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The perils of high altitude train travel

Matthew Woodward's next rail journey will take him through the world's highest railway station in Tibet. How should he prepare?

Train passing by Nyenchen Tanglha Mountains Tibet (Shutterstock.com. See main credit below)

I have been doing quite a bit of reading this week about my planned journey from Beijing via Golmud up to Lhasa. I'm really trying to get my head around the enormity of what has been built and there is a serious danger that I might accidentally slip into trainspotter speak.

The route boasts not only the highest railway in the world, but the highest tunnel and the longest mountain tunnel, and is built on special supports in the permafrost (with passive heat exchangers, whatever they might be). There are 675 bridges and the trains have an enriched oxygen atmosphere onboard.

It reaches the last part of China to be without a modern railway, and also has the potential to be a bridge into Central Asia, with an extension planned to Nepal (2020), and possibly even India at some point.

This has got me thinking about the practical implications of this part of the trip. The journey up from Beijing takes three days, and the altitude profile is quite steep over the last 24 hours, topping out at the Tanggula Pass (5,072m) before a slight descent into Lhasa. The Tanggula Pass is the undisputed highest point of any railway on the planet.

I remember taking a train across South America a few years ago and really feeling the altitude. It is not like climbing, where you often have acclimatisation periods and sleep lower than you climb each day.

I'm no mountaineer, but in 2002 I summited Mt Kilimanjaro and Mt Kinabalu in the same year. On the top of Kili (5,895m) I remember how the colours I saw looked saturated, my thinking was slowed and the strange sensation of looking down on myself. An out of body experience... or more likely my brain slowly shutting down with the lack of oxygen.

So I have been researching what to do to prepare for this. Other than get super fit and train at high altitude (little hope), there are some medical options.

I understand that officially only one person has died of AMS on the Lhasa train to date. I'm not sure if that is a comforting statistic or not, and wonder how many might have needed treatment on arrival. On the plus side, the train is supposed to add extra oxygen to the carriage atmosphere, which should be supported to some extent as it passes above Golmud. Apparently this gets the altitude equivalent to about that of Lhasa inside the carriage (3,490m).

There is also supplemental oxygen available at each seat, so I guess if I felt bad I could go onto breathing this and then catch the next train down to a lower altitude. The only snag being to go down you would have to go back over the higher Tanggula Pass first. No wonder they make you sign a health disclaimer before you can get on the train.

Practically the vital steps are to stay well hydrated (passing urine is important), avoiding alcohol and using ibuprofen to treat any headaches. I have gone a stage further than this and will be bringing a supply of Diamox (Acetazolamide) to use preventively twice a day.

Hopefully it will help me to sleep, breathe normally and and generally acclimatise. There is plenty of medical debate about this approach, but I did use it on Kili and it seems to work for me. Apparently there are also a range of Tibetan herbs that can be used, but I don't think I'm going to find them in time.

Some travellers have even used dexamthazone, but I shall leave this for a doctor to give me if there is an emergency, as from what I understand it is a pretty serious steroid with quite serious and sometimes permanent side effects. I believe there is a doctor on every train.

One bit of advice from a mountain doctor was to start taking Diamox 48 hours before getting to any serious altitude and eat mainly carbs which produce more energy with lower amounts of oxygen. I shall plan to live on a diet of water (mixed with rehydration salts) and noodles.

Do you have any advice for Matthew? Tell us in the comments below.

Matthew Woodward has completed several amazing long distance rail adventures using the Trans-Siberian railway and onward across Asia. From from his home in Edinburgh he has reached Shanghai, Singapore and Tokyo and is now headed for Tibet. His blog can be found at Toad's Travel Adventures.

Main image: Train passing by Nyenchen Tanglha Mountains Tibet (Shutterstock)

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