Understand Your Opponent: What Is AMS?
Acute Mountain Sickness (AMS) is your body’s reaction to ascending to high altitudes too quickly. As you go higher, the air pressure drops and each breath contains less oxygen. This can lead to symptoms like headaches, nausea, dizziness, fatigue, and difficulty
sleeping. It commonly affects travellers above 8,000 feet, and much of the Manali-Leh highway is significantly higher than that, crossing passes well over 16,000 feet. AMS doesn't discriminate based on age or fitness; anyone can be affected. For drivers, symptoms like dizziness and fatigue are not just uncomfortable—they are dangerous, impairing judgment and reaction time when you need them most.
The Golden Rule: Gradual Acclimatization
The single most effective way to prevent AMS is to allow your body time to adjust to the lower oxygen levels. This is called acclimatization. Rushing the Manali-Leh highway in two days is a common mistake and significantly increases the risk of AMS. The recommended approach is a three-day journey. Plan your first overnight stop at a moderate altitude. Instead of pushing to Sarchu (around 4,290m), which is notorious for causing AMS, stay at Keylong or Jispa (around 3,200m). This gentler ascent on the first day allows your body to begin the acclimatization process while you sleep, making you better prepared for the higher passes on day two.
Fuel Your Body Correctly
What you eat and drink plays a crucial role. Dehydration can mimic and worsen the symptoms of AMS, so aggressive hydration is key. Aim to drink 4-5 litres of fluid daily, including water, herbal tea, and soups. Avoid alcohol and smoking entirely, especially in the first 48 hours at altitude, as they can interfere with acclimatization and increase dehydration. Your diet should be rich in carbohydrates, which require less oxygen to metabolize compared to fats and proteins. Opt for light meals like pasta, rice, potatoes, and bread. Avoid heavy, fatty, or oily foods that are harder for your body to digest at high altitudes.
Know the Symptoms and When to Act
As a driver, you must be hyper-aware of your body. The early signs of AMS are often a persistent headache, loss of appetite, nausea, and unusual fatigue. Do not ignore these warnings or try to 'push through' them. If you or a passenger starts feeling unwell, the first step is to stop ascending. Rest where you are. Often, mild symptoms will resolve with rest and hydration. However, if symptoms worsen—for example, if a mild headache becomes severe, or if vomiting, confusion, or loss of coordination occurs—it's a critical signal. The only effective treatment for severe AMS is to descend to a lower altitude immediately. Going down by even 500-1,000 meters can make a significant difference.
To Medicate or Not? The Diamox Question
Acetazolamide, commonly sold under the brand name Diamox, is a medication that can help speed up the body's acclimatization process. Many travellers use it as a preventive measure, typically starting a course a day or two before beginning their ascent. It works by making your blood more acidic, which stimulates your breathing rate, thereby increasing oxygen intake. However, it is a prescription medication and is not suitable for everyone; it has side effects, including a tingling sensation in your hands and feet and increased urination. It is essential to consult your doctor before your trip to discuss whether Diamox is a good option for you and to get the correct dosage information. It is an aid, not a substitute for proper acclimatization.
Tips Specifically for the Driver
Driving on this route is physically demanding. Avoid over-exertion, both behind the wheel and during stops. Let others handle tasks like changing a tyre if possible. Keep the car ventilated. When you stop to admire a view at a high pass, walk slowly and avoid running or climbing up slopes for a better picture. A pulse oximeter is a small, inexpensive device that can be useful to monitor your blood oxygen levels. While it's not a diagnostic tool for AMS, a consistently low reading can be a prompt to take it easy. Most importantly, never drive if you are feeling dizzy, disoriented, or have a severe headache. Hand over the keys to a co-driver or wait until you feel better. Your safety, and that of your passengers, depends on it.
