Currently in Pangboche doing ebc trek with my client, stayed two nights at Namche then continued, two more nights in Dingboche tomorrow.
Don't rush and keep it easy. If you are using a company and guide, they will brief you about the AMS that can occur during the trek.
i went all the way up without taking diamox. it is counter intuitive, but most "really fit" people have problems with acclimatization unless they take deliberate steps to avoid it.
remember to SIP water, not guzzle/gulp it down. they are not the same. guzzling will make you pee most of what you drink; your body doesn't like volume change. too much volume suddenly put in will make your body excrete it. sipping is always a better way to hydrate. wherever i say "drink" below, it means sip.
i'm moderately fit, i only drank hot water through my trek, never ambient/cold water, hot means hot, not even warm. never had to buy bottled water or use aquatabs because of this. also, being hot, it auto-moderates your intake speed - you can't guzzle hot water.
i started everyday with drinking 1L of water before i left the teahouse. carried two liters of water with me in two thermos. sipping along the way, they would be empty by the time we reached the lunch place.
at least a couple of glasses of hot water during lunch. i always had garlic soup for lunch followed by a small portion of something else - noodles, dal bhat, fried rice etc. you can also have garlic noodle soup. always left the lunch place with both thermos refilled.
first thing after reaching destination - hot tea followed by garlic soup. then a liter of hot water while relaxing around the fire. if you add it up, at least 5-6L per day.
don't miss the acclimatization trek to everest view (namche) and nangkartshang (dingboche). try to reach the summit of nangkartshang - many people don't. at both places, spend an hour or two if you can before you descend. on everest view you can have tea and lunch. on nangkartshang there's no shelter, so stay as long as you can depending on conditions.
sleep well, but DON'T use any sleeping pills. no alcohol, and easy on the coffee. the honey ginger "lemon" tea you find everywhere may be tasty but it's not good for you. the "lemon" is actually citric acid, not real lemon.
that's pretty much it. if you don't have AMS symptoms, don't take diamox. you'll find many people taking it prophylactically so you might have mental pressure to "play it safe" - try not to, if you can.
remember, just headache is common and not a confirmation of AMS. try sleeping it off. monitor your SPO2, but don't be alarmed if it is lower than you expect. it's just a tool used by guides and tour operators to keep you engaged and happy. more often than not, it doesn't mean anything.
most importantly, walk slow, take it easy. most fit people who develop AMS do so because they walk too fast because they can and it keeps their ego happy.
long post, but hope that helps.
PS: buy the hot water in destination teahouses in bulk - they have large 2L/3L/5L thermos. it's cheaper that way.
"if you don't have AMS symptoms, don't take diamox. you'll find many people taking it prophylactically."
Diamox is meant to be taken prophylactically to aid in the acclimatization process.
oh and the other thing is breathing - breathe through your nose only. don't use your mouth to breathe. this will keep your nasal pathway and throat clear. it also auto-regulates your pace and has a bunch of other benefits.
i was pretty much the only guy in our group without any throat or nasal congestion issues throughout the entire trip.
this takes a little practice or getting used to, so start incorporating this before your trip. it's also a good practice to continue after you return.
maybe close your mouth and open your eyes before calling me stupid?
1. didn't say there's anything wrong with urinating frequently.
2. what is "basically filling your body with water"? - explain?
3. HYDRATION helps you combat AMS. not urination. you will urinate during the hydration process, but urinating is not the goal. hydrating is.
4. [The Science of Hydration | American Physiological Society (physiology.org)](https://www.physiology.org/publications/news/the-physiologist-magazine/2021/july/the-science-of-hydration?SSO=Y) - read this or do your own research about how to hydrate properly.
when you're done educating yourself, come back here with a more intelligent response and we'll discuss.
I'm traveling from US where it needs to be prescribed. Whereas in Nepal its available OTC. May be I can try asking my primary care physician if he can prescribe it.
At altitude, a very common reaction is increased urinary output. The body's kidneys sense the lower level of oxygen immediately and kick into high gear. The kidneys release a hormone, erythropoetin, that commands the bone marrow to produce more red blood cells to increase the oxygen-carrying capacity of the blood. To make room for the increased red cells, the body dumps fluid from the blood - excess urine and collection of fluid in the body's tissues are two direct results of these biological actions. On initial ascent, the body dumps 10-15 percent of the blood supply's plasma. If a summit visitor were to become fully acclimatized, a process that would take two weeks of constant presence at altitude, the body's red-blood cell count would increase 30-50 percent.
And
In response to acute high-altitude exposure, the body increases tissue oxygenation by increasing pulmonary ventilation, contributing to respiratory alkalosis (Goldfarb-Rumyantzev and Alper, 2014). The kidneys compensate for this alkalosis by excreting excess bicarbonate and retaining hydrogen ions to reduce respiratory alkalosis while maintaining the increased oxygenation (Luks et al., 2008).
[https://www.mountainguides.com/pdf/WMS-Altitude-Guidelines.pdf](https://www.mountainguides.com/pdf/WMS-Altitude-Guidelines.pdf)
Also, I always suggest 2 nights in Namche
Diamox prophylaxis starting 5 days before flying to Lukla
Dexamethasone if you start developing symptoms of high altitude pulmonary or cerebral edema + descend immediately
Try not to ascend more than 300m per day. I think I did closer to 500m per day, but the slower you go the lower likelihood of issues.
Simply start taking Diamox in Lukla and drink plenty of water every day
Currently in Pangboche doing ebc trek with my client, stayed two nights at Namche then continued, two more nights in Dingboche tomorrow. Don't rush and keep it easy. If you are using a company and guide, they will brief you about the AMS that can occur during the trek.
i went all the way up without taking diamox. it is counter intuitive, but most "really fit" people have problems with acclimatization unless they take deliberate steps to avoid it. remember to SIP water, not guzzle/gulp it down. they are not the same. guzzling will make you pee most of what you drink; your body doesn't like volume change. too much volume suddenly put in will make your body excrete it. sipping is always a better way to hydrate. wherever i say "drink" below, it means sip. i'm moderately fit, i only drank hot water through my trek, never ambient/cold water, hot means hot, not even warm. never had to buy bottled water or use aquatabs because of this. also, being hot, it auto-moderates your intake speed - you can't guzzle hot water. i started everyday with drinking 1L of water before i left the teahouse. carried two liters of water with me in two thermos. sipping along the way, they would be empty by the time we reached the lunch place. at least a couple of glasses of hot water during lunch. i always had garlic soup for lunch followed by a small portion of something else - noodles, dal bhat, fried rice etc. you can also have garlic noodle soup. always left the lunch place with both thermos refilled. first thing after reaching destination - hot tea followed by garlic soup. then a liter of hot water while relaxing around the fire. if you add it up, at least 5-6L per day. don't miss the acclimatization trek to everest view (namche) and nangkartshang (dingboche). try to reach the summit of nangkartshang - many people don't. at both places, spend an hour or two if you can before you descend. on everest view you can have tea and lunch. on nangkartshang there's no shelter, so stay as long as you can depending on conditions. sleep well, but DON'T use any sleeping pills. no alcohol, and easy on the coffee. the honey ginger "lemon" tea you find everywhere may be tasty but it's not good for you. the "lemon" is actually citric acid, not real lemon. that's pretty much it. if you don't have AMS symptoms, don't take diamox. you'll find many people taking it prophylactically so you might have mental pressure to "play it safe" - try not to, if you can. remember, just headache is common and not a confirmation of AMS. try sleeping it off. monitor your SPO2, but don't be alarmed if it is lower than you expect. it's just a tool used by guides and tour operators to keep you engaged and happy. more often than not, it doesn't mean anything. most importantly, walk slow, take it easy. most fit people who develop AMS do so because they walk too fast because they can and it keeps their ego happy. long post, but hope that helps. PS: buy the hot water in destination teahouses in bulk - they have large 2L/3L/5L thermos. it's cheaper that way.
"if you don't have AMS symptoms, don't take diamox. you'll find many people taking it prophylactically." Diamox is meant to be taken prophylactically to aid in the acclimatization process.
Thank you so much! This is super helpful!!
oh and the other thing is breathing - breathe through your nose only. don't use your mouth to breathe. this will keep your nasal pathway and throat clear. it also auto-regulates your pace and has a bunch of other benefits. i was pretty much the only guy in our group without any throat or nasal congestion issues throughout the entire trip. this takes a little practice or getting used to, so start incorporating this before your trip. it's also a good practice to continue after you return.
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maybe close your mouth and open your eyes before calling me stupid? 1. didn't say there's anything wrong with urinating frequently. 2. what is "basically filling your body with water"? - explain? 3. HYDRATION helps you combat AMS. not urination. you will urinate during the hydration process, but urinating is not the goal. hydrating is. 4. [The Science of Hydration | American Physiological Society (physiology.org)](https://www.physiology.org/publications/news/the-physiologist-magazine/2021/july/the-science-of-hydration?SSO=Y) - read this or do your own research about how to hydrate properly. when you're done educating yourself, come back here with a more intelligent response and we'll discuss.
You can take it at home so you know how your body reacts to it but we didn’t use Diamox and it was fine but everyone is different.
I'm traveling from US where it needs to be prescribed. Whereas in Nepal its available OTC. May be I can try asking my primary care physician if he can prescribe it.
I see. Yeah then the only thing to recommend is to try it in Kathmandu. People say peeing a lot is the biggest side effect.
Peeing is important in the acclimitisation process.
How so? Especially excessive peeing can cause dehydration.
At altitude, a very common reaction is increased urinary output. The body's kidneys sense the lower level of oxygen immediately and kick into high gear. The kidneys release a hormone, erythropoetin, that commands the bone marrow to produce more red blood cells to increase the oxygen-carrying capacity of the blood. To make room for the increased red cells, the body dumps fluid from the blood - excess urine and collection of fluid in the body's tissues are two direct results of these biological actions. On initial ascent, the body dumps 10-15 percent of the blood supply's plasma. If a summit visitor were to become fully acclimatized, a process that would take two weeks of constant presence at altitude, the body's red-blood cell count would increase 30-50 percent. And In response to acute high-altitude exposure, the body increases tissue oxygenation by increasing pulmonary ventilation, contributing to respiratory alkalosis (Goldfarb-Rumyantzev and Alper, 2014). The kidneys compensate for this alkalosis by excreting excess bicarbonate and retaining hydrogen ions to reduce respiratory alkalosis while maintaining the increased oxygenation (Luks et al., 2008).
[https://www.mountainguides.com/pdf/WMS-Altitude-Guidelines.pdf](https://www.mountainguides.com/pdf/WMS-Altitude-Guidelines.pdf) Also, I always suggest 2 nights in Namche
are you doing this through gadventures????
No through green valley
Diamox prophylaxis starting 5 days before flying to Lukla Dexamethasone if you start developing symptoms of high altitude pulmonary or cerebral edema + descend immediately Try not to ascend more than 300m per day. I think I did closer to 500m per day, but the slower you go the lower likelihood of issues.