Altitude sickness, also known as acute mountain sickness (AMS), altitude illness, or soroche is a condition that is caused by exposure to low air pressure (high altitudes). AMS or Acute mountain sickness as I will refer to it from now on usually occurs above 2400m (approximately 8,000 feet). AMS is the first stage of the condition and it can progress to high altitude pulmonary edema (HAPE) or high altitude celebral edema (HACE).
The cause of altitude sickness is still not known and it is hard to determine who will suffer from it since there are no specific factors that actually show it in advance. AMS is defined simply as when you feel sick in high altitudes. The symptoms are numerous and include headache, fatigue, stomach illness, dizziness, and sleep disturbance. Headache can also be a symptom of dehydration due to the higher rate of water vapor lost from the lungs at higher altitudes.
We started to feel it around 4000m and it is not very pleasant. I drank enough water so my headache was most likely caused by AMS. So when the porters and guides say "Pole Pole" (slowly slowly), listen to them. The only thing that really works against AMS is to ascend slowly and to rest well in each base camp. Strenous activities will worsen the AMS and if you at the same time ascent quickly it could give you HAPE or HACE.
HAPE(High Altitude Pulmonary Edema):
HAPE is one of the severe illnesses that you can get from ascending too quickly. Its basically fluid in your lungs and is very much life threatening. Symptoms of HAPE include persistent dry cough, fever and shortness of breath even when resting.
HACE(High Altitude Celebral Edema):
HACE is even more serious than HAPE and is basically a swelling of the brain caused by the rise in altitude. Symptoms of HACE include headache that does not respond to analgesics, unsteady gait, increased vomiting and gradual loss of consciousness
The only real cure for HAPE and HACE is a quick descent to lower altitudes. If you are fearing that you or one of the climbers in your team have the symptoms of either then dont hesitate to climb down again.
How to avoid AMS, HAPE or HACE:
It depends from person to person how hard you will be effected by the altitude. In our group of five people just one one of us barely had any problems. The rest had varying degrees of AMS. The only real solution is to acclimatize to the altitude slowly. This is why as I wrote in the Kilimanjaro routes section that I dont reccomend the Marangu route. The Marangu route is one day shorter and thus cheaper than the rest of the routes but this will also significantly lower your chance of success since you will have less time to acclimatize to the altitude. The golder rule to acclimatization is - "Climb high, sleep low". And this actually works! On our Machame route we always ascended to a greater altitude before returning down to what was going to be our basecacmp for the night.
Another way to avoid AMS is drugs. Drugs like Diamox will remove a lot of the symptoms of the illness but could in my opinion be dangeour just because of this. If you cannot see the symptoms it is hard to see if the condition worsen from AMS to HAPE or HACE. I ended up bringing painkillers and used those to great success. I could still feel the symptoms on my body but I always knew that I was in the safe zone and was just having trouble with AMS, not HAPE or HACE.
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