Precautions

HIGH ALTITUDE MEDICAL PRECAUTION

Changing time zones knocks people, add the stress of winding up at work and many people arrive feeling slammed, needing a holiday. This is the time you are most likely to get sick; try to take it easy, and definitely take multi-vitamin tablets. If travelling from America the flights are particularly long with annoying stopovers and a brutal time change; we recommend arriving a day earlier to recover. For India if the trek begins in Leh then fly up there one day earlier.

High Altitude Medical Advice For Travelers

It's okay to get altitude illness, but it's not okay to die from altitude illness. Trekking in the Himalayas brings people to high altitude for longer periods of time than in most other situations, and the risk of dying from altitude sickness is consequently higher in this region. Trekking in Himalayas affords the opportunity to acclimatize gradually.

Human bodies have built-in adjustment mechanisms that can optimize performance at altitudes. This process is known as acclimatization. The power of acclimatization can be demonstrated by the following examples. If a person were transported suddenly to the summit of Mt.Everest (29,128 feet; 8848 mts.), person would lose consciousness in a few minutes, and most likely die within an hour or two due to acute hypoxia. However, over 60 people have climbed to the summit of Mt.Everest without using supplemental oxygen after acclimatization for many weeks. This fact demonstrates how profound the process of acclimatization can be.

DO'S & DON'T'S

Acute mountain sickness (AMS) can occur to anyone at altitudes above 3,000 m / 10,000 feet. The most common symptoms are breathlessness, coughing, disturbed sleep, headache, inability to concentrate, lassitude, loss of appetite, and nausea.

Leh is situated at an altitude of approx. 3,500 m / 11,500 feet, you are advised to properly acclimatize your body for the first two days by taking complete rest after arrival. Do not exert yourself. Drink enough (at least up to 2 liters) every day. Keep your body hydrated, walk/move slowly, and do not climb higher.

AMS - Acute Mountain Sickness

Commonly called altitude sickness, this has the potential to affect all trekkers from 2500m and higher. Your body needs days to adjust to smaller quantities of oxygen in the air - at 5500m/18,044ft the air pressure is approximately half that of sea level, i.e., there is half the amount of oxygen (and nitrogen).

Altitude sickness is preventable. Go up slowly, giving your body enough time to adjust. These are the 'safe' rates for the majority of trekkers: spend 2-3 nights between 2000m/6562ft and 3000m/10,000ft before going higher. From 3000m sleep an average of 300m/1000ft higher each night with a rest day every 900-1000m/3000ft. Ultimately it is up to you to recognize the symptoms, and only ascend if you are relatively symptom-free.

Normal symptoms at altitude

Don't expect to feel perfect at altitudes of more than 3000m. These are the normal altitude symptoms that you should expect BUT NOT worry about. Every trekker will experience some or all of these, no matter how slowly they ascend.

  • Periods of sleeplessness
  • The need for more sleep than normal, often 10 hours or more
  • Occasional loss of appetite
  • Vivid, wild dreams at around 2500-3800m in altitude
  • Unexpected momentary shortness of breath, day and night
  • Periodic breathing that wakes you occasionally - consider taking Diamox
  • The need to rest/catch your breath frequently while trekking, especially above 4000m
  • Your nose turning into a full-time snot factory

Mild Symptoms

You only need to get one of the symptoms to be getting altitude sickness, not all of them.

  • Headache - common among trekkers. Often a headache comes on during the evening and nearly always worsens during the night. Raising your head and shoulders while trying to sleep sometimes offers partial relief. If it is bad you may want to try taking a painkiller.
  • Nausea (feeling sick) - can occur without other symptoms, but often nausea will develop with a bad headache. If you are better in the morning take a rest day, or if you still feel bad descend.
  • Dizziness (mild) - if this occurs while walking, stop out of the sun and have a rest and drink.
  • Lack of appetite or generally feeling bad - common at altitude due to too rapid an ascent.
  • Painful cough or a dry raspy cough.

Serious Symptoms

  • Persistent, severe headache
  • Persistent vomiting
  • Ataxia - loss of co-ordination, cannot walk in a straight line, looks drunk
  • Losing consciousness - cannot stay awake or understand things very well
  • Liquid sounds in the lungs
  • Very persistent cough
  • Real difficulty breathing
  • Rapid breathing or feeling breathless at rest
  • Coughing blood or pink goo or lots of clear fluid
  • Marked blueness of face and lips
  • High resting heart beat - over 120 beats per minute
  • Severe lethargy and drowsiness
  • Mild symptoms rapidly getting worse

Basic Rule: IMMEDIATE AND FAST DESCENT WITH SEVERE SYMPTOMS

Take as far down as possible, even if it is during the night. The patient must be supported by several people or carried by a porter - his/her condition may get worse before getting better. Later the patient must rest and see a doctor. People with severe symptoms may not be able to think for themselves and may say they feel OK. They are not.

Food Poisoning

This comes on suddenly and severely, usually from both ends - vomiting and diarrhoea. It happens about 4 to 8 hours after eating the contaminated food. Luckily it usually lasts less than 24 hours and recovery is quick, although you may feel weakened.

Dehydration

At altitude, dehydration is a significant issue. Make sure you drink plenty of fluids to stay hydrated, especially in dry, thin air.

Blisters

Blisters can be a problem during treks. Prevention is key, and prompt action is needed if a blister begins to form.

How do high altitudes affect people with asthma?

If you have asthma, higher altitudes can affect you due to cooler and drier air and reduced oxygen levels. Make sure to take appropriate precautions if traveling to higher altitudes.