High Road to Leh - The Basics

vistet · May 27th, 2008, 22:12

I´ve been reading the recent Ladakh threads with a growing sense of despair : the itineraries , esp. Manali-Leh bring back images of some of the hairier stuff I´ve seen on the roads in Ladakh , Spiti & Tibet : most of it completely unnecessary.Read the safety guide lines, treat them with the same respect as diving tables , problem over. Preferably one night near but below 3000, one night around 3000 mandatory , next night below 4000.

The altitude issue : safety guide lines are the results of previous bad experience , something which we can do without repeating . Going too fast , too high involves a price in working capacity , well being ( headaches , nausea, vomiting and other neurological symptoms) or worse : pulmonary and cerebral edema are are ultimately fatal conditions.

Taking this not only from what I´ve seen myself , but from the descriptions of those who feel that they were more or less ok :

NEUROLOGICAL SYMPTOMS

"I was not sick, although there were some slight funny symptoms of altitude. I remember at the camp in Sarchu (4100 m) inside the toilet tent that I moved around to search for my torch, then my toilet paper, then my camera that I dropped etc and because of my too many fast movements I felt as if I was a bit drunk, I had slight orientation problems, but so only then when I moved too fast. It was funny smile. Also at Sarchu I had to laugh a lot about stupid things and couldn`t stop laughing... So I felt nice. "

"After some time I was lost into a strange world. The Illusion of being in hell was just flapping my eyes. My eyes were open but could see glowing colors. A normal man would say he say an alien ship but I knew that it was more of a Shock to the brain due to lack of Oxygen. I some how managed to get up and go out of the tent. I felt like the ground was shaking and the illusion was so damn real I could barely differentiate."

The first description sounds like being pleasantly drunk , the other less pleasantly so. The shaking ground part reminds me of the person who I later saw go unconscious , at the stage where two Sikh soldiers struggled to keep him upright while vomiting.

An obvious question comes to mind already at this stage : are you prepared to see any in the same state as a driver ?

The other less obvious conclusion is that all neurological symptoms are serious warnings : during the construction of the railway to Lhasa a simple balance test was used as a test for altitude sickness , and in a number of cases railway workers were evaced by helicopter after testing positive. These all worked and slept around the same altitude as Pang, and had a minimum transport only time up to that altitude of four days.

OTHER SYMPTOMS :

"Started feeling a strange sensation on my chest. Felt like a huge load of stones were on top. "

That would probably be the early stages of pulmonary edema. Next stage is a funny gurgling noise from the chest : not funny haha , more like where is that chopper ?

On the less serious side you have work capacity : read the numerous comments on low physical condition from the freshly arrived ( "I had zero energy to even move few feet to the left.") and sensitivity to cold . Coping with cold is intimately linked to acclimatization - the body basically can´t afford normal circulation in the periphery , like hands and feet , while dramatically increasing the same in lungs and brain.

CONCLUSIONS :
Need and and acceptable risk are different for different people.
Some factors should be strong indicators to adhere to safety guide lines, if any reason at all should be given :

*travelling with children. I find it appalling that anyone can recommend going 4000+ without any effective acclimatization with a minor in the company. I have experienced a child suddenly going quiet , for all the wrong reasons , in this situation : believe me , it´s hard enough just as a bystander.

*Pre-existing health conditions : asthma has been mentioned recently. Ditching safety standards is a poor idea to start with , I won´t go in to further detail on the topic except to say that anyone planning to hit 5000 in this situation needs to speak with a good doc , among other things to discuss medication.

*The driver : having a driver that is familiar with the roads and have the basic advantage of being acclimatised to 2000 meters may be a marginal advantage , but in this situation you don´t have the option of giving up any marginals.If you plan to hire a vehicle with driver , do it in Manali. If you plan to do it yourself , do it in the right way.

THE POSITIVE OPTIONS :

For anyone doing the complete circuit Delhi-Leh-Srinagar it´s real simple : do it the other direction. You get one night at 2700 in Kargil , next night in Leh with the intervening passes all lower than the Vomit Hilton at 4253 ( or , god forbid , Pang).
This should also be the logical first choice for those who want to drive themselves , with children etc.More on the Srinagar-Leh road here : Chilling in Kargil : Tweaking the Srinagar-Leh Road

Doing the Manali-Leh route the single most important safety factor is to get an acclimatization stop at around 3000 : Keylong , just under 3100 is the easiest option , Jispa and Darcha (3400) are also possible .After Darcha practically everything is above 4000, and a lot between the altitudes of Mont Blanc and Everest Base Camp : retreating to a safe altitude is very hard , and will often involve going over higher passes.
If you want to do Sarchu (yes, it can be heartbreakingly beautiful) do it on the return leg , you´ll get more out of the experience.

More on the Manali-Leh road here : Sleepless in Sarchu : Tweaking the Manali-Leh Highway

capt_mahajan · May 27th, 2008, 22:39

Thanks, vistet.

A trip has been germinating in my mind for awhile. Last few times I went there, I was stupid. This time I plan to be less so.

Quote:

treat them with the same respect as diving tables

that I can kind of relate to.

vistet · May 28th, 2008, 00:04

Experience are the mistakes we face up to : I´m still pretty embarassed by some of the the choices I made on my first Manali-Leh run.Some things never hit me until some years later , like the boot thing : I have this perfect image of my boots standing by the opening of the tent in Pang , when I woke up , looking like they had been meticulously painted with slurry. Perfect image of just how exhausted I was after the somewhat chaotic clearing of the road high above Pang. Perfect image - in my head. Took me a long while to reflect on the simple fact that I could see the image , but didn´t take the shot.

dzibead · May 28th, 2008, 00:33

I wish people would listen to you, vistet, but so many people who have posted recently are so sure they know what they're doing, and are so nonchalant about their own safety (and the safety of others!)

dumb_bacchus · May 28th, 2008, 01:34

I am so proud of myself that I listened to all you folks before embarking on my first Delhi - Leh - Srinagar - Delhi bike trip. I did it with ease, slowly, carefully and methodologically - had a time of my life. Thanks.
Trust me what matters is to be in heaven and still be alive!

Best luck to all the travelers of this season :-)

Dilliwala · May 28th, 2008, 06:01

Thanks again, vistet, great stuff.
Well, you can only do so much about educating people, at some point they have to take responsibility for themselves. I certainly have great appreciation for all the excellent posts on AMS that you, AvidTrekker and a few others have put on the site - I now realise my own knowledge before was practically zero! Consequently my own minuscule contribution is to point to any such posts or the info gained from them whenever I see e.g. someone thinking of the Vomit Hilton and the Vomit Hilton Plus! (Pang).
If I may say so, my reading is that quite a few members do heed the advice when it's pointed out to them (more than half for sure); like me, they tend to start out knowing next to nothing - more a case of ignorance rather than bravado. So carry on fighting the good fight.

A question:
Wud it be ok to drop links to some of the posts/threads here? There is a LOT of info on IM, and it's difficult to track down and/or collate sometimes. And it's definitely not easy to remember all of it one go

. I.e. periodic refreshers are useful, specially shortly before starting a tour.

Actually I've felt for a while that a bang-up all-in-one thread with the various links and other info wud be very helpful, after all this concerns high-altitude trekkers too.
There is already a sticky on AMS, it cud be done in that thread if that's more appropriate, or any other one deemed appropriate. What do you think?
Others feel free to add your ideas.

May 27th, 2008, 22:12	#1
vistet Maha Guru Member Join Date: Jul 2002 Location: Umeå , Sweden Posts: 1,733	High Road to Leh - The Basics I´ve been reading the recent Ladakh threads with a growing sense of despair : the itineraries , esp. Manali-Leh bring back images of some of the hairier stuff I´ve seen on the roads in Ladakh , Spiti & Tibet : most of it completely unnecessary.Read the safety guide lines, treat them with the same respect as diving tables , problem over. Preferably one night near but below 3000, one night around 3000 mandatory , next night below 4000. The altitude issue : safety guide lines are the results of previous bad experience , something which we can do without repeating . Going too fast , too high involves a price in working capacity , well being ( headaches , nausea, vomiting and other neurological symptoms) or worse : pulmonary and cerebral edema are are ultimately fatal conditions. Taking this not only from what I´ve seen myself , but from the descriptions of those who feel that they were more or less ok : NEUROLOGICAL SYMPTOMS "I was not sick, although there were some slight funny symptoms of altitude. I remember at the camp in Sarchu (4100 m) inside the toilet tent that I moved around to search for my torch, then my toilet paper, then my camera that I dropped etc and because of my too many fast movements I felt as if I was a bit drunk, I had slight orientation problems, but so only then when I moved too fast. It was funny smile. Also at Sarchu I had to laugh a lot about stupid things and couldn`t stop laughing... So I felt nice. " "After some time I was lost into a strange world. The Illusion of being in hell was just flapping my eyes. My eyes were open but could see glowing colors. A normal man would say he say an alien ship but I knew that it was more of a Shock to the brain due to lack of Oxygen. I some how managed to get up and go out of the tent. I felt like the ground was shaking and the illusion was so damn real I could barely differentiate." The first description sounds like being pleasantly drunk , the other less pleasantly so. The shaking ground part reminds me of the person who I later saw go unconscious , at the stage where two Sikh soldiers struggled to keep him upright while vomiting. An obvious question comes to mind already at this stage : are you prepared to see any in the same state as a driver ? The other less obvious conclusion is that all neurological symptoms are serious warnings : during the construction of the railway to Lhasa a simple balance test was used as a test for altitude sickness , and in a number of cases railway workers were evaced by helicopter after testing positive. These all worked and slept around the same altitude as Pang, and had a minimum transport only time up to that altitude of four days. OTHER SYMPTOMS : "Started feeling a strange sensation on my chest. Felt like a huge load of stones were on top. " That would probably be the early stages of pulmonary edema. Next stage is a funny gurgling noise from the chest : not funny haha , more like where is that chopper ? On the less serious side you have work capacity : read the numerous comments on low physical condition from the freshly arrived ( "I had zero energy to even move few feet to the left.") and sensitivity to cold . Coping with cold is intimately linked to acclimatization - the body basically can´t afford normal circulation in the periphery , like hands and feet , while dramatically increasing the same in lungs and brain. CONCLUSIONS : Need and and acceptable risk are different for different people. Some factors should be strong indicators to adhere to safety guide lines, if any reason at all should be given : travelling with children. I find it appalling that anyone can recommend going 4000+ without any effective acclimatization with a minor in the company. I have experienced a child suddenly going quiet , for all the wrong reasons , in this situation : believe me , it´s hard enough just as a bystander. Pre-existing health conditions : asthma has been mentioned recently. Ditching safety standards is a poor idea to start with , I won´t go in to further detail on the topic except to say that anyone planning to hit 5000 in this situation needs to speak with a good doc , among other things to discuss medication. The driver : having a driver that is familiar with the roads and have the basic advantage of being acclimatised to 2000 meters may be a marginal advantage , but in this situation you don´t have the option of giving up any marginals.If you plan to hire a vehicle with driver , do it in Manali. If you plan to do it yourself , do it in the right way. THE POSITIVE OPTIONS : For anyone doing the complete circuit Delhi-Leh-Srinagar it´s real simple : do it the other direction. You get one night at 2700 in Kargil , next night in Leh with the intervening passes all lower than the Vomit Hilton at 4253 ( or , god forbid , Pang). This should also be the logical first choice for those who want to drive themselves , with children etc.More on the Srinagar-Leh road here : Chilling in Kargil : Tweaking the Srinagar-Leh Road Doing the Manali-Leh route the single most important safety factor is to get an acclimatization stop at around 3000 : Keylong , just under 3100 is the easiest option , Jispa and Darcha (3400) are also possible .After Darcha practically everything is above 4000, and a lot between the altitudes of Mont Blanc and Everest Base Camp : retreating to a safe altitude is very hard , and will often involve going over higher passes. If you want to do Sarchu (yes, it can be heartbreakingly beautiful) do it on the return leg , you´ll get more out of the experience. More on the Manali-Leh road here : Sleepless in Sarchu : Tweaking the Manali-Leh Highway __________________ high road to .. Last edited by vistet : May 28th, 2008 at 05:36.*

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May 28th, 2008, 00:04	#3
vistet Maha Guru Member Join Date: Jul 2002 Location: Umeå , Sweden Posts: 1,733	Experience are the mistakes we face up to : I´m still pretty embarassed by some of the the choices I made on my first Manali-Leh run.Some things never hit me until some years later , like the boot thing : I have this perfect image of my boots standing by the opening of the tent in Pang , when I woke up , looking like they had been meticulously painted with slurry. Perfect image of just how exhausted I was after the somewhat chaotic clearing of the road high above Pang. Perfect image - in my head. Took me a long while to reflect on the simple fact that I could see the image , but didn´t take the shot.

May 28th, 2008, 00:33	#4
dzibead Maha Guru Member Join Date: Sep 2004 Location: Northern California Posts: 2,077	I wish people would listen to you, vistet, but so many people who have posted recently are so sure they know what they're doing, and are so nonchalant about their own safety (and the safety of others!)

May 28th, 2008, 01:34	#5
dumb_bacchus Senior Member Join Date: Sep 2004 Location: New Delhi Posts: 158	I am so proud of myself that I listened to all you folks before embarking on my first Delhi - Leh - Srinagar - Delhi bike trip. I did it with ease, slowly, carefully and methodologically - had a time of my life. Thanks. Trust me what matters is to be in heaven and still be alive! Best luck to all the travelers of this season :-)

May 28th, 2008, 06:01	#6
Dilliwala Funky flunky Join Date: May 2007 Location: Dilli Posts: 3,562	Thanks again, vistet, great stuff. Well, you can only do so much about educating people, at some point they have to take responsibility for themselves. I certainly have great appreciation for all the excellent posts on AMS that you, AvidTrekker and a few others have put on the site - I now realise my own knowledge before was practically zero! Consequently my own minuscule contribution is to point to any such posts or the info gained from them whenever I see e.g. someone thinking of the Vomit Hilton and the Vomit Hilton Plus! (Pang). If I may say so, my reading is that quite a few members do heed the advice when it's pointed out to them (more than half for sure); like me, they tend to start out knowing next to nothing - more a case of ignorance rather than bravado. So carry on fighting the good fight. A question: Wud it be ok to drop links to some of the posts/threads here? There is a LOT of info on IM, and it's difficult to track down and/or collate sometimes. And it's definitely not easy to remember all of it one go . I.e. periodic refreshers are useful, specially shortly before starting a tour. Actually I've felt for a while that a bang-up all-in-one thread with the various links and other info wud be very helpful, after all this concerns high-altitude trekkers too. There is already a sticky on AMS, it cud be done in that thread if that's more appropriate, or any other one deemed appropriate. What do you think? Others feel free to add your ideas.

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