Bhutan - Lindsay Brown [168]
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HEALTH & SAFETY
For general advice on medical issues Click here. For information on high altitudes and acclimatisation, Click here.
Trekking in Bhutan involves multiple long ascents and descents. This can prove physically tiring, especially as the altitude increases. The best training is to walk up and, in particular, down hills as much as possible. If you have a busy life, with little access to hiking on weekends, you should train with exercise machines (such as ‘Stairmasters’), ride a bicycle or jog. If you have no hills to train on, try putting a pack on your back to increase the strength training associated with walking or jogging. Take stairs whenever possible in preference to a lift (elevator).
People over 45 often worry about altitude and potential heart problems. There is no evidence that altitude is likely to bring on previously undiagnosed heart disease. If you are able to exercise to your maximum at sea level, you should not have an increased risk of heart attack while trekking at altitude. However, if you have known heart disease and your exercise is already limited by symptoms at low altitude, you may have trouble at altitude. If you have a history of heart disease, you should consult a doctor who has some knowledge of high altitude before committing yourself to a trek.
Common Ailments
TREKKERS’ KNEE
If your legs have not been gradually accustomed to walking uphill and downhill through training, there is a chance that you will develop some knee soreness after a long descent. The pain generally comes from mild trauma repeated thousands of times on the descent. The two areas most affected are the outer side of the knee and the area under the kneecap. You may experience difficulty walking and have to rest for a few days before continuing. Anti-inflammatory pills are helpful, as are ski poles or a walking stick. The pain can take several weeks to go away completely, but there are no long-term consequences.
BLISTERS
The repeated rubbing of the skin against the inside of your shoe or boot can cause blisters. The superficial surface of the skin eventually gets lifted off its base and fluid collects in the resulting bubble. Blisters can usually be avoided by conscientious attention to your feet as you hike. You should immediately investigate any sore spot on your foot and put some form of protection over the area that is being rubbed. There are many commercial products that protect your feet from blisters. Moleskin is the most popular item, but adhesive tape also works. Newer products, utilising soft gels, have recently been added to the mix. Using a thin inner sock inside a thicker sock can provide a sliding layer that reduces the friction on the foot. Try not to begin a trek in brand-new shoes or boots.
Blisters are not infected when they first form, but after the bubble breaks infection can develop. Wash the area and keep it clean. If swelling and redness develop, you should take oral antibiotics.
SNOW BLINDNESS
This is a temporary, painful condition resulting from sunburn of the clear surface of the eye (the cornea). It comes from heavy exposure to ultraviolet radiation, almost exclusively when walking on snow without sunglasses. If you are in a party of trekkers attempting to cross a high pass covered with snow, try to make sure everyone has something to protect their eyes, even if it means using pieces of cardboard with narrow slits cut in them.
The treatment is simply to try to relieve the pain. Cold cloths held against the outside of the eyelids can bring relief. Antibiotic eye drops are not necessary and anaesthetic drops should be avoided as they slow the healing and make the eyes vulnerable to other injuries. The cornea will be completely repaired within a few days and there are no long-term consequences.