Altitude Sickness in the Himalayas: Prevent It, Don't Fight It

Acute Mountain Sickness is not about fitness. Marathon runners get it and grandmothers do not; it depends on how fast you gained height and how much you drank.

The first day in Leh at 3,500 m should be boring on purpose. No sightseeing beyond a slow walk, three to four litres of water, no alcohol, no smoking, and an early night.

Watch for headache that does not respond to paracetamol, nausea, breathlessness at rest, and disturbed sleep. Those are the warnings. Confusion, an unsteady walk, or a wet cough are emergencies — descend immediately, do not wait for morning.

The rule that saves lives is simple: never sleep more than 500 m higher than the previous night once you are past 3,000 m, and never ascend with symptoms.

Diamox helps some people if started a day before ascent, but it is a prescription drug — ask your own doctor, not a travel forum.

Our convoys carry oxygen cylinders, a pulse oximeter and a first-aid kit, and trip leads take readings every evening. If your saturation drops and stays down, we drive you lower. No itinerary is worth a hospital.