I Got Altitude Sickness in Ladakh: What Worked and What Didn't

Day 1 in Leh, 2 PM. I was lying face-down on my guesthouse bed with a headache that felt like a slow, deliberate fist closing around my skull from the back. My throat was dry despite drinking two litres of water. I had zero appetite. I was nauseated but not quite sick. My feet felt distant from my body in a way that is hard to describe.

This is what altitude sickness actually feels like, as opposed to what altitude sickness sounds like in travel guides.

What I Did Wrong

I flew from Bengaluru (920m) to Leh (3,500m) and immediately, on the drive from the airport to the guesthouse, started planning the afternoon: Shanti Stupa, then the old town, then dinner at the rooftop restaurant I'd bookmarked. My driver, who had presumably seen this before, gently suggested I might want to rest first. I said I felt fine.

I was fine for about three hours. Then I was not fine.

Symptoms: The Honest Version

• Headache: Dull at first, then persistent. Not migraine-level but constant and draining.
• Nausea: Not vomiting, but no desire to eat anything. The smell of food was unpleasant.
• Fatigue: Disproportionate to effort. Getting up to use the bathroom felt genuinely tiring.
• Sleep disruption: Woke up repeatedly at night, breathing felt slightly labored, had strange vivid dreams (common at altitude).
• Cognitive fog: Mild — sentences took slightly longer to form. I reread the same paragraph in my book three times before giving up.

What Didn't Help

• Paracetamol alone — took the edge off the headache for 2–3 hours, then it returned.
• Trying to push through and "see how I feel in an hour" — it got worse, not better.
• Lying in the dark stressing about the itinerary I was missing — this definitely didn't help.

What Actually Helped

• Complete rest for 24 hours: I cancelled all plans for day 1 afternoon and all of day 2 morning. This was the single most important decision.
• Water, constantly: I drank approximately 4 litres over day 1, 3 litres on day 2. Dehydration compounds altitude symptoms significantly.
• Diamox (acetazolamide): I had not taken it prophylactically (should have), but taking it once symptoms appeared helped considerably within about 12 hours. It caused tingling in my fingers and made carbonated water taste metallic, but both are minor. Note: consult a doctor before taking — not suitable for everyone.
• Eating something light: Dal khichdi from the guesthouse kitchen. Simple carbohydrates and salt. Not eating was making the nausea worse, oddly.
• Acceptance: Once I stopped fighting the acclimatization and accepted that day 1 was a rest day, the trip got better. By day 3 I felt completely normal. By day 4 I was climbing stairs without noticing.

What I'd Do Differently

Start Diamox 24 hours before landing in Leh (after medical consultation). Book accommodation that includes a proper meal service for the first day. Build two full acclimatization days into the itinerary before any high-altitude excursions (Khardung La, Pangong). Stop telling myself I feel fine when I don't feel fine.

Ladakh is worth it. Ladakh with proper acclimatization is significantly more worth it.