Altitude sickness… what is it, where do you get it and how can you try and prevent it?

Being born and raised in England, altitude sickness is something that I had truthfully never even thought about until I planned to visit South America. South America has some of the highest altitudes in the world and is infamous among travellers for causing altitude sickness. Not only are most of the famous hikes at high altitude, but also some of the main cities. You don’t have to be climbing the highest mountains to experience it, you are likely to feel the effects when you land at the airport or just from staying in the cities.

The most common places to get altitude sickness in Bolivia is anywhere in the west of the country. The capital city La Paz is the highest capital in the world at a staggering 4058m above sea level and in some parts of Uyuni you will reach nearly 5000m.

Before my trip, I was under the impression that if I was physically fit, I would be fine in high altitude, however this was certainly not the case. I am fairly athletic and would consider myself in good physical health and fitness and I still experienced it. You could be the fittest, healthiest person in the world and still get altitude sickness. There is no way to predict if you will get it or not; it is solely dependent upon your body and how it reacts to the elevation.

This guide will explain what altitude sickness is, the symptoms, my top tips on how to prevent it and also, an insight into my experience of altitude sickness in Bolivia.

What is altitude sickness?

Altitude sickness is also known as acute mountain sickness (AMS) and is caused by high elevations and low levels of oxygen. Symptoms usually develop when you are exposed to altitudes above 2500m above sea level.

The higher you go, the thinner the air becomes and the more you will feel the effects of the elevation. Your body will begin to work harder in order to manage on less oxygen. Most of the time, you will just feel as if you are out of breath and when undertaking the simplest tasks like walking up the stairs, you will question whether you are completely out of shape or whether it is the altitude.

Of course, for your own piece of mind, you blame the altitude!

The symptoms of altitude sickness can range from mild to extreme.

Mild symptoms can include:

• Dizziness
• Throbbing headache
• Nausea
• Tiredness or unable to sleep
• Loss of appetite
• Faster breathing

If you develop mild symptoms and you’re in the city, you should take it easy for a few days. If needed, most hotels/hostels will have oxygen tanks. If you are hiking/climbing, you should stop climbing any higher and return to a lower elevation as soon as possible. The symptoms should gradually improve as your body begins to re-adjust.

The majority of us will only experience mild symptoms, however if you do experience severe symptoms, you should return to a lower elevation as soon as possible and seek immediate medical advice. Altitude is very serious and can cause life threatening conditions and at worst case-scenario, can kill you.

Severe symptoms may include:

• Tightness and pain in the chest
• Shortness of breath
• Coughing and congestion in the chest
• Confusion and difficulty walking.
• Changes in skin colour.

My experience in Bolivia

I arrived in San Pedro de Atacama, the driest desert in the world from Punta Arenas, one of the most southern parts of Patagonia (bar Ushuaia). I had taken 3 buses, 2 flights and spent the night in the airport. The climate had changed from snow to 30 degrees and the elevation from 35m to well above 2500m. My body was already pretty confused with the changes by the point.

I was exhausted and ready to rest for a couple of days. I had already visited San Pedro a couple of months prior and seen everything I wanted to see so this time my plan was to chill out and rest before taking the tour to Salar de Uyuni.

The last time I was in San Pedro de Atacama I was feeling unwell and decided not to take the tour to Bolivia so this was my second attempt at the salt flat tour.

As I mentioned in my Salar de Uyuni (Salt Flat) tour article, altitude in Bolivia had quite an effect on me. On day 1 of the tour, we had travelled from 2500m in the driest desert in the world to a whopping 5000m above sea level to see the geysers. I had never experienced altitude this high before and was not acclimatised to it at all.

Around 4:00 pm, I started to feel the effects of both car sickness and altitude. I already suffer from motion sickness and therefore chose to sit in the front of the car to hopefully stop me from vommiting. The pain began in my head and gradually got worse and worse until it felt like my head was exploding.

My usual tactic is to try and sleep to stop me from feeling ill and vomiting. Usually I can sleep anywhere but at this point my head was pounding so much that I couldn’t even manage to sleep. I tried to drink and every sip made me feel nauseous.

The driver could see I was suffering and continually said ‘calma, calma, todo bien’ to which I replied with a desperate look, no. He attempted to drive slower and encouraged me to eat ‘coca leaves. He had been chewing and spitting them out the entire duration of the journey. I had already tried them in San Pedro and knew how bitter they were so I refused. I think I was already past the point of them helping to be honest. Nevertheless, he tried.

Within a few minutes we had to stop the car.  After throwing up many times, we carried on the journey to the accommodation. During the drive, I continued to be sick into a bag. Very attractive right!

We arrived at the accommodation around 20minutes later and I went straight to lie on the bed. At this point my vision was blurred and I couldn’t even keep my eyes open or speak. It was such a strange feeling and not what I expected altitude sickness to be like. I imagined I would be short of breath and panting, but this felt like an extreme hangover!

I felt as if all my energy had been drained and I was struggling to even find the strength to walk without keeping my head in my hands. My head was banging and I felt dizzy. I generally felt like I had been hit by a bus!

For the next 7 hours, I tried to force myself to sleep. Every time I managed to fall asleep for a short period, I was awoken to be sick again. I literally spent my whole evening running between the bedroom and the bathroom to vomit. I didn’t think it was ever going to end!

There were a couple of doctors in another tour group who were also staying at the same accommodation. They tried to help and give me some tablets to stop the sickness, but that also failed…everything just came back up. I was unable to drink or eat anything and desperately wanted to sleep to take the head pain away.

The guides were very helpful and continually came to check on me and also brought me coca tea. Unfortunately, I couldn’t even manage to drink a sip. Apologies for the gory details but I generally think I had brought up a weeks’ worth of food and drink. I had probably lost a stone in weight!

Finally, around 12pm, I managed to sleep through until the next morning. Thank the lord!

When I woke up the next morning, my head was still hurting but I felt so pleased that I had finally stopped vomiting. My body could not have taken anymore. The doctors encouraged me to try and eat something as they said I would be very dehydrated and my body would need sugar. I was feeling slightly better and forced myself to eat some pancakes and bread. I also drank two large bottles of coca cola #sugarush.

Within half an hour, I felt human again and was able to function.

Thank god it was over.

Although it was pretty scary, thankfully it did not ruin my experience and I still had a great time and was able to complete the tour. Nevertheless, I had never felt anything like it before and it was an experience I would never forget.

Can you get altitude sickness if you have already had it before?

Strangely after this, I visited many other countries with high altitude, such as Ecuador and Peru where I hiked over 5000m high and had no problems. I think I had just been unlucky on this occasion. There is no way to predict if you will get altitude sickness or not and you never know how your body is going to handle altitude until you experience it. Just because you have experienced it once, it does not mean you will not experience it again.

Top tips

• Acclimatise- spend a few days in the place and take it easy before you do any serious hiking or activity. This will allow your body to gradually get used to functioning on less oxygen.

• Avoid flying directly into areas of high altitude. Travel gradually to higher areas by bus, train or car if possible.

• Keep hydrated- drink plenty of liquids.

• Eat a light but high calorie diet.

• As boring as it sounds, try and avoid drinking alcohol. You need to allow your body to adjust to the altitude before adding a hangover in the mix.

• If you wish to, you can purchase altitude sickness tablets from the pharmacy. There is no need to buy these in advance, all pharmacies in South America usually sell them. I did not use them but met many travellers who did and they spoke positively about them.

• Locals will encourage you to either chew coca leaves or drink coca tea. In my opinion I found them very bitter to chew, but the sweets and tea are much more pleasant. Although there is no evidence that coca leaves actually work, it is highly advised by the locals and you will see locals constantly chewing them. To be honest, I am not sure whether they actually made any difference or whether it was the ‘placebo effect’, but I drank lots of tea in Peru before hiking and I did not experience any sickness.

• On many hiking tours, the guides will also offer to put a small amount of alcohol onto your fingernails for you to sniff as this is also said to help with preventing altitude sickness. Again, who knows if it works or not, but either way, it doesn’t hurt to try.

• Ensure that you add ‘hiking at high elevation’ onto your travel insurance so that you are covered. Most insurances will not cover hiking at elevations above 2500/3000 m. I bought mine with Alpha and was able to add it on as an extra.

Disclaimer: This article is not designed to provide medical advice, diagnosis or treatment. I am not a trained medical professional and the information I have written in this article is from my personal experience.