Preparing for a trek in Nepal
Every step you take at high altitude requires more effort (Photo: Jenny)
Preparing for a trek in Nepal
For those of you new to trekking, you have a wonderful experience in store. Trekking is walking, generally on good trails, usually up and down (sometimes 3,000 feet/900 meters a day), carrying only a day pack, through magnificent scenery. The day starts early - often the bulk of the day's distance is covered before lunch. Lunch is a hot meal served on the trail by the staff. A shorter afternoon hike brings you to camp or your lodge with time to rest, have a cup of tea, take pictures, make journal notes, and wash up before dinner.
Nepal is not like home. It is exotic, it is wonderful, but it is also different. Remarkable elevation changes, different customs and language, new foods, and the many other mysteries and wonders of travel in Nepal are all conditions you must be physically and mentally prepared for. The itinerary may change and you may meet unknown hardships as well as unexpected pleasures. Come with an open mind and a positive spirit.
For all Nepal treks, you should be in good physical shape. Depending on the trek you finally choose, you should be comfortable hiking seven to twelve miles per day on a trail carrying a day pack of about ten pounds.
Remember, the better physical condition you are in, the more you will enjoy your trek. The more you can condition by closely simulating the activities of trekking, the better off you will be. Nothing prepares you for hiking like hiking.
- Put together a workout schedule that will enable you to be in top form before your trek. General rule of thumb: Commit to a minimum of 3 months of continual conditioning. Of course, more is better.
- Aerobic fitness is a key factor of a comfortable trekking experience; if your body is used to physical exertion, you will be less likely to suffer from exhaustion or injury.
- Focus on endurance. Trekking in the Himalayas can require long days of sustained movement. Once or twice per week, try a longer workout to prepare your body for longer distances. If you need guidance, research and follow training programs for 10K or longer races.
- Don't forget strength training. In addition to your aerobic conditioning, use strength training exercises to tone your muscles before your trek in the Himalayas. Using free weights or machines at the gym will build up your strength.
- Hike on hills. Trekking in the Himalayas will include many steep ascents and descents, soprepare your body accordingly. At least once or twice per week, make a point to include hills in your daily workout. Alternate between steep hills and gradual inclines. If you can, carry your backpack during these workouts for additional physical conditioning.
- Make an effort to do some altitude training. Himalayan treks often include forays into high altitudes, which can affect the body in dramatic ways. Plan several weekend or longer trips to an area of high elevation to get an idea of how your body will react.
- REST: Rest days are important. Train hard but allow your body to recover. That includes a couple days of rest every week during training, and before the trek. Rule of thumb is to work up to peak fitness 2 weeks prior to the trek and then gradually reduce your physical effort and rest more.
Clothing and Equipment
- In Kathmandu or on the trek, dress conservatively. Women should avoid tank-tops and shorts (shorts than cover the knees are fine). Summer temperatures (May, June, July and August) in Kathmandu can rise up to 33 C/92 F with humidity in the upper eighties. Crystal Mountain Treks and Grand Asian Journeys will provide you average on-trek temperatures and a recommended clothing list after you book a trip with us.
- There have been several incidents of baggage not arriving with the passenger (in the peak season they may take as long as a week to arrive). This is especially the case when your flight to Nepal involves several connections. You can usually replace/rent everything in Kathmandu besides your hiking boots. Wear your hiking boots or hand-carry it. You may also want to include your sleeping bags in you carry-on baggage.
- Break in your hiking boots. Aim to wear your hiking boots for at least 20 miles before setting out on a Nepal trek. There is nothing that will ruin a trek faster than blisters caused by too-new boots.
Allow at least 3 months for all pre-trip preparations. Some vaccinations need to be taken as a series, so plan early. No Immunization is required for Nepal but the following are recommended. (Consult with your travel clinic)
- Hepatitis A
- Hepatitis B
- Typhoid Fever
- Meningococcal Meningitis
- Polio (Booster)
- Malaria (if you are visiting Chitwan or the Terai lowlands of Nepal)
- Japanese Encephalitis
In our years of experience organizing treks, the following three are the most common illnesses acquired by travelers in Nepal:
- Diarrhoea: The organisms that cause diarrhoea are acquired from eating or drinking contaminated food or water. More than 80% of diarrhoea cases in Nepal are caused bacteria. Giardia - 12%, E histolytica - 1%, Gastrointestinal virus - 5% and Cyclospora are other causes. A bacterial diarrhoea can easily be shortened by antibiotic treatment. Bacterial diarrhoea is characterized by the sudden onset of relatively uncomfortable diarrhoea. This means you can recall the time of the day your illness began. In contrast, protozoal diarrhoea usually begins with just a few loose stools, making people wonder if they are getting sick.
Diarrhoea treatments include
- Bacterial diarrhoea - Norfloxacin (400 mg) or Ciprofloxacin (500 mg), both taken twice a day for one to two days. If the diarrhoea goes away quickly, no need to take further treatment. If it doesn't, there is some other cause of diarrhoea present.
- Giardia - Tinidazole (2g) as a single dose each day for two days or albenazole (400 mg) once a day for seven days. The latter has fewer side effects.
- Respiratory infection: Many trips are ruined by severe respiratory infections. Virtually all respiratory infections begin as a common cold, caused by a virus. The symptoms consist of runny nose, congestion, sore throat and cough. The virus is picked up when you encounter people with colds, most likely at your lodge. Under normal circumstances the cold should last three to seven days and go away by itself. However, colds can lead to bacterial infections of the sinus (sinusitis), lungs (bronchitis) and ears (ear infections).
- Sinusitis - Any cold that is not getting better or, in fact, getting worse after seven days should be considered a possible sinus infection. Take Azithromycin (250 mg), two pills on the first day followed by one each morning for the next four days.
- Bronchitis and Pneumonia - Bronchitis is an infection of the breathing tubes in the lungs. Symptoms are progressively worse cough, accompanied by the production of greenish or yellowish mucus when you cough. Take Azithromycin (250 mg), two pills on the first day followed by one each morning for the next four days. A deep cough accompanied by high fever is pneumonia. Professional medical attention is required for Pneumonia.
- High altitude sickness: Most people are able to safely ascend up to 2,800 m (9,000 ft.) without suffering the effects of altitude sickness. If a person travels up to altitude more rapidly than her body can adjust, Acute Mountain Sickness (AMS) symptoms develop. Fluid accumulates in between the cells in the body and eventually collects where it can do the most harm. If ignored, the symptoms can occasionally progress to the more severe forms of altitude mountain sickness: High-altitude pulmonary edema and High-altitude cerebral edema.
- HAPE: With the onset of AMS, as fluid collects in the lungs, you become breathless more easily while walking, and eventually more breathless at rest. A cough begins, initially dry and irritative, but progressing to the production of pink, frothy sputum in its most severe form. The patient eventually drowns in this fluid if he or she doesn't descend.
- HACE: When fluid collects in the brain, you develop a headache, loss of appetite, nausea, and sometimes vomiting. You become tired and progressively develop a problem with balance and coordination.
The best treatment for the two severe forms of altitude sickness is RAPID DESCENT. Pharmacological treatments include Acetazolamide (Diamox) for both prevention (125mg every 12 hours) and treatment (250mg every 12 hours) of Acute Mountain Sickness, Dexamethasone (4mg every six hours) for High-altitude cerebral edema and Nifedipine (10mg every eight hours) for High-altitude pulmonary edema. But with both HAPE and HACE, immediate descent is required.
All the above medications will be available in our first-aid kit.
Advice from some of our veteran trekkers
"I've become a huge fan of probiotics and take two a day when I'm in Nepal and India. No tummy problems since I started doing this."
Claudine Weatherford, Bluemont, VA, USA
Article on probiotics:
- Lonely Planet, Trekking in the Nepal Himalaya by Stan Armington
- First Aid and Wilderness Medicine by Drs Jim Duff and Peter Gormly
- Travler's Tales, Nepal collected and edited by Rajendra S. Khadka