Every base camp trek we run has rest days built into it that look, on paper, like wasted time. They are the reason our trips finish.
The rule we plan around
Above 3,000m, we plan for an average gain of no more than 300–500m of sleeping altitude per day, with a full rest day every third or fourth day. Walking higher during the day and coming back down to sleep is fine, and is in fact the mechanism.
What we watch for
- Headache that does not clear with fluid and a rest.
- Loss of appetite and nausea beyond ordinary trail tiredness.
- Sleep disturbance and a resting pulse that stays elevated overnight.
- Any loss of coordination or confusion — this is the one that ends the discussion.
The only reliable treatment
Descent. Everything else buys time. Our guides carry a full medical kit and satellite communications, and on expeditions we carry oxygen, but the treatment for altitude illness is losing height and we will do that without debate.
What you can do before you arrive
Arrive rested, arrive hydrated, and do not treat the first days in Skardu as a rush. The single biggest controllable factor is not fitness — it is how fast you go up.
