The Dudh Koshi Valley and River
The Dudh Koshi is one of the highest elevated rivers in the world. It drains the Mount Everest massif and begins just east of the Gokyo lakes, which is where our eventual detour would take us in about 10 days.
The trailhead in Lukla is not quite by the river, but you meet up with it soon enough.
The trail follows the river all the way to Namche Bazaar, where it splits into several tributaries. For now we would be only hiking to PhakDing, not visible yet in this picture.
This shot also highlights the elevation changes on day one, so I will post them again:
Ascent: 139 m
Descent: -358 m
High: 2,840 m
Low: 2,555 m
Compared to the rest of the hike this was not an especially difficult day.. But I was already feeling the altitude.. I was running out of energy a lot faster than usual and any time we had to walk uphill it was a bit of a struggle.
I forget at which point of the hike I started taking Diamox high altitude pills, but that quickly became a part of the daily medical regimen. Every morning I took half a diamox pill, a high blood pressure pill, an aspirin, and a multivitamin. Also every morning I mixed an isotonic/vitamin C mix with water in one of my two water bottles, so I could drink it on the trail.. For the trail I always prepared energy gummy bear chewables and a sort of natural boost designed for the trail that I can't really remember. It was a capsule with a blended powdery mixture inside.. I saved those for especially challenging parts of the trail, such as long uphill sections and acclimatization days. The effect felt from these was minimal, but the science seemed to imply that it was helping. Perhaps it was also a bit of a psychological boost.
All the things I just mentioned were researched to help me hike in high altitudes. I went to a travel clinic and actually ended up at the hospital about 2 days before the flight to Nepal as well.. I have high blood pressure problems and at the time it was especially high. The doctor at the hospital somehow had high altitude hiking experience in Peru and even know the villages we would be hiking through in Nepal. He looked at my high blood pressure medication, said that on the trail I should be taking something else, and wrote me a new prescription.. It would be better for high altitudes, since it did not have some acid in it (from what I remember). I was really happy that this doctor showed up. I had to wait 4 and a half hours overall I think, and this was during my last day at work before the trip.. I did not mind at all, but the added hassle and stress were getting to me.. I was really fortunate to get somebody like that giving me expert medical advice for the exact conditions I was going to be experiencing on my hike
My first aid kit, always in my day pack, also included cold medication (day and night), stoppers & goers (diarrhea meds), zantac (acid indigestion med), bandaids, blister kits, neosporin, and a set of antibiotic and stereoid cremes in case a rash problem I once had resurfaced on the trail.. On top of all that my first aid kit also had things like athletic tape, gauze pads, throat lozenges, lip balm, and a safety pin. I also always had sunscreen on me and a large number of water purification tablets that I used on every single sip of water taken on the trail. The water was always filled up every morning by being boiled first, after which I would throw in the purification tablets and let them do their thing.
You really had to come prepared on this hike, since any medical facilities you come across on the trail will be incredibly bare, and in many villages they won't even exist. You're on the trail for 2 weeks, so you have to look after yourself and have medication on hand in case you develop a cold or your stomach disagrees with something, or who knows what could happen..