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Welcome to Nepal

Friday, 20 April 2007

Pheriche [Day 9]

No improvement

What a hell hole for this second phase of acclimatisation. Pheriche is a barren place with a few teahouses, lodges and the famous Himalayan Rescue Post. The moraine, river, rocks and dust dominate the village, encircled by high ridgelines of the surrounding mountains.

Pheriche moraine

In the afternoon, the cloud base descends and the temperature plummets, making everybody don their duvet jackets and wait for the yak dung burner to be lit in the lodge. A miserable existence. I feel quite sorry for the Pheriche Lab team who are here until June... particularly when the teams at Kathmandu and Namche (and even at Base Camp) have all the comforts of home... well almost.

This morning I wake with the same bad headache.... I've had enough of this! This is despite a good night sleep and drinking almost 1 litre of fluid. However, I passed 1.5 litres of urine last night - a record so far. Just shows how altitude dehydrates the human body... and proves how right our trek leader was in dissuading us from drinking alcohol. It is hard enough taking on board enough fluid without having anything else to exacerbate the dehydration problem. I can't help but think my headaches are somehow altitude-related, but the Kiwi doctor thinks not (as I had started getting headaches ever since arriving in Kathmandu).

We carried out our tests again religiously, despite a number of us not feeling brilliant.  My results for today are: Resting O2 83; HR 67; BR 11.  BP 133/81; 145/82; 136/78.  After exercise O2 75; HR 138; BR 16.

Looking around the room this morning, you can really see how this trek is affecting us all. My fellow trekkers look knackered and are sniffling and coughing. Many look like they are suffering from bad hangovers and are losing weight too.

Exhausted (courtesy of Felicity)

I am beginning to get really concerned about my severe headaches and what is causing them. I am an awful long way from home and any hospital. The upside is that the Pheriche doctors are on immediate call (and there are very competent doctors in my own team too), but I am worried what might happen if things deteriorate even further, especially as the next two stages before EBC do not have dedicated medical support. However, I now have a day of R & R ahead where I might be able to recharge my batteries and perhaps improve the situation. For the moment though we are all sitting in the dining room of the lodge trying to rest.

I meet with the Pheriche Lab doctor again to update him on my headaches. He seems satisfied with the outcome of his examination... and advises all I can do is keep taking the medication. To give you an idea, my 'intake' today is (at 0630hrs) 5 drops of Otrivine (each nostril); 2 inhalations Decomit (each nostril); 1,000mg paracetamol and 400mg Ibuprofen.  At 0830hrs one Sinex tablet. At 1035hrs a further 1,000mg paracetamol.  At 1220hrs 400mg Ibuprofen. At 1430hrs, yet another 1,000mg paracetamol. At 1615hrs, another Sinex tablet.

This is barmy... nothing is touching my severe headache.  Is it AMS... how the hell do I know? If it is, the only recipe is descend, descend, descend. The last thing I want is to suffer an emergency evacuation at this altitude - I want to get home safe and sound to my family without any long lasting effects.

Why does the mind start to play tricks and talk to you like this when one doesn't feel well... I must snap out of this negative thinking!

Himalayan Rescue Centre, Pheriche

My headache continues to get even worse, resulting in yet another consultation with the Kiwi doctor at 1650hrs. He takes my temperature, checks my eyes with his torch and finger, looks in my throat, checks my teeth for sensitivity, taps my head in various places for tenderness. He really doesn't know what is causing the pain... maybe sinuses, migraine or cluster headaches... but he still doesn't think it is AMS.

He suggests a steam inhalation might help or a saltwater douche, as my nose is very dry and crusted with blood. The only thing he can do is try and manage the pain, so he prescribes 30mg Codeine (3 times daily) and 50mg Tramadol (4 times daily). I go to bed early again to try and get some respite.

What a bundle of fun - I'm really not enjoying this experience now and have gone off my food as well now feeling quite nauseous... what next?

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