You can get a visa valid for up to 60 days in the US, which should make renewals in Nepal unnecessary. There is no money-changing requirement to get a trekking permit, and no need to get it in person if you don't mind paying a small service charge to a travel agent. The road east out of Pokhara now extends beyond Birethanti, although some maps still don't show it going that far. You can walk from the road to Birethanti in a half hour or so. A hot spring next to the Modi Khola river, between New Bridge and Chhomrong, has become a very popular stop on the Annapurna Sanctuary trek, although it is barely mentioned in Bezruchka's guide, and is not among the suggested stops in the Lonely Planet guide.
Most lodges have extensive menus, especially in the Annapurna region.
There is no need to eat dal bhatt , the rice and lentil dish popular locally, unless you want to. Most Nepalese food is extremely bland and underspiced. You may want to bring some condiments.