The Fine Line Between Life and Death:Complications with High Altitude Medicine (HAM)

When trekking high-altitude mountains, the risks extend far beyond injuries and hypothermic conditions. Two major health issues, in addition to injuries, are Acute Mountain Sickness (AMS) and Extreme Exhaustion (EE). While many trekkers are familiar with AMS, fewer realize the dangers posed by extreme exhaustion, which can also turn deadly at high altitudes.

AMS, a condition most trekkers are aware of, results from poor acclimatization to low-oxygen environments. On the other hand, extreme exhaustion often goes unnoticed but can be just as dangerous. Both conditions share similar symptoms: severe fatigue, breathlessness, and physical weakness. However, AMS may present with more severe symptoms such as difficulty breathing and pounding headaches, whereas extreme exhaustion results from pushing the body beyond its limits. Trekkers experiencing extreme exhaustion may feel so tired that they cannot move, yet they remain fully conscious.

The causes behind these conditions differ. AMS is caused by the body’s inability to adapt to low oxygen levels, while extreme exhaustion stems from muscle fatigue and the depletion of fluids and electrolytes. Despite these variations, if the right steps like descent and rest are not performed right away, either situation has the potential to be lethal.

As a mid-level high-altitude trekking enthusiast, I’ve encountered both AMS and extreme exhaustion firsthand, and I’ve assisted fellow hikers facing these challenges. Let me share two experiences that highlight the seriousness of these conditions.

On a trek to Everest Base Camp (EBC), I was forced to discontinue my ascent at 4,410 meters when a fellow hiker developed AMS, which progressed to High Altitude Pulmonary Edema (HAPE). HAPE, a severe and potentially fatal form of AMS, caused fluid to accumulate in her lungs. Recognizing the urgency, we decided to descend immediately. A helicopter was called to evacuate her to a lower altitude, which undoubtedly saved her life. No medication was needed just the swift decision to descend, sparing no time.

Another incident occurred during a hike up Mt. Fuji, where a fellow trekker suffered from extreme exhaustion between the 7th and 8th stations, at an altitude of 2,800 to 3,100 meters. He could barely move due to muscle fatigue, but his mind remained clear. Recognizing that further ascent could have been fatal, I walked him to Station 8, where we rested, rehydrated, and waited for his condition to improve. He descended later, after regaining strength.

One common issue I’ve noticed among trekkers, particularly those accustomed to rainforest hiking, is the rush to ascend quickly. In rainforests, people often race to the peak to avoid the heat and humidity. However, in high-altitude environments, this approach can be deadly. A steady and careful ascent is crucial to prevent extreme tiredness and altitude sickness (AMS) by allowing the body to adjust to the thinning air.

The mountains will always exist, but our lives are incredibly precious. Understanding the risks of AMS and extreme exhaustion and training accordingly can make the difference between a life-threatening emergency and a safe, exhilarating experience at high altitude.