Preparation for Kailash Mansarovar Yatra (Medical and Physical planning) - 2018 experience of our Guide Lakhpat Sherpa

Kailash Manasarovar Yatra has its own significance and sanctity because of the spiritual association; in spite of the unpredictable harsh conditions several thousand enjoy the pilgrimage on this route. The region is located 18000 plus feet above sea level. With our experience we are saying in every group/overall about 50% of the yatris are affected by altitude sickness and nausea. Our small outline and a brief experience could help the pilgrims in better preparing for the yatra since it is a combination of high climb on foot (trekking) and by transport (long drives and uphill tough terrains with huge mountains all around). Here the Group experience Nature managed i.e., unpredictable extreme climate from snowing to frozen atmosphere, with sunlight, harsh wind and even rain are experienced simultaneously, and there is no greenery around. Pilgrim must be optimistic and should plan in advance to combat with the yatra natural shades and our body management system.

 Getting Prepared:

·   Check for a proper acclimatization and minimum relaxation and stoppage so that we are less affected and tour is best planned by a tour operator.

·   We must plan a judicious baggage with appropriate shoes and warm clothes (thermals, sweaters), socks, cap and Jackets.

·   To combat the extreme climate our body must be adjusted so we must start with the morning and evening walk for one hour (wearing proper shoes)  and try Pranayam (under the guidance of trainer). It is advisable to do this 4-6mnths before the yatra in order to set the body system and meticulously combat the tough terrain.

·   Blood sugar, cholesterol and triglyceride, urea and creatinine, Blood Pressure and ECG must be checked 6 months prior to your trip so that remedy could be devised and yatra could be planned.

·   Develop the habit of taking Multivitamins and these days after checking with the doctor Vitamin D is also essential; Evion 400 & Calcium tablets 180 days minimum prior to your tour. Although there is no such guideline still we suggest so that yatra is conducted peacefully and enjoyed thoroughly with full attention on the mesmerism created by the almighty all around and mission is succeeded well.

·   Pilgrims with the ailments like Asthma or breathing problems, heart problem and high blood pressure, recent injuries, sugar are advised to avoid the yatra until they are fit or guided by the Doctor.

Altitude Sickness

High altitude: 5000ft to 11500 ft

Very high altitude: 11500ft to 18000ft

The way altitude increase , atmospheric pressure decreases where the percentage of Oxygen remains at certain level ; the pressure of the oxygen is slow ; oxygen is thinner; and this leads to altitude sickness, usually most of the pilgrims could climb around 1500-200 m in a day, without any hastle whereas 50% of Pilgrims develop issues  when they touch 3000m. The distance climbs (gaining height), high altitude and rest and improper acclimatization and poor preparation before the yatra (walk etc. as guided above) are the factors and reasons of  Altitude sickness.

High Altitude illness include the following  

1. Acute Mountain sickness

2. High altitude pulmonary edema (HAPE)

3. High altitude cerebral edema (HACE)

The observant reasons vary from individual to individual, most important is persistent headache Burning or watery eyes, giddiness, dryness in nose and hard to breath, Nose bleeding, and sleep disorder are seen. Fatigue is most easily seen and felt. Gastrointestinal symptoms include vomiting, loss of appetite, distension of abdomen and nausea.

Threat to life can be observed with the conditions like HAPE the real symptoms are breathlessness when you are at ease or resting, cyanosis (blue tinge in finger tips), persistent coughing, fever and giddiness.

HACE common symptom is irritability lethargy, difficulty in walking (gait impairment), drowsiness, mental status altered, coma and these kinds of conditions oxygen is given to the patient, and sending back to the plains and lower altitude is the only option.  Steroids do help under the guidance of the physician.

Medicines required:

1. Acetazolamide (Diamox)

2. For pain relief – Hifenac (aciclofinac sodium).

3. Anti allergics  – Deslor/Allegra 120

4. Antiemitics – ondansetron - tablet and  injections

5. Anti - diarrhoeal

6. Glucose, ORS, Paracetamol

7. High blood pressure medicines

8. Nasal spray-saline - otrivin

9. Antibiotics are to be carried by doctor’s advice

10.   Sunscreen with SPF 50

 Diamox tablet 250mg minimum should be taken to combat altitude sickness at least once daily from the day we start gaining height and should be better taken in the morning and should be continued unless we return the base. The side affect of this medicine is tingliness affect so we must consume optimum water and combine with multivitamin so that tour is healthy with enough substitutes.

Finally with our experience we say if yatra is meticulously planned with enough of medical care and walk we could enjoy best of the Yatra in full swings and optimum so preparation and is essential and minimum baggage and body temperature consistency is essential. It is essential first you take care of yourselves and be observant of your co yatris so that immediate medical aid could be extended and we conclude the yatra successfully.

(NTP Team leader and Guide experience Lakhpat Sherpa (2015) Kailash Mansarovar Yatra)