Addendum to Trekking Advice

I attach a letter from my friend and school-mate Paul Mathew as an addendum to 'Trekking Advice'. Paul is a US-based doctor and a trekker, and has a perspective that combines these (and is therefore rare). Very useful additional information, particularly on implements and appliances and on must-have medicines. Please have a read!


Dear Ajit

Thanks for sharing this personal note with me. It was very interesting to see a perspective from someone who has done a lot more high altitude than I have or perhaps ever will....

I jotted a few notes while reading it, extracting from memory some of the stuff I found valuable from the last trip...I should say that we had mules carrying stuff on their backs for us so weight was not as much a concern although clearly there were limits.... we did carry our layers, water and snacks in Himachal.

- Wet wipes were a savior but a bundle of them does have significant weight...nevertheless a great personal hygeine item to freshen up the unmentionables and deal with the ripeness. A well calibrated number of them e.g. 3-6 per day shouldnt weigh that much....didnt use a shit mug as thats a very Indian thing you know...just toilet paper followed by wet wipes.

- My all time fave was the pee bottle for the night in high altitude. I still give thanks to the Almighty for just being able to roll over, unzip, pee, rezip and go back to sleep...no getting out into a freezing night and panting and gasping just to pee. Plus since we are pushing fluids, I had to pee twice every night...prostate isnt getting any smaller you know...The key things was not to overfill the bottle or spill it inside the tent ! My tentmate Vinod was both jealous and suspicious of the thing...he thought I derived personal enjoyment from its use....somehow he never got up at night to pee and was able to hold it... I wondered at that.

- Highly endorse the layers concept. Including liner socks below the woolen ones, woollen hat that comes down over the ears...I avoided cotton as it doesnt wick as efficiently. I tried to get all breathable woolen stuff as undies for the cold......I had a non-woolen top-and-bottom pair for the lower altitudes and warmer temps to be flexible. A rinse at the end of the day before the sun goes down when the opportunity arises allows it to clean and dry fast....It was good to have a water and windproof outermost layer - both jacket and trousers.
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- For the snow, wrap-around goggles were better than the sunglasses which leaked in glare from the sides....

- I didnt have camp slippers but up high I preferred to unlace my boots so that they were loose and tuck the laces into the boots and walked around camp that way...it was easy to slip in and out of them.

- For drinking the platypus (or bladders as you may call them) that contained up to 3 liters of water with electrolytes (1 tab/liter) in them helped stay the inevitable cramps that I dread at night...I also had a nifty large capacity water filter and iodine tablets for purification. Yup, the weight did add up but again, there were mules...

- Another major joy was the inflatable lightweight (1 lb) ridge mattress that provided sweet comfort and insulation as we camped on snow. I had an insulating sheet over it (vanishingly light material) and then over that my sleeping bag.

- We took diamox for high-altitude sickness prophylaxis and had dexamethasone on hand in case we got sick. Ending up using it as we did ascend rather fast and I started getting headaches and feeling out of it....probably was overkill...but I felt a helluva lot better the next morning and cut down on the dex....There are pretty good websites out there that give good scientific opinions on what best practices are for prevention and treatment of high-altitude sicknesses of varying severity...

Having antibiotics (azithromycin preferred over ciprofloxacin based on my travel docs advice and he was right...cipro didnt work but azithro did for the diarrhea...I was surprised) and anti-diarrheals was great as there was shit everywhere on the trail close to our water sources and we all had loose stools eventually...there are some warnings out on azithromycin and heart arrhythmias now...so we'll see if the recommendations change...

Insect-repellant always a good idea if there are flies/mosquitoes possible...I had hell in Yosemite with the mosquitoes one August. They seemed immune to the repellant..

A whistle in a pocket is a great thing to have - managed to scare a bear that was coming straight toward me while alone on a path in Yosemite...and it could be useful to call for help if needed...

Dont know how to use a compass....yet...or read a relief map. Hoping to take a course on that but with a guide, one doesnt really need that...as long as you are on a well-marked trail...

How about trekking poles? I loved having them, as much for the downhills to take pressure off the knees (fully extended) or on the stiff uphills or traversing rocky surfaces, to test their stability or even while crossing a
stream, for stabilization....

An inner pair of gloves able to operate a camera was also useful in the cold if the outer gloves were too bulky....

Head-torch is the best...hands-free in the bogs...

Learning to shit into the hole with all those clothing layers was quite a performance. Of course the closer you get to the shit tent, the urge to explode is something else !!!

Some of the gear I am mentioning can be expensive stuff but I am hoping to have long use of what I have now...

Anyway, this is the fat spoiled American version...I couldnt help noticing the casual underdressed look of the local camp crew...they are hardy hill folk and I am just a city slicker so not too much shame there....

I think fitness is a big deal as you put it...we were pretty close in fitness until we got above 12,000 and then I really started to struggle...I think it was not merely a fitness thing but a high-altitude tolerance variable as well.... but next trip, I want to be in better shape than I was in Himachal so lets see if I actually follow through....

Keep in touch...ending up being a rather long note...apologies...

XX
Paul