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Showing posts with label Acute Mountain Sickness. Show all posts
Showing posts with label Acute Mountain Sickness. Show all posts

Monday, 23 April 2007

Pheriche to Dingboche [Day 12]

Feeling all alone

I have a good sleep for my last night at the 'White Yak'. A quick wash using wet wipes, I freshen up, clean my teeth and use the loo - all signs that I am getting back to normal. Best of all is that I am headache-free. I also pass almost a litre of urine during the night - however it was dark yellow, almost brown, indicating I have still not taken enough liquid on-board.

The view from my window

At breakfast, everyone in Trek E are really friendly and supportive. This team seem to have a much more relaxed attitude to rising in the morning for the tests... tending to drift downstairs in one's and two's. I am unsure whether I am still required to carry out my own tests because my Trek group have departed. I also wonder if all the medication I've been taking will adversely affect the results. Nobody seems to know, so I participate in any case.

Results for today are: Resting - O2 80; HR 67; BR 9.  BP 145/81; 144/82; 140/80. Unfortunately, nobody is available to test my 'At exercise' rates.

Departure

The Trek E leader checks with me to determine a convenient time to go to Dingboche (4,410 metres). He still needs to arrange a porter to accompany us. I say I am happy to fit in with his plans - he mentions a 0900hrs departure - so I agree and thank him.

I go back to my room and pack my holdall. I also get my rucksack sorted out for the climb over the ridge. I leave my holdall outside for the porter and sign for my extra days lodging and meals.

My kit - farewell to Pheriche

The Trek E leader and his porter meet me outside at 0900hrs ready to accompany me to Dingboche. The route is a rough track that winds up the steep hillside outside the White Yak. I am glad to be feeling much better as both set a blistering pace.

I must have gained some of my strength back overnight as I am not breathing too hard, despite the extra altitude gain and effort. We summit the ridge quickly and start to descend to Dingboche past a large Chorten with fluttering prayer flags. I can see the village spreading out below.


Dingboche - from the top of the village

As we descend, the Trek E leader suddenly says he doesn't know which lodge he was supposed to escort me to - he had forgotten to ask. In the event, we decide to head for the top of the village and work our way down making enquiries. Sods law it is the very last lodge at the lowest point in the village!


Peaceful Lodge

The Trek E leader stays for some refreshment before heading back. I give his porter 100NR and settle their bill. The Trek E leader then mentions that he has paid his porter 500NR to transport my holdall from Pheriche, but advised me he would take it out of his contingency fund. I am at a bit of a loss as to what the correct protocol was in this situation. After a final chat, they leave me alone with the Nepalese family at the Peaceful Lodge and Restaurant - it is only 1015hrs.

I wish I can be certain this is definitely my rendezvous point for Trek C. I now have the rest of the day to kill before the other group of trekkers arrive. I therefore decide to put my holdall in an unoccupied room and have a wander up the valley.

I put on my rucksack and start up the central village path through Dingboche. A little stream gurgles its way downhill amongst the stones as I make my way between stone walls and mani stones. I keep greeting people 'Namaste' as I pass them and before I know it, I am heading out of the village at the top of the valley.

Dingboche is an altogether nicer place than Pheriche. The sun appears to stay longer in this valley and the wind seems much less severe. I then decide to gain height up to a ridgeline to get a better view back to the village.

The trail climbs steadily upwards and despite taking it easy, I begin to feel light-headed. There is just a vague glimmer of a headache. As a precaution, I turn around to descend back to the lodge, getting back at 1150hrs.

Barren terrain at Dingboche

Rather bored, I wander over to the sun lounge to continue reading my book (Memoirs of a Mountaineer by F Spencer Chapman). There is an old Nepalese man in the lounge chanting mantras, spinning a hand held prayer wheel. A little snot-nosed girl comes over to me and brings her playing cards and slides for her hair. She offers these to me, wanting me to play. We try to build the cards as high as we can until they all fall down... and she smiles with a big grin.

Looking through the window, we notice snow beginning to fall. All the family members rush out to cover their vegetable patch... the little girl included. A tarpaulin is stretched out and heavy stones laid as anchors to hold it down in the rising wind. The soil starts to steam as the snow lands. The earth has retained its heat from the sun's rays in the thin atmosphere. No wonder these people are burnt brown... which explains how we are also getting tanned and need the attention of a Factor 50 cream.

Protection for the crops

The little girl comes back to play cards with me and noticing a dirty mark on one, promptly spits on it and wipes it with her sleeve. Porters walk past the entrance to this lodge carrying their heavy loads ever higher up the mountain. Ghostly figures in the driving snow.

I decide to go back to my room where I take a preventative Sinex tablet and vow I will never leave my wife at home, no matter what sort of adventure beckons.

My room at the Peaceful Lodge

After a short while I decide it is not very healthy, emotionally, sitting on my own in my room, so I lock up and go to the lodge dining room. To my surprise I come across someone I know. Helen, a fellow volunteer with Trek C had been at Pheriche suffering from D & V - I wasn't aware she hadn't been able to continue to EBC.

She had been escorted to Dingboche the other day when I was really poorly, ready to accompany Trek C to Namche as well. It was so nice to have a friendly face, confirming this was the correct lodge.

The owner of the lodge lit the Yak dung burner in the dining room and everybody huddles round trying to get some of its early warmth. Two other trekkers have joined Helen and I. An Australian woman who is trekking on her own and a German climber who has been here many times, but is suffering from early AMS. He has had to descend to Dingboche for further acclimatisation.

The Australian lady is really chatty. A lovely woman who works with socially-deprived youngsters back home. Approaching the yak burner for more heat, she gets a little close and the front of her duvet jacket melts into a hole. Feather down starts to float everywhere. 'Shit, shit, shit' she shouts, for the down jacket is rented. She spent the rest of the afternoon trying to darn the man-made fabric and mend the hole.

My thoughts extend to Trek C having to navigate their way back down from EBC during the snowfall. An early start will have been necessary to have attempted Kala Pattar (5,199 metres), before descending via Gorak Shep. It is now 1615hrs and there are no signs of them. The cloud base has also dropped, mist cloaking everything... and the temperature is plummeting.

Trek C yaks start to arrive... unloading is an unceremonious affair. Bags thrown left, right and centre. The yaks are carrying their own food in the form of hay bales. It won't be long before the trekkers arrive - it is now nearly 1700hrs. I hope I get the same friendly welcome as that from Trek E.


Trek C transportation

Snow is falling heavily now - I'm so glad to be here in the warm, toasting my feet and hands on the yak burner and drinking lemon tea. Suddenly, through the gloom, people begin to arrive. I go out to greet them as they have experienced a very long, difficult day. It is 1800hrs and they had been trekking from before 0600hrs.

John Dick (Trek C Leader) comes straight over to introduce himself. He has met Deborah (Trek D Leader), so had been expecting me. He is a lovely chap - a true gentleman in every sense. The evening was spent chatting and Trek C make me very welcome - a lovely group of people, every single one.

Tired, I excuse myself for bed, visiting the basic loo on the way. To my horror I discover I have diarrhoea. I take the anti-bacterial drug, clothrimazole and an Imodium in the hope that this works overnight before having to trek down to Tengboche tomorrow at 0830hrs.

Friday, 20 April 2007

Pheriche [Day 9]

No improvement

What a hell hole for this second phase of our 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 brutal headache.... I've had enough of this! This is despite a good sleep and drinking almost 1 litre of fluid overnight. 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. My appetite for food has also waned. 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 well.  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 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 very concerned about my severe headaches and their cause. 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 crazy... nothing is easing my severe headache.  Is it a result of 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 worse and 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.

I'm really not enjoying this experience now and have gone off my food feeling quite nauseous... what next?

Monday, 19 February 2007

Everest on Sky

TV Programme

My son has recorded 'Everest'... a series about an American team attempting the summit. This programme freaked my wife out somewhat as there were a number of instances of altitude mountain sickness.

Maria is already worried enough about me trekking to Everest Base Camp, without seeing the effects of AMS in others. I tried to reassure her by pointing out these climbers were much higher on the 'hill'. However, even at EBC one can suffer from AMS if you haven't acclimatised properly.

Our trek has plenty of time built in for this and we are under close medical supervision because of the research nature of the expedition... so no worries... I hope!