Everest Base Camp Trek

Acclimatization and Altitude sickness

Here is a great resource to learn about altitude sickness, how to avoid it, acclimatization tips as well as medication to prevent or treat altitude sickness: https://wwwnc.cdc.gov/travel/yellowbook/2018/the-pre-travel-consultation/altitude-illness

1. In general it's best to acclimatize and avoid altitude sickness at the first place.
2. It's also important to keep any eye and recognize any altitude sickness symptoms during the trek so corrective actions can be taken.
3. Last but not the least it’s important to have medications, access to oxygen cylinders and insurance that covers helicopter in the rare case HAPE or HACE occurs. Of course it's best that we never have to use the third option.
Acclimatization Tips
• Ascend gradually: Once above 9,000 ft, move sleeping altitude no higher than 1,600 ft (500 m) per day, and plan an extra day for acclimatization every 3,300 ft (1,000 m). We take two acclimatization breaks - one at Namche Bazar and other one at Dingboche to follow this tip
• Diamox: We recommend using acetazolamide (DIamox) as a prophylactic to speed acclimatization,
• Avoid alcohol in Kathmandu and as we are ascending on the trek. It's OK to drink in moderation when we are on our way down, or when we are back in Kathmandu after our trek.
• Don't over exert. Walk slow, take enough breaks. Go on acclimatization hikes on the break day only if you are feeling rested. If not, full rest is recommended.
• Eat and drink a lot of water during the trek. Eat simple foods especially as we get higher/closer to the base camp.
• Having a high-altitude exposure at more than 9,000 ft (2,750 m) for 2 nights or more, within 30 days before the trip, is useful.

Please discuss your travel plans with you doctor and get a prescription for Acetazolamide(Diamox). Some more details on Acetazolamide is given below. You could also discuss with you doctor whether you may need Dexmethasone or NIfedipine. You can buy all these medications over the counter in Nepal for very cheap.

ACETAZOLAMIDE(DIAMOX) : Acetazolamide prevents AMS when taken before ascent and can speed recovery if taken after symptoms have developed. The drug works by acidifying the blood, which causes an increase in respiration and arterial oxygenation and thus aids acclimatization. An effective dose that minimizes the common side effects of increased urination and paresthesias of the fingers and toes is 125 mg every 12 hours, beginning the day before ascent.

DEXAMETHASONE: Dexamethasone is effective for preventing and treating AMS and HACE and prevents HAPE as well. Unlike acetazolamide, if the drug is discontinued at altitude before acclimatization, mild rebound can occur. Acetazolamide is preferable to prevent AMS while ascending, with dexamethasone reserved for treatment, as an adjunct to descent. The adult dose is 4 mg every 6 hours. An increasing trend is to use dexamethasone for “summit day” on high peaks such as Kilimanjaro and Aconcagua, in order to prevent abrupt altitude illness.