Perched 3,400 meters above sea level on the Tibetan Plateau, almost every visitor to Lhasa will feel the effects of the city's high altitude, some more extreme than others. The most common symptoms include discomfort, breathlessness, poor sleeping patterns or limited capacity for physical exertion. These symptoms can usually be overcome once the body has had a chance to acclimatize, usually after a day or two. However, in the worst case scenario altitude sickness can be life threatening and it is therefore essential that travelers to Tibet know how to minimize the potentially harmful effects of altitude sickness, how to identify the symptoms and what to do when serious reactions occur.
The basics: what exactly is altitude sickness?
Altitude sickness occurs in destinations high above sea level and is a natural reaction by the body as it attempts to acclimate itself to the high altitudes, pressure differences, lack of oxygen, dry atmosphere and other changes.
What are the symptoms?
Common symptoms of altitude sickness include: headaches, shortness of breath, tightness in the chest, severe lack of appetite, burning, dizziness, fatigue and increased urination. Due to the lack of oxygen, other symptoms may occur in certain individuals including the inability to sleep, giddiness, lips and fingertips turning bluish purple, drowsiness and other symptoms. Due to the dry atmosphere, others might experience nosebleeds, rough skin, chapped lips or (in more serious cases) blood clots.
While experts cannot predict who will be affected by altitude sickness, elderly people or those in poor physical shape are far more likely to feel stronger symptoms. Other extremely vulnerable groups include those with respiratory dysfunction, heart or cardiovascular disease, psychiatric disorders, or other serious health problems. In addition, individuals who have colds, diabetes, heart disease, severe hypertension and bronchitis may not be able to gain entry to Tibet. It is advised that travelers do a cardiopulmonary exam before going to Tibet to ensure that you do not have any serious respiratory or cardiovascular health problems.
Got a bad cold? Think twice about going!
Colds can significantly wear down the body's defense system against disease and harsh climates. Therefore, it can be easier to contract altitude related illnesses, the worst of which is pulmonary edema which can be especially life threatening if not treated right away. Moreover, it is very difficult to recover from a cold on high altitudes. It is recommended that you first recover from your cold before going to Tibet and don't just bring medicine with you.
If you catch a cold while in Tibet however, there is usually nothing to worry about. Your body will eventually acclimate to the surrounding environment and then heal itself accordingly. Tibetan hospitals are very experienced in treating colds and can provide medicine, but feel free to bring your own over-the-counter medicine (it's advisable to bring Ibuprofen and Aspirin). Give your body plenty of time to recover before starting any physically exertive activities while in Tibet.
Travelling to Lhasa by plane vs. train
Arriving by plane means sudden exposure to altitude above 3,000 meters and no gradual incline or acclimation. For this reason, altitude sickness is much more common for fliers. If you are entering Tibet by ground transport (train being the most common), the change is more gradual and you may have less severe symptoms as a result. However, there are also a number of disadvantages to travelling via ground. The train from Beijing to Lhasa actually reaches heights far above Lhasa's, with the highest areas reaching over 4,000 meters. Despite providing oxygen on board, most people still suffer from altitude related symptoms while travelling by train. Buses are also no guarantee for a smooth, symptom-free transition as roads are also well above 3,000 meters and semi-frequent landslides, mudslides and severe rainstorms often result in delays or treacherous conditions. Obvious safety issues aside, some of the roads along the Yunnan-Tibet or Sichuan-Tibet borders are on high mountaintops and there are no hospitals or medical centers nearby. Inexperienced travelers are advised to travel by plane, while those who insist on backpacking via ground should try to enter via the Qinghai-Tibet border, as it can be a bit safer than the other borders.
How can you avoid or reduce altitude sickness?
Travelers are advised to refrain from smoking and drinking alcohol and to get into physical shape over a period of a few months before heading to Tibet. Eat more fruits and vegetables, drink more water, pay attention to your body temperature, shower less and try to avoid cold environments that may tax your body and increase the likelihood of colds. Traveler should not physically over exert themselves upon arrival. Try to breathe normally and avoid hyperventilating. Butter tea is a well-known remedy against altitude sickness and is recommended once you arrive. Some people also take high-altitude medication a day before they arrive in Tibet. In China, a common medicine is called Gaoyuan An (高原安) which should be available at most pharmacies. However, the best thing to do before your trip is to consult a doctor about the best way to treat or prevent altitude sickness.
What should you do if you get altitude sickness after arriving in Tibet?
Generally speaking, most people need about two days to acclimatize. During that time, it is important to take it easy and to avoid catching a cold. Milder symptoms such as shortness of breath, sleeplessness, fatigue and dizziness, usually pass after two days. If however, you suffer from extreme symptoms like a serious cold, edema, pulmonary edema or severe headaches, then go to the hospital immediately. In serious cases, the only cure is to descend to lower altitudes. Fortunately, getting out of the plateau in Lhasa is actually quite easy. There are regular flights between Lhasa and other places in Mainland China.
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