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Report 1932: Ladakh Takes Your Breath Away

By Eleanor from UK, Spring 2011

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Page 2 of 25: A word about Altitude

photo by Michael

Sunset over the Stok Range

Altitude does need to be taken seriously when planning a holiday to Ladakh. Acute Mountain Sickness (AMS) can and does kill. Altitude can affect anyone regardless of age, sex or general fitness. The degree of severity can vary and some people are affected at lower altitudes than others. Most people acclimatise quickly at around 2500m and altitude isnít usually a problem until 3000+m. It can be a major problem if you change altitude rapidly.

This means flying into Leh at 3555 meters (11,490ft) and starting off on a full itinerary of activities is not a good idea.

General advice for Ladakh is to rest the first day and take it easy the following day. This can be difficult as where ever you go in Ladakh there are likely to be steps to climb. The Disability Discrimination Act hasnít arrived here yet.

Much of Ladakh is around 3500m or above, so it is important to build time in at the start of a trip to allow the body to acclimatise. There is an argument for starting the holiday in Alchi rather than Leh as the altitude is less.

A trip to Pangong Lake should be planned for the end of the trip as in involves a drive over ChangLa Pass at 5360m (17,590ft)and the Lake is at 4267m (14000ft).

It makes sense to do the drive over KhardungLA Pass on the way to the Nubra and Shyok valleys before doing Pangong Lake. Although the pass is a similar height, the valleys are about 3000m.

Heed the advice to spend not more than 20 minutes at the passes.

Most people will experience minor symptoms of breathlessness and headache (treat with paracetamol or ibuprofen). These usually disappear within 24 hours.

Any exercise will leave you puffing and steps or climbs are a real killer (no pun intended). Bending down isnít a problem but standing up afterwards can be. Be sensible and take things steadily. Remember to rest and take your time. Do not rush! Think before getting out of a car as in your excitement to see the view or take that fascinating photo it is very easy to forget the altitude.

If you do experience problems or mild symptoms last for more than a few days you may need to think about going down - even 500m will help. This again is difficult in Ladakh as this effectively means Alchi at 3100m (10200 ft).

Make sure you can recognise the symptoms of High Altitude Pulmonary Oedema (HAPE) and High Altitude Cerebral Oedema (HACE). Both are serious and immediate action needs to be taken. Donít be big and brave and hope it will go away. It wonít. Make sure your travel insurance covers you for emergency evacuation and air lift if it is needed. There is information in the Resources section at the end of the report.

As there is less oxygen at high altitudes you will be breathing more and may need to drink more to replace fluid lost through the lungs when breathing. Think twice before drinking alcohol as this can increase the side effects of altitude - even as little as one drink. Smoking is also bad.

People often feel less hungry at altitude. Eat smaller meals but more often if necessary. Blood goes to the stomach after a meal to help digestion, so a large meal not only slows you down it can also leave you lethargic and a bit head-achy.

You are likely to feel tired and need more sleep.

Some people find it more difficult to sleep at altitude or they wake feeling they can't breathe. If this is the case, think about your breathing and make yourself take deep regular breaths until your natural breathing pattern is restored. Propping yourself up in bed with lots of pillows can help rather than lying flat, or try sleeping in a comfortable chair.

Some people take diamox to help with altitude. Talk to your doctor first as it can interact with drugs you may be taking and some doctors are not happy with its use.

Cars may carry a supply of oxygen but this is only a short term measure. There are military medical services at the top of ChangLA and KhargungLa Passes who are experienced in dealing with problems of Altitude sickness.

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