I am no expert on high altitude and high altitude sickness. It is commonly known as AMS or acute mountain sickness. But I am someone who loves going to the mountains. For me views are more important than gaining height. But as it is easy to gain height on treks these days, I have been up to Kala Pathar (Everest Base Camp Trek, Nepal) which is 5,643 meters or just a little above 18,000 feet. I am someone who tries to trek at least once a year. Recently I came across a program where I felt they were treating Diamox as a substitute for acclimatization. I feel very strongly that Diamox is not a substitute for acclimatization.
It is said that the risk of altitude sickness may start from 2,400 meters or 8,000 feet. By 10,000 feet almost everyone will end up paying attention. Anyone can reach 10,000 feet easily in India if you visit Leh or Kaza.
As there is less oxygen on the higher altitude, it affects the body adversely. The body needs time to adjust to the less oxygen. Some of the very common symptoms of AMS are headache, nausea, feeling breathless etc. There is a vast literature on the internet that documents all things related to altitude sickness.
One of the most common advice (for me the soundest advice too) to deal with altitude sickness is to take it slow. One should not be in a hurry to gain height. It helps to gain height gradually, whether you are walking or moving in a vehicle. For example, when I was trekking up to the Everest Base Camp, there were two days, one at Namche and another at Dingboche, where we stayed for one extra night at the same place. They were heaven sent to me, it helped in soothing my aching limbs and giving me a better shot at acclimatizing to the height. I would not dream of chopping it off from my itinerary. The other advice is drink plenty of fluids (not alcohol though) to keep the body hydrated.
A very common medicine mentioned to deal with the problems of high altitude is Diamox. All my guides carry it. But all of them are stellar people, they plan the trek so well, that I never had any need to take Diamox. But then that is just me. It is entirely your and your doctor’s call whether you need Diamox or not. If there is a need for Diamox, along with acclimatization, it should be done properly.
However, I came across a trekking program recently which was planned such that there were no rests. And it was mandatory for everyone to take Diamox before the trek! The height gained was not more than 3600 meters! It took me completely by surprise, and then it left me seething.
The group was starting by train from a state in South India. They were proceeding to Uttarkashi the same night they arrived after their 42 hour train journey. And after reaching Uttarkashi they would start trekking the very next day. If I would have joined that group (and I would have been paid for it too) I would at least start from Delhi. And yet the road journey was done in such a haste that it made me hesitate. I went on a conference call with the stakeholders. And that is when I learned that it was compulsory to take Diamox if you wanted to join the trek!
I was so angry, I could not think straight. I mean you rush people like a piece of luggage from one part of the country to another and then insist that everyone treks after taking Diamox! Now what kind of planning is that? I dropped out of that trip without any hesitation.
And then I hit the search button on the internet. I found that the company was not alone. Some were more sophisticated in their approach but the essence was same, we have limited holidays, let us go as high we want on Diamox!
And it is not that I never used to work! In fact all my major treks were done while I was working full time. I never came across a guide who even tried to suggest Diamox as compulsion!
I will repeat once again that I am no expert on high altitude but even in my limited experience I firmly believe that Diamox is not a substitute for proper acclimatization.
Last year in 2014 I went to Chandratal (4,300 meters) after staying in Manali for two nights. Then we stayed at Batal for a night. I was perfectly fine at Chandratal. This year in 2015 I stayed one night in Manali and then headed straight for Chandratal without a stop at Batal. On the first evening I had a headache and I was not feeling happy in general. I took it easy at night and then the next day we headed down to Tabo and I did fine after that. So, it is not that if I have been to a place before I can rush to it the second time!
Maybe it is me who is out of touch with the world but for me Diamox will never be the only acclimatization plan for my trip in high mountains!
Even though it was a rest day, I still woke up at 5.30 am and looked out of the window. And after just one look, I went to sleep again, it was completely overcast, not a patch of color that I usually associate with the sunrise or the morning sky! I eventually woke up at 8.00 am, by 8.30 I was in the dining hall for breakfast. We thought we would go for our acclimatization walk around 9.30 am. But the weather had other ideas. By the time I sat in the dining hall again in the evening, I wrote this one line, “it rained throughout the day, end of the story.”
Manang, Annapurna Circuit Trek, Nepal
Clouds or not, Manang is picture postcard beautiful but by now I was really desperate for a little sunshine and blue skies. Outside it just rained. So I started reading travel magazines kept in the dining hall. Thus came the lunch time and it still rained. We kept postponing our walk thinking it might stop raining.
I started chatting with the lady who owned the lodge. She could speak Hindi and had been to Delhi, Mumbai, Kashmir and Bangalore. She liked the big cities! When I asked about the road she said, it brought the prices down otherwise Manang used to be a very expensive place. But two hours after lunch, when it was still raining, I told Hari, “Let us go and get done with the walk, rain or no rain.”
Gangpurna Lake, Manang, Nepal
Our first stop was Gangpurna Lake which is right in Manang’s backyard. Walk down to the fields behind the village and a little to the right, there it is. Hari and I were the only people around. Heera Kazi who was with Justin and Erick told me the night before, “Go to Gangpurna Lake and then climb Annapurna III.” To which I told him, “I would sleep over it!” Annapurna III was that close and yet I never saw it, damn clouds they were not willing to yield an inch. And if you think I am cribbing too much this is how Manang looks without the clouds.
Prayer Flags above Manang, Annapurna Circuit Trek, Nepal
We eventually walked up to these prayer flags. Rain was falling intermittently, so sometimes I was Gandalf with a clock (without magic) and sometimes I could take the cloak (raincoat) off. This was a stiff climb uphill but at least I could see how far we had to go. It took me a little more than hour to get there at a leisurely pace.
Gangpurna Lake, Annapurna Circuit Trek, Nepal
On the way up I could see the Gangpurna Lake and what a beauty it is! Once we reached the prayer flags, Hari suggested to go a bit further till the kharka. Kharka means a meadow or a clearing and we walked up to it as well. Then came the time to walk down and it was steep down. I hate getting down a steep path, I am the slowest on such tracks.
I got a fabulous view of the village while climbing down but it was really slow going for me. And then at one point I fell. I have often taken a tumble on treks, particularly when I have slipped on loose stones, which is not much. But this was an uncoordinated fall, one that scared me. Thankfully there was no visible damage, so I picked myself up and walked again. I had told Hari to go ahead so thankfully there were no witness to my fall. After this I went down even more slowly. And it still hurts a bit just below my knee from this fall.
Kids at Manang, Nepal
However, as this was just a short hike above the village I got down eventually. Instead of going to the lodge I decided to sit in the village square for a while. The women turning the prayer wheel asked me the favorite question, shaadi banaya (are you married)? When I said yes, the next predictable question was, “So where is the family?”. It was always asked in a good way at various places but by the end I was really tired explaining why I was trekking alone. It was quite refreshing though that to Erick and Justin I never had to explain why I was trekking alone in spite of having a husband and child.
Then came the kids and they were only interested in my gadgets. There first question was if I had games on my cell phone. They were quite disappointed to learn that I didn’t have a single game on my phone. Soon they were flipping through my photo gallery and watching my South Africa videos with rapt attention.
A Brat at Manang, Annapurna Circuit Trek, Nepal
This young boy was the biggest brat of them all and he was interested in my precious, my camera. I gave it to him on the condition that he would put the strap around the neck, so even if he drops it accidentally it will not fall. He agreed and clicked my pictures! Only after being scolded by an elderly gentleman he returned me my precious.
Kids at Manang, Nepal
At this point I realized that the card in the camera was full. I took out the spare card only to find that I kept a damaged one as spare. Now this was a minor crisis. For me taking pictures is essential and the future of the trek looked doubly bleak. But the local shop to my pleasant surprise was selling 4 GB memory cards that worked perfectly with my camera. Now that my precious had a new card we walked back to the lodge to a pot of ginger tea. Later they lit fire in the dining room and it immediately made the atmosphere cheerful. There were two other young boys from US at our lodge who were on a flexible itinerary, so they didn’t care about the rain. The sky was not in a cheerful mood at all, it was still raining after dinner. Walking for the entire day in rain to Ledar felt like a real possibility now.
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