Upper Dolpo-Jomsome-Juphal Trek(Annapurna Region)

Upper Dolpo till today stands as one of the most isolated and remote regions of this Himalayan country. But, the magnificence of this region is second to none. Snuggled between the Tibetan plateau and Dhaulagiri Himalaya Chain, it is your Shangri-La. Upper Dolpa area was open to foreigners only from 1989. Dolpo is a culturally Tib...
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Altitude Sickness

Altitude Sickness

Acute Mountain Sickness (AMS) is common at high altitudes sickness. In general may occur when people ascend too quickly normally in altitudes of over 3000 m. The symptoms of altitude sickness are due to lower air pressure at high altitudes, which results in lower oxygen levels as you breathe the air in. The air is under less pressure and this makes it harder for your body to get the oxygen out of the air and into the circulation. It's this extra strain on the body that causes altitude sickness.

Symptoms tend to be worse at night and include headache, dizziness, and lethargy, loss of appetite, nausea, breathlessness and irritability. Difficulty sleeping is another common symptom.

The major symptoms of altitude sickness

Initial symptoms

Periods of sleeplessness
Runny nose.
Extra tiredness
Occasional loss of appetite
Feeling laziness
Wish to vomiting
Periodic breathing

Above are normal symptoms which may occur into your body that you should not be worried. Every trekker will experience some or all of these, no matter how slowly they ascend.

Advance symptoms

Headache and vomiting
Dizziness
Racing heartbeat
Exhaustion
Nausea
Diarrhoea
Loss of apatite
Weakness
Hard to breath
Extra tired
Dry Raspy cough
Sleeplessness

When above symptoms will occur into your body, these symptoms usually resolve by spending one or two extra nights at the same altitude or using medicine. Even you are resting at the same altitude or using medicine, if symptoms are becoming worse, then it is necessary to descend.

Serious Symptoms

Worsening headache and vomiting
Swelling of hands and face
Reduced urine output
Walking with a staggering gait
Confusion
Increased tiredness
Breathing irregularity
Visual hallucinations (seeing things that are not real)
Changes in the ability to think
Changes in normal behavior

If above serious symptoms will occur into your body, these extremely dangerous symptoms are called High Altitude Cerebral Edema (or HACE). They can lead to unconsciousness and death within 12 hours. Increasing shortness of breath, cough and tiredness may also be signs of High Altitude Pulmonary Edema or HAPE. HAPE can also be rapidly fatal if ignored.

To prevent acute mountain sickness:

If possible, don't fly or drive to high altitude. Start below 3,000 metres (10,000 feet) and walk up.
If you do fly or drive, do not overexert yourself or move higher for the first 24 hours.
If you go above 3,000 metres (10,000 feet), only increase your altitude by 350 to 500 metres (1,000 feet) per day
Climb high and sleep low! You can climb more than 300 to 500 metres in a day as long as you come back down and sleep at a lower altitude.
If you begin to show symptoms of moderate altitude sickness, don't go higher until symptoms decrease.
Drink plenty of water, tea or juice etc (at least three to 4 liters per day). Urine output should be copious and clear to pale yellow.
Eat high-carbohydrate foods (rice, pasta, cereal) for more energy.
Take it easy and don't overexert yourself when you first get up to altitude. But, light activity during the day is better than sleeping because respiration decreases during sleep, exacerbating the symptoms.
Avoid alcohol as it may increase the risk of dehydration, and don't smoke.
Don't push yourself when climbing up to passes, rather take plenty of breaks.
Avoid taking sleeping pills.
Avoid active movements and try to relax in the first one or two days upon arrival at the high altitude areas.
Bring adequate medicine.
If nothing else works, return to the areas with the lower elevation.
Allow sufficient time for acclimatization (After 3000 meters).
Don’t make rapid Ascent. Don’t go too far too fast.
Do not trek/travel alone, take guide/porter.
Follow the advice from your guide, hotel, local, guide book.
Descent if mild symptoms rapidly getting worse.
Never leave or descent sick person along.
Avoid getting cold.
Take an easy and comfortable trekking route even if its longer

Medicine:

Following is a list of items you should consider including in your medical kit - consult your pharmacist for brands available in your country.

Aspirin or paracetamol - for pain or fever
Antihistamine - for allergies, eg hay fever; to ease the itch from insect bites or stings; and to prevent motion sickness.
Antibiotics consider including these if you're traveling well off the beaten track' see your doctor, as they must be prescribed, and carry the prescription with you.
Loperamides or Diphenoxylate 'blockers' for diarrhea' Prochlorperazine or metaclopramide for nausea and vomiting.
Rehydration mixture to prevent dehydration, eg due to severe diarrhea; particularly important when traveling with children.
Insect repellent, sunscreen, lip balm and eye drops.
Calamine lotion, sting relief spray or aloe vera-to ease irritation from sunburn and insect bites or stings.
Antifungal cream or powder - for fungal skin infections and thrush.
Antiseptic, such as povidone-iodine for cuts and grazes.
Bandages, band-aids or plasters and other would dressings.
Scissors, tweezers and a thermometer (note that mercury thermometers are prohibited by airlines)
Cold and Flu tablets, throat lozenges and nasal decongestant.
Multivitamines - consider for long trips, when dietary vitamin intake may be inadequate.

Note: We have guides trained at the High Altitude Medical Training Center. Our staff is very experienced in dealing with the effects of higher altitudes. As they are natives of Nepal, they easily acclimatize and therefore can care for their clients. They are equipped with necessary medical supplies and will assist you with basic first aid treatment. We design our tours to ensure clients are ready for high altitude, and arrange alternative itineraries for those at risk

Insurance

Insurance

Travel insurance is compulsory for all Clients undertaking any tour. It should provide adequate protection for the full duration of the tour to cover personal injury, medical expenses, repatriation expenses, helicopter evacuation, loss of luggage, etc.

For your kind information, we would like to give a list of the insurance companies, please go through the links below:

For Canadians and Americans

For Australians and New Zealanders

For British

For Europe and Slovenia

For South-Africa

For Indians

http://www.internationalsos.com/en/asia-pacific_india.htm

Equipment List

Footwear

Trekking Boot	1 Pair
Thick Socks	4 Pairs
Light Socks	3 Pairs
Camp Shoes	1 Pair
Sandals	1 Pair

Other Equipments

Sleeping Bag(4seasons)	1
Down Jacket	1
Daypack	1
Water Bottle	1
Sun Cream
Sunglasses
Flashlight With Spare Bulbs, Batteries, Lip Salve, Gaiters.

Clothing

Down Or Fiber Filled Waterproof Jacket And Trousers	1
Fleece Jacket Or Pullover	1
Warm Cotton Trousers	2 Pairs
Shirts And T-Shirts	4 Pieces
Lightweight Cotton Long Pants	3 Pairs
Long Under Wear	2 Pieces
Short Under Wear	4 Pieces
Sun Hat Or Scarf	1
Woolen Hat	1
Sunglasses	1
Lightweight Gloves	1
Rain Coat	1
Heavyweight Gloves Or Mittens With A Waterproof	1