The secret to stress free travel
Simply put, pack light and arrive at the starting point of your trip a day early. Many have told us this was the most important thing they did to get ready for their trip. They felt rested and more acquainted with the customs and pace of life of their new surroundings.
U.S. citizens must have a current Passport. Make sure your PASSPORT DOES NOT EXPIRE WITHIN 6 MONTHS OF THE COMPLETION OF YOUR TOUR. These requirements do vary from country to country, but just to be safe, we recommend going by the 6 month standard, because it’s definitely better to be safe than sorry when it comes to international travel!
Make copies of your passport! We recommend making 2 photocopies of your passport’s photo page and any other valuable documents you might carry with you on the tour. Travel with one copy stored separately from your passport. Leave the other copy at home with a relative or friend (ideally the same person you gave as your emergency contact). In the event that any of your documents are lost or stolen, this will greatly assist the process of replacement.
ITINERARY CHANGES MAY BE MADE DUE TO LOCAL CONDITIONS BEYOND OUR CONTROL OR BY DISCRETION OF GROUP LEADERS. All Nichols Expeditions services described are arranged weeks or months in advance of your trip. If airline schedule changes, unusual weather conditions or other circumstances beyond our control prevent us from operating the services according to the schedule described above, we will attempt to substitute services of equivalent value. If we are unable to do so, passengers may be responsible for additional costs due to circumstances beyond our control.
From our experience leading many high altitude tours and from information gathered from medical experts, we can help you understand more about the affects of traveling at high altitude and how to lessen or prevent AMS (acute mountain sickness). High altitude begins at 8,000 ft. On the first part of the tour we will spend several days acclimatizing at 7-8000 ft. During the trip we will have 5 days that we go over passes above 10,000 ft. The good news is that we never sleep above 8,500 ft.
Frequently asked questions:
Above 8,000 ft., many people experience some type of mild, short-lived reaction to the altitude. The most common reactions are shortness of breath, a mild headache, fatigue, dizziness, a change in breathing, loss of appetite, nausea and insomnia. These symptoms usually go away within a day or two, and when they do, this is what “being acclimatized” means. However, if after a few days you are still bothered by these symptoms, or if the symptoms become worse (vomiting, a headache that will not go away with Ibuprofen or aspirin, or decreased coordination) you have AMS.
To aid in your acclimatization, drink plenty of fluids, eat mostly carbohydrates, limit strenuous exercise the first day, do not smoke, do not use depressant-type prescription sleeping pills (Melatonin is OK) and initially avoid alcoholic beverages. In addition to these precautions, and especially if you are prone to AMS, we suggest bringing Acetazolamide and Dexamethasone so you have the medications if you need them. Both are prescription medications used to prevent and treat AMS.
Treating AMS starts with recognizing and personally acknowledging the symptoms, and then assessing the severity of the symptoms and acting to reduce the affects. Treatment may require rest, prescription medications, oxygen or descent to a lower altitude.
- Acetazolamide (Diamox) Important Note: People with a Sulfa Allergy should not use Acetazolamide.
This prescription medication is the most widely used AMS preventative, and it has been shown to shorten the acclimatization process by increasing the rate and depth of breathing. Acetazolamide is a mild diuretic and common side effects are increased urination and a tingling sensation in the fingers (the tingling can be lessened by taking a potassium supplement). If there is any question about your tolerance for this medication, consider trying it at home before the tour. Suggested dose is 125 mg (cut a 250 mg dose in half) twice per day for persons below 220 lbs., and 250 mg twice per day for persons over 220 lbs. Begin taking the medication the day prior to the trek on Day 6, and continue using it twice per day until reaching the tour’s maximum altitude on Day 8. Keep a few days extra in case you have trouble breathing later in the tour.
- Dexamethasone (Decdron) – Important Note: Dexamethasone should not be given to diabetics or anyone fro whom steroids are contraindicated
This prescription medication is a steroidal anti-inflammatory used primarily to treat AMS. The medical community is split on its use as a prophylactic to aid acclimatization, but it may be a reasonable alternative for those with a sulfa allergy who cannot tolerate Acetazolamide. They do agree that Dexamethasone is effective for treating AMS. As a prophylactic, dosage is 4 mg twice per day starting the first day of the trek (Day 7), and continuing for a few days until no symptoms occur, then taper off gradually. As a treatment for AMS, take two 4 mg doses 6 hours apart. Do not ascend until at least 12 hours after the last dose, and then only if there are no symptoms of AMS.
- Ginko Biloba Extract – This dietary supplement is available over the counter and it has been shown to be effective in preventing or lessening the symptoms of AMS. It has yet to be determined exactly how Ginkgo Biloba works at altitude, but it may act as an antioxidant, reducing stress on tissues that have been injured by low oxygen levels. The recommended dose of Ginkgo Biloba extract (24% flavonoid glycosides, 6% terpenoids) is 80 – 120 mg twice a day, starting 5 days before the tour and continuing while at altitude.
- If you have a Sulfa Allergy – For those who are allergic to Sulfa drugs, here are two other prescription medications to discuss with your doctor: oral NIFEDIPINE and SALMETEROL (SEREVENT).
- Base Camp MD – http://www.basecampmd.com/expguide/amspremed.shtml
- International Society For Mountain Medicine–http://www.ismmed.org/np_altitude_tutorial.htm#AMS
- MD Travel Health – http://www.mdtravelhealth.com/illness/altitude_sickness.html
- CIWEC Clinic Travel Medicine Center In Katmandu, Nepal – http://ciwec-clinic.com/
- Wilderness Medicine: Management of Wilderness and Environmental
Emergencies, by Paul S. Auerbach, Mosby – Year Book Publication, 3rd
- High Altitude Medicine and Physiology, by John B. West,
Robert B. Schoene & James S. Milledge, A Hodder Arnold Publication, 4th edition,
- High Altitude Medicine, written & published by Herb Hultgren,
For all travelers, we suggest keeping your tetanus immunization up to date (every 10 years), and we suggest a Hepatitis A immunization, too. You can check your state health department, the Center for Disease Control (CDC) or the online traveler’s data base http://www.mdtravelhealth.com/ for the most current information.
Whether you shoot a digital or film camera, bring more media storage cards or film than you think you need! A portable hard drive may be the answer for digital storage. Other useful items are plenty of extra batteries, lens cleaner, lens tissue, lens brush, a mini tabletop tripod and a clean toothbrush to remove grit from your camera.
Nichols Expeditions is not responsible for any costs you may incur due to travel delays or other contingencies we are unable to control. For international flights, arrive at least 2-3 hours prior to departure (check with your air carrier for their requirements) and allow ample time between connecting flights. If you miss your flight and you need a special shuttle to meet up with the group, you will be responsible for the cost.
To protect you against life’s uncertainties, we have a Travel Insurance Policy that protects you against tour cancellation, trip interruption and medical emergencies along with baggage benefits. WE HIGHLY RECOMMEND TRAVEL INSURANCE!