High Altitude visit - AMS ?

High Altitude visit - AMS ?

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SteveKTMer

Original Poster:

957 posts

36 months

Thursday 1st September 2022
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Afternoon, I'm going to India and will be staying at high altitude, Srinagar, Kargil, Leh and riding up some of the highest passes at over 5300m and staying at 4500m for a few days then coming back to 3500m.

Just wondering if anybody else has gone from living at sea level then moving around at high altitude ? I've read a lot about it but nothing beats personal experience. I plan spending a night at 1800m then 2700m then finally 3500m and spending a couple of days at 3500m before going higher which I gather should be sufficient to avid bad AMS.

My GP doesn't prescribe anything like Diamox which is what some people seem to use, so I'll be keeping well hydrated because thinner air is dryer and just giving it a few easy days to adjust.

My resting heart rate is 60 to 75 so I'm guessing this will rise to in the region of 100 or more at high altitude. Is there a resting rate that could be dangerous ?

Beggarall

560 posts

246 months

Thursday 1st September 2022
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AMS can be quite unpredictable but you are obviously going to altitudes where you are at risk. We have travelled and hiked a lot at high altitude and have heard of some very serious cases - even leading to death. It is less common (but not unknown) below 3000m. Surprisingly, fitness has very little bearing on your risk - so your pulse rate is irrelevant. I have known it disable fitness instructors while overweight smokers are unaffected. Some degree of mountain sickness is common at the altitudes you are going - notably headache, but this can also be a warning sign of more serious things to come. Don't ignore it. If things start to get worse the only (and most important) thing you can do is go down. Ignoring warning signs is more likely to happen in groups where there is pressure to keep up. The best advice I can give from my experience is to drink plenty and also try to ascend gradually - acclimatisation is very important. You are more at risk if you go up quickly (e.g. in a car). 5300m is going to make you puff! Presumably you are going over a pass? Diamox is useful - you should be able to get it on a private prescription - either from your GP or even on-line. You will only need to take it when you start the higher altitude travels and stop once you are on your way down. Have a safe trip!

Edited by Beggarall on Thursday 1st September 15:47

Lotus Notes

1,230 posts

196 months

Thursday 1st September 2022
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It's sounds as though you're doing the right thing, If you're fit, I wouldn't bother with 1800m and spend two nights at 2700m if possible before moving onto 3500m for the two days. I wouldn't be too concerned at 5000m if taking your time acclimatising.

I've never bothered with drugs, fitness and hydration is key, green tea is my chosen beverage to stave off sickness. Pack some Immodium as digestive problems can occur! If you're ill drop down for a few days to recover and keep an eye out for signs of coughing, foaming and crackling of the lungs when breathing. If this occurs, call it a day.

Otherwise enjoy the trip.

oddman

2,598 posts

257 months

Friday 2nd September 2022
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HR will be an indirect measure of your acclimatisation but if you really want to geek out then the higher end Garmin devices will measure Oxygen Saturation and claim to track/manage acclimatisation. My guess is that the data is unlikely to influence your schedule unless you are feeling bad.

As others said acclimatisation is really idiosyncratic. Your response will be your response but it makes sense to be as fit and light as possible.

The schedule you post is probably realistic for somebody average and looks like it has been planned to avoid AMS but it may still be quite challenging and unpleasant. Do your best to rest and get a good nights sleep wherever you stop. Take a bottle of water to bed, use silicone ear plugs, everything you know about yourself to maximise sleep.

Bill

53,859 posts

260 months

Friday 2nd September 2022
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Beggarall said:
smokers
Ironically they (and asthmatics) are used to being hypoxic...

Looks like a decent enough plan OP, I wouldn't have thought 1800 is necessary. Traditional plan when mountaineering is to sleep 1000ft lower than your high point during the day.

ChocolateFrog

27,552 posts

178 months

Friday 2nd September 2022
quotequote all
SteveKTMer said:
Afternoon, I'm going to India and will be staying at high altitude, Srinagar, Kargil, Leh and riding up some of the highest passes at over 5300m and staying at 4500m for a few days then coming back to 3500m.

Just wondering if anybody else has gone from living at sea level then moving around at high altitude ? I've read a lot about it but nothing beats personal experience. I plan spending a night at 1800m then 2700m then finally 3500m and spending a couple of days at 3500m before going higher which I gather should be sufficient to avid bad AMS.

My GP doesn't prescribe anything like Diamox which is what some people seem to use, so I'll be keeping well hydrated because thinner air is dryer and just giving it a few easy days to adjust.

My resting heart rate is 60 to 75 so I'm guessing this will rise to in the region of 100 or more at high altitude. Is there a resting rate that could be dangerous ?
It depends in your physiology. Smokers do better apparently.

I suffer quite badly. I acclimatised for 2 weeks above 4000m the last time I went above 6000m and still got AMS.

Keep healthy and hydrated and a day or two above 5000m should be OK though.



Zaichik

238 posts

41 months

Friday 2nd September 2022
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The advice given by others above is all good.
Above 3000m for anything more than 24hours and you will feel mild AMS. If you ascend too quickly this will become more severe so you must watch for the danger signs in particular HAPE/HACE. Sounds like you may be on a motorcycle so descending quickly shouldn't be an issue. Even descending 100m at those altitudes can help. Your recover very quickly with even small descents.

Google Lake Louise AMS score for something to help measure this. In a group you should keep slow and watch out for each other - don't compete to ascend too quickly. Stay relaxed and enjoy the sights.

Take ibuprofen/paracetamol to relieve headaches. A mild/regular headache shouldn't panic you - this is reasonably normal at altitude.
Diamox can help your body to acclimatise more rapidly but has its own side effects which are not harmful but some find uncomfortable. I have used it and personally find it is not worth it.

Having climbed several peaks in the 7000m range, my advice would be to avoid sleeping more than 300-500m higher than the previous night. By all means ascend higher in the day - this can help (climb high sleep low).

Keep hydrated. This plus your body having to remove the extra CO2 from your bloodstream means you will need to pee. A lot.

Enjoy it.

SteveKTMer

Original Poster:

957 posts

36 months

Friday 2nd September 2022
quotequote all
Thanks for all the advice, much appreciated. I'll have an oximeter with me to see the oxygen level in my blood, plus it reads pulse.

The highest pass, if it's open and as a foreigner I'm permitted that far, is Umling La at 5798m https://en.wikipedia.org/wiki/Umling_La but I'll only be at that altitude for a few hours.

Fingers crossed ! smile

GM182

1,300 posts

230 months

Friday 2nd September 2022
quotequote all
Sounds like a good trip you have planned.
I did similar three years ago and went to the the Altitude Centre in London prior for an assessment, mainly for my own peace of mind.
I was in the normal range for everything and I seemed to be quite effective at getting oxygen into my blood even when the concentration was down to 11% equivalent at 5000m.

I acclimatised for three days at 3700m - a few headaches and one day when I felt totally knackered. Other than that it was fine. I only spent one night at 5000m otherwise at 3-4000m range on the Tibetan plateau. Side hikes up to monastaries at 4000m+ were quite taxing.

For reference my BMI is about 30 and ex-smoker so I'm not exactly fit!


CAPP0

19,829 posts

208 months

Friday 2nd September 2022
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I returned from a very similar trip 2 days ago! Delhi > Shimla > Shoja > Manali > Keylong > Sarchu > Leh > Pangong Tso > Nubra > Turtuk > Leh > Delhi.

That included Khardung La, claimed (slightly under dispute) as the highest motorable pass in the world. We went over a few other high passes too; Lachalung, Baralacha La, Taglang La, Chang La, etc.

I started on Diamox from Keylong onwards. As someone said above, some strange side effects including very tingly extremities (fingers, toes). As I had never been before I have no reference on whether the drug helped or not. At the highest points, you definitely felt fuzzy of head and short of breath fairly quickly, but I also found the first night at altitude (Sarchu) slightly hard going too.

One friend in our group (who is very physically fit) was evacuated and hospitalised from Sarchu, that was a combination of mild Delhi belly but they were also showing significant symptoms of HACE. On oxygen for quite a long time after. They didn't rejoin the tour, they were too ill, although happily recovering now.

It was a fantastic experience, with some amazing destinations, but now I've done it, I wouldn't go again. It's reasonably tough at times, and the country (well that part of it at least) is, let's say, infrastructurally challenged in multiple different ways. Not unexpected of course, but once seen, that was enough. And (whilst again not unexpected!), curry for breakfast, lunch and dinner starts to lose it's appeal after a while. There were several days at a stretch where curry and/or bread were the only options, and outside the towns, a lot of the curries were indistinguishable from the previous/following meal.

Which company are you going with? (Assuming it's an organised tour?).