Some activities such as walking Kokoda, require a high degree of physical fitness (6000 meters up and 6000 metres down in a high humidity environment), while other treks have specific issues such as altitude and cold.
High altitude treks to Kilimanjaro, Aconcagua and Everest all require a high level of physical fitness as well as careful planning. A spontaneous decision to undertake these treks is not sensible and can be fatal. Preparation involves a good understanding of the muscle groups affected by climbing and descending, as well as the body’s response to low levels of oxygen. At 5000m altitude there is only 50% of oxygen available when compared to sea level. This has major implications for physiological adaptation. A good understanding of the medications used to prevent and treat altitude sickness is very important.
If you are considering a trek, then it is also a good time to consider a cardiovascular risk assessment. This form of physical exercise is outside of what you do on a normal daily basis and the environmental conditions (elevation, cold, heat) are extra stressors. Medical support services are rarely available at short notice. Appropriate travel insurance is essential.
For individuals planning a trek to the top of Kilimanjaro, the Inca trail or Mt Kinabalu, there are concerns about the speed of ascent. Longer treks such as the Annapurna circuit and Everest base camp require more attention to endurance training. Rarely do you hear someone say their preparation was “over the top”. It is always better to be the tortoise rather than the hare at altitude.
Although physical fitness has no true bearing on physiological adaptation at high altitude, the knowledge that you are at peak aerobic fitness helps in determining the cause of the severe headache, nausea and breathlessness you may be experiencing.
Preparing for your trek, both physically and mentally, is very important. This takes time. You will probably walk Kokoda or trek to Everest Base Camp once in your life. Starting out with a good level of fitness is very important. You are more likely to enjoy the experience if you can walk at the same pace as the group. A reasonable preparation takes 3-6 months. Longer if you come from a low base of physical fitness. Set goals in your training. For Kokoda, it might be a climb of 700 - 900 metres, up and down over a specific time, then back-to-back climbs without a stop. Mount Lofty is a good training walk in Adelaide, but it can be busy. There are many other circuits. The training can set up a pattern of fitness which you might continue to follow on return. Seek out a walking group or aim to prepare for the trek with other participants from the same locality. An experienced adventure operator should be able to help you develop a fitness program.
They should also be able to help you with “things to pack”. It is important to keep within the weight guidelines. If you intend to carry only a day pack of 6-8 kg and use a porter for the rest, then train with 10-12kg. Always calculate a water component to weight. There are extra fluid requirements for both a Kokoda trek and walking at high altitude.
All trekkers should consider taking a targeted medical kit. It shouldn’t be a last-minute decision. Medications are best sourced in Australia. Similar medications are certainly available overseas but there can be quality issues. You might decide to have a shared base kit (medications/ first aid) and each have some extra targeted medications for diarrhoea and vomiting.
Are you taking any regular medications? If yes, do you have extra tablets should you be delayed through unexpected circumstances such as illness or flight delays.
Are there any other medications you might use occasionally such as antihistamines? You might have an allergy to animal dander and sleeping in local accommodation might provide exposure.
Are you taking a blood thinner? If yes, does your first aid cover a small compression bandage for an injury.
Do you need to carry a medication, specific for the trip. Acetazolamide (Diamox) is used to prevent altitude sickness. Is this indicated for your trip? How does it work? Are there any potential side effects? Am I able to take it?
Medications for the management of traveller’s diarrhoea should always be included in a medical kit and a course of antibiotics might be included depending on the type of trek. An antibiotic for skin might be in a “Kokoda kit” and an antibiotic for chest might be in an “Everest kit”. The first aid components would also differ.
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