There is much more to worry about than the altitude on this notorious Nepalese trek.

I spent months preparing myself both physically and mentally for the trek to Nepal’s Everest Base Camp (EBC). The 17,598-foot altitude terrified me.

Years before, I had hiked the Peruvian Inca Trail to Machu Picchu, and I vividly remember the feeling wrought by the altitude. The sense memory of the cotton-wool mouth and breathlessness concerned me, as it is much lower than EBC (its highest point is nearly 14,000 feet). When it came to booking the Everest Base Camp trek with my partner Christopher, I told myself that I would be prepared for anything. I wanted to be as fit as possible, even though fitness level isn’t really related to altitude sickness. I figured it couldn’t hurt the journey!

After landing in Thamel, I went to the trek shops and pharmacies to buy extra clothing, broad-spectrum antibiotics, and altitude sickness tablets so that I was ready for any problem that befell us. My biggest concern was being unable to complete the trek due to sickness, whether that be the altitude, a stomach bug, or the flu. After spending nearly $2,000 on the flights and the trek, it would be devastating to miss the opportunity to see Mount Everest for the cost alone, which is to say nothing of my ego.

The hike took place in October, the most popular month to do the trek as the weather conditions are most favorable. The notoriously dangerous flight to access the trek is to a tiny landing strip in Lukla. The plan was to spend two days getting acclimated and nine days trekking. The night before our flight, we met our trekking group (seven in total, three of whom had climbed Tanzania’s Mount Kilimanjaro) and were feeling as ready as ever.

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But the best laid plans meant our flight was cancelled due to weather conditions. As it wasn’t possible to leave from Kathmandu, we had to get up at 4 a.m. for a rickety bus journey to a tiny airstrip in Mathali, deep in rural Nepal. After landing safely in Lukla, we ate steaming bowls of vegetable noodles and then had to trek straight away to the next stop on the hike which was Phakding, even though we were already exhausted. The chaotic start to the trek certainly had an effect as one of the women who’d scaled Kilimanjaro had developed an industrial-strength stomach bug which had us stopping frequently. That day we trekked for four hours, but this would increase to 10 hours on the way back.

The author and her trek group.Jennifer Sizeland

Even though altitude sickness can affect anyone, I was surprised when Christopher started to decline on the second day. I’d been so preoccupied by own anxiety around altitude sickness that I’d failed to consider my partner’s potential reaction. In order to deal with the altitude, you’re required to drink 100 ounces of water per day which means frequent rest stops as we needed to relieve ourselves quite often. As the day went on, Christopher became slower and slower. At one of the cafes, he sat with his head in his hands and the two guides who looked after our group were concerned.

Thankfully he responded to the altitude medication and was able to rest as we were on our way to Namche Bazaar which is one of the biggest towns on the trek. It’s also where we had our acclimatization day so he was able to rest after we’d done our short trek for that day. He was lucky because the woman with the stomach bug that refused to respond to medication became so weak and unable to eat that she had to descend with one of the porters on the fourth day of the trek.

On the fifth day, we left Namche with renewed energy and found a Nepalese man face down on the way to a famous landmark on the trail, the Tengboche monastery, and I immediately assumed that he was dead. After our guide poked him, we were relieved to discover he was just drunk and had passed out underneath a tree. Death is a regular occurrence in the Himalayas, whether it’s at Lukla’s dangerous airport, on the trek or while ascending Everest. Our sixth and seventh days were spent in Pheriche, a quiet town set in a desolate ridge valley, for our second acclimatization day. Here we had a lecture from a doctor on how to avoid altitude sickness at the local hospital. Outside I saw a trekker on horseback, receiving oxygen on the way to be treated and it was a stark reminder of the dangers he’d spoken about.

On the way to Lobuche which is at the beginning of the Khumbu Glacier, where the trek gets significantly harder, there is an army of stone cairns lining the path as a memorial to the sherpas who have lost their lives here. Just a week after we left, a trekker did die from altitude sickness in Lobuche, so a healthy respect for the mountain and the two acclimatization days that are built into the itinerary are a must.

One of the most difficult days was when we reached EBC as there were 8-9 hours of walking from Lobuche to reach the last town on the trek, Gorak Shep, for lunch and then onto the camp itself. At EBC there is a makeshift stone platform surrounded by colorful prayer flags which provide a photo opportunity or a political platform depending on who is on it. I saw people discussing missing family members as well as a group who spoke on human rights abuses in Iran, so it is a serious pilgrimage for some of the hikers.

Jennifer Sizeland

What many people don’t know is that the view from Everest Base Camp of the mountain is actually surprisingly poor, and you can only see a small part of it if weather conditions permit, which they fortunately did for us. The peak is so high that you can see the snow coming off it like smoke. It felt like the hardest part was over now that we’d reached our destination, but this is when the problems really began.

Back at Gorak Shep, the longest day of walking on the trek really took its toll on the entire group and despite our achievement, nobody was saying anything and we were pushing food around our plates. Out of the six of us who were left, three of us were feeling out of sorts. Morale was very low. My partner’s altitude sickness returned, and I also felt awful, but in a completely different way. It turned out that my pounding headache and vomiting were due to sunstroke from being exposed to the elements for an entire day without any shade. While none of the books that I’d read mentioned sunstroke, one of the guides said that it happens more often than you think, as nobody expects it to be so sunny in the Himalayas. Even though the sun was on me, it didn’t feel that hot so I wasn’t particularly concerned. I’d followed the packing list to the letter by buying a wide-brimmed hat, but I’d bought a foldable one due to the lack of space in my bag and it was clearly not up to the job. It crossed my mind as to what would be up to the job as I was also wearing sunglasses and sunscreen. I’d had a long list of worries but catching too much sun in such a cold place wasn’t one of them. At dinner, I ate spaghetti in the teahouse only to go upstairs and vomit.

Jennifer Sizeland

As a group, we had to make the decision not to trek up the Kala Patthar ridge, which is the most accessible way to get a good view of Everest from Gorak Shep. It takes about two hours to ascend but it means getting up at 4 a.m. as you still have a full day of trekking ahead of you. The descent from Gorak Shep is the same pathway but the trekking days are longer so you go up in eight days and return in three as lowering altitudes meaning you can travel farther. While I felt sad not to get a better view of Everest, I felt grateful to have gotten to Base Camp when one of the group hadn’t made it.

After a rough night with very little sleep, as I was either throwing up or looking after my boyfriend, we still had to trek for nine hours. At 1 a.m. my boyfriend was pale and shivering, forcing me to stumble around looking for one our guides to check his blood oxygen levels and find him more medication. As we had to travel all the way back to Pheriche it was the right decision not to push our bodies further than they could go at that time. If I could do it again, I would certainly invest in a better hat and try to find shelter wherever possible during rest stops.

Jennifer Sizeland

We still needed our wits about us as we were close to the end when we heard shouting and a loose horse galloped past us on a cliff path. Had we not been alert and moved out of the way fast, it could have knocked us off the mountain. As we also shouted ahead, the groups in front also managed to move in time. The reality is that you never know what is around the corner on the EBC trek. It could be a stunning vista or a runaway horse and no two people do the same trek, that’s for sure. While there may be a lot to think about, it’s one of the most amazing treks in the world and will definitely be something to earn you bragging rights.