Visiting Nepal without trek is same as visiting your own country. Know about your strength and weakness against the high altitudes and prepare yourself for the worst-case scenarios. Here are the tentative list of equipments, precautions, and informations for comfortable trek in Nepal.

 

Equipment's List :

1. Down Sleeping Bag
2. Down Jacket
3. Long sleeved shirt
4. Jumper or fleecy jacket
5. 3++ T-shirts
6. Trekking shoes or boots
7. Comfy shoes for around the camp
8. Polypropylene/wool socks
9. Light cotton socks
10. Rucksack
11. Sun hat
12. Woolen hat
13. Gloves
14. Sun block for Faces and Lips
15. Goggles or sunglasses
16. Underwears
17. Insulated pants / Nylon windbreaker
18. Nylon wind pants
19. Water bottle
20. Sewing kit
21. Medical & first aid kit
22. Flash light
23. Batteries and bulbs
24. Towel and toiletries

 

First Aid Kit :

This is the basic lists for the climbing groups, expeditions and trekkers who are going to isolated areas alone.

1. Bandage for sprains.
2. Plasters/Band-aids.
3. Iodine or water filter (optional).
4. Moleskin/Second skin - for blisters.
5. Antiseptic ointment for cuts.
6. Anti-bacterial throat lozenges (with antiseptic)
7. Aspirin/Paracetamol - general painkiller.
8. Oral rehydration salts.
9. Broad-spectrum antibiotic (norfloxacin or ciprofloxin).
10. Anti-diarrhoea medication (antibiotic).
11. Diarrhea stopper (Imodium - optional).
12. Antibiotic for Guardia or similar microbe or bacteria.
13. Diamox 250/500mg (for altitude sickness).
14. Gel hand cleaner

 

High Altitude Sickness, HACE & HAPE

Altitude sickness is known as an Acute Mountain Sickness (AMS). Generally it occurs when people ascend up to the high altitude too quickly [generally above 3000 m]. AMS occurs when the body does not adapt well to the lack of oxygen present at higher altitudes. At 5490 meters (18,000ft), there is just half the oxygen available as there is at sea level, while there is only a third available at the summit of Mount Everest. The itineraries of Alpes Himalaya Treks are designed to reduce the risk of altitude sickness as much as possible, although individual susceptibility to altitude sickness seems to be genetically determined.

 

What happens to the body during altitude illness?

1. The body tries to adapt to having less available oxygen by increasing the rate and depth of breathing, as well as the heart rate.
2. Fluids accumulate in between the cells in the brain, the lungs or both, creating mild to severe symptoms.
3. Mild symptoms include headache, loss of appetite, nausea, fatigue, insomnia and dizziness. These symptoms are usually resolved by spending one or two extra nights at the same altitude.
4. If symptoms worsen, descent to lower altitudes is warranted. If you are resting at the same altitude and your symptoms worsen, then it is also necessary to descend.
5. More serious symptoms of AMS include increased tiredness, severe headaches, vomiting, loss of coordination, shortness of breath and coughing fits. These extremely dangerous symptoms are called high altitude cerebral edema (or HACE). They can lead to unconsciousness and death within 12 hours.
6. Increasing shortness of breath, cough and tiredness may also be signs of high altitude pulmonary edema or HAPE. This condition can rapidly prove to be fatal if ignored.
7. Respiratory depression (the slowing down of breathing) can be caused by various substances, and may be a problem at altitude.

 

What you have to do if you get mild symptoms?

1. If you get mild symptoms, stop and relax (with your head out of sun) and drink some fluids frequently.
2. Stop and have a rest more and take 125-250mg Diamox, it generally takes one to four hours to be cool down.
3. Take 125-250mg Diamox in the evening and drink plenty of fluids.
4. If you feel a bit better, don’t leave taking precautions at the point, take another 250mg Diamox 6-8 hours later.
5. If the symptoms continue to get worse, try to descend down, acclimatize and again ascend up.

 

The symptoms of serious AMS:

1. Persistent and severe headache.
2. Persistent vomiting.
3. An inability to walk in a straight line and making the sufferer look drunk.
4. Losing consciousness.
5. Mental confusion.
6. Liquid sounds in the lungs.
7. Difficulty breathing.
8. Rapid breathing or feeling breathless at rest.
9. Coughing clear fluid, pink phlegm or blood (a very bad sign).
10. Marked blueness of face and lips.
11. High resting heartbeat (over 130 beats per minute)
12. Mild symptoms rapidly getting worse.
13. High Altitude Cerebral Edema (HACE), dangerous cases of AMS

If, above mentioned symptoms get worse and required precautions couldn't be taken on time, then the person could die within the period of 12 hours, but if the person takes precautions immediately, it takes one or two days to recover well. Therefore, upon getting such symptoms, it is better to take treatment with medication, oxygen and descent down. Usually 4 to 8mg of dexamethasone is given as a first dose to those who suffer from such sickness and then 4mg Diamox is given an every six hours gap. Similarly, 2-4 litres/minute oxygen is given and the person is taken to down if it is necessary.

 

High Altitude Pulmonary Edema (HAPE):

This is a serious case, if one gets the above mention symptoms worse, furthermore, if one accumulates of fluid in the lungs and mild fever, and then, there is chance of High Altitude Pulmonary Edema (HAPE). The treatment, one is give the oxygen at the rate of 4 liters a minute, using Portable Altitude Chamber (PAC). If there is no PAC bag or oxygen then one is taken down to the low altitude, it is only the way of life saving. the HAPE can also lead to unconsciousness are death in short period of time.

 

Prevention of Acute Mountain Sickness (AMS):

1. Make sufficient time for acclimatization (After 3000 meters).
2. Don’t ascent up rapidly.
3. Don’t’ use alcohol, sleeping pills and smoking.
4. Drink more fluid 3-4 liters a day, clean boiled water / tea / coffee / soup / juice etc.
5. Climb high and sleep low.
6. Don’t go trekking alone, take guide/porter.
7. Follow the advice from your guide, hotel, local people, guide book.
8. Descent if mild symptoms rapidly getting worse.
9. Never leave or descent sick person alone.
10. Avoid getting cold.
11. Take an easy and comfortable trekking route even if its longer.
12. Sleep more than normal..

 

Insurance :

Alpes Himalaya insures the staff who leads you.

Nonetheless, a very important point, it is your responsibility to insure yourself before departure in:

1. Civil liability
2. Insurance of cancellation/luggage for your two-way ticket flight to Nepal
3. Insurance of search/rescue services/repatriation, which includes your destination in Nepal. Please check with your company that the insurance is working, mentioning the precise trek’s location and the maximum altitude, or the touristic trip.