Eny one drove from dushanbe via khorog to sary tash (m41) and can share what he did and where he stoped to prevent altitude sickness?

I spent 10 months traveling the high Andes countries, lots of Bus rides up over 4000 meters, Colombia, Ecuador, Peru', Bolivia.

Not everyone is even affected by altitude. Other can be bed ridden, can't go on. Best policy it to allow time for acclimation. Takes about two weeks to adjust for many, but not for all.

A Peruvian Doctor I met on a 12 hour bus ride going up and over 4K meters gave me Hard Candy, saying the Sugar rush "may" help reduce "Soroche" (Local Spanish term for this). He was eating Candy, so I tried it. Never got even a whiff of dreaded Soroche.

2 Swiss backpackers were so sick they STUPIDLY got off the bus at our highest point! They had both Motion Sickness combined with high altitude sickness.

The Doctor assured them they would not get better if they got off the Bus and advised they stay onboard, as, at this point we would go LOWER. They did not listen. One guy was so sick, could barely move. Wife better, but not good. Both were carrying 50 lb. back packs (mine was 20 lb.) Liter bottles of Shampoo and all their own food!

The Aymara (indigenous folk) chewed Coca leaves entire trip ... all smiling the whole way. (12 hour ride) The Smell of 40 people chewing Coca is overwhelming! Babies and toddlers were given Coca Tea.

I stuck with the hard Candy ... and only ruined my teeth!

Hi,

I recommend Diamox pills. But you have to be carefull in what health conditions you are. There are some circumstances you shouldn't take that, for instance heart problems, etc....

Have a save trip, Dave

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We didnt take anything, and even went to 5600 meter with the car. Just felt a bit weak from time to time. And sometimes a bit headache coming up, then you can decide to go forward to lower area again.
Just dont make a huge step in the altitude you sleep at!
Dont sleep at 4000 meter when before you were sleeping at 2000 meter, you probably get a huge headache

Sounds like the Swiss couple was already to far and unable to take the right decision.

AMS is a very individual and depending mostly on your physical state, a little on mental as well. Remember the only real cure to the AMS is by going down again.

I've gotten AMS two times in my life. Once when riding from 0 meters camping on a Pacific beach in Chile to 5000 meters Altiplano in Bolivia in less than 30 hours. That was the worst one I've experienced - and my first introduction to this effect (I then lived all my life on the sealevel). Second time on the same Trans-Pamir road the thread author is planning. From Dushanbe I went up too fast, but thanfully that wasn't too bad - just a single all night of vomiting at 4000 meters (coming from 2500).

Also depends how much physical work you do - it's a big difference being in a comfortable bus or a car, or riding your motorcycle in technical steep offroad mountain track.

Remember AMS is mostly your own immune system fighting you. What I've observed the people who are more fit tend to suffer more when rushing into altitude post 3000-3500 meters - ditto on me, since my wife doesn't do any sports and she only had a mild headache when I suffered more. Ironically those who heavily smoke and drink cope much better (their immune system is weakened and lungs already used with "low" oxygen). I've talked both with Pakistani and Indian soldiers on both sides of Kashmir who still wage a secret war in Siachen glacier at around 6000 meters daily and they observed the same ironic thing - a bit fattier heavy smoker "soft" soldier copes much better than the otherwise very capable "superfit" soldier in combat operations at those extreme altitudes.

If you want to be certain then my experience is that after the critical level, for most people at 2500-3000 meters you need to sleep out the best around 500 m or max 1000 meters higher each night than the night before, over this you're pushing your luck by getting an AMS (and believe me it can come very suddenly the least when you expect it). In my experience it's mostly the sleep cycle that "sets" you to adapt to the coming altitude. You can go temporarily higher during the daytime, i.e. up to 4000 meter or more from 2.5K, but come back down 3K to sleep and continue higher the next day.

With this method I've visited most of the Indian Himalaya high passes around 5300 meters without any problems, since I knowngly planned more time to adapt with the altitude with overnight sleeps.

I've tried Acetazolamide (or known as Diamox), this may help a little to lessen the risks of getting an AMS, but can have nasty side effects. The best method is still taking a proper time to adapt with the gradual sleep cycles IMO.

PS: if you like more offroad a great alternative is head down from Khorog to Wakhan corridor. It's a great gravel track and you can take a good look into Afghanistan on the opposite side of the Panj river. We loved it. The road starts to climb quickly if you leave the Panj behind from 3000 meters on the way to Alichur around 4000 meters - plan a good camping or two on the way.

Some pictures and words here: http://advrider.com/index.php?thread...80532/page-148

Yea, that's right. I got on the Bus with them, in Lima, Peru', (sea level). They had just flown in from EU. I had been traveling already 6 months at that point, in Colombia and Ecuador, so maybe I was acclimated? The Swiss were not.

From Lima the road climbs up and up and up. Six hours later you end up around 4000 meters. So yes, a big shock to the system I guess.

Somehow I did not get a headache.

Yeah that is a big shock.

Anyway, we will also be driving the Pamir within a few weeks so we will see. We are not taking any medicine for it as it was fine when we were higher.

Maybe the smokers and drinkers can take more changes, but when at altitude the drinking is a bad idea :P the effects are much stronger.

Was the periodic breathing that I didn't like. Mild headache that responds to normal analgesics is OK and diamox for the periodic breathing. Plenty of water, no alcohol or coffee and diet high in carbs
Anything worse then get down fast.

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Tony
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Here is useful info including altitude profiles

https://caravanistan.com/tajikistan/...itude-profiles

Haha and then try to explain that to the border customs.

That's really useful - thanks.

Coming from Kazakhstan direction I'm considering stopping at Sary-Tash for a while to acclimatise to altitude before proceeding, though as a bit of a one-horse town I'm open to other suggestions. Those who've done it, does that seem like a reasonable strategy, is it likely to need more than one acclimatisation stop and how long would it be reasonable to give it? TIA.

From Kazakhstan? Stop at Song Kol: there are way more things to do and see, compared to Sary Tash, then you can consider Pik Lenin basecamp before heading to Pamir..