Altitude Sickness, Nepal
When you gain altitude, you must obey the rules, These rules are Very Simple, Once you reach 10,000 feet (3.000m) you Must stay 2 nights to aid acclimatisation, then after this you Must Only gain 1,000 feet (300m) per day (Sometimes it isn’t possible to stick to this rule because of a lack of accommodation, so if you gain more altitude than you should, then you Need to spend another extra night to acclimatise before proceeding up) , Otherwise your risk of being subject to AMS (Acute Mountain Sickness) is Substantially enhanced.
However Even if you obey this rule you can still get AMS and the Only cure is to loose altitude, However sometimes this isn’t easy as you might have to gain altitude before you can loose it, Here Diamox comes in handy as it treats the symptoms, Headaches, sickness, double vision to name a few, thus enabling you to loose this Necessary altitude to aid your recovery.
Some doctors now think that regularly taking Diamox helps the acclimatisation process, However one problem is that if you don’t get the AMS symptoms, then you aren’t aware that you are starting with AMS and therefore have a lot less time to act when you do realise that you are starting with it !!
Organised treks often put there clients on a regular dose of Diamox, I personally disagree with this practice and once got into a massive argument with an Australian based outfit on their way up to Gokyo who were feeding Diamox to their clients like Smarties !!
So – All I can say is you have to make your own mind up, weigh up the Pro’s and Con’s and come to your own decision.
I have now done 10 high altitude treks in Nepal, I always take Diamox in my first aid pack, but Thankfully to this day haven’t had the occasion to have to take one – Fingers Crossed that that continues !!
Do Not Cross Cho La Alone – Trekkers are still missing presumed dead who have attempted this !!
However, a lot of people don’t wish to employ a guide for their entire trek so another option is to hire your guide out in Namche Bazaar, give him a small deposit and arrange for him to meet you in Gokyo the evening before you plan to cross.
The guide will probably walk up from Namche in one day as he will be pre-acclimatised, Where you should take 4 days to trek up there.
Namche Bazaar is at an altitude of 3440m and Gokyo is at 4750m and the rules to minimise your chances of going down with AMS for trekking are not to gain more than 300m in a day.
You are Strongly advised to stick to these rules as The Gokyo Valley is known locally as “The Valley Off Death” – You will se yourself the amount of memorials to those that died of AMS when you do the trek – So Please Don’t add to these
A sensible schedule would be something like this (After you Rest / Acclimatisation day in Namche Of Course !!)
1)Namche – to a little teahouse (Himalaya View) oposite Phortse (Aprox 3810m)
2)Himalaya View Lodge – Gyele (4116m)
3)Gyele - Machhermo (4470m)
4)Machhermo - Gokyo (4750m)
Good Luck and Safe Trekking
AMS, HACE and HAPE????
Three types of altitude sickness :
AMS: Acute Mountain Sickness; HECE: High Altitude Cerebral Oedema; HAPE: High Altitude Pulmonary Oedema.
Do read about it and do understand it before you leave and while trekking and mountaineering in Nepal. This handbook is very handy and portable, easy to read and not expensive:
"The High Altuitude medicine Handbook. Micro edition", A:J:Pollard and D.R.Murdoch, Book Faith India, 1997.
Available in Delhi, Kathmandu and elsewhere. Distributed by Pilgrims Book House in Kathmandu.
Anyone headed to Nepal has most likely heard about altitude sickness, but I'll explain the basics anyway.
Altitude Sickness is a condition where the body does not receive enough oxygen and the brain begins to swell. Altitude Sickness starts at about 3,200 meters and gets stronger the higher you go up. Symptoms include dizziness, and lightheadedness. If you develop Altitude Sickness you MUST go down to a lower altitude. Altitude Sickness is dangerous! There are some medicines out there to treat Altitude Sickness, and even some local remedies, but by far, the best way to overcome Altitude Sickness, is by acclimatizing.
Take it slow, easy, and watch out for yourself when trekking and or climbing in Nepal!
Following a recent greement between the government and the Maoist, it appears a cease fire is holding. The Maoists were always at pain not to harm tourists and therefore were rarely a threat. The biggest danger to an individual visiting Nepal is hygene and themselves...
Falling ill is almost a aprt of a visit to Nepal, but the risks can be minimalised.
Drink either bottled or purified water. It is ideal to purify it yourself to save plastic bottles littering the countryside. Iodine is the favourite choise, though I used Chlorine. Remember the neutralising tablets.
Try to avoid fruits or vegetables that cannot be peeled. Some restaurants advertise their foods have been soaked in iodine.
Follow the rules on acclimatisation. Many people, on feeling well at the time, skip mandatory rest days and then become ill further on. A saying goes; 'It is ok to get AMS (Acute Mountain Sickness) but not to die from it'. Generaly, assume any illness at high altitude is AMS unless proved otherwise and do not ascend further. If the symptoms persist or worsen, descend immediately.
People in groups are more likely to suffer AMS simply because of the pressure to continue rather than slow up the group. Never trek alone. (Yea, yea, ok!) Read up on AMS before trekking and how acclimatisation may affect your route. AMS can affect anyone and does not descrimanate between the fit and unfit or young and old. AMS can sart anywhere from around 2-2500m.Don't forget, it can kill you
When you hike in the mountains, be prepared to get the High Altitude Sickness. Get as much information about it as possible. Don't walk alone! Drink a lot of water!
High Altitude Sickness can happen to everybody - old or young, in good shape or not. Specially dangerous is this disease for the young, sportive and strong people, because they don't care. This people think, they cannot get High Altitude Sickness. And when they get it, they don't recognize the symptoms.
When I was in Nepal, a young and strong physician died of High Altitude Sickness, So please take care! There are many possibilities to get information, books in Kathmandu.
This photo was taken one day before I got sick. I was still feeling very well.
Altitude sickness sucks! Diamox was a lifesaver for me. Without it I wouldn't have made the pass. We had a prescription filled at home but found that it was available at the mountain saftey clinic at Manang. I developed altitude symptoms above Letdar and had to decend and spend the night shivering with a headache until the Diamox kicked in. I took it every day until we crossed the pass and was fine. It speeds up your breathing a great deal and you urinate about a hundred times a day but it was well worth it.
Mountain sickness can catch you totally unprepared. It can come in various ways, so you don't always know you've got it, and that's when it's mostly dagerous! The couse of this sickness is lack of oxigen. When you climb above 3500 meters, you get about 75% of the oxigen at sea level. That's when some people begin to feel simptoms. Above 5000 meters, you have 50% of the oxigen, which is too little for you brain to cope with. the only way to deal with it, is to get adjusted - meaning, not to climb any further up and see if your body get adjusted.
SYMPTOMS: The symptoms are totally different from one person to the other. You might feel headache, your fingers may go slightly numb, you may feel you need to throw up, you may start to breathe too heavy feeling as if you don't have enough air in your lungs all the time etc. All these are symptoms of people I know.
WHAT TO DO: When symptoms occur, you should stop at this hight and not go any further up. Sometimes it will even be wise to go down a little. WATER is the main cure for such sickness. Water have oxigen inside, and drinking a lot, helps your body get the amount of water it needs. A good way to know if you acclimitized or not: drink a lot. If your urine is light yello-white - you are fine. If it's dark yello as if you didn't drink, it means, that your body as taken all the oxigen from it - in this case, you need some more acclimitizing to do.
Even if you don't feel sick, it's better to make a one day stop at around 3500 meters before you go on up.
WARNING: DO NOT TAKE PILLS!!! Pills against headache, or mountain sickness, make you not feel the symptoms, you may continue up when it's dangerous for you. People died because of this! Let your body acclimitize by itself, don't try to help it because you'll make it worse!
Altitude sickness if trekking in the mountains! Make certain you are in excellent physical shape if you are going to do any high elevation hiking. Also drink plenty of (purified) water and don't rush. There's beauty everywhere you look!
When you are in the high mountains of the Himalyas there is always the danger of AMS, acute mountain sickness. Please do not think to lightly about the hazards this condition can give you! When you ignore the first symptomes and continu your ascent you are very likely going to develop HAPE or HACE of which you will die!
For more information on the dangers of mountain sickness visit this homepage of the Himalaya Rescue Association
Altitude sickness cannot be ignored when making a trip to higher altitude areas of Nepal. This means any height above 8,000 feet or 2,500 metres. This covers most if not all the main trekking areas in the Himalayas, including the popular Annapurna Circuit and the Everest Base Camp trek. I have placed a sizeable section on altitude sickness on my 'Tibet Frequently Asked Questions' page on my website at http://www.tibet.freeserve.co.uk.
There's also a problem with Maoist guerillas in some districts - check with the police or your embassy if you're going trekking in remoter areas of Nepal.
* Picture - The main Stupa at the Newar Buddhist Swayambhunath Temple.
AMS (Acute Mountain Sickness) - For the full info click on AMS Information. It's a MUST site for those venturing above 8000ft. Understanding how AMS creeps up on you, the increased breathing, expelling too much CO2, ph blood level going alkaline, nausea etc. A simple tip like breathing into a paper bag to re-inhale valuable CO2 may mean the difference between getting to a safe level and dying. All the pulmonary/cerebral edema symptoms are explained to catch it early.
Take care of the mountain sickness, it's easily happen around 3000 to 4000 metres. So it's worth to stay one more day in Namche Bazaar to accumulate the altitude.
If you feel some sickness to the altitude, such as headache or hard to breath, as I experience at above 4000m, stop at the nearest village, stay and rest for one day. If you are OK in next day, go ahead, if not, back and go down.