Essential Nepal Information

  • – Acute Mountain Sickness
  • – What is AMS
  • – AMS Symptoms
  • – How to Avoid AMS
  • – AMS Treatment

 

Acute Mountain Sickness (AMS)

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Many of our itineraries in Nepal go above 2,800 metres (9,200 feet) where it is quite common for travellers to experience some adverse effects on their health due to the altitude.

It has even been reported that it happened to Sir Edmund Hillary!

Whilst our leaders have basic first aid training and are aware of the closest medical facilities and familiar with the symptoms of altitude sickness, it is very important that you make yourself familiar with the effects and the causes of travelling at altitude, monitor your health and seek assistance accordingly.

Our experienced guides and leaders are equipped with first aid kits and safety items such as Portable Altitude Chambers (PAC’s) that can be used in the event of severe altitude sickness.

Please read this document carefully and utilise the table at the end on a daily basis to record the symptoms of your general health that you may be experiencing.

Please note this document is assembled from feedback and information provided from our group leaders and tour guides on the ground.

The following information is for general advice and guideline purposes only and is in no way intended to replace the advice of a trained medical professional.

As such You-in is unable to accept responsibility for any inconvenience, injury and/or loss sustained by any person, caused by errors and omissions, or as a result of the advice and information given here.

We recommend all travelling passengers to conduct their research before travelling.

For free and useful resource information please also visit-

http://medex.org.uk/medex_book/

 

What Is AMS?

Acute Mountain Sickness or ore commonly known – Altitude sickness, is the reaction of the body adjusting to a lower amount of oxygen in the atmosphere.

Normally, the higher the altitude, there is less oxygen available for the body to absorb and carry on normal functions.

AMS most commonly occurs from above 2,800 metres (9,200 ft) but this varies for everyone – to put simply, there is no way of knowing your susceptibility being exposed to altitude, thus it is vital you monitor your health.

Symptoms may be mild and may subside or even go away after a day’s rest on one of your scheduled rest days, or if it is ignored and not treated it could lead to death in severe cases.

 

AMS Symptoms

Some symptoms can appear within 1-2 hours, although most often appear around 6-10 hours after ascent and generally subside in 1-2 days as your body adjusts to altitude.

They may reappear as you continue to go to a higher altitude.

Symptoms generally occur gradually and usually can be one or a combination of the following:

If the body is unable to adjust to altitude these symptoms will persist and, if they are left untreated, altitude sickness may progress to High Altitude Cerebral Edema (HACE) or High Altitude Pulmonary Edema (HAPE). *** Both can be fatal if ignored ***

 

Symptoms of HAPE (fluid on the lungs):

HAPE can occasionally develop without the usual symptoms of AMS – a telltale sign is when at rest, breathing does not return to normal, it remains shallow, rapid and panting even after an extended period of inactivity, and is often accompanied by a cough.

Symptoms of HACE (fluid on the brain):

How To Avoid Altitude Sickness?

Certain medications (such as sleeping pills) or medical conditions (such as respiratory disease) can increase the risk of altitude sickness – you must inform your leader of any medical conditions or medications before ascending to altitude.

You can reduce symptoms and help your body to acclimatise and avoid altitude sickness by:

AMS Treatment

Our experienced guides and leaders are equipped with first aid kits and safety items such as Portable Altitude Chambers (PAC’s) that can be used in the event of severe altitude sickness.

By following the previously mentioned guidelines, most travellers can successfully acclimatise. However, there are some instances where medical treatment is required.

Ultimately, the best treatment for acute altitude sickness is to descend to a lower altitude.

In the best interests of your health and well-being, there may be times when your leader makes the decision that you or a member of your group is at risk of serious altitude sickness and for safety insists that you/they cannot ascend further – please respect that they are within their rights to do so and are making that decision in the best interests for you.

By completing the below chart from the first day you experience any altitude sickness symptoms, this will help you to keep track and monitor any of the altitude-related symptoms you may experience.

We encourage you to discuss with your leader straight away if you are experiencing any altitude sickness symptoms, so you both can follow your acclimatisation progress.

However, should you rate the severity of any symptoms at 7 or more, or the symptoms continue/worsen after the initial 1-2 days, please inform your leader without delay, so that we can seek the advice of a trained medical professional if necessary.

The key is to personally assess whether your symptoms are improving or worsening, as everyone will have a different perception of the severity of their symptoms.

A rough guide would be:

1 = Very minor symptoms that are causing no discomfort
5 = Moderate discomfort
10 = Extreme discomfort

Passport and visas

Visas are the responsibility of the individual traveller(s). 

Visa requirements can change at any time, so you must check for the latest information. Please visit the relevant consular website of the country or countries you’re visiting for detailed and up-to-date visa information specific to your nationality. 

Your You-in representative will also be happy to point you in the right direction with acquiring visas. 

Visas can take several weeks to process, so familiarise yourself with any requirements as soon as you have considered your trip to allow for any delays in the processing time.

NEPAL:
Visas are obtainable on arrival at Kathmandu’s Tribhuvan Airport and from embassies abroad in your respective country.

All foreign nationals (except Indian passport holders) require a visa to enter Nepal.

Getting a visa at the airport or land border entry points can sometimes take time due to long queues. There have been instances where travellers are asked to show proof of exit from the country, ie flight tickets. 

You may also need to provide two passport photos and the following fees in US dollars (subject to change, cash only). 

Other currencies are also accepted although rates may differ. 

The following costs were correct at time of writing:

– Multi entry visa valid for 15 days – US$30
– Multi entry visa valid for 30 days – US$50
– Multi entry visa valid for 90 days – US$125

Your visa application form may require you to state the dates on which you enter and exit that country. 

Please note we suggest you list your date of entry to a few days before, and exit date a few days after your intended dates in case you encounter any delays or problems en route.

We would advise you obtain the correct visa before departure to ensure there are no processing issues at your point of entry.

Currency Information

NEPAL:
The official currency of Nepal is the Nepali rupee (NPR). Its symbol is often displayed as Rs. USD are also widely accepted in Nepal. 

ATMs are limited and can only be found in Kathmandu, Pokhara, and Bhaktapur so make sure you carry sufficient cash to cover your needs when travelling outside of these main cities. 

Money exchange facilities are available in Kathmandu, Namche, Pokhara, Chitwan (only outside the park) and Bhaktapur. 

International credit cards are not widely accepted and should not be relied on.

Please be aware that the government of Nepal has banned the use of 500 and 1000 Indian rupee notes in Nepal. Please ensure you are not carrying these notes on arrival in Nepal as they will be confiscated from you and you could be fined.

It is also worth noting that most establishments in Asia will not accept notes of foreign currency that are old, torn and/or faded and they can be very difficult to exchange or extra fees can be added when exchanging at banks. Please ensure that you have new, clean notes where possible to reduce any risks.

Before departing on a trek, make sure you have enough Nepalese currency for snacks and drinks etc you may wish to purchase, and in smaller denominations where possible, and as there are no ATMs and larger notes (such as 1000R / $13 AUD) can be difficult to receive change.

SPENDING MONEY:
Every traveller is a little different when it comes to spending money on any trip. You know your spending habits better than anyone, so please budget a sensible amount for things like meals and drinks that are not included, shopping, any optional activities and laundry, WIFI, electricity where required. 

It’s always better to bring more than you think you’ll need and common sense should prevail. Please also make sure you’ve read your trip details thoroughly so you know what’s included in the trip price and what isn’t. If you have any questions, please do not hesitate to contact one of our team members for clarification.

This should make budgeting a little easier for you. You’ll find this info in the Inclusions section of your Trip itinerary.

EMERGENCY FUNDS:
At You-in we try to plan for every eventuality, but like many things in life, there are still some things beyond our control. Please make sure you have access to an extra US$500 (minimum) for emergencies like severe weather, natural disasters, civil unrest, airport closures or cancellations, strikes or any other events that would result in unavoidable changes to the itinerary. 

Sometimes these things necessitate last-minute changes to enable our trips to continue to run, and as a result, there may be some extra costs involved.

Travel Insurance

Travel insurance is compulsory for all our trips and must be shown on arrival to your tour leader. We require that, at a minimum, you are covered for medical expenses including emergency repatriation including includes helicopter rescue and air ambulance. 

We strongly recommend that the policy also covers personal liability, cancellation, curtailment and loss of luggage and personal effects.

When travelling on a trip, you won’t be permitted to join the group until evidence of travel insurance and the insurance company’s 24-hour emergency contact number has been sighted by your leader.

If you have credit card insurance your group leader will require details of the participating insurer/underwriter, the level of coverage, policy number and emergency contact number rather than the bank’s name and credit card details. 

Please request your bank for these details prior to arriving in-country.

Alternatively, please speak to your You-in representative who can advise on insurance companies who offer comprehensive insurance that will cover all aspects of your trip.

Cancellation insurance will not and does not cover you if you change your mind.

 
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