Treking in Nepal

[Taki]

Hi

Just new to the site and in fact new to trekking. Don't know whether I am silly or not but am about to embark on a 16 day trek in the Annapurna region of Nepal with my son. I have just turned 63 and am fairly trim and fit for my age but I am stressing quite a bit about the trip especially in my ability to complete it and not hold up the rest of the group. I have been doing a lot of cardiac work and am finding this quite useful.

Any tips and am I suffering from altitude sickness already

Taki

[Lizzy]

You'll have a great time. Make sure you stay well hydrated. Try to sleep lower that your highest point trekking that day. Try not to ascend more than 300m a day once above 3000m. Hopefully if you are on a tour they will look after this bit. If you have a rest day try & go for a walk to a close high point to aid acclimatisation. You can also get a medication Diamox- which can be of some benefit if you need to ascend rapidly. Dont carry too much (may not be a problem if you have porters). Any major problems- descend to lower altitude. Take lots of memory for your camera it is superb over there!

[Hallu]

Staying in town a couple of days or a week before setting off is usually a good idea to get used to the altitude. Finding out you have altitude sickness at the start of the trek could ruin it for you.

[johnrs]

Take care with your food and water in Kathmandu before your trek.
No salads no matter what the claimed care has been,
only self treated or bottled water
and don't forget the Imodium.
Providing you stay well you will have no problems with your trek.
John

[Eremophila]

.... and take plenty of bog roll!!

I'm planning Anapurna Sanctuary for my 50th... which is only 2 years away

Have a porter carry your pack. And spend some time acclimatising, as suggested. A few weeks of iron tablets beforehand, won't hurt either

[GPSGuided]

EPO has been a big topic in cycling sport of recent for its haematocrit elevation benefits. Apart from taking iron tablets, which I understand doesn't really change anything unless one has an existing iron deficiency, does any of the high altitude visitors use EPO in their preparation? Whilst it's not a sanctioned use (as far as I know) but curious if it's been used by some? Will need to Google around and see.

[Nick S]

Hi taki,

I met heaps of people your age and above around the Everest region, if you keep up the cardio work then you have just as much chance as making it over the pass or into the sanctuary.

Regarding altitude, consider taking diamox, take it easy above 3500m and so on. Reality is that some people tend to hit a wall above a certain height, eg. Above lobuche on the EBC, but I think the main reason is that they didn't give themselves enough acclimatisation days.

[Taki]

Thanks everyone for your comments, really appreciate it. Your comments have given me great confidence in undertaking the trek and am now really looking forward to it.

Cheers

[icefest]

EPO has been a big topic in cycling sport of recent for its haematocrit elevation benefits. Apart from taking iron tablets, which I understand doesn't really change anything unless one has an existing iron deficiency, does any of the high altitude visitors use EPO in their preparation? Whilst it's not a sanctioned use (as far as I know) but curious if it's been used by some? Will need to Google around and see.

If you decide to go the most legal way, you need an nephrologist to prescribe it for you (and then only if haemoglobin levels are less than 100 g per L, where intrinsic renal disease is the primary cause of the anaemia)
This is cheap (not to mention unethical, please report that Doctor).

If you buy it without the PBS a course of 4 weeks will cost you around 500-800 dollars (depending on your weight and your haematocrit aim).

You could also buy it from a shady online dealer (black market) DON'T DO THIS

What do you get from all this?
Increased exercise tolerance. Lessened effects of acetazolamide (Diamox).
Does it change your AMS, HAPE and HACE risk? Maybe, maybe not. I could not find any literature supporting this use of EPO (one study is being done in China).
What are the side effects? Fever. Increased risk of strokes. Hypertension. Vomiting. Headache. Cough. Sense of impeding doom. Doom.

You can get the effects of EPO, cheaper, easier and safer using altitude simulation. You still have the stroke risk.

Do you want me to try to explain the physiology of AMS?
If I'm wrong, please point out the mistakes and/or fix them.

[johnrs]

Hi Guys
Epo seems a really bad idea.
Part of the early normal response to altitude is haemoconcentration .
This is achieved by passing extra urine.
So each ml of blood contains more red cells and can carry more oxygen.
This results in increased blood viscosity or resistance to flow.
and can contribute to aspects of altitude sickness.

Quite recently it has been shown that Sherpas do not
have this blood thickening response and that their haemoglobin concentration
is similar to ours at sea level.
This reduces their blood thickness or viscosity and reduces the strain on their
circulation increasing their endurance at high altitude.

Best to be fit before you travel, ascend slowly and use Diamox for short periods only.
John

[GPSGuided]

Relax guys! I was just thinking physiologically. The obvious hypothesis here is that people living at altitude invariably have elevated HCT, one that EPO can mimic. Just on that basis, I am curious of the result of that Chinese study. Medline search is in order.

[icefest]

No need to search, I think this is the article mentioned by johnrs: http://www.pnas.org/content/73/3/747.full.pdf
Here is information on related genetics: http://icb.oxfordjournals.org/content/46/1/18.full
The current EPO & AMS study just got marked as completed two days ago: http://clinicaltrials.gov/ct2/show/NCT01665781



If you have journal access then read this one too
This is the relevant paragraph:

[icefest]

That being said, Tibetans also have a higher affinity for oxygen at the same altitude as non tibetans (Left shift of the Hb dissociation curve)

[findbuddha]

From that paragraph, Hb increases with altitude in Tibetans, even though it raises to a lower level than non-Tibetans - presumably the rise is still important.

[Snowzone]

I did the Annapurna circuit last year with a group aged from their 30's to over 70. It was the younger members that struggled more with altitude problems so just because your older doesn't make you more succeptible to altitude sickness. If your on a guided group, you will probably find they will make you walk slower than your used to and will make sure you aclimatise to the altitude.
Be careful with what water you drink and what food you are eating. It is a fabulous area so take lots of memory cards and spare batteries and enjoy!

Dont worry about holding the group up. Take your time and see all there is to see, no point rushing because then you miss all the wonderful views there are to see.

[GPSGuided]

I did the Annapurna circuit last year with a group aged from their 30's to over 70. It was the younger members that struggled more with altitude problems so just because your older doesn't make you more succeptible to altitude sickness.

That's actually a well documented clinical fact, that the 20-35 age group is most predisposed to altitude sickness.

[Ellobuddha]

I did the Anapurna curcuit in May. It was brilliant.
Just make sure you put the brakes on when you get to Manang. There is a altitude rest day there. Use that day to do a day climb to help adjust. When you come back down the oxygen in Manang feels thick as butter - excellent.

I didnt use diamox except for at night last two nights as was waling up gasping for air.

Its well worth doing. Dont be concerned about the oxygen levels you will be fine

[jeremy089786]

From my recent 6 weeks in Nepal, I would definitely say the food would be your biggest risk. I got food poisoning twice and lost about 10kg, my partner didn't recognise me at the airport!

Also to be avoided: ice, water for brushing your teeth, a quick drink in the shower, looking or smiling at salads etc etc. The himalayas are however as good as everyone says.

Finally, on the overland track a couple of years ago my friend (21) was taken over every day by an 80 year old couple. People well over your age also usually smoke me when Rogaining!

[KANANGRABOYD]

From my recent 6 weeks in Nepal, I would definitely say the food would be your biggest risk. I got food poisoning twice and lost about 10kg, my partner didn't recognise me at the airport!

Also to be avoided: ice, water for brushing your teeth, a quick drink in the shower, looking or smiling at salads etc etc. The himalayas are however as good as everyone says.

Finally, on the overland track a couple of years ago my friend (21) was taken over every day by an 80 year old couple. People well over your age also usually smoke me when Rogaining!

Is this Glenbrook Gorge, Eskimo roll, Cox's River, Z-packs, et all Jeremy?

[ninjapuppet]

Is this Glenbrook Gorge, Eskimo roll, Cox's River, Z-packs, et all Jeremy?

Haha, it is.

Go to youtube and Check out his latest pack rafting adventures in Norwegian whitewater.



In Nepal, even have to watch out in some of the top restaurants.
I went to the rum doodle, one of the most famous there, and had a yak steak with 3 mates. All of us had bad gastro for a good day and a half after that.
This hampered my immune system and i caught a cold for the first time in 3 years. the cold didnt help when i got to the point I developed high altitude pulmonary oedema due to a poor tight schedule which didn't allow adequate recovery and acclimatisation.

[johnrs]

Some more on racial differences in acclimatisation
see Genes for High Altitudes
DOI: 10.1126/science.1192481
Science 329, 40 (2010);
Jay F. Storz

[jeremy089786]

Before stumbling on this post I actually just put up a quick blog post on the pros and cons of Nepal. Does anyone have any more or think any are a little unfair?

http://adventuresandtinkerings.blogspot ... ng-in.html

Also Kanangra and Ninja, indeed this is that Jeremy ha, I didn't think I would be remembered I have finally stopped constant travelling in the last 4 months, so now have a little more time to get back on this thing. As Oslo gets colder and darker I'm sure you will be seeing much more of me!! It got to 26C here this summer and people didn't know what to do with themselves.