Ladakh: Altitude Sickness and Acclimatisation

Altitude sickness, also known as acute mountain sickness (AMS), is a condition that can occur when ascending to high altitudes too quickly without proper acclimatisation. It is caused by the reduced oxygen levels and lower air pressure at higher elevations as in Ladakh. Altitude sickness can range from mild to severe and can affect anyone, regardless of their age or physical fitness level.

Tourists generally remain above 10,000ft when in Leh Ladakh. They even travel through some portions which are higher than 17,000ft. Tourists may have to spend night near Pangong lake and Tsomoriri lake which are 14,000ft and 15,000 ft high respectively. So, they are required to acclimatise properly in Leh before moving to higher regions to avoid health related complications.

In Ladakh, many tourists have lost lives in the past due to altitude sickness and many of them took it very lightly and did not acclimatise properly at Leh.

Symptoms of altitude sickness can vary but commonly include:

1. Headache: A persistent, throbbing headache is often the first symptom of altitude sickness.
2. Fatigue: Feeling unusually tired or weak, even with minimal physical exertion.
3. Dizziness and lightheadedness: Feeling unsteady, dizzy, or having a sensation of spinning.
4. Nausea and vomiting: Experiencing an upset stomach, loss of appetite, and sometimes vomiting.
5. Shortness of breath: Difficulty breathing or feeling breathless, especially during exertion.
6. Difficulty sleeping: Insomnia or disrupted sleep patterns are common at high altitudes.

If altitude sickness is left untreated or ignored, it can progress to more severe forms, such as high altitude pulmonary edema (HAPE) or high altitude cerebral edema (HACE). HAPE involves fluid accumulation in the lungs, leading to breathlessness, coughing, chest congestion, and a bluish tint to the lips and fingertips. HACE, on the other hand, involves swelling of the brain, resulting in confusion, loss of coordination, seizures, and eventually unconsciousness.

Acclimatisation is the process by which the body adjusts to the low-oxygen environment at high altitudes, reducing the risk of altitude sickness. Many tourists in Leh Ladakh do not take acclimatisation seriously and become victim to altitude sickness.

Acclimatisation in Leh Ladakh

High altitude acclimatisation, also known as altitude acclimatisation or acclimatisation to altitude or acclimation, refers to the process by which the human body adjusts to the reduced oxygen levels and lower air pressure at high altitudes of Ladakh. This adjustment is necessary to avoid altitude sickness and allow the body to function properly in oxygen-deprived environments of Ladakh.

When ascending to high altitudes like Khardungla pass, Changla pass, Pangong lake, Tso Moriri etc., it’s essential to acclimatise gradually to minimize the risk of altitude-related illnesses like acute mountain sickness (AMS), high altitude pulmonary edema (HAPE), and high altitude cerebral edema (HACE). Here are some key points and recommendations for high altitude acclimatization:

1. Gradual ascent: Ascend slowly, allowing your body time to adapt to the changing conditions. Generally, it is recommended to ascend no more than 300-500 meters (1,000-1,500 feet) per day above 2,500 meters (8,000 feet). Take rest days at regular intervals to allow your body to adjust. Do not spend more than 30 minutes at high altitude mountain passes like Khardung la, Chang la, Taglang la etc.
2. Hydration: Drink plenty of fluids, preferably water, to stay hydrated at high altitudes. Avoid excessive alcohol consumption as it can exacerbate dehydration.
3. Adequate rest: Get enough sleep and avoid overexertion. Take rest for at least one full day at Leh. Rest allows your body to recover and adapt to the altitude.
4. Proper nutrition: Maintain a balanced diet with sufficient calories to fuel your body’s energy requirements at high altitudes. Consume a mix of carbohydrates, proteins, and healthy fats.
5. Medication: Consult with a healthcare professional about the potential use of medications like acetazolamide (Diamox) to aid in acclimatization. These medications can help prevent or alleviate altitude sickness symptoms.
6. Descend if necessary: If symptoms of severe altitude sickness, such as persistent headache, vomiting, dizziness, or difficulty breathing, occur and do not improve with rest and medication, descend to a lower altitude promptly.
7. Listen to your body: Pay attention to your body’s signals and be aware of any symptoms of altitude sickness. If you experience mild symptoms, such as headache or mild nausea, take it as a warning sign and respond accordingly.
8. Oxygen supplementation: In extreme cases or for individuals with pre-existing health conditions, supplemental oxygen may be required. Portable oxygen concentrators or oxygen cylinders are used to provide additional oxygen at high altitudes.

Remember, high altitude acclimatisation is a gradual process, and everyone responds differently to altitude. It is important to be patient, listen to your body, and prioritize your safety when venturing into high altitude environments. If you have any concerns or pre-existing health conditions, consult a healthcare professional before your trip.

48 Hours acclimatisation mandatory in Ladakh

The government of Ladakh UT has made it mandatory for all the tourists to undergo acclimatisation period of 48 hours in Leh before moving to higher places like Khardungla, Changla, Pangong and Tsomoriri.

Should I carry oxygen cylinder in Ladakh?

Carrying an oxygen cylinder to a high-altitude area can be a prudent precaution, especially for individuals who are prone to altitude sickness or have respiratory conditions. Here are some important considerations when carrying an oxygen cylinder to a high-altitude area:

1. Consult with a healthcare professional: Before deciding to carry an oxygen cylinder, it is crucial to consult with a healthcare professional who specializes in high-altitude medicine or respiratory conditions. They can evaluate your specific health needs and provide appropriate recommendations.
2. Assess the need for oxygen: Altitude sickness affects individuals differently, and not everyone requires supplemental oxygen. Discuss your travel plans and medical history with a healthcare professional to determine if carrying an oxygen cylinder is necessary for your specific circumstances.
3. Keen in the car: Borrowing and keeping an oxygen cylinder in your car is not harmful. You can ask your driver or travel agent to help you borrow a cylinder while visiting Khardungla, Nubra, Pangong, Tso Moriri etc.
4. Obtain the correct equipment: If you decide to carry an oxygen cylinder, ensure that you have the appropriate equipment. Purchase or rent a reliable, medical-grade oxygen cylinder that meets safety standards and is specifically designed for high-altitude use.
5. Talk about the rend in advance: As Discover Leh Ladakh do not deal in renting out of oxygen cylinder, you should directly talk to the person renting out the oxygen cylinder. Fix the price in advance. Remember that you will be charged rent even if you do not use oxygen.
6. Ensure proper storage and handling: Store the oxygen cylinder securely in an upright position, away from heat, flames, or other potential ignition sources. Familiarize yourself with the proper handling and safety procedures, including any maintenance requirements.

Remember that carrying an oxygen cylinder should be part of a comprehensive approach to high-altitude safety. Proper acclimatisation, gradual ascent, staying hydrated, and recognizing the symptoms of altitude sickness are vital. If you experience severe symptoms, descending to a lower altitude and seeking medical assistance should be the priority.

Always consult with a healthcare professional who is knowledgeable about high-altitude medicine and travel medicine to receive personalized advice based on your health condition and specific travel plans to high-altitude areas.

In Ladakh, follow the acclimatisation rules, have complete rest on first day of your trip, take it easy on second day (you can travel around Leh) and keep yourself hydrated. As a precaution, you can hire an oxygen cylinder in Leh.

Best practices for acclimatisation in Leh Ladakh

Acclimatization is crucial when visiting Ladakh due to its high altitude, ranging from 9,800 feet (2,987 meters) in Leh to over 17,000 feet (5,182 meters) in some mountain passes. Proper acclimatization helps reduce the risk of altitude sickness and ensures a more enjoyable and safe travel experience. Here are some best practices for acclimatisation in Ladakh:

1. Gradual Ascent:
   • Plan your itinerary to allow for a gradual ascent. Spend the first couple of days in Leh, which is at a relatively lower altitude, before heading to higher-altitude destinations like Pangong Lake or Nubra Valley.
2. Stay Hydrated:
   • Drink plenty of water to stay hydrated, but avoid excessive caffeine and alcohol consumption, as they can contribute to dehydration. Ladakh’s dry climate increases the need for sufficient fluid intake.
3. Balanced Diet:
   • Maintain a balanced diet rich in carbohydrates, moderate in protein, and low in fat. This helps your body adapt to the high-altitude conditions. Include local foods like barley-based dishes and drink plenty of butter tea.
4. Avoid Overexertion:
   • Limit physical exertion during the first few days of your stay. Allow your body to adjust to the reduced oxygen levels. Overexertion can exacerbate symptoms of altitude sickness.
5. Rest and Sleep:
   • Ensure adequate rest and quality sleep. Lack of sleep can contribute to altitude-related issues. Take short naps if needed, especially during the first few days of acclimatisation.
6. Medication:
   • Consult with a healthcare professional before traveling and discuss the possibility of taking acetazolamide (Diamox) as a preventive measure against altitude sickness. However, medication is not a substitute for proper acclimatisation.
7. Avoid Alcohol and Smoking:
   • Minimize alcohol consumption and avoid smoking, as these can exacerbate the effects of high altitude. Alcohol and tobacco can contribute to dehydration, which is already a concern at high elevations.
8. Symptom Monitoring:
   • Pay attention to symptoms of altitude sickness, which may include headaches, nausea, dizziness, and shortness of breath. If symptoms persist or worsen, descend to lower altitudes.
9. Local Remedies:
   • Locals often recommend drinking traditional teas made from local herbs, such as chamomile or mint, to help with acclimatization. However, consult with local experts or healthcare professionals before trying these remedies.
10. Emergency Plan:
    • Be aware of the location of medical facilities in the area you are visiting. Have an emergency plan in case altitude sickness symptoms become severe, and evacuation is necessary.

Remember that everyone acclimatizes differently, and there is no foolproof way to completely avoid altitude-related issues. Taking it slow, being mindful of your body’s signals, and allowing time for acclimatization are key to enjoying your time in Ladakh safely. If symptoms persist or worsen, seek medical attention promptly.