The tour reaches an altitude of over 5000m and we therefore build in several acclimatisation days and plan the daily walking schedule to take account of the effects that spending time at high altitude can have on you. These acclimatisation days are compulsory; you may not miss them out and push on ahead even if you think you are feeling fine at the time or you want to shorten the tour.
Acute Mountain Sickness (AMS) can develop at any altitude over 2000 meters. The early symptoms are headache, extreme fatigue, and loss of appetite. Some people become breathless at rest. AMS is the result of fluid accumulating in parts of the body where it does not belong: in the brain, in the lungs, or both. When mild symptoms develop, it is a signal that you must stay at that altitude or descend until symptoms have gone away. Never ascend with any symptoms of AMS!
Most people reaching altitudes above 3000m and certainly above 3500m will experience some breathlessness, mild headaches, and poor sleep patterns. Other common symptoms include lack of appetite, increased urination (though you should be drinking a lot so should expect this anyway), strange dreams, tightness in the chest and fatigue. However, few people get very severe symptoms or go on to develop acute altitude sickness (AMS) which requires medical treatment.
If you are male and/or unfit/unhealthy and/or older (60s, 70s, 80s) then you are more likely to be affected than if you are female and/or fit & healthy and/or younger. However, there is no hard and fast rule and there are plenty of exceptions to these generalisations.
To try and minimise the effects of altitude, we recommend that you:
- Ensure you keep warm
- Don’t take any baths or showers for your first couple of days at altitude
- Don’t smoke
- Eat more fruit & vegetables than normal
- Breathe deeply but normally – don’t be tempted to gasp and hyperventilate
- Drink lots of water (several litres) before you leave low altitude, and carry on drinking a lot of water while at high altitude.
- Don’t rush – walk slowly and don’t exert yourselves. Taking things easy and slowly really helps prevent mountain sickness
- Don’t drink alcohol
- Tell each other and your guide how you are feeling as time goes on (this helps others spot if symptoms are becoming severe)
People with serious heart disease should not visit high altitudes, and people with light heart troubles should check with their doctor and follow their advice , as should people with high or low blood pressure.
More severe symptoms that may require medical treatment or an early descent to a lower altitude include severe and persistent headaches, nausea & vomiting, disorientation and loss of co-ordination, irrational behaviour. If you do experience any of these, make sure you tell each other and your guide straight away.
Trekking and Altitude Sickness
If you are trekking with us then you should keep your guide informed at all times of any symptoms you may be developing, especially headaches and breathlessness while at rest. You may need to spend a night or two at the same altitude before continuing your trek. All our trekking tours have acclimatisation days built into the itinerary where necessary to help with this. Usually within one or two days you will feel well and can continue your trek. On private tours, your guide will adjust your itinerary to try and ensure the normal route can be achieved, though this may not always be possible. On group tours, the group may delay their ascent if the itinerary allows, or a porter or second guide may remain with you until the group descends and rejoins you, or you try and ascend to catch up later.
If you are resting at the same altitude and your symptoms are becoming worse, then it is necessary to descend. Worsening symptoms of AMS including increasing tiredness, severe headache, vomiting, and loss of coordination. These are signs of High Altitude Cerebral Edema (or HACE). HACE can lead to unconsciousness and death within 12 hours if progressive symptoms are ignored. Increasing shortness of breath, cough, and tiredness are signs of High Altitude Pulmonary Edema or HAPE. HAPE can also be rapidly fatal if ignored.
A person suffering from AMS may not have clear thinking and may have to be forced to descend. You accept that our guides have the final decision on whether you should descend and that ignoring their advice constitutes leaving the tour. Even if someone is willing to descent they should never be allowed to descend alone and one of our porters or a second guide will accompany you. Keep descending until the person shows some sign of improvement, usually after 300-500 meters of descent. Even if the diagnosis is not clear, but might be AMS, you should descend. You can always re-ascend when you feel better.
It is best to start descending while the person who is ill can still walk. In Tanzania, if the person can no longer walk porters can often be found to carry a sick person down. Do not wait for a helicopter. If you choose to administer oxygen or medications do not delay the descent to watch for improvement.
In summary, if you are not doing well at altitude, most likely you have some mild symptoms of AMS. Rest at the same altitude until you feel well. If you are getting worse at the same altitude, descend to at least the last point at which you felt well. If you are not sure of the diagnosis, err on the side of being too cautious. Remember severe altitude sickness is entirely preventable if you follow these guidelines.
Costs for changing itineraries:
If you are not able to complete your trek or tour for any reason and choose to return back down early, then you may be liable to pay for extra accommodation and transport costs (see our booking conditions for full details). We try to be as flexible and helpful as possible in these cases, and will aim to arrange some lower altitude trekking or other tours during the time you would have spent at higher altitude. You must ensure that you have travel insurance that will cover you for any extra costs incurred due to symptoms or treatment or altitude sickness, and that your policy will cover you to the altitudes reached on your tour.
More useful information on altitude sickness