EXPEDITION HEALTH, HYGIENE AND ALTITUDE ISSUES

Personal health and hygiene is not only an important issue for your enjoyment of your visit to Asia but is also something that could potentially ruin your trip. Here are a few points for consideration and tips to make your trip more enjoyable.

 Vaccinations and health issues prior to travelling

Prior to your visit it is advisable to visit your GP and dentist for a check up. When visiting your dentist allow enough time not only for your check up but also for any follow up work that may be required. If you mention that you are going to altitude your dentist may want to give you an x-ray just to make sure that there are not going to be any problems with the cold conditions.

Whilst with your GP enquire about the latest advice for vaccinations and inoculations.

 Food and drink

For most visitors to Asia (not to mention Milton Keynes) diarrhoea is usually an unfortunate part of the experience. This is often the body’s reaction to a change of diet and unfamiliar food – it is not necessarily due to poor standards of hygiene. It can last from a few hours to a few days and can be personally limited by reducing food intake, particularly fatty or fried food, milk products and sugars. An important factor is to make sure that you keep up your fluid intake – particularly with rehydration salts.

Occasionally people succumb to slightly more serious bouts of diarrhoea but this can be treated with a simple course of antibiotics which are readily available in Kathmandu. However it is best to avoid diarrhoea in the first place and there are some simple guidelines that can be followed :-

• Don’t drink tap water or brush your teeth in it (or use it to clean contact lenses)
• Don’t drink jugs or glasses of water in restaurants unless you KNOW that it is safe
• Don’t have ice in your drinks (unless you KNOW that it is safe)
• Check that bottles of water still have their protective seal in tact
• Don’t drink unboiled milk or eat ice cream
• Don’t eat salads except at the more major restaurants in KTM (most restaurants sterilise salads by washing or soaking in potassium permanganate or iodised water - this will be stated on their menu)
• Don’t eat the peel when eating fruit
• Don’t eat at a restaurant if you feel that it is unhygienic – take a look in the kitchen if in doubt
• Avoid seafood dishes

 Staying healthy on a daily basis

For the duration of the trip it is really important to maintain high standards of personal hygiene – not only for your own health but also for the benefit of those around you. To that end it is imperative that you :-

• Wash your hands before each meal – hot water will be provided by the cook crew
• Wash your hands or sterilise them after going to the toilet (remember that the door handle will probably be particularly unhygienic so wait until you are outside – anti-bacterial gel is particularly useful)
• Wash your parts every morning where possible (hot water is provided for you in your tent). A cloth or sponge is really useful and prevents you spilling water around your tent

 Altitude issues

Altitude affects everyone differently and people acclimatise at different rates. But don’t panic – people don’t just fall over and croak it – casualties and fatalities are usually quite unwell for many days before becoming very ill and have basically ignored the messages that their bodies are giving them. If you pay attention to what your body is telling you you will not have any problems.

Some basic rules of thumb that will optimise your chances of not succumbing to Acute Mountain Sickness (AMS) are as follows :-

• Take it really easy when mooching around Base Camp.
• The more you exert your body the harder it is to recover from the day’s exercise. Stop and enjoy the views – take plenty of photos.
• Drink plenty throughout the day – if you become dehydrated you are more likely to develop AMS.
• Try to regulate your breathing whilst trekking and climbing – consciously raising your breathing rate will give your body more oxygen.
• If you get a headache take some headache tablets!! It seems obvious but many people suffer in silence for days – there is no need to live in discomfort. Don’t be afraid to take some tablets – but do inform those around you that that is the case so that we can all keep an eye on each other.
• If headache tablets don’t work then don’t go any higher and take plenty of fluids. If the headache still does not go then descend (usually to the last camp) and then re-ascend later.
• DO NOT take sleeping tablets to assist you in sleeping.
• DO NOT take narcotics or alcohol at altitude.

By following these simple points you will probably not succumb to AMS. AMS is generally a precursor to HACE (High Altitude Cerebral Edema) and HAPE (High Altitude Pulmonary Edema) and so these will not be covered here but will be discussed in detail during the trek in.

For further reading please consult :

• Altitude Illness Prevention and Treatment – Stephen Bezruchka, M.D. (Cordee)
• The High Altitude Medicine Handbook - Pollard & Murdoch (Radcliffe)
• Medicine for Mountaineering & other Wilderness Activities - James A Wilkerson (The Mountaineers Books)
• The Internet

I would like to take this opportunity to apologise to anyone who lives, has lived or has relatives who live in Milton Keynes.

Any further queries? Please don’t hesitate to ask.