himachal Pradesh: 2,050 metres
- Shimla, Himachal Pradesh: 2,276 metres
- Kaza, Spiti: 3,800 metres
- Leh, Ladakh: 3,500 metres
- Kedarnath, Uttarakhand: 3,553 metres
- Pahalgam, Kashmir: 2,130 metres
- Mahabaleshwar, Maharashtra: 1,353 metres
- Munnar, Kerala: 1,532 metres
- Ooty, Tamil Nadu: 2,240 metres
- Tawang, Arunachal Pradesh: 2,669 metres
Different bodies respond differently to altitude change which is why it is important to make a point of these points before heading to the mountains.
Changes Inside Your Body at High Altitudes
Now, several things are happening within you at a physiological level. Dr Gupta lists them down in the following manner:
- i) Vasodilation in all tissues as a result of dilated blood vessels.
- ii) More oxygen is getting delivered to the tissue despite the low oxygen levels in blood
- iii) Increased pulmonary ventilation (breathing)
- iv) Increase in the number of red blood cells.
- v) Increased diffusing capacity of the lungs. This capacity refers to the transfer of oxygen and carbon dioxide between the lungs and blood.
Basically, a lot is happening within the body when you change the height of its geographical location. This is why Dr Vandana Boobna, Senior Consultant, Internal Medicine, Max Super Speciality Hospital, Shalimar Bagh, insists on giving the body the time it needs to get its bearings.
The external changes, which are the most significant factors behind the physiological processes mentioned above, also include low temperature and moisture level variation depending on the location of the person, she adds.
What Happens if You Don’t Give the Body Enough Time to Acclimatize?
Dr Gupta clubs common symptoms like headache, nausea, vertigo, disorientation and lethargy under two categories:
i) High altitude cerebral edema: Vasodilation and increased blood flow leads to leakage in fluid in brain cells. This leads to cerebral swelling and headache.
ii) High altitude pulmonary edema: Vasoconstriction in lungs due to low oxygen leads to higher capillary pressure in other vessels. This causes leakage of fluid outside cells leading to edema.
However, these symptoms can easily range from mild to coma-inducing or life threatening if not addressed.
"If not provided with sufficient time to adjust, people might feel nausea, breathlessness and more, which may further lead to serious complications." - Dr Vandana Boobna, Senior Consultant, Internal Medicine, Max Super Speciality Hospital, Shalimar BaghWhat Are The Symptoms?
The symptoms that become a cause of worry include severe headache, breathlessness, confusion, altered sensorium (changes in sensory perception).
Lungs, heart and brain are working extra hard to keep you well at a high altitude, which is why it’s important to pay extra attention to them.
Specific Medical Conditions to be Noted
The medical conditions include:
- Lung problems (interstitial lung disease, COPD, emphysema)
- Heart problems
- General caution for children under the age of twelve
Dr Boobna explains this in the following manner:
"Moving to higher altitudes is challenging, specifically, for those with anaemia, because due to low haemoglobin content in blood, they already lack oxygen supply. On top of that if the oxygen in the surroundings is depleted, there are very high chances of it impacting brain function. The body would increase the heart rate to boost oxygen supply to itself and the brain. So, under high altitude, both heart and lungs work exceptionally fast. Therefore, people with medical conditions of the kind should first consult a doctor and carry sufficient supply of medicines before going to higher altitudes." - Dr Vandana Boobna, Senior Consultant, Internal Medicine, Max Super Speciality Hospital, Shalimar Bagh
She further adds that patients suffering from cardiovascular diseases are already weak and prone to dizziness and headaches. Under extreme cases or prolonged exposure to extreme conditions, they can face unconsciousness and suffer a cardiac arrest.
"The pressure on heart is high, whereas the output of the blood getting expelled by it is low, and this puts extra pressure on the lungs. Along with nausea and dizziness, that many people experience, their blood pressure might also shoot up and their brain tissues might get affected." - Dr Vandana Boobna, Senior Consultant, Internal MedicineHow to Keep Yourself Protected?
For an average, healthy adult, up to 8,000 feet or 2,500 metres of a climb is alright. Mild symptoms might still appear and one should keep an eye out for them. Here’s how you prepare yourself for a change in altitude, according to Dr Gupta:
- i) Keep yourself hydrated.
- ii) Keep your ascent gradual (after an altitude of 2,500 metres, it should not be more than about 400 metres a day).
- iii) Do not sleep at high altitudes if you are not fully acclimatized.
- iv) In case of breathing related symptoms, ensure you have immediate access to oxygen.
- v) Descent gradually (about 300 metres a day).
- vi) Avoid alcohol and overexertion.
- vii) Ensure you have carried your emergency medication with you after consultation with your doctor. They may also advise you to take medication before leaving plains, to keep the body prepared for the eventual fall in oxygen levels.
Dr Gupta offers a final word of caution which involves to not let your first night be spent at a height beyond 2,800 metres.
(Rosheena Zehra is a published author and media professional. You can find out more about her work here.)
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