An often used phrase in Nepal is ‘Nepali flat’. Your guide will surely say this to you a few times. This means the trail is about to ‘undulate’ quite considerably. Distances are not measured in conventional metres, kms or even miles on the trails in Nepal, but in walking times. This is because the trails go uphill or downhill but seemingly never flat. Therefore it is best to arrive in Nepal suitably conditioned, and if you have not done so already then start to get fit. Visit your local gym or go for a bike ride. If you arrive there suitably conditioned then you will enjoy the trip so much more. You should be able to walk for 7 to 9 hrs in a day on undulating terrain (ie going up and down hill) and not feel exhausted! There are also a few steep hills to negotiate (takes about 2hrs) and so you should be ready for these.
Most of the treks visit high altitudes! You will be spending few nights at or above 5000m which is a serious altitude. Though it is imperative you are properly acclimatised not only to have a safe trek, but also an enjoyable one as altitude sickness has the capacity to make you feel very miserable! All along the way you will find warnings about ascending too quickly. If you show signs of altitude sickness, appropriate measures (ie descent) must be taken. Inform yourself as much as possible about this issue before you go so that you have an understanding of how it can affect you. Keep your guide informed regarding how you are feeling during the trek. The most important aspect of the trip to ensure proper acclimatisation is your waling schedule. This we feel is appropriate to give all the best chance to acclimatise. Furthermore however, you can do many things which will aid this process. Walk within a pace that is comfortable for yourself. Remain well hydrated. Avoid diuretics (tea/coffee etc). Your leaders will advise you more during the trek.
Our bodies have ability to adjust to high altitude but need time. This illness occurs as the result of failure to adapt to a higher altitude, normally while you go beyond 2000 meters rapidly, which is called Acute Mountain Sickness (AMS). Fluid accumulates in between the cells in the body specially – in the LUNGS and BRAIN. The early symptoms are headache, extreme fatigue, and loss of appetite. When mild symptoms develop, you must stay at the altitude until symptoms have gone away. Trek up gently about 300 meters in a day beyond 3000 meters to adjust your body system with altitude.
If the fluid collects in Lungs-
-Symptoms are: Short breaths, a cough begins- first dry, irritating than to Pink.
This is known as HAPE- High-altitude pulmonary edema
If the fluid collects in Brain:
-Symptoms are: – Headache, Loss of appetite, nausea, and Vomiting.
This is known as HACE- High-altitude cerebral edema.
This makes you tired and want to lie down, do not want to do anything.
You develop a problem with balance and coordination and you sleep in to coma.
If we ignored, symptoms can be progress- sever forms of Altitude sickness:
AMS- Acute Mountain Sickness takes several hours to develop after reaching a new height.
Rules to avoid High Altitude sickness:
-Early symptoms: Short breaths, cough or Headache, loss of appetite, nausea, fatigue – MUST DESCEND
-If there is symptoms of AMS, never ascend to sleep in new height.
-Descend immediately if your symptoms are getting worse while resting at the same
Drunk Test- if victim can’t do – it is HACE
If it is HAPE- If you feel you need to rest more and more and do not recover your breathing rate at rest even after having rest for 10 minutes.
- Not to rise
- If no way to descend – use PAC (to create hi-air pressure, where victim gets more oxygen) or Oxygen for one hour and sometime 4-6 hours of treatment needed.
- Inhaling medicine such as Nosia would also help
If you are flying in to high altitude straight such as Lhasa or Shyangboche beyond 3000 meters, taking Diamox in advance would be better, otherwise use it when you get mild symptoms of it.
MEDICINE: Diamox – ½ tab (125 gm) every 12 hours. After using this, you will have mild tingling of hands/feet is common.
Allergy to sulfur based drugs – should not take Diamox. This medicine is meant for Glaucoma – eye disease.