Family trek in Ladakh

montana

I'm travelling to Ladakh this summer with my husband and 11 year old daughter. A local agency is helping organize our stay, which will include treks, but I'd love to hear from other families who had had the experience and can recommend itineraries that are do-able (altitude-wise) and fun for kids. How did they do with the altitude? Is a 7 day trek too long if it's organized well (w/riding ponies)? And is the Tsomoriri region a good sidetrip?
There's not a lot on the web about travelling with kids in Ladakh, so would be most grateful for any tips, advice, recommandations!

mountaingirl

Hi! which trek are you planning to go on? How many days are you spending in Ladakh in total and how are you going up to Leh? how much time have you given yourself to acclimatise to the altitude?

montana

We're spending 18 days in Ladakh, arriving with flight from Delhi, spending 4-5 days acclimatizing, then doing a modified Markha Valley trek (it cuts off the first two days of the classic hike and thereby avoids a 5000 m pass the second day). that trip will last 7-8 days, but will involve crossing 5100 m pass later on. the agency I'm working with took a family last year and has experience organizing with children, but I'd still like to hear from other families' who have trekked in Ladakh.

AvidTrekker

I have trekked at these altitudes with 25 to 40 children at times. Of these at least 7 or 8 were 10/11/12 yrs old. Most were 14/15/16. Some were 17/18.

Take care that your child drinks water adequately. Do not climb more than 1500ft in a day. If your flying into Leh, do nothing for the first four days. Only go for short walks, no more than 5 km a day. Then you are acclimatized for the trek proper.

Over the years, many of my friends have discovered that you acclimatize better when your getting older. Children take more time. Here are some medical tips :

The urine should be colourless. This means hydration is "adequate". If its dark yellow, ring the alarm bells. Appetite should be "present". It reduces in the mountains, but should not "disappear". Faeces should be more dung-like i.e. should be slightly "loose". Hard faeces means "low hydration" & "alarm bells". "No faeces" means not gone for a shit. Hydration is down, down, down. A headache may be just round the corner. For those who defecate regularly all mornings, ask yourself this question: did I have sound sleep last night? If the answer is "no" then all is not well. Descend to a lower altitude and/or drink the Great Lakes.


Have garlic soup every day. It is the BEST acclimatization food. The Himalayan people taught me. Raw garlic is the best, but even I cannot eat it every day. As a compromise, one may take two garlic tablets all mornings in the mountains.

The best research on hi-altitude mountain medicine is done at the Army Research Centre in Ladakh. How many doctors would have a research facility at an altitude of 14,000 feet? They have successfully brought down HAPE/HACE related fatalities to almost ZERO. Even they recommend eating garlic every day apart from all the other precautions.

Very Happy Trekking!!!

__________________
The Universe is an ellipsoid?... or a Spheroid?? If the sphere smiles... it becomes an ellipse. This IS Creation.

montana

Thank you very much for your advice and symptoms to watch for. It's VERY much appreciated.
Best regards.

medicineman

Well, we're a medium sized group and we have three children the youngest is 4 and the oldest is 7 we also have a middleaged couple. No one has any medical problems. I and my wife are Doctors BUT still does anyone have any data on incidence of High Altitude effects on children. I should be able to recognise the symptoms and signs but why expose the children to the risk. We are not going to be trekking at all. We'll probably hire a van or something. Does Avidtrekker have any experince in this regard I wonder??
Thanks LOL

indiawise

I was talking to this friend of mine from Ladakh..our conversation got cut short as I had to run off on an erand. Well he told me that basically the idea is to not DO ANYTHING for the first 40 hours. That is to take is real easy and rest for this time, preferably not wander out of your hotel room. Then after this u could take a SHORT walk to the bazaar. The same formula applies for taxi etc. I'll hopefuly be getting more details tomorrow which I'll post. Avidtrekker however seems to have had personal experience and his tips are very informative.

montana

Medicineman's query prompted me to do some more research for myself as well. You should check out the following site:

http://www.ismmed.org/ISMM_Children_...# preexisting

A google search for Hape Hace children will turn up several others, including treksafe.com, which includes good general advice.

lightning

Montana,
I picked up an excellent book by a guy called Stephen Bezruchka, called
Trekking in Nepal, A Traveler's Guide.
Pub. CORDEE in GB. 7th ed.
in USA : mountaineers books
ISBN 1-871890-93-4

He is a medical doctor who has been trekking the Himalayas since the 70's also with his wife and young family. His medical section particularly on altitude sickness is very thorogh.
As well as being a most informative guide generally, he has a section about trekking with children (!)
It's a pleasure to read as he gives a lot of cultural and social insights into mountain life

vistet

I´ve seen people from different age groups having altitude symtoms (not claiming any statistical relevance) , including a 18 month baby and a teenager.
I´ve read up a fair bit on the subject and havent seen anyone presenting any evidence than any age group is more affected.
It`s interesting to compare discussions (on the road, TT, here) with the attitudes towards diving. If we had discussions on diving along the same lines as we find in threads on AMS we would meet suggestions of drugs extracted from Irish peat, tales of rapid ascents without problems, and more ...
Personally I would welcome more of a divers attitude towards AMS : establishing & adhering to ascent tables in the same way divers have decompression tables etc. Sure there are individual variations - but this is probably not the reasons why it is so hard to establish safe norms.

One of these reasons is obviously is just money: travel agencies will work close or over the danger threshold in order to pack a intense , short experience. These trips (viewed in catalogues, travel programs etc) becomes the norm for a lot of others.
Another reason is the anonymity of porters and sherpas etc : if westerners were aware of how often locals are affected they would step back and reconsider more often.
If this was a condition that in a higher degree affected the moneyed I´m sure resources also would be found to make a scoring system that would make a more systematic approach possible.

None of this is meant to be discouraging : acclimatise after arriving in Leh, listen to your bodies as you already have said and you will have a smashing time.
One last point : consider pediatric doses of ASA(for adults) after you`ve acclimatised and start out for longish bus trips.

AvidTrekker

Yes, Stephen Bezruchka's writing is excellent, both the medical and the non-medical sections.

Some general tips for the Kiddos :

1. Keep the children generally HAPPY. Not to meet unreasonable demands though.... like "I wanna eat chocolate all day and nothing else" Watch out for signs of general moroseness which could be "blood-chemistry" related.

2. Feed them more carbohydrates than sugar. Carbs give "long-term" energy cuz they are "slow burners". This holds true both at hi-altitude as well as sea level. Of course, I have yet to see a child who refrains from sweets. Just keep them "limited". For example, a 30kg child can eat 150gm of chocolate THROUGHOUT the day. Other sweets may be eaten alongwith meals... just so that the (carbs+ors) are 75% and sweets are 25% or less. Proteins could be upto 15%. (daahl is protein). Any flesh, red or white, should be brought from your home country, canned. I would not risk local flesh, especially goat/sheep. Chicken in the mountains is relatively safe, though. If you wanna play absolutely safe, stick to a vegetarian diet in the mountains. Supplements of vitamins B3+B6+B12 plus folate will help if taken daily. Calcium+zinc+alpha D3 may be taken mornings.

3. Desist from junk food as far as possible. Too much salt and/or sugar is the principle reason for "hyper" activity in children (at all altitudes). Sometimes I know that their favourite "junk-food" is the only thing that will placate them if they are upset for some reason.

4. Ask them if they been "to the potty" today? "No" means trouble could come up. Make them drink lotsa water. Regular hydration is the ONLY real medicine. When you enter Leh by aircraft the faeces will be well formed. In the next three or four acclimatization days, the faeces will become somewhat dung-like and will tend to spread out on falling. This is a good sign. Well formed faeces is "so-so". Hard faeces is a "bad" sign. This is true for all... children + adults.

5. Watch out for "a mild headache" or "I am not hungry". If the child says "I am not hungry" DO NOT force the child to eat. Not eating is certainly better than "eating" without the requisite acid pH (2.5 to 3.5 pH) in the stomach (this is called "hunger" by humans) By all means you may force the child to drink water if you feel that the intake is not enough. Three big sips every 30 mins should be adequate.

6. You have said that "you won't be trekking at all". Means " gonna do Ladakh by vehicle". Vehicular motion related "motion sickness" is a very REAL problem faced by people. Even local Ladakhis could be found vomitting out of bus-windows. Get your medication from your hometown if any one is prone to vehicular motion sickness. The concerned person (adults included) would be better off taking a dose "before" getting into the vehicle. It does seem to prevent episodes, definitely does reduce their frequency/intensity.

Most likely, you are flying into Leh.

7. In this case, do nothing for the first three days. Just saunter around town. Eat sparingly.... such that you are constantly slightly hungry. Of course, you will get bored in three hours doing nothing.... but can't be helped. You can take short rides in jeeps for 20 mins.

8. On the third day, if everyone feels "fine" then go for a long walk (say 4 to 5 hrs) (without large backpacks). Walk at an easy pace. If the children feel ravenous after the long walk..... you have made it!! Go now wherever you wanna go!

9. Be careful of children going out at night to pee. See that they are warmly dressed up in three layers. One of my wards (he was a strapping youth of 15 and quite healthy) went out to pee wearing only his shorts and cotton vest. The sudden change in temp. from 32 deg C (inside the sleeping bag) to 2 deg C (outside the log hut) resulted in a sudden loss of body heat and he fainted on the steps of the log hut on his way back. Fortunately he had obeyed rules: "Thou shall not go outside without a buddy at night" The buddy reported this immdtly. The buddy was very warmly dressed .... presumably the same thing did not happen to him. The boy in question lost two days of trekking.

This peeing matter cannot be taken lightly. In the extreme cold, urination is quite frequent. And all of us MUST drink plenty of water.... so just be careful. Best thing is to go inside your sleeping bag well dressed. Most of us get up at night with a "bladder-full" sensation. There is no time for "dressing up".

I have written this extempore.... cuz i'm in a bit of a hurry. Rest will write as & when it occurs to me.

HAVE FUN GUYS!!!

vistet

Avid ,
good solid advice as always. I disagree on on the above point, though. Since nausea/loss of balance also are symtoms of hypoxia & altititude sickness , I feel that nausea in combination with a recent ascent should be viewed and treated as such to be on the safe side.

vistet

Sounds interesting .. he has also written a travel health book called The Pocket Doctor.

Alan D

Just a small point from your very informative last post AvidTrekker - My wife and I both got sick from eating chicken in Leh.

The family at the guest house where we were staying told us that it is risky in summer as the chicken comes up in unrefrigerated trucks from Srinagar and can "go off" in the high temperatures. We will be sticking to veg food on our next visit!

montana

Lightening, thanks for the book suggestion. I'll order it immediately.

And Avidtreker, thanks again for your precise advise (headaches, car sicknessness, all of that is very useful. Some more questions if you still have the patience:

1. Is it recommended for children to take anything--either preventatively, or when symptoms appear-- for altitude sickness? What about diamox? I haven't read up enough on this yet, so please forgive my basic questions. Should mention also that my daughter (11) has asthmatic symptoms (provoked by dust, mites) but has followed a long term treatment, has no crises, and according to her lung doctor has lung capacity better than the norm. She sees no inconveniances with her going to Ladakh as long as we monitor effort and any eventual difficulty closely. If anybody has experience in this area, however, would appreciate hearing.

2. I often experienced mild constipation for the first few days in the Alps. Is hard faeces a symptom to watch for, or can simply eating dried fruit help? Again, I'm mainly concerned about my child. I wouldn't want to "cover up" symptoms that should be noticed by feeding her or us too many dried prunes...

3. On eating: our organizer say meals include chicken in the mountains (Avidtreker seems to think this is safe) with lots of vegetables including "salad". In most remote places or developing countries I've travelled in, you don't touch a raw vegetable with a barge pole unless you've practically sterilized it yourself. What are vegie meals on the trek in Ladakh (Alan D)? Mostly cooked? Should we avoid anything raw?

Thanks and best , Montana