Challenges Faced by Himalayan Climbers Living at 5364 mamsl for 2 Months.

Every participant in a long Himalayan expedition puts his body to a very hard test. Hypoxia already makes itself felt from 4,000-5,000 meters above sea level, and above 6,000 meters above sea level the processes of cachexia begin to prevail in our body over the processes of regeneration. This makes prolonged exposure to such altitude extremely difficult and debilitating. It is possible to acclimatize to short stays at >7000 m.a.s.l., while in the so-called “death zone” (>8000 m.a.s.l.) it seems impossible for human beings and staying there without oxygen leads to death every minute.

Base camps are usually located at an altitude that allows for normal daily functioning, but nevertheless prolonged stays at this altitude take their toll. Even in a safe place like a base camp, oxygen deficiency is still felt and significantly reduces our daily well-being.

Everest Base Camp — “Door” to base camp after Everest

Altitude and the associated oxygen deficiency are not optimal conditions for the body to function, so from a certain altitude you need to take care of yourself much more than at sea level. The same problems await you at altitude as at sea level, but their treatment is much more difficult, which is why proper medical preparation before the expedition is so important.

How do we properly take care of ourselves so that our expedition is successful? The most important thing is prevention!

1 Cover your mouth and nose with a buff sling from the very beginning of the trek . Dust and cool, dry air dry and irritate mucous membranes, leading to nosebleeds and a bothersome dry cough. Use moisturizing nose drops/ointments to avoid this. I highly recommend for the nose oily ointments with vitamin A and a moisturizing nasal spray, for example, with hyaluronic acid and panthenol/dexpanthenol to soothe irritation. Have dry cough pills/syrup with you. Unfortunately, dry cough is very difficult to get rid of on an expedition and can be very bothersome, so it is very important to cover your face with a buff from the very beginning of the trek. This method is used by all Sherpas, and it is worth taking advantage of their knowledge and experience in this case – it is worth remembering, because if we can protect ourselves from dry cough we will be winners. Dry cough is the biggest epidemic in the Himalayas.

2 Protect your eyes with sunglasses. In glacier terrain, these should be special glacier glasses. Use moisturizing eye drops/ointment (with hyaluronic acid/panthenol/dexpanthenol). Wearing normal glasses on the glacier instead of those with side shields can result in significant corneal and conjunctival irritation, even on a cloudy day (I know what I’m saying!). In such situations, save yourself with drops, and preferably with a special ointment. In extreme cases, the lack of adequate protection can lead to reversible but worrisome and dangerous snow blindness.

3 Don’t part with your baseball cap (wear it even under your helmet), use sunscreen and lipstick with a high UV filter. Use aloe vera gel/oily vitamin ointment on your skin in case of sunburn . Special nose covers are very useful – the sun in the Himalayas is unforgiving, even when meticulously applying layer after layer of sunscreen. As a result of hypoxia and limited hygiene, the skin turns gray, pimples often appear – take care to clean it well (as much as possible) and moisturize it properly. A useful piece of equipment is a washer/sponge to help get rid of keratinized skin.

4. take care of proper hydration, remember electrolytes. Drinking water alone can very easily lead to dangerous electrolyte disorders. At altitude we should drink more than at sea level – about 2-4 liters a day. It is normal that we will go to the toilet more often, even at night, be ready for it. It’s a good idea to have a container in the tent for emergency night pee – to avoid nighttime exits from the tent in dangerous terrain, as well as the so-called urgency urges that can happen as a result of rapid bladder filling (diuresis is greater than at sea level). If, in addition, you are taking acetazolamide, the problem will be even more acute, and you need to take even more care to provide your body with more fluids.

5. gases at altitude occupy a larger volume, which we can observe in the example of packages with various types of snacks. Unfortunately, the same thing happens in our intestines, so being at altitude, bloating and persistent gas are a common problem, be prepared for this (it’s worth packing dimethicone in your first aid kit as well). Be prepared for all sorts of stomach sensations. Diarrhea is common, due to disruption of blood supply to the intestines, a change in diet and the possibility of water contamination (water comes from melted glaciers, but there is always a risk that they can be contaminated with human fecal matter – unfortunate, but true. Such a situation probably once occurred at the camp below Broad Peak, which is lower than the K2 base camp, but this is just speculation…). That is why boiling water, carried out meticulously by Sherps, which, however, does not protect us 100%, is so important). Antibiotics effective against diarrhea are azithromycin and metronidazole, loperamide should work symptomatically. During a high-mountain expedition, persistent constipation is also possible – such a situation is possible especially if you bring your body to extreme dehydration – for example, during a demanding summit attack. Medications for both constipation (bisacodyl) and diarrhea (loperamide) should be in our medicine cabinet.

Water on high mountain expedition from melted ice — The boiler, in which water boils practically all the time, and a strainer for filtering it. Water from melted ice/snow is needed for drinking, cooking, washing, and bathing and laundry.

6 Due to the possibility of water contamination , it’s a good idea to get vaccinated before you leave for typhoid, hepatitis A and cholera, which we can contract by consuming contaminated water or food. Due to being in a large concentration of people, I recommend meningococcal vaccination, which protects against sepsis of this etiology. It’s worth refreshing the tetanus vaccination, which we are at risk from wounds contaminated with soil. Consider rabies vaccination – there is always a risk of being bitten by a dog while trekking, and the serum to be administered after exposure is a drug that is usually difficult to access.

Vaccinations before the expedition — It’s a good idea to think about vaccinations at least 1-2 months before the trip

7. if you stay at altitude for a long time, think about A complex vitamin preparation. A diet poor in fresh fruits and vegetables and with little variety will quickly lead to a vitamin deficiencies, especially those in the B vitamin group. Tune in significant weight loss – the period before and during the expedition is not a good time to lose weight!

8 Be sure to visit your dentist before your trip – unsealed fillings can become a source of problems. If a gas space forms under such a filling, at high altitude the gas will begin to occupy a much larger volume, which can lead to severe pain, preventing further climbing. Before the expedition, it is essential to heal the inflammation, and during the expedition, pay close attention to any worrying symptoms from the teeth.

9. At altitude you face the same problems as at sea level, but their treatment is much more difficult! Take your basic antibiotic and cold medicine with you and take care of yourself at 200%. It is always easier to prevent than to cure. Always sleep with a hat on so you don’t get headaches and ear and sinus problems.