If travelling to high-altitude areas,keep these 10 things in mind

Severe high altitude sickness can lead to accumulation of fluids in the lung and brain,causing breathing problems,disorientation,seizures and severe drop in oxygen. Also known as high altitude pulmonary edema,this needs immediate medical attention.

People with heart disease those with recent history of heart attack or stent in heart arteries,uncontrolled blood pressure,diabetes,severe asthma or emphysema and severe anaemia should avoid travel to these places without adequate precautions. Also best avoided by elderly,pregnant women,those with history of high altitude sickness and clotting disorders.

Disturbance in carbohydrate absorption,insulin action and lack of oxygen may cause fluctuating glucose levels,high blood pressure and angina. For patients on insulin,insulin should be given at the end of the meal There may be a problem with glucose monitoring strips due to humidity.

Before the trip,consult a physician and get baseline blood tests done,including ECG. Ensure adequate hydration,and carry appropriate drugs to control nausea and vomiting. Blood glucose and blood pressure should be monitored. Avoid strenuous activity. Take adequate rest and avoid alcohol in the first 24 hours. In case of shortness of breath,pressure or pain in chest,consult a physician.

For trekking,gradual ascent is recommended,of not more than 300 metres per day. Hydration should be maintained and return to a lower level in case of any discomfort.

Hospitalisation,intravenous diuretics to remove fluid in lungs and oxygen are needed in severe cases.

Acetazolamide Diamox is a mild diuretic that may be prescribed to be started one day before ascent and continued for two days.

Eat easily digestible foods dal,roti,rice and vegetables cooked in minimal spices and and salt.

Dr Shuchee Madhusudan,Dr Anoop Misra-Center of Internal Medicine,Fortis Hospital,Vasant Kunj As told to Teena Thacker