The most common Nepali advice is to “walk slow and have lots of garlic soup.” That’s a good start, but there’s a lot more to it!
Altitude produces a whole host of effects on the body as it ascends into less and less atmospheric pressure. We ALL get it, no matter how fit and experienced we are. Normal responses include mild headache, fatigue, and mild shortness of breath. Even Sherpas can succumb, so altitude is nothing to take lightly. But for most people, we can manage the effects of altitude into a safe margin by observing the following:
1. Ascend slowly. Your guide should have this planned so you don’t climb too much in any one day. But some days require more climbing than others. If you are sleeping more than 1500 feet above your previous night, you should be especially alert for symptoms (see list below). We always have TWO guides on our treks so that one guide can stay behind or return to a lower altitude with anyone having problems. Decent of as little as a thousand feet can produce dramatic improvements.
2. Stay well hydrated! (Learn about safe drinking water while trekking in Nepal.) When your cells experience less pressure, they become stressed and they “leak” a little bit. Staying well hydrated replaces this loss to leakage. It also encourages your kidneys to flush out excess fluid. This diuretic response is important to ward off the process of edema, which is excess fluid collecting in body spaces. It is normal for you to experience some swelling at altitude from edema. You may notice rings are hard to slide off your fingers. More pronounced edema might make your face swell, and severe edema can fill your lungs or brain with fluid. That’s potentially deadly! So don’t ignore the early signs.
3. Don’t over exert yourself when you are acclimatizing. OK, how to do that when you are hiking all day? Just go at a comfortable pace and take rests when you need them. Your heart is working harder just being at altitude. We’ve seen people who were fine, and then they got flattened after playing a game of Frisbee. If you push your heart rate too high for too long, your pulse can freak out and just not come back down, starting a cascade of symptoms that could end your trip. We carry a great little gadget called a pulse oximeter. It helps to track any concerning changes in your pulse and level of oxygen in your blood. They are available quite cheaply online if you want to bring your own.
4. Watch for symptoms and take them seriously. These include:
- Severe headache (throbbing or drilling)
- Notable swelling of face or extremities
- High pulse rate that will not come down after rest
- Loss of appetite and/or nausea
- Lassitude (lessened energy/mental sharpness/coordination)
There are more severe symptoms too, but we are just bringing up the basics. If you progress beyond the above, you should be evacuated by helicopter!
5. Consider bringing altitude medications. As always, talk to your doctor because we cannot prescribe anything. But we can report that many trekkers carry Diamox (Acetazolemide). This can be used as a preventative OR as a treatment. We carry 250 mg tablets. Higher doses often cause very unpleasant side effects. Another potential treatment is called Dexamethazone. This is for life threatening situations and the scope is too advanced to go into here. If considering any altitude medications, you must extensively consult with your doctor!
Unfortunately, there is a small minority of people who simply don’t adjust well to altitude. There is no substitute for experience to see how you will perform.