The excitement, thrill and beauty of trekking in Nepal are directly proportional to elevation. This is because as you ascend higher the nature starts to reveal her latent magnificence, relatively honest and candid natives are encountered and many forms of pollution start to almost disappear. However, there is a dark side of trekking at higher altitude, usually ignored, which may even claim the lives of trekkers. The culprit is known as “Altitude Sickness” which is to a great extent preventable and also curable if proper measures are taken as soon as the warnings show up. Every trekker traveling above 8000 ft. should be aware of the symptoms of the illness due to altitude.

According to netdoctor.co.uk, a leading health websie, at least seven cases of fatality due to altitude sickness occur each year among 50,000 trekkers into Nepal. Gokyo valley notorious as “death valley” is said to claim at least 3 lives per year. It is really unfortunate that such tranquil and spellbinding places under Himalaya where monks have meditated for centuries and where many yogis have acquired fortunes of wisdom turn into a place of misfortune. Though some hardy and “in-form” trekkers hold that altitude sickness attacks only the feeble and old people, nevertheless, data reveal that old people generally are at low risk of contracting altitude related problems than the young ones. This is probably because young trekkers are eager to rush as further as they can, compared to the matured travelers since the major causative factor of altitude sickness is ascending more than prescribed height in a day.

The altitude sickness can occur in 3 forms: mild altitude sickness or acute mountain sickness (AMS), high altitude pulmonary edema (HAPE) and high altitude cerebral edema (HACE). The latter two complications are deteriorated conditions of AMS and also life-threatening. So, if proper attention is paid during the AMS stage then further complications can be avoided. Common symptoms of altitude sickness are difficulty in breathing, headache, nausea and vomiting but not limited to these as a statement by Dr. Shilm that has been quoted or paraphrased in many articles and books goes – “until proven otherwise, if you feel unwell in altitude it’s altitude sickness “. In case of HAPE and HACE, victims show much severe symptoms like severe headache, confusion, pink frothy sputum, bluish lips, elevated temperature etc. In such serious cases, emergency measures should be sought immediately like taking to the nearest health center via porter or horse or if possible, summoning rescue helicopters etc. Even though the symptoms are not severe to that extent in the mild form of altitude illness, it must not be taken lightheartedly which may eventually worsen if left untreated.

The first and foremost treatment to altitude related complications is descending down and halting your program of going up. Many modern treatments and herbs have been advertised in the market as prevention to the altitude sickness. BEWARE OF QUACKERY! The only drug known currently to prevent AMS is acetazolamide or Diamox. So administer the drug to the victim or yourself in case you observe any of the symptoms mentioned in the previous paragraph. Highland dwellers and some trekkers claim that garlic is panacea to altitude related problems but though it may be beneficial, it must not be taken as a substitute to the medicine though combination of the two won’t have any negative reaction.

Prevention is better than cure. AMS can be avoided simply by following the simple thumb rule: at height above 3000 meter, the difference in elevation between two consecutive overnight destinations should be less than 500 m. That is, if you stay at 3000 meter on Day 06 and go high up to 4000 meter on the 7th day, you should descend back to the place at or lower than 3500 m. for the night stay. Also, it will help to acclimatize few days in lower elevations before passing over high altitude. Plenty of water should be taken and it is better if you can avoid alcohol in higher altitude instead of emulating the Sherpas or Bhotias who are immune to the complications of altitude. To reiterate, if you sense any symptom of illness then do not go further up but rather descend as soon as possible. Take Diamox in case of headache or nausea, keeping aside the opinion on the medicinal side effects for some time.

Trekking is not an extreme adventure but an activity that can be undertaken by anyone healthy enough to walk. As pleasurable activity trekking can be, it can equally be dangerous if certain simple precautions are not followed. Altitude sickness is another such “danger” which can be prevented easily by simply following this basic advice- walk slower as you go higher!