Trekking Advice

PRACTICAL INFORMATION
MEDICINAL ADVICE

Trekking need not be considered risky affair as far as your health is concerned. Nevertheless, preventive measures such as a through medical check up and inoculations before you start trekking can save you from unexpected hazards. Since the remote places are not supplied with necessities that are essential for modern medical facilities and as the rescue and evacuation are measured in days, it is imperative to make a comprehensive first aid box consisting of basic drugs and accessories as part of the paraphernalia for trekking. Modern dentristry is unknown in the hills so it is advised to have a checkup before departure from home. Tooth fillings; sometimes loosen in cold temperatures and high altitudes, so it is recommended to have them checked. Travelers are requested to bring medicine prescribed by their doctor at home. Common medicine for stomach problems, headache, and malaria is available in any Market. Medicine is usually not available in remote areas. So necessary medicine is advisable to carry with you.

OVERCOMING ALTITUDE PROBLEM:
This is often known as Acute Mountain Sickness (AMS), which is particularly a matter of important medical consideration while trekking in the Himalayas. Altitude Sickness means the effect of altitude on those who ascend too rapidly to elevations above 3000 meters. Early mountain sickness will manifest itself in headache, nausea, shortness of breath, fatigue; etc can be encountered as initials of the sickness. 
CAUSE/FACTOR OF ALTITUDE SICKNESS

1. Less Oxygen
2. Low Pressure i.e. Barometric Pressure
3. Rapid Ascent
4. Possible Dehydration
5. Hypothermia TYPE OF ALTITUDE SICKNESS

TYPES ALTITUDE SICKNESS

1.
 AMS - Acute Mountain Sickness
2. HAPE - High Altitude Pulmonary Edema
3. Hace - High Altitude Cerebral Edema

SYMPTOMS


1. (AMS) ACUTE MOUNTAIN SICKNESS
Mild symptom feels like hangover/not feeling good
a. Headache
b. Fatigue/Tiredness
c. Nausea
d. Shortness of breath
e. Loss of appetite
f. Sleep disturbance
g. Dizziness

2. (HAPE) HIGH ALTITUDE PULMONARY EDEMA (Water in lungs)
a. Increasing shortness of breath even at rest
b. Severe cough-dry/Productive
c. Very tired-Unusual fatigue while walking
d. High Pulse rate i.e. 110
e. Blueness of face, lips, finger nails that means inability to transport Oxygen into the blood

3. (HACE) HIGH ALTITUDE CEREBRAL EDEMA (Water in the head)

Severe symptoms of altitude sickness
a. Severe Headache
b. Vomiting
c. Walking like a drunk (Ataxia)
d. Mental confusion/Altered mental status
e. Irritable-Does not want to be bothered by other people
f. Unconsciousness or Coma
TEST - Tandem walking test, Heel to toe step fall off from the line.

DECISION MAKING
1. Find out the main problem i.e. at altitude. Assume all problems are Altitude Sickness unless proven otherwise.
2. If it is an attitude problem with mild symptoms, stay at the same altitude until the symptoms are completely gone. Take an Aspirin tablet, try to go up but listen to your body. If symptoms are worsening, go down.

PREVENTION

1. Acclimatization: - After a 1000m. ascent, stay one more night for acclimatization.
2. Do not make RAPID ASCENT; don't go too fast too high.
3. No alcohol, sleeping pills, and smoking.
4. Drink more fluid 3-4ltrs a day… clean, boiled or treated water/tea/coffee/soup/juice etc.
5. Do not carry heavy packs, 10 - 12 Kilograms is ok.
6. Climb higher sleep lower.
7. Over 3000m, 300m. Ascent a day.
8. Do not travel alone.

TREATMENT
1. DESCENT is the best medicine; do not wait for the Helicopter.
2. Medicine:
a. Oxygen.
b. Diamox…for AMS 125mg. Before dinner, for the sleeping problem if feeling suffocated.
c. Nifedipine for HAPE
d. Steroids/Dexamethasone for HACE
3. Hyperbolic Bag - Gamow Bag
4. Golden Rules
a. Awareness of ALTITUDE SICKNESS
b. If you have mild symptoms, do not go higher. Take Aspirin.
c. If you have worsening symptoms, go down.
d. Do not leave your team member behind unattended, either trekker or porter.
5. IMPORTANT
a. Go up slowly.
b. Drink plenty of fluids (at least 3 liters per day)
c. Get all information about Altitude Sickness before your trekking tour that will make you confident to make your tour successful.

Our advice: Drink 4 ltr of water minimum a day, don't exhaust yourself so much and breathe deep and take rest more than usual.