Planning Information

Hi Himalayas Medical Information

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Health and Inoculations

Anyone with heart, lung and blood pressure abnormalities or a continuing medical condition should have a check-up and get a medical opinion before setting off.

Older people Many recently-retired people have made it to the top of the Thorung Las (5400m) so age need not be a barrier. The older you are, the more important prior fitness preparation is.

Asthma is no reason to avoid trekking. Except in polluted Kathmandu there are fewer irritants in the air so most asthmatics actually feel better while trekking. Look after your medication - wear your inhaler on a chain around your neck or keep it in a pocket. There is still the normal risk of a serious attack so brief your companions on what to do.

Diabetes - if it is well-controlled diabetes is no reason to avoid trekking. You cannot afford to lose the medication so keep it with you at all times and warn you friends on the procedures in case there's an emergency. Your increased energy expenditure will change carbohydrate and insulin levels so it's very important to monitor your glucose levels frequently and carefully and to keep blood sugar levels well controlled.

High blood pressure (hypertension) Blood pressure will fluctuate more and be higher than usual while on a trek. You should seek the advice of a doctor who is aware of the history of your condition.

Previous heart attacks Studies have yet to be conducted but it is likely that the level of exertion required on a trek is more significant than the altitude factor. Seek the advice of your doctor.

Epilepsy There is a moderately increased risk of a seizure at altitude, but is not a reason to stop you trekking. You companions must be briefed on all the relevant procedures.

Pregnancy Complications are common, especially in the first pregnancy. Sometimes sophisticated care is needed so it's probably not a good idea to go trekking while pregnant. The effects of reduced oxygen at high altitude on the foetus have not yet been studied.

Past history of chest infections If you are prone to these bring the medicine you are normally prescribed (usually Augmentin or Roxi-something), and at least 2 full courses of it. If you are ascending to high altitude for only a short time in the Everest region you may want to take it prophylactically, since your chances of picking one up are high.

Immunisations: (note that medical insurance will NOT generally cover the cost of immunisations)The most accurate immunisation advice for visiting Nepal can be found on the Web. Check out the CIWEC clinic page at http://www.bena.com/ciwec They are Kathmandu's most professional medical clinic. It is worth reading very carefully and printing this advice out, plus what follows, before getting your shots. The best people to consult about the vaccinations currently recommended are clinics specialising in travel medicine like Auckland’s Travel Medical Vaccination Centre. You can ring them on (09) 373 3531.

The injections recommended for this trip by the travel doctor are;

Hepatitis A Usually passed on in contaminated water; immunisation is considered a must by most doctors unless you have had hepatitis A before. The new vaccine is Havrix and a full course will give up to ten years protection.

Hepatitis B This disease is avoidable since, like AIDS, it's passed by unsafe sex or contaminated blood products. A vaccine is available. You wont need this if you don’t intend sharing bodily fluids.

Meningitis Occasional cases of meningococcal meningitis occur in Nepal. It is an often fatal disease but the vaccine is safe and effective and should be obtained.

Typhoid is prevalent in Nepal. There are now a variety of vaccines and one should be obtained.

Tetanus-Diptheria This vaccine is recommended if you have not had a booster in the last 10 years. Many doctors advise a tetanus booster every time you intend to travel for any length of time.

Polio If you escaped immunisation as a child a series of vaccinations is recommended. If you have not had a booster as an adult, one may be required. Check with your doctor.

Measles, mumps and rubella If you did not have these diseases (or the vaccinations) as a child you may need a vaccination.

Rabies:(not essential and expensive.) This deadly virus is transmitted by the bite of an infected animal, usually a monkey or dog. The risk of being bitten is minimal but it has happened. A vaccination is available but even if you've had it you'll then need a follow-up course of two further injections. If you've not been vaccinated and are unlucky enough to be bitten, a series of injections is available only from the CIWEC clinic in Kathmandu and should be started within a week or so of being bitten.

Should anything go wrong medically CIWEC is an excellent traveller’s clinic in Kathmandu and there are also dozens of “chemists” with all sorts of drugs available. Their quality remains doubtful as much of it comes from India where production standards are perhaps not as high as other countries. However plenty of trekkers have used these medications without any problems….your call.

Your medical kit:

The most common ailments suffered by visitors to Nepal are stomach ailments and chest infections as well as the effects of altitude.

Muscle aches and pains associated with continuous exercise are also likely to be experienced if you are not fit, as well as perhaps a twisted ankle, cuts and bruises.All of these, apart from the most severe can be treated with drugs and medical supplies you should carry in a personal medical kit.

The best thing to do when you go to your doctor for injections is to get him/her to write you a prescription for the following drugs. Explain you are going to Nepal and are going into the hills and would like to be able to deal with mild and severe bouts of bacterial stomach ailments. You also need to have something to deal with a chest infection and altitude symptoms.

Here is the list of medications I recommend people bring along for a trekking trip. Those marked with an asterix are ones you will need a prescription for from your doctor. The list looks long and you might want to go halves with a “buddy” as chances are you won’t be using all these things. For the antibiotics though you are going to have to get a prescription that will be for a course covering one person’s needs only. The other stuff I am sure you are going to be able to share with your buddy.

Amoxycillan or Zithromax*: for chest/sinus infection

.Buccastem or Stemetil*: for nausea.

Temazepam*: sleeping tablets if you think you are going to need them. Be aware that I DO NOT recommend people using sleeping tablets at altitude. Restful Sleep from Healthries or other herbal tablets are adequate alternative I have found.

Gastrolyte: available for the chemist and essential for rehydration. This is very good for getting your salts back into balance after trekking and sweating your way through the low lands.

Imodium/Lopermide: available from chemist to “bung” you up if you are suffering from diarrohoea. This is not something I would recommend taking at the first sign of runny poos but if it persists and is making life difficult then we will consider this in the short term.

Norfloxacin*(there may be something else the doctor can recommend): for mild stomach ailment.

Zithromax*: for more serious bacterial stomach ailment. Please note that Ciproflaxin is no longer recommended for treatment of bacterial infections in Nepal due to overuse of this antibiotic and the resulting drug resistant strains that have developed.

Strepsils: for sore throat. Cough mixture you can also consider if you are suceptible to throat irritations.

Betadene: for cuts and grazes.

Sticking plasters, gauze and tape for cuts and sprains: (whatever you would normally take tramping)

Panadol/Dispirin/Aspirin: for annoying altitude headaches.

Cold medicine: sudafed or coldral to clear your head. Be warned that psudoephedrine has a side effect of keeping you awake and a little jumpy so either find one without or only take it during the day.

Laxative: hard to imagine I know but speaking from experience!

Canestan/treatment for thrush: A common side effect of strong antibiotics is thrush. Come prepared with whatever you choose to use for this complaint

Lamisil Cream: antiifungal cream.

Anti blister tape: the best solution for this is well worn in boots but if you get blisters some tape to protect the sensitive skin is a good idea.

Ibuprofen/Nurofen: moderate painkiller for really annoying altitude headaches and muscular aches.

Nose and eye drops:

Water purification: Potable aqua plus is a great two step system that also nuetralises the taste of iodine. There are new chlorine based simple two step products available too. We will also be boiling water but it is better to be super safe.

The secret is of course NOT to get sick and this means being very very careful with our health and hygiene.

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