Tibet self-guided tour, please ask experienced old donkeys for help

The beautiful Potala Palace, the mysterious Mount Siguniang, and the majestic Mount Everest are places that every mountain lover who loves mountaineering longs for. While enjoying the magnificent scenery and pushing your limits, altitude sickness also accompanies every mountaineering activity. According to statistics, a considerable number of mountain disaster accidents are caused by altitude sickness.

With the opening of the Qinghai-Tibet Railway, more and more people can easily reach high-altitude areas, and more and more people will suffer from altitude sickness. Regarding altitude sickness, we neither need to talk about it, nor can we underestimate the harm it brings. I hope this article can give you a correct understanding of altitude sickness.

Altitude sickness, also known as altitude sickness, occurs when unacclimated people quickly enter a plateau area above 3,000 meters. Due to the decrease in the oxygen partial pressure in the atmosphere, the body's tolerance to a low-oxygen environment decreases, making it difficult to adapt. Hypoxia causes a series of altitude sickness. Of course, in addition to the factors of plateau hypoxia, there are also severe weather conditions such as wind, rain, snow, cold, strong ultraviolet radiation, etc., which can aggravate plateau maladaptation and cause different plateau adaptation syndromes.

After the body adapts for a period of time, it can undergo a series of adaptive changes, such as increasing ventilation so that tissue utilization of oxygen reaches or approaches normal levels; accelerating the heart rate and increasing the heart's pumping capacity, so as to Increase cardiac blood volume per minute and improve hypoxic conditions; increase the amount of red blood cells and hemoglobin to increase oxygen-carrying capacity to ensure the body's oxygen supply, etc. However, some people are more sensitive to low oxygen pressure in the air and have poor adaptability. They will develop a series of symptoms and functional and metabolic changes called altitude maladaptation, also known as acute altitude sickness. Abroad, it is divided into acute mountain sickness, high altitude pulmonary edema, high altitude cerebral edema, high altitude retinal hemorrhage and chronic mountain sickness. In my country, it is divided into acute and chronic mountain sickness. For individuals, the onset is often mixed and difficult to distinguish. During the entire onset process, one manifestation is more prominent at a certain stage.

Symptoms and self-judgment of altitude sickness

Some people who enter the plateau for the first time develop headache, dizziness, dizziness, tinnitus, general weakness, etc. within 24 hours at an altitude of 3,000 meters. Symptoms include difficulty walking and falling asleep. In severe cases, symptoms include abdominal distension, loss of appetite, nausea, vomiting, palpitation, shortness of breath, chest tightness, purple complexion and lips, or facial edema. If these symptoms occur, you should stay at the original altitude and rest for 3 to 5 days, or immediately descend to a height of several hundred meters. Generally, you can return to normal.

It is reported that the incidence rate below 3,500 meters accounts for 37 to 51, and the incidence rate between 3,600 meters and 5,000 meters reaches 50. This shows that the higher the altitude, the higher the incidence of altitude sickness.

Severe altitude sickness is very harmful to the human body. Therefore, if the following symptoms appear after entering the plateau, you should consider that altitude sickness has occurred:

1. Headache Severe pain in the head, palpitation, shortness of breath, chest tightness, loss of appetite, nausea, vomiting, cyanosis of lips and nails.

2. Trance of consciousness and sudden decrease in cognitive ability. The main manifestation is difficulty in calculation. Before entering the plateau, do a simple addition problem and record the time. When symptoms appear, repeat the same calculation problem. If the time taken is longer than the original, it means that altitude sickness has occurred.

3. Hallucinations, feeling warm, and often walking behind others aimlessly.

Preventive measures and drugs to reduce symptoms

Strict physical examination before entering the plateau. People with severe anemia, high blood pressure, obvious heart, liver, lung, kidney and other diseases should not enter the plateau. Due to their higher oxygen consumption, obese people are generally more likely to suffer from altitude sickness than thinner people.

When you first enter the plateau, you need to reduce physical activity to protect your heart, so you must strictly control your climbing speed. Generally, you should not climb more than 1,000 meters in one day during mountaineering activities.

Two days before entering the plateau and within three days after entering the plateau, preventive oral administration of some drugs can reduce the symptoms of altitude sickness:

Acetazolamide 0.25 g, 2 times/day .

Acetazolamide itself has a diuretic effect and is mainly used for cardiac edema, cerebral edema and peptic tract ulcers. Taking it preventively can reduce the symptoms of altitude sickness. Side effects of acetazolamide are renal colic, kidney stones, sulfonamide urine crystals, nephrotic syndrome, and agranulocytosis (sulfonamide allergy). Long-term use may cause low potassium ions in the blood, and potassium needs to be supplemented (you can eat oranges or bananas). People with hepatic coma and decreased kidney function should not take it.

Rhodiola rosea is a medicine that many people hope to prevent altitude sickness. Its function is to clear away heat, detoxify, and dry dampness, and is used for lung heat, pulse heat, plague, and swelling of the limbs. In recent years, my country has isolated salidroside from Rhodiola rosea, which has been experimentally proven to have the effects of strengthening the heart, sedating, raising blood pressure, and resisting fatigue. Rhodiola rosea extract is used to resist fatigue, increase physical strength and endurance, and reduce weakness after illness. Whether it can prevent and treat altitude sickness, the author has not yet found a scientific basis.

According to the hypoxia situation, 0.75~6 mg of dexamethasone can be added, divided into 2~4 times per day. The main function of this drug in alleviating altitude sickness and hypoxia is to increase the content of red blood cells and hemoglobin to improve the ability to carry oxygen. Dexamethasone is a glucocorticoid drug and the indications must be strictly controlled. Abuse of this drug will reduce its intended effect when rescue is really needed. Used in large doses, it can cause obesity, increased intraocular pressure, hypertension, gastrointestinal ulcers, bleeding and even perforation. Especially for people with viral infections, taking glucocorticoids can cause the viral infection to spread and worsen.

Urofen can relieve headaches caused by high altitude. Take 50 mg orally, 3 to 4 times a day. Nifedipine dilates arterioles and can reduce pulmonary edema. Appropriate amounts of sedatives, multivitamins and aminophylline can all reduce symptoms.

When entering the plateau, you should also pay attention to a reasonable diet, eat more carbohydrates and less indigestible foods. Special reminder that alcohol is prohibited. Drinking alcohol can speed up the heartbeat and increase the load on the unaccustomed heart; drinking alcohol can dilate blood vessels throughout the body, causing the skin to increase heat dissipation, thus speeding up the heartbeat again. Repeatedly, this vicious cycle greatly increases the chance of heart failure and high-altitude cerebral edema.

Plateau environment, long-term hypoxia, etc. can cause a significant increase in the number of red blood cells and an increase in blood viscosity. Sweating too much while climbing and breathing too quickly and deeply will increase the amount of water consumed in the body and make the blood thicker. Thick blood leads to poor blood circulation and insufficient blood and oxygen supply. As a result, many people suffer from severe headaches, chest tightness, shortness of breath, fatigue and other symptoms. In severe cases, it can lead to heart failure. Therefore, drink at least 3 to 4 liters of water every day to ensure that the body is adequately hydrated. Dilution of the blood can reduce the load on the heart and reduce symptoms of altitude sickness. Whether the water replenishment is reasonable or not depends on sufficient urine output and clear urine, and pay attention to electrolyte balance.

High altitude pulmonary edema and cerebral edema

Altitude sickness seriously threatens people's lives and health. How can we detect and carry out self-rescue and mutual rescue on the spot in a timely manner?

High altitude pulmonary edema is a common severe altitude sickness, with an incidence rate of about 3. It usually occurs above 4,000 meters, and often occurs rapidly 3-48 hours after climbing, or as late as 3-10 days. The important triggers are respiratory infections caused by cold, fatigue, and decreased resistance. When there is headache, chest tightness, varying degrees of cough (dry cough at first, phlegm later), difficulty breathing and being unable to lie down, or in severe cases, pink frothy sputum, the rescuer can hear blisters in the lungs by placing their ears close to the patient's chest wall. Breathing sounds (medically called crackles). At this time, the patient is frightened, palpitated, and has cyanosis of the lips and face. In severe cases, hematuria or gradual confusion. Severe pulmonary edema can worsen rapidly, with the patient comatose or dying within hours.

The on-site first aid measure for pulmonary edema is to rest in a semi-recumbent position, with the legs hanging down, and immediately take in sufficient oxygen, preferably oxygen containing 50 to 70% alcohol, with a flow rate of 6 to 8 liters/min; take orally immediately Furosemide (furosemide) 40 mg/day. Slight nausea, diarrhea, drug rash, blurred vision, orthostatic dizziness, muscle cramps, thirst, etc. may occur when using furosemide. Be careful not to use too much at the beginning. Depending on the situation, it can be increased to 80 mg, twice a day. Nifedipine reduces pulmonary edema. Antibiotics plus dexamethasone 4 mg (oral once only) can be used to prevent and treat upper respiratory tract infections. When you feel restless, use a small amount of sedatives.

Keep warm and avoid drinking a lot of water. After initial first aid and his condition stabilized, he was quickly moved to a lower altitude. Once breathing or cardiac arrest occurs, perform cardiopulmonary resuscitation immediately.

It should be noted that colds should be avoided as much as possible in plateau areas. Fever temperature may appear false when you have a plateau cold. The temperature measured is often 1 degree lower than the actual temperature, so it is easy to be ignored. Respiratory tract infections, even mild ones, can increase the risk of developing high altitude pulmonary edema. Therefore, it is necessary to strengthen heat preservation and prevention. After entering the plateau, reduce the number of baths or not wash at all. If you notice the first symptoms of a cold, take anti-cold medicine immediately. If you take anti-cold medicines after two days, they are generally no longer effective.

People with recurrent high altitude pulmonary edema are considered susceptible, and men are five times more likely to suffer from it than women. If you have had pulmonary edema before, we recommend not climbing mountains above 3,000 meters.

High-altitude cerebral edema is another severe altitude sickness with an acute onset, often at night. The incidence is low, but the mortality rate is high. Symptoms: In addition to early altitude sickness, there are severe headaches, vomiting and even projectile vomiting; gradual confusion, poor orientation, convulsions, incontinence of urine and feces in some individuals, and finally drowsiness to coma. Retinal hemorrhage may occur in a small number of people.

In the past, mountain friends used experience to judge whether cerebral edema has occurred. The method often used was to ask people with suspected cerebral edema to walk in a straight line to determine whether they have poor orientation. From a scientific point of view, this method is not advisable! In patients with cerebral edema, the brain tissue has been severely deprived of oxygen. If a dazed person is allowed to walk at this time, he is likely to fall to the ground and fall into a coma immediately. This kind of inspection method that aggravates the damage is risky. The correct way to judge is to have the patient in a semi-recumbent position and ask him to point his fingers to his nose, ears, eyes, etc. as instructed to see if his movements are accurate. If it fails, it means cerebral edema may have occurred.

If cerebral edema and coma are found, oxygen containing 5 carbon dioxide should be given quickly and continuously until they wake up, and oxygen should be given intermittently after they wake up. Conditional application of hypertonic glucose, mannitol, adrenocortical hormone, cytochrome C and other treatments can reduce cerebral edema and promote recovery. Central nervous system stimulants such as lobeline hydrochloride (Lobeline), nicosamide (colamin), etc. may be used as appropriate. Pay attention to water, salt and electrolyte balance and take necessary anti-infective measures. After his condition stabilized, he immediately went down the mountain and was rushed to the hospital.

In a hypoxic environment, people will use faster and deeper breathing to improve the hypoxic condition, which increases the amount of carbon dioxide exhaled, leading to respiratory alkalosis. Respiratory alkalosis not only constricts cerebral blood vessels, but can also cause loss of consciousness and cause high-altitude cerebral edema. The most effective way to prevent respiratory alkalosis is to roll a newspaper into a cone shape, tear a small hole with a diameter of 1-2 cm at the tip of the cone, and place the cone-shaped newspaper close to the face so that the exhaled air can be breathed back again. That is to say, the exhaled carbon dioxide is breathed back again to improve the pH in the body and correct respiratory alkalosis.

There is no need to force yourself when facing the plateau

Not everyone who climbs the plateau will suffer from altitude sickness. The incidence of altitude sickness and the speed of recovery are related to the individual's compensatory adaptability. Individual differences vary greatly, and people who do not suffer from altitude sickness this time may not suffer from it the next time they go to the plateau. Some people will suffer from altitude sickness every time. These people are sensitive or highly susceptible to altitude sickness. What needs to be reminded here is that altitude sickness cannot be overcome through repeated exercise. Therefore, in order to ensure good health, it is recommended that people who are susceptible to altitude sickness should not continue to climb to such high areas. Fitness and mountaineering in low-altitude areas can also cultivate their sentiments and exercise their bodies.

Tibet Travel Guide: Lhasa Area:

Potala Palace

Open every day 09:00-12:30 15:00-18:00

The visit should take more than 2 hours. But after more than an hour after the opening time, tickets were basically no longer sold. Every Monday, Wednesday and Friday are the days when Tibetans worship Buddha, and there are many people there. You can also take a car and drive directly to the top from the back door, and then come down from the front door after visiting, which saves effort.

Note:

1. The palace is relatively high, so walk slowly up and down.

2. It is cold inside the palace, so it is best to prepare a coat even in summer.

3. If you want to take pictures in the palace, the fee is very high. Gu recommends hanging the camera on your chest and taking blind photos without flash, which is still satisfactory.

4. There are few restrooms in the Bu Palace and it is difficult to find them. It is best to go to the entrance before visiting. In addition, the toilet at the back door of Bu Palace is very unique and a sight to behold, don’t miss it.

5. The inspection of the Bu Palace is very strict, and it is basically impossible to evade fares. There is a method you can try. There is a small room after the steps. Tibetans buy tickets here for 2 yuan each. You can ask Tibetans to buy one for you. Before entering the main hall, there are people collecting tickets and checking them, so it is best to dress up in advance and hold a ticket in your hand. If you bring a kettle or some ghee or khata and pretend to be worshiping Buddha, you can probably get by.

Tickets are 40 yuan, 10 yuan if you go to the Golden Summit, and 10 yuan for the cultural relics exhibition room.

Jokhang Temple

07:00-12:00 15:00-18:30

It takes more than an hour to visit, and the morning is basically morning. There are a lot of people there when visiting Buddha. Tour groups usually go in the afternoon and enter through the side door. If you are a self-service individual, it is recommended that you go in the morning and go in with the people who pay the court fee through the main entrance. There is no need to buy a ticket, and many small halls are open in the morning. Coming out of Jokhang Temple, Bajiao Street is particularly worth visiting. It is not only a pilgrimage route, but also the best place to buy souvenirs and experience Tibetan folk customs. You can stop by and visit the houses in the lane. There is a song describing it this way: "On the ancient Bajiao Street, there are more windows than doors, and the girls in the windows have softer bones than flesh."

Note:

1. When you come to the Jokhang Temple, be careful of the beggars here. Either prepare some extra 10 cents of change, or ignore them and walk away quickly, otherwise you will have a lot of painful experiences.

2. It is best not to be impulsive when shopping on Bajiao Street, or you may regret it.

Admission fee is 25 yuan

Sera Monastery

Open from 08:00 to 18:30. Visiting time is 2 hours. There are lamas in the afternoon from Monday to Friday The Buddhist scripture debate (15:00-17:00) is worth a visit. The No. 5 minibus can go directly to the temple gate for 2 yuan/person. You can wait at the Jokhang Temple parking lot, Qingnian intersection and Niangre Road. Sera Monastery is not far from the city, and the taxi fare is 10 yuan.

Note:

1. It is recommended to visit in the afternoon from Monday to Friday and arrive before 15:00.

2. The inspection of Sera Monastery is not strict. The ticket office is in a small house on the side of the road outside. If you don’t dress like a tourist, you can just walk in. If they see that you are not worshiping Buddha, they will sue you. Since I am from the General Hospital of the Military Region next door, I can get by if I come to look for someone.

Admission fee is 30 yuan.

Drepung Monastery

Open from 08:00 in the morning to 18:30 in the afternoon. The visiting time is 2 and a half hours. It is relatively far from the city. It’s far away. In the morning, there are minibus routes 4 to the temple for 3 yuan/person. Route 3 only goes to the foot of the mountain. It takes an hour to walk up and the taxi fare is 15-20 yuan. Drepung Monastery is very large and built against a mountain, so there are natural opportunities for fare evasion.

Note: There is a ritual event every Wednesday, and many lamas gather together to chant sutras. If you can go there at this time, you will gain even more.

Tickets are 30 yuan

Norbulingka

09:30-18:30

Visiting time is 1 and a half hours, 2 way The bus passes by, and the No. 3 bus has to walk for a while. This scenic spot is not very impressive, so you can give up if you are pressed for time. Go on Sunday or important holidays, the ticket is 2 yuan. Because of the holidays, more locals visit Linka.

Admission fee is 25 yuan

Yaowang Mountain Cliff Painting

A scenic spot on the Zhuanjing Road, open all day long, no buses and buses pass by, it is convenient to take a taxi, and there are stone carvings here The cliff paintings are very unique. If you are strong enough, you can climb to the top of the mountain to have a panoramic view of Lhasa. This is also a perfect location to take a panoramic view of the Potala Palace.

Note:

1. Tickets are generally free, but occasionally a lama will come and charge you 5 yuan.

2. There are many stones carved with Tibetan characters on the mountain. These are sacred objects worshiped by Tibetans, so don’t take them randomly.

Ganden Monastery

Ganden Monastery, located 40 kilometers east of Lhasa, was built in 1409 and was the first monastery of the Gelug Sect. It was severely damaged during the Cultural Revolution and has been severely damaged in recent years. Only then were they rebuilt one after another.

Tickets: Free for Tibetans, RMB 15 for tourists; Opening hours: 09:00-16:00

Visiting time: The visit should take less than 2 hours, but the distance is long and Depending on the bus schedule, it will take a whole day

Note: CMB may be canceled or diverted to other destinations due to insufficient number of people. The scenery along the way is unique, with mountains, water, and grasslands. It costs $16 for a two-way trip, and you can save the ticket for the return trip.

Chubu Monastery

It is located in the upper reaches of the Chubu River, 60 kilometers west of Lhasa. There is no accommodation at Tsurphu Monastery, so it is best not to miss the only return trip. However, along the way back, you can stay in school buildings in many villages. The scenery on the way is beautiful. You may consider walking and hitchhiking back to Lhasa halfway.

Tickets: Free for Tibetans, ￥20 per visitor; Opening hours: 09:00-14:00

Visiting time: If you arrive at 12:00 by car, two hours is enough enough. But the whole journey takes one day.

Transportation: In the alley 200 meters southbound from the flower garden on the west side of the Jokhang Temple, from 07:00 to 08:00, minibuses will leave as soon as they are full. The fare is RMB 15. The original bus returns at 15:00.

1. Recommended self-guided two-day tour itinerary

Day 1:

8:30: Have dinner at the Post Hotel and walk 5 minutes to the Potala Palace.

9:00-12:00: Visit the Potala Palace and take a panoramic photo in Potala Palace Square.

12:30-13:00: Go to the Snow God Palace Tibetan Restaurant on the west side of the Potala Palace to enjoy an authentic meal.

14:00-16:00: Sera Monastery, from Monday to Saturday around 15:00 pm is the Bible debate time, which is worth a visit.

16:30-17:30: Visit the Jokhang Temple and take photos of the Potala Palace from the golden dome on the second floor. The effect is excellent.

17:30-19:30: Shopping and sightseeing in Bajiao Street, stopping by Barkhor Cafe or Maggie Ami to have a drink and watch the people doing their prayers.

19:30-20:30: Try Nepali food and experience the exotic delicacies at the Snowy Restaurant (50 meters to the right of the Jokhang Temple Square).

Day 2:

9:30-12:30: Visit Drepung Monastery (take bus No. 3 from the Post Hotel, but the minibus only goes to the foot of the mountain, so you need to change again Take a motorbike or minibus to go up the mountain, which is a long walk; you can also take a taxi directly)

14:30-16:00: Visit Norbulingka. (You can take a minibus directly from Drepung Monastery)

16:30-18:00: After coming out, walk to the museum opposite.

19:00-21:00: Enjoy various snacks at Xijiao Night Market.

Note: If you are short of time in Lhasa, you can only choose the first day of the itinerary, which is representative; if you have more time, you can visit Yaowang Cliff Paintings, Ramoche Temple, Nun Temple, Chongsai Kang, and Longwang Attractions such as Tan Park are also worth a visit.

Ticket prices during the opening hours of city attractions

Potala Palace: 9:00-13:00 15:00-18:00 40 yuan

Dazhao Temple: 9:00-12:30 15:00-18:30 25 yuan

Norbulingka: 09:30-17:30 25 yuan Drepung Monastery: 09:30-17:00 30 Yuan

Museum: 10:00-18:00 20 Yuan Sera Monastery: 9:30-17:00 30 Yuan

Lhasa Tourism Practical Information

City Internal transportation:

1. Taxi: 10 yuan in the city. To go to distant places, you need to negotiate the price. There is no meter.

2. Minibuses: The main passenger transport in the city is minibuses. You can take minibuses to several major scenic spots, and the price is 2 yuan for both distances.

3. Tricycle: wave to stop and negotiate the price, usually 3-6 yuan.

Shopping recommendations:

1. Tibetan medicine and medicinal materials unique to Tibet (if you want peace of mind, it is best to buy them at state-owned pharmacies)

2. Tibetan specialty souvenirs: prayer wheels, thangkas, Tibetan boots, handmade carpets, cow and sheep heads, Buddhist beads, sky-eye stones, turquoise jewelry, Tibetan knives (must be mailed), etc.

3. Handicrafts from Nepal and India: economical and unique. They are sold in handicraft stores and there are several specialty stores on Bajiao Street. (Crafts are mainly concentrated on Yutuo East Road, Bajiao Street (opposite Jokhang Temple Square) and at the entrances of Potala Palace and Norbulingka)

Catering and entertainment:

1. Tibetan flavor: Mad Cow Tibetan food at Jiri Hotel on Beijing East Road and the authentic Tibetan food at Snow God Palace at the west end of Potala Palace.

2. Nepalese flavor: Located at No. 4 Tibetan Hospital Road, north of Jokhang Temple Square, the Snowy Restaurant has an elegant environment and good taste.

3. Chinese food: Mainly concentrated in the western suburbs, mainly Sichuan cuisine, but also special snacks, such as jade buns.

4. Cafe: Barkhor Cafe located next to the Jokhang Temple Square and Maggie Ami on Bajiao Street have a variety of unique drinks and Western food, which are very atmospheric, and both have Internet cafes.

5． Entertainment: Nightclubs are concentrated in the western suburbs, and Tibetan-style Langma dance halls can be found everywhere. The top disco bar on Jiangsu Road is particularly worth a visit.

Others:

1. Bank: There are many branches of Bank of China, Agricultural Bank of China and China Construction Bank, but there is no Industrial and Commercial Bank of China, so Peony Card cannot be used.

2. Post Office: The Post and Telecommunications Building on the east side of the Potala Palace is very convenient for sending letters and parcels.

3. Bookstore: Xinhua Bookstore opposite the department store has a comprehensive range of books, postcards, stamps, etc. about Tibet.