The Effects of Altitude

Medical problems associated with altitude include several uncomfortable symptoms and can ultimately become life threatening. All are due to decreased oxygen concentration in the blood caused by the lower atmospheric pressure at altitude.

The effects of altitude deign to make themselves felt at around 2800-3200m (8-9000’) whilst rapid ascent above 4300m (14000’) without prior acclimatisation is dangerous.

Acclimatisation
There is wide variation in an individual’s ability to acclimatise – in absolute terms (i.e. whether they ever do or not); in the time it takes them to achieve a given level of tolerance, and in performance on different expeditions. Previous lack of difficulties should not lead to over-confidence in this area.

Other generalised observations are:

• Individuals over 25 have fewer problems – probably due to maturity of bone marrow. Children are particularly susceptible.
• Yearly exposure over a number of years (i.e. experience) decreases the likelihood of altitude problems – probably due to better precautions rather than any physiological effect.
• Physical fitness has no positive effect on acclimatisation. Marathon runners in fact often have more problems by virtue of their (usual) ability to retain water under specific physiological stress.
• In other words watch the young fitness fanatic with no previous experience if you are on a high altitude trek.
• Slow ascent is the only way to acclimatise. The old adage ‘climb high, sleep low’ is a good idea although lower on the mountain, a gradual daily increment is generally acceptable. The ‘acclimatisation profile’ plot of altitude v expedition day does not exceed accepted limits for this trip.

What are the symptoms of altitude sickness?
Symptoms are described below to allow personal monitoring of your acclimatisation:

Fatigue - Undue tiredness in relation to work put in. Our altitude itineraries are planned with this in mind.
Headaches - Drink copious quantities of fluid – 6 litres per 24 hours if you can manage it; one should pass a clear stream of urine 3 or 4 times a day. Take a mild pain killer if a bad headache does develop.
Nausea - Replace fluids if you are sick. Use isotonic fluids such as ‘Dioralyte’.
Anorexia - Loss of appetite. (A sign of acclimatisation is when it returns in a big way!)
Breathlessness - Quick breathing, blue lips.
Photosensitivity - Sneezing in bright sunlight.
Cheyne-Stokes Breathing - Irregular, cyclic breathing pattern, especially at night. Listen to partners who may suddenly inhale deeply and sharply.
Oedema - Swollen wrists (watch too tight?) puffy eyes etc.
Altitude also affects the higher brain centres and can lead to depression and irritability especially at the end of a long day. Vivid dreams and anxiety are also fairly common.

Very few of these symptoms should be experienced by the majority of expedition members.

Diamox:

• Diamox (Acetazolamide) is a drug that has gained a certain vogue for mitigating the effects of altitude even though it is contra-indicated for certain kidney, eye and liver conditions. Your doctor’s advice should be taken prior to its use.
• It functions by affecting the acid-base balance in the body at a time when normal balances are already stressed by altitude.
• Once symptoms of acute mountain sickness do develop the only real treatment is immediate and rapid descent – to less than 3000m (10000’) if need be – although even a descent of a few hundred metres can make a marked difference. It is sometimes forgotten that Acute Mountain Sickness (AMS) is a life-threatening condition and descent is the only reliable cure.

One of the biggest concerns for people getting involved with any of the Big Issue Foundation events is the sponsorship. This is particularly true with the Kilimanjaro 10 day trek, £2995 is a lot of money to raise but do not fear its not impossible. You just have to go about it in the right way and you would be amazed where sponsorship can come from.

A great place to start is with the newly revamped Big Issue Foundation A – Z of fundraising, this is a great first stop on the ride to success!

Many companies will also run matched sponsorship schemes for employees where they will match your sponsorship, sometimes up to the level of £500!

Another great way to raise money is to put on your own events. Events are a fantastic and fun way to raise sponsorship and also get support for your own personal challenge and the organisation. Once you sign up to this event you will receive further indepth fundraising information and support so don’t let that put you off doing what could be one of the greatest experiences of your life!

John, Sept 08
Nothing was too much trouble for the Crew, they were always willing to give that bit extra, always smiling and cheerful.  A well organised trip, excellent service, before we went any queries we had were answered the same day.  Our guide was a true professional. Hopefully I will be back next year to do it all over again.

Mark, Sept 08
I said when I had completed the challenge I could not do it again, been back for 2 weeks and have already changed my mind!

Will, Sept 08
I very much liked having the opportunity to meet some incredible Tanzanian people, especially the guides and porters.

Ruth, Sept 08
A fantastic experience.  The trip was extremely well organised, the guide amazing and the local crew worth their weight in gold.  I have already recommended the trip a several friends.

Do I need to be fit?
You have to have a good basic level of fitness. This trek is graded strenuous/tough and is challenging in itself, but the main challenge lies in the altitude.  The good news is that the specific route taken on our trek allows better acclimatisation to the altitude compared to other routes.

How much do I need to raise?
To take part you need to pay a registration fee of £199 which is used solely for non-travel costs and is non-refundable. You must also pledge to raise a minimum of £2995 in sponsorship funds and donations for the Big Issue Foundation and pay it in 12 weeks prior to departure. In return everything for the challenge will be provided - travel, food, accommodation, guides, medical support etc.

What is included?
All transport from London to Kilimanjaro International airport return       
All food (other than one lunch and one evening meal) & accommodation
Backup porters to carry communal equipment & food on the trek
Discover Adventure leaders & Doctors & local guides, cooks etc

What is excluded?
Sleeping bag & sleeping mat.   
Two meals (celebration dinner day 8 & lunch day 9)
Travel insurance
Tip for the porters and guides
Tanzanian Visa

Do I need Insurance?
Yes, it is compulsory that all participants on the event have travel insurance.  The tour operator offers standard insurance for this trip alternatively a participant may provide their own subject to certain criteria being met.

Do I need inoculations?
Yes, you must have had a tetanus injection in the last ten years and we highly recommend that you have vaccinations against polio, hepatitis A, typhoid and yellow fever. Protection against malaria is also recommended.

What type of passport do I need?
A valid ten-year passport with at least one year to run is essential.

Can I extend my stay?
Yes, if you wish to extend your trip after the event you will need to give as much notice as possible (normally a minimum of 3 months prior to departure). This option is subject to availability and a fee will be incurred.