Expect the Unexpected #1: Altitude Sickness
The first unexpected that one comes across is Altitude Sickness. It is also called Acute Mountain Sickness (AMS). As altitude increases, the effective oxygen in air reduces. Effective oxygen at 8,000 feet is roughly 75%, at 12,000 feet it is 40% and at 18,000 feet it is half of effective oxygen at sea level.
This low levels of oxygen causes altitude sickness. It manifests itself in the form of headache, nausea, and fatigue. This is very common: some people are only slightly affected, others feel awful. But in its acute form excess fluid build on the lungs and causes breathlessness. And in its worst form fluid starts building in the brain and it causes confusion, clumsiness, and stumbling. The first signs may be uncharacteristic behavior such as laziness, excessive emotion or violence. Drowsiness and loss of consciousness occur shortly.
Altitude sickness can happen to anybody irrespective of age, sex, or physical condition. Some people get it and some people don’t. If you haven’t been to high altitude before, it’s important to be cautious. If you have been at that altitude before still it is better to be cautious.
The only cure for AMS is either acclimatization or descent. Human body has amazing ability to get adjusted to altitudes, provided we climb only 500m per day. Unfortunately, in today’s world of fast travel we invariably end up ascending more than 500m per day and give very little time to our body to acclimatize.
The alternatives to a slow 500m/day climb are –
(1) Carry a personal portable oxygen cylinder with you. Many tour operators carry oxygen cylinders with them as a precaution,
(2) Use drug like Acetazolamide (Diamox) to accelerate acclimatization. This drug is said to create conditions very similar to high altitudes conditions in our body. This helps body acclimatize faster provided Diamox is taken two days prior to the beginning of ascent. Unfortunately, I have seen people start taking Diamox only after they start experiencing AMS and then Diamox worsens the condition. Please consult your doctor before using Diamox or any other drug. Take Diamox two days prior, if you have to. Be ready for its side-effects.
(3) Carry camphor with you. Bheemseni Camphor is the preferred variety of camphor. Keep inhaling it. How does it work? Some say it helps decongest your breathing track allowing you to take in more air, some say it attracts oxygen molecules from the air which then you inhale and some others say it’s a placebo effect. Whatever it is, I have always used camphor and it has worked for me.
Best is to allow body to acclimatize normally by ascending at 500m per day. Talk less. Restrain yourself from exerting and running around in excitement (though it is difficult to restrain).
Expect the Unexpected #2: Medical Assistance
God forbid, no one should need medical assistance at high altitude destinations. Why? Because most of the places are in remote locations without proper medical practitioners in the vicinity. Medical facilities are available in large towns but the remote location you are in may not have it. Rushing to the nearest large town may mean a day’s arduous journey or using air ambulance. It’s doable, it’s costly, but worse is that we lose time.
Many of us move around with our life-time partners like BP, Diabetes, Cholesterol, Thyroid, and so on. Carry sufficient quantity of your regular medicines with you. Make sure you make sets of your medicines according to your daily schedule and split the sets across different pieces of luggage. Luggage pieces have tendency to get lost during travel. So carry at least one set in your hand-luggage. This set should contain sufficient medicines for entire vacation.
In case you fall short of your medicines, you may not get the same brands in the local pharmacy. Carry the prescription with you so that the local doctor or pharmacist can suggest alternate drug to you. Do not depend on calling your doctor at last moment because expect the unexpected #3.
Expect the Unexpected #3: Telephone connectivity
So you are at 14,000 feet altitude in xyz village in a homestay. You suddenly realize that you have exhausted your stock of BP pills. Your tour companions have extra stock and you can possibly borrow. But tablets are not the same. You want to consult your family doctor because there are three more days to go. You start dialing your mobile-phone only to realize that there is no range.
This situation is not a fiction. Many high altitude destinations do not have telephone connectivity – neither land line nor mobile range. In quite a few places only one mobile operator operates – BSNL – that too if it is post-paid card. (This is true as of writing this blog. Things are changing and improving over the years!!) So carry a BSNL card but do not assume you will be able to always connect. Keep your near, dear ones and, last but not the least – supervisors at work, informed that you will not be reachable for few days.
I know of a very high ranking official in 24×7 global software services organization went for vacation in Kailash-Manasarovar in Tibet. He became unreachable for consultation during a crisis situation at work. On returning to work, when he faced his CEO he realized that he would have been better-off by taking refuge for life-time in one of the Buddhist monasteries in Tibet.
Expect the Unexpected #4: Electricity
Many high altitude destinations get electricity supply only for a few hours, that too if they are connected to a grid. So, you may have cell phone range but may not have electricity to charge your cell phone. So carry power banks with you.
Many villages now have solar panels installed. That generates energy to power solar lamps. But you are unlikely to find room heaters in these places.