Acute Mountain Sickness and Importance of Acclimatization

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We all want to enjoy the lovely nature and breathtaking views of Himalayas. While going to Himalayas, many of us take the high altitudes very lightly and always consider the brighter side of it i.e majestic vistas :). However, there is a darker side attached to the high altitudes as well. How many times have you been to high altitudes and either you or people around you complained that shortness of breath, nausea, headaches or vomiting etc? I am sure you must have encounter such uncommon situations while in the Himalayas especially at the high altitudes like regions of Manali – Leh Highway, Leh – Ladakh, Rohtang Pass, Spiti Valley in India to name a few. To be very frank, some people suffer mildly and some may not suffer altogether; consider your self very lucky in such a case. However, some persons suffer drastically and the effects can be seriously ugly from them.

Illness or sickness on Himalayan trips is very common especially if you are directly flying or driving to a higher altitude which almost certain the chances. Such Illness can spoil a much awaited relaxing holiday into something ugly and in some cases may have severe consequences too. Higher you go directly, higher will be the risks. Hence, its always better to know what the altitude sickness means and what we can do to prevent it. Further in the article, I try to lay out some important theory and facts about the mountain sickness and acclimatization which may help you be prepared for altitude changes and enjoy that ever awaited holiday of yours :).

Acclimatization and Acute Mountain Sickness (AMS)

Altitude can be categorized into the following scales —

  • High (8,000 – 12,000 feet [2,438 – 3,658 meters])
  • Very High (12,000 – 18,000 feet [3,658 – 5,487 meters])
  • Extremely High (18,000+ feet [5,500+ meters])

Generally, people can go up to 8000 feet without much problems of mountain sickness. As you start to increase altitude, the barometric pressure starts to decrease which reduces the Oxygen intake per breath. Now, in order to compensate for the less Oxygen intake, your body need to increase the breathing rate. Although the increased breathing rate does increase the Oxygen level in the blood but it does not take the Oxygen level to the same level as required by the body while you are at home doing some activity. By spending proper amount of time at such altitude your body will adapt to such changes in Oxygen levels and this process is called as acclimatization.Always keep in mind that different people will acclimatize at different rates. Hence, always try to avoid any sought of comparison and wait for the person suffering in the group better acclimatize.

Acute mountain sickness (AMS) is caused above the altitudes of 10,000 Feet or 3,048 Mtrs to majority of people. Higher is the elevation and rate of ascent, more will be the effects of AMS. Hence, do not try to directly go or stay at very high altitudes directly. When you sleep, the symptoms will get worse as our body respiration decrease while sleeping.

The best cure is either to acclimatize properly or descend. However, effects of mild AMS can be cured by taking some preventive AMS medicines like headache pain relief or Diamox with proper consultation and prescription with your doctor or physician prior to the start of the trip. Diamox is a sulfa drug and does have side effects including allergies. Hence, Diamox shall only be taken after proper prescription by your doctor or physician. Diamox can also be helpful in case a person suffer from periodic loss of breath, which especially occurs in the night while sleeping.

Incase, you feel the personal is suffering badly then ask him to walk in a straight line by placing toe to toe. If the person is not able to walk in a straight line i.e. he is suffering with ataxia. IMMEDIATELY DESCEND!!

Tips for Better Acclimatization

Below are few tips that will certainly help you in better acclimatization:

Increase the altitude gradually

The acclimatization rules states that after 10,000 feet we must stay overnight for every 1000 feet or 305 Mtrs of elevation in order to properly acclimatize our body. This schedule in between shall allow a complete day acclimatization rest after 3000 feet or 915 Mtrs with overnight stay at the same altitude. If you can adjust your plan to this rule then perhaps you will not suffer with mountain sickness. However, the ground reality is only few people stick to this schedule especially in India where leaves are hard to find from their work life :lol:.

Keep your body properly hydrated

Do take plenty of intake of water with ORS or fluids like milk tea, juice, soup (garlic one will do wonders). If possible, take ORS soluted water or ORS – L tetra packs with you to replenish the lost nutrients immediately. Also, garlic flavored water ( keep garlic in water bottles) will help much more than drinking plain water which shall be avoided. This will help keep the oxygen level to normal in the body. You should avoid too much black tea or coffee as well…

AVOID over hydration because as quoted by vistet linked here(post #12):-
Forcing children to drink when they are not thirsty : at best they will vomit ( which will force you to descend ) , at worst they´ll start to develop cerebral edema – either only from water intoxication , or as a mixed result from this and altitude sickness. See for example Peter Hackett ( Everest-climbing doctor and co-author of the CDC altitude advisory ) on this : ” Too much water is harmful and can dilute your body’s sodium levels (hyponatremia) causing weakness, confusion, seizures, and coma.”

Avoid sleeping at high altitudes

As sleeping decrease the respiratory drive of our body, it is recommended that one shall hike to high altitudes in the day but should always come back to by the evening to sleep at lower altitude.

Avoid over exertion

Do not over exert your body with any unnecessary physical activity which may lead you pump more breath.

Avoid tobacco and smoking and alcohol and other depressant drugs

Avoid tobacco and smoking and alcohol and other depressant drugs including, barbiturates, tranquilizers, and sleeping pills. These depressants further decrease the respiratory drive during sleep resulting in a worsening of the symptoms.

Keep your body warm

Keep your body warm with woolens and do not let it cool. Make sure your clothes are always dry.

Eat lots of Carbohydrates

Eat a high carbohydrate diet (more than 70% of your calories from carbohydrates) while at altitude.

Avoid sleep during the day

Try not to sleep during the day and keep yourself involved in some light activity during the day. Respiration decreases during sleep which further exacerbate the symptoms.

Sleep in upright position, if possible

Try to lay down or sleep by resting your back against the wall. If you cannot sleep in such mode then do not flatten your head on the bed rather place a bag below your head and then one or two pillows and then sleep in such a posture. It will help you keep your head much lighter.

Carry preventive medicines for AMS

Do take preventive AMS medicines along with you on the trip but only after consultation with your doctor or physician because the AMS medicines may lead to some side effects too. If you are not sure about any allergy with these medicines then try them one or two week before you plan the trip. Check to see if there are any allergic effects and decide.

Carry Small Oxygen Kit

If possible, you may also carry a oxygen cylinder to counter the AMS symptoms. It will certainly help as a supplement but do take proper consultation from your doctor for the intake amount of oxygen, before the trip.  Oxygen intake will help you incase of any emergency and will spare you more time to descend to lower altitudes as soon as possible.

A note from the pioneer, Vistet linked here at post #12: on oxygen cylinders:
Small tanks of even medical grade oxygen provides a false sense of security : they will at extreme best last for an hour or two. For the value of cheap , portable oxygen solutions see here, # 5 and #7 check here

Immediately descend, if symptoms increase

Last but not the least, if the AMS symptoms start to increase then you should consider immediate descend. This is the only cure in some conditions when the symptoms have reached moderate levels and are not decreasing.

Symptoms of Acute Mountain Sickness (AMS)

Below is the categorization of symptoms for different levels of Acute Mountain Sickness (AMS) along with indicative cure for it…

AMS Symptoms

AMS Level

Possible Cure

Headache, dizziness, fatigue, shortness of breath, loss of appetite, nausea, disturbed sleep, and a general feeling of malaise

Mild

Medication or Descend
Decreased coordination (ataxia), Severe headache (not relieved by medicine), other mild level symptoms with increased affect

Moderate

Advanced Medication or Descend  about 305-610 Mtrs
Inability to walk, decreasing mental status, and fluid build-up in the lungs

Severe

Immediate Descend about 610-1,220 Mtrs

Taking baby or kid to high altitude?

Many a times when you want to travel to high altitudes, you may likely to worry for your kid or baby or infant. Well, personally I suggest you travel with kid or infant atleast 12 months old. However, studies suggest its safe to travel with an infant more than 3 months old IFF he/she is not born prematurely or do not suffer from any illness. NEVER travel with a baby less than 3 months old While the above tips are helpful for kids or babies above 3 months old as well but there are other tips which need special attention for traveling with Kids and babies. I have tried to cover the details for traveling with babies or kids in the link below: Traveling to High Altitude with Kids or Babies

Thanks to Ram Kris for this awesome FAQs on AMS and Acclimatization

References

If you need more detailed information about Acute Mountain Sickness, then you may read the following links as well…

Please share your valuable comments on acclimatization and acute mountain sickness or if you like the article and it could be of some help for you too.

Having said all that, it is still recommended that you CONSULT A DOCTOR or PHYSICIAN before you make a trip to a high altitude region just to ensure everything is in right place. Again, these are just my suggestions based on my very limited or negligible knowledge of AMS or mountain sickness but I will definitely suggest you that you consult some physician or doctor before going on the trip because I am not any of them. For more details on the same you MUST READ the links mentioned in the references which explains it in better details

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219 Comments

  1. Deven soni on

    Hi Dheeraj my name is Deven soni I am traveling with my family to Srinagar I want to have a trip to gulmarg gondola ride and I want my family to see the second stage which is around 8,000 Feet
    But the is a problem my wife suffers from asthma do you have any contacts in Srinagar from where I can hire a Portible Oxygen Kit for 2 or 3 days.

    Thanks

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  3. hii Dheeraj,
    I m from maharashtra..
    we 7 frnds are interested to go to leh by road as per your suggestion we choose shrinagar-leh route for start the journey, we have 15 days to complete the journey, shrinagar-leh-manali..
    please guide us for better experience..
    please tell me about what is the right time to start a road trip

  4. Hello sir
    We are a group of 7 and planning a trip to Leh on 4th oct to 11th oct.
    Should we travel by road or by air.
    We want chepeast way to travel so that we have enough time to explore the beauty. also how do you recommend the return.

    • Nikhil, try and check the tickets of air because you do not have sufficient days to complete a road trip to Ladakh. Also, it is not a season to do road trip to Ladakh as snowfall starts on passes and cold intensifies.

        • 15K will be tight I will say especially because in general Leh air tickets are quite costly and of course, the Ladakh taxi too is costly. If you hire bike, it comes about 800-1500 per day depending upon condition, model and make of the bike.

  5. Hi Dheeraj, your blog is very helpful and descriptive. thanks for it. Needed your guidance on one concern, we are group of 6 people are going to Leh-Ladakh on 14.8.14. We have our flight from Delhi to Srinagar on 14.8.14 arriving Srinagar at 1:30PM.Hence, we can not reach Kargil the same day therefore, we are planning to start very early on 25.08.14 at around 3:00AM, enabling us to reach Leh by same day evening. We are returning back from Srinagar -Leh on 22.8.2014 and will stay at Kargil while coming back to Srinagar. Pls. suggest what precautions should we take to avoid AMS while going to Leh on 15.08.2014..

  6. Hi Dheeraj,

    so great to read your blog bro, we are planning to travel to Leh on Aug 9th our plan is as below:-

    DELHI to Manali (by road hiring a taxi )
    Manali to Sarchu (stay over at Sarchu)
    Sarchu to Leh and
    then take a flight from Leh back to Delhi on 15th, can you suggest how good are the roads from Delhi to Manali also is it advisable to travel such a long distance by road (Delhi to manali)

    • Shaheen, are you interested in just Manali – Leh Highway? If yes, then it is better to stay overnight at Jispa and then do Jispa to Leh. You are not spending much time in Ladakh to see it beauty. Also, it is monsoon time and you will face hassles upto Jispa, so keep a day’s buffer too.

      • thanks a lot dheeraj, we have changed the plan now, we will be traveling to Srinagar from Delhi, and we will be taking the sreenagar – Leh Route by road, and would spend our days in Leh and would return from Leh to Delhi, we have 7 days would that be enough, and how good are the roads from Srinagar to Leh, will we face some hassles through this road, we are opting this way coz we came to know this road would be better for AMS compared to Manali – leh, waiting for your advise.

        • Shaheen, for sure Srinagar – Leh Highway is far far better than Manali – Leh Highway when it comes to acclimatization as it provides gradual ascend. However, it takes 4 days from Delhi to reach Leh from Srinagar. Then 1 day of acclimatization. In the remaining 2 days, you can make a visit to Pangong Tso & Khardung La / Nubra Valley as 1 day trips. Surely as you can see there is very least amount of rest.

  7. SYLVESTER THOMAS on

    Dheeraj !!
    I am not travelling anywhere. 🙂
    Just wanted to quickly convey that your blog is superb! and it appears that…
    Your patience is incredible!
    Your responses are detailed and immensely helpful and encouraging!
    And… you are not trying to selling anything to these folks!
    God bless you buddy.

    btw: Catchy name “DevilOnWheels!” but to all the folks who have benefited from your blog it would be AngelOnWheels 😉

    God bless you …again 😉
    Sylvester.

  8. Pratik Maru on

    Hello Dheeraj,

    We are 4 frds leaving on 13th June to 24th june and want to cover both ways. We are planning to go from Delhi-Manali-Leh Route and coming back from Leh-Srinagar-Delhi route.

    Is there any problem if we take this route or it should be other way round?
    Pls suggest :)TIA

    • It will be much much better if you do the journey in reverse direction. I will suggest you that please plan it in other direction as going via Srinagar – Leh Highway will be much much easier on your body and help you acclimatize to the high altitude of Manali – Leh Highway. Also, it allows you to enjoy the beauty of Manali – Leh by splitting the journey almost evenly in two days which is very difficult in the other direction. Thirdly, it will allow you to fit Tso Moriri lake into the itinerary in better way. You can read more reasons on the link here

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    • Pratik Maru on

      Thanks a lot Dheeraj.One more thing – Is it possible to cover thus whole trip in exact 11 days.

      PS : We have reserved one day for Kasol too.

      • You mean Delhi – Srinagar – Ladakh – Manali – Kasol – Delhi in 11 Days with one day in Kasol? Very tight, actually you will just be doing or traversing on roads rather than anything else.

        • Pratik Maru on

          Sorry for the late reply Dheeraj.
          Yes.From 13th morning Delhi to 23rd evening Delhi 😐
          I know it is very tough. Could you pls us a better option ?

        • Pratik, you can follow something like below then:

          Day 1 | Delhi – Jammu / Patnitop
          — Overnight at Jammu or Patnitop

          Day 2 | Jammu / Patnitop – Srinagar
          — Enjoy walk around Dal lake and may be Shikara ride as well
          — If you have time then check out, floating market, Shalimar Garden.
          — Overnight at Srinagar

          Day 3 | Srinagar – Sonamarg – Zozi La – Drass – Kargil
          — Enjoy the vistas enroute
          — Have late drunch meal at Drass is you are a vegetarian as sometimes it gets difficult to find veg. food at Kargil
          — Overnight at Kargil

          Day 4 | Kargil – Lamayuru – Leh
          — Cover Mulbekh Maitrey, Lamayuru Moanstery, Lunar Landscapes
          — On the way you can also see Gurudwara Pather Sahib, Magnetic Hills, Confluence at Nimmu
          — Overnight at Leh

          Day 5 | Leh Local Sightseeing + Inner Line Permits
          — To know the about the places to visit check the link: Travel Guide for Local Sightseeing of Leh Town in Ladakh
          — For more details on inner line permits process and to download application form read the link here
          — Overnight at Leh

          Day 6 | Leh – Khardung La – Diskit – Leh
          – Head for Nubra Valley very early in the day and come back by late evening after visiting Deskit. If you have time go little further and see Hunder sand dunes too
          – On the way enjoy a cup of soup at Highest Motorable Pass (as claimed) Khardung La
          – Diskit has monasteries with tallest lord Buddha statue and Hunder has sand dunes and bacterian camel safari

          Day 7 | Leh – Pangong Tso Lake – Leh
          – Day trip to Pangong Tso
          – Overnight at Leh

          Day 8 | Leh – Taglang La – Pang – Sarchu
          — Try to start early in the day so that you reach Sarchu where the accommodation options are better than Pang
          — Overnight at Sarchu or Pang

          Day 9 | Sarchu – Baralacha La – Keylong – Rohtang Pass – Manali – Kasol
          — On the way cover Suraj Tal, Deepak Tal which are on the road sides only
          — Overnight at Manali
          Day 10 | Kasol
          Day 11 | Kasol – Delhi

        • Pratik Maru on

          You just made my day Dheeraj. Thanks a lot for your patience and help really appreciate this plan.

          One final question. If we taking our own taxi so will it be allowed to go to Nubra and Pangong as well or we have to hire a separate taxi in Leh for these places?

        • Pratik Maru on

          Thanks Dheeraj.

          Last help :|. Do you have any contact of a travel agent in Delhi from which we can hire a taxi for this whole trip?

  10. I’m traveling with my husband to Ladakh from bahrain (technically below sea level) we r suppose to go straight to leh airport via delhi with no rest. The tour guide suggested to only acclimatize for a day then go to pangong lake for two and back for one… Will we be okay? Do I need to stay the night in delhi? Should we go by car?

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  12. ANSHUL WADHWA on

    Dear dheeraj,first of all, i must say that you respond promptly to all the querries,within few hours,really appreciate…as i am travelling from srinagar to leh,i went through your blog on how to plan the journry on srinagar leh highway,Iam travelling with my wife and 8 yr old daughter,we are all healthy and quite active(thank God),we will be reaching leh on 23rd june,at around 12 pm,the previous day(22nd) we will be taking a night halt at alchi,(you suggested it in your blog),21st night will be in kargil,I want to know whether this is sufficient acclimatization,as we plan to do leh to nubra on 24th,overnite at nubra,(pls suggest a place??desert oasis)25th,back from nubra,26th to pangong,overnite at pangong,27th,back to leh,on 28th we are flying back…
    thanks

    • Anshul, that will be very much sufficient for raising the altitude slowly to Leh. Just keep in mind, along with it YOU MUST keep your bodies adequately hydrated. Use enough juices as water sometimes is difficult to gulp forcefully. It will help a lot. Keep your activity after reaching Leh to bare minimum, short walks, again ample of water and good diet. In Nubra you can stay at Hunder. Last time I stayed at Yourdum Guest House – Hunder, Nubra Valley, Ladakh | Review

  13. deven mehta on

    sir, please give me your contact number, already e-mail you many times for that, we are planing to go leh in july 1st week, our aim is Amarnath Yatra, 1st we will dont amarnath yatra and thn we will go leh, our registration for amarnath is on 1st july, i heard there is a lama’s festival so we are confused abt is,, please give me your contact details so i can clear some confusion…

  14. we plan to visit leh and other parts in early may. we will fly to leh from delhi day 1 and acclimatize , on day 3 go to nubra, stay overnight at nubra, day 6 pangong lake.day 8 leave leh. the rest of the days 2,4,5,7 in and around leh. does it seem a good schedule as far as acclimatize goes. our 11 year old daughter is travelling with us.thanks.

    • Anu, yes, it seems a very good schedule I will say. First two days are utmost importance. Follow the tips in above article and keep resting for first two days. Hydration is key over there and rest for couple of days.

  15. Hello Dhiraj,
    What a wonderful and helpful blog. Thank you. It’s really nice that you have taken your passion and are using what you gain from it to help so many travelers. My question is – Are Two days of acclimation in Leh enough before heading to Nubra Valley and crossing the pass? I know Nubra Valley is at a lower elevation but crossing the pass is the challenge. We will be arriving from the USA and have 2 days to acclimatize before having to start our itenary. Wanted to get an opinion from someone like you. Thank you.

    • Sheetal, thanks alot. Yes, two days are good to go. Take necessary precautions as suggested in the article above. Hydration and rest are key to acclimatization in initial days. Yes, crossing the pass will be challenge, so keep the stay to minimum over there. Don;t worry too much, you should be good to go. You can check a very balanced and most common itinerary for Leh – Ladakh by Air followed by many travelers including me at the link here for 8 days: Leh – Ladakh | Most Common Itinerary by Air.

      First two days will certainly help you get an idea.

  16. dr.sonu patel on

    please sir guide me is der any watercluster problem during road journy as snow will melt in early june period and water will b lodge on road so can we able to drive through these water cluster
    or we can avoide this problem in last week of july???????

  17. hi dheeraj

    is there any major problem of water crossing during mid june as snow going to melt and will create road blocks is it so ??? or we can manage driving in that type of water cluster on rough road??
    please guide me sir

  18. sonu patel on

    According to my knowledge dalai lama going to come at Ladakh on 1st week of July to 15 of July so it’s batter to go in mid June

  19. dr.sonu patel on

    which time is better june end or july end because someone says dat at end of july u will not find much water crossing which is going to make ur drive easy but frankly speeking my mind is not ready to wait till july end …..
    but u tel me i will follow ur timing only
    thanx

    • I will say go with June, avoid first two weeks of July as it is time for Kalachakra festival and there will be lacs of people around there in Leh that time of the year.

  20. dr.sonu patel on

    hellow dhiraj
    me n my wife r planning to go leh ladakh on last week of june by car bmw x1 is proper car to go and is it safe to travel me and my wifw alone
    second can u suggest me route and places where we can visit and where we can stay
    please answer me as soon as possible so we can plan accoriding to dat

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    • dr.sonu patel on

      thanx dheeraj for valuable information
      please tell me is it safe for me n my wife to travel alone in a car please

      • If you are talking in terms of safety from humans, it should be totally safe as Ladakhis are the MOST humble and caring people on this earth I have ever met.

        • dr.sonu patel on

          HELLOW DHEERAJ
          wow my concern was just safty of my wife
          i have taken list of moderate type of hotel list from link
          please send me luxury type of accomodation list if u have
          and please tell me is it nessesary that everytime we have to come back to leh for night hold or we can stay in upward area as we can save time of comming back n go for next day on same route
          we can manage fuel as our car tank capacity is 60 liter and we will carry barrel of fuel approx 40 liter so please guide us on this issue
          thanx

        • Dr. Sonu, yeah it is better to follow the itinerary suggested to keep things simple, comfortable and enjoyable. It is not just about fuel but related to safe routes too in terms of difficulty of terrain and desolation. Regarding luxury type of stays, I do not have any list but you can check with guys at info@offbeatescapes.com for the same. You can refer either my name or DoW and they would be happy to help you with any sought of accommodation throughout ladakh with special prices for DoW readers as per last year offerings to other readers.

  22. Hi I’m planning to a trip in kulu manali in december
    i’m suffering from asthma so will this asthma affect me when i go to this trip?

    • Sahana, carry your regular medicines with you and it shall be fine enough. You will not be scaling much of height in visiting Kullu and Manali, so nothing much to worry about AMS too. It is regular destination and is not at all at high altitude.

      PS: Sorry for delayed reply as I was traveling Ladakh for last couple of weeks.

      Regards
      Dheeraj Sharma

  23. vijayakumar on

    thank you very much this site was very helpfull for me and my daughter. we both will be traveling on 24 sep 2013 by air directly to leh.as per your expereince srinagar leh route will be diff for us .

  24. Abhay Krishnan on

    Hi Dheeraj,

    I’m planning a bike trip to Leh from Manali via Rahtang Pass. Will we be able to acclimatize properly if we are taking this route.

    • Abhay, I will suggest you that please plan it in other direction as going via Srinagar – Leh Highway will be much much easier on your body and help you acclimatize to the high altitude of Manali – Leh Highway. Also, it allows you to enjoy the beauty of Manali – Leh by splitting the journey almost evenly in two days which is very difficult in the other direction. Thirdly, it will allow you to fit Tso Moriri lake into the itinerary in better way. You can read more reasons on the link here

  25. Hi Dhiraj!
    Would u plz let me know whether it is advisable to go for Ladakh tour during August or September? Actually we have planned to go there during that time. Whether it is possible to cover whole Ladakh during Octobre. We intend to enter through Kargil and to end the tour through Manali, keeping Tso Moriri as the last spot to cover. Our team will consist of 60+, 50+ as well as 20+ people.Remember, we intend to cover entire Ladakh as far as possible. Whether it is O K to have from Delhi to Delhi.Plz let me know whether the weather is favourable (generally) during August/ September, considering heavy rain and flood during August 2010.

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  31. Sir i want to go srinagar to leh by road in the month of may, kindly tell which time will be ok for this trip, the highway will be open on may month. Thanks and your sugessions are realy helpfull.

    • Pradeep, in May the Highway may not be open or may be open and the chances are 50-50. If you can make it to second week of june then both Manali – Leh as well as Srinagar – Leh will be highly likely open.

      Regards
      Dheeraj Sharma

  32. Hi Dheeraj,

    Went to the doctor, so that he could prescribe diamox, and to understand the dosage. But he was unaware that diamox is also used for preventing AMS. He said it is used for glucoma. What should i do.

    • Hi Glenda,

      Then better check with some good doctor, may be who knows that it is also used for AMS 🙂 … Or on the other hand, take care of the points mentioned above as precautionary tips and you shall be fine with the trip.

      Sorry for the delayed reply.

      Regards
      Dheeraj Sharma

      • Dear Dheeraj,

        I have just returned from my trip to Ladakh.

        Thanks to your guidance I had a wonderful time.

        I did not carry diamox with me, but since I went from the srinagar route, I did not face any problems at all.

        Thanks a ton for your help.

        • Very glad to know about your lovely experience Glenda. Feel very nice that my blog helped you had a lovely trip 🙂

          Regards
          Dheeraj

  33. nilesh patel on

    Hello Dhiraj

    i have planned to go to leh dt:-23/07/2012 from ahmedabad. I will reach sonmarg on 26/07/2012 night.

    At that time Amarnath yatra will be on,so i just wanted to know that from jammu to sonmarg there is any type of harresment from j&k police or military. Is it safe to go at that time from jammu to leh via srinagar or from manali to leh? reply asap

    • Hello Nilesh,

      Yes, they do pose some concerns but mostly allow tourist to go by with some rigorous security checks. But, generally it would be OK to travel if you do not mind some delays or security stops at quite a few places.

      Regards
      Dheeraj

  34. Hi Dheeraj

    I am planning a trip to Leh for one week from 15th June.

    Two questions:

    1. I will be flying into Leh travelling 17 hrs at a stretch. I am flying Hong Kong – Singapore – Delhi – Leh. Could this increase the extent of AMS.

    2. My parents who are 72 and 65 plan to join me for the trip travelling from Mumbai. Could AMS affect them more.

    Thanks

    Regards

    Manish

    • Hello Manish,

      I guess, you meant 15 July. AMS affect people irrespective of age for healthy people. So, like your parents you are also equally vulnerable to AMS. If you can fly to Srinagar and then take on the journey by road from there then it will be much easy on your body.

      If you are flying directly then your first two days should be planned like below only:

      Day 1 | Delhi – Leh (By Flight)
      — Checkin at Hotel. Many hotels provide free pick and drop from Airport. Ask while you book them.
      — Take ample of rest as well as water or anything that keep your body hydrated enough. DO NOT OVER HYDRATE. Take ORS Soluted water or ORS – L tetra packs from home.
      — Do not over exert your body at any cost. Avoid too much up-down on stairs or avoid it in entirety, if possible.
      — After 5-6 Hrs of rest you can visit Leh Palace, Local Leh market, Shankar Gompa .
      — If you feel exerted go back to Hotel, have dinner at Hotel and take rest. Avoid any exertion. Else continue and,
      — Follow the sunset by stroll at Changspa road and have a nice dinner on varied cuisines offered in-around Changspa road.
      — Go back to hotel for overnight stay at Leh.
       
      Day 2 | Leh Local Sighseeing + Inner Line Permits
      — For more details on inner line permits process and to download application form read the link here:
      — Hire a taxi from Leh taxi stand or Hotel whichever suits you.
      — Bargain hard with taxi driver. Book that single taxi for entire trip after explaining the complete plan.
      — Take his inputs if you feel reasonable and if required modify the plan accordingly but should suits you best.
      — Ask him to be with you guys starting first day itself, if required and charged reasonable else do it at your own.
      — Again DO NOT over exert and take little steps and slow walks only.
      — If feeling OK then do Local sightseeing include Namgyal Gompa, Leh Palace, Shanti Stupa, Shankar Gompa, Main Market, Hall of Fame, Spituk Gompa, Changspa Road Stroll in evening
      — Do not use stairs at any of these places just to see them as it will exert your body much more.
      — Overnight at Leh

      You can read more tips on Hydrated body here: Acute Mountain Sickness and Importance of Acclimatization

      Regards
      Dheeraj Sharma

  35. parini vyas on

    Hi Dheeraj,

    I have been reading about AMS from a longtime. Recently I came across this "Asthmatic people should avoid going to ladakh" on the internet.. How true is this?

    • Hello Parini,

      I will direct you to the pioneer for such questions "Vistet" at his blog here. He will be most apt person to answer this question after any doctor 🙂 … So, consult them both!!

      Regards
      Dheeraj Sharma

    • Parini, asthmatic people are more likely to have breathing problems in Ladakh but whether one can cope up to it or not is something none can say for sure.

      With adequate medication and precaution (extremely zero level of physical activity), one might be able to finish his/ her Ladakh trip but how worthwhile that would be, is a question that only you can answer for yourself.

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  37. sayee krishnan on

    Dear Dheeraj,
    Excellent advise on the site and I am following this closely. I need your advise as well. I am visiting Manali with my family (wife and 2 kids – aged 12 and 7 years) in May 2012 and the itenary is as follows
    Day 1 Delhi to Simla, overnight at Simla

    Day 2 Simla to Manali overnight stay at Manali

    Day3 Rohtang Pass

    Day 4- Kulu Manikaran

    Day 5 return to Delhi via volvo

    My question in light of AMS

    After a day travel from Simla to Manali on Day2 and a overnight stay at Manali I am planning to do Rohtang pass next day – will an overnight stay at Manali help my family to acclamaitize or do I need another full day before I take up Rohtang travel – please advise

    • Well, i have been to simla, as well as manali. Though not at the same time z u r planing.

      I traveled with my son 4 years of age and we took a road trip. We traveled straight to manali from delhi with overnight journey. It was beautiful, and my child didn't suffer anything majoy except routing motion sickness in hills.

      Then we enjoyed d day at manali and next day we again drove to Rohtang pas.

      Infact, that time I didnt even thought about HMS. Lucky me, there was not even single episode of any discomfort among my whole family including my son.

      And the journey from Manali to Rohtang pass is awesome.

      So u need not worry about, until n unless they suffer with some ailments.

      Infact, i m planing to take him to manali – leh route this week.

      • Sachin, as I said on the other post Rohtang Pass is nothing as compared to what you will get on Manali – Leh Highway. Plus it is the sleep at high altitude that makes the matter worse, a hike to high altitude and then back to low altitude will not make any difference but constant exposure to high altitude with non-acclimatized body, is like calling the trouble to yourself. I have seen, read and heard through my blog various instances of ugly experiences. Rohtang Pass does have lots of vegetation around, you go few KMs down and there is even more towards Manali side. At Manali – Leh highway, most of the time you would be at altitude (14K feet) more than Rohtang Pass (is 13K feet) beyond Darcha and there is no vegetation at all or you can say almost very minimum. This makes breathing more difficult and lack of oxygen also counts for AMS issues.

        Regards
        Dheeraj Sharma

        • Chitradhamodaran on

          Greetings!!! I’m Chitradhamodaran, South Indian, planning for a Trip from Manali –Srinagar from 28th June to 11 the July .The Tour was planned by a 7 YEARS EXPERIENCED Himalayan Bike raider come Travel’s Owner .We, 15 Bike Raiders and Two family in INNOVA are the Tour team .The Tour is planned in such a way that, Max 150Km /day is Travel ( from 7 am to 15.00 PM) and Rest till Leh.
          Just referring Internet ,I found your valuable tips . You are recommending to start from Srinagar, but it was well before organized to start from Ratang .So, it found difficult to change .
          My questions are ;-
          a)What will be peak climate at day & Night
          b)We are plan to Buy Oxygen cylinder at Chandigar .Do you recommend any Shop or
          Brand. Apart from Diamox, we are carrying Head-ache tablet . is it any more Medicine is require
          c)Diamox has to be 3 times per day ?
          d)My Husband is Aged 49, Fat and he will be uncomfortable if NO free air. Is it any danger
          In the Trip. Last year we were at Manali and he was so comfortable .But , it is New Route & High attitude .So pls advise.
          e)We are using Thermal wear, T-Shirt, Fleece , Woolen Swatter & Rain coat and Thermal cloth for Head to Neck , Gloves for Hand, Leather shoe & Socks .Is it ok or Need more precaution.
          f) Incase of emergency, Hospitals are available on the way ?
          g) Your are recommending Carbohydrates Food . Hope Rice is high Carbohydrates Food. Is it available in Hotels there . Pls advise list of Carbohydrates Food ?
          h)Is it ORS – L tetra packs is available in all shop in the Trip route
          i)Honey, Lemon , Glucose and Nuts shall be effective food during travel ?
          j)How the climate in June end to July ?
          k)We are staying Two days in Sri Nagar . In that, one day in lake . Pls list the beautiful site seeing Places in Srinagar with in 100 Kms

          We are so impressed in your answer and brought confident . Expecting your kind reply for the above and any more advise ,if shall be better .
          Thanking you ,
          Best regards ,
          Chitradhamodaran

        • Please find my replies below:

          a) It will be mostly pleasant in July.
          b) Small Oxygen cylinders will not help much as they dont last long.
          c) Please consult your doctor first before taking diamox. It has side effects and should be taken under supervision of doctor only.
          d) AMS do not matter with respect to age or sex or any physical health condition. It can happen to anyone of any age or sex or fitness I shall say :D..
          e) Should be fine.
          f) No hospitals are available few army settlements are there who will help. But, they are not close but too much away from each other. Consider 100+ KMs on Manali – Leh Highway
          g) Yes, it is available.
          h) No, you will need to carry them
          i) Yes, all should be effective.
          k) Pay a day visit to Gulmarg if possible else drop it.

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    • Hi Shrihari,

      Indeed it is very important and yet people take it very lightly. I do try my best to convey people about the same but guess lack of holidays compel them to take such risks. But, one should always feel and be serious regarding AMS. Sad, to hear that… May god bless him. Thanks for the share as it may help others to analyze that situation is not that simple in greater Himalayas than what they think.

      Regards
      Dheeraj

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