Why I Couldn’t Breathe

The long walk from Namche Bazar to the airport town of Lukla took all day. While mostly downhill, the trail climbed in many places because of the rugged terrain. I had plenty of time along this tiring march to think about the last two weeks, and why I couldn’t complete the trek.

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My lunch stop on the last day.  Lots of ups and downs going along this valley.

About 15 years ago, one afternoon I went out for a run and found myself gasping for breath after only a few minutes. I fought through it, and my breathing improved and I was able to complete the run. For the next couple of weeks, the same thing happened, it was as if my lungs were closing down at first, but then would improve if I went slow and relaxed. I went to my family doctor and he suspected I had some kind of asthma. He prescribed an inhaler to be used twice a day. It worked like a miracle. I told the doc on my follow up that it was like having 25 year old lungs again. A few years later, after a long bout with bronchitis, my doc referred me to to a specialist, who confirmed my asthma diagnosis. I had feared that I had COPD, but the specialist said that the inhaler wouldn’t work on that, and that his testing indicated asthma. Relieved, I still suspect that this stemmed from growing up in a miasma of second hand smoke from my mother. For the next several years, I used the inhaler only before vigorous exercise and it worked very well for a very long time.

After retirement and my move to Thailand, I found out that I no longer needed the inhaler. Being older, I didn’t exercise so vigorously, and my lungs seemed to like the moist hot air of the tropics. The bag of inhalers I brought from the USA with me got stashed in the back of a drawer and forgotten. A couple of times during my preparations for the trek, I thought to myself that I ought to take an inhaler along “just in case”. But that item never got on my list, and I didn’t remember again until I was in Kathmandu. BIG MISTAKE. My guess is the extremely cold, dry air triggered my asthma. I was ok while hiking if I started slowly, but it seemed to kick in again while trying to sleep. This would explain my lack of headaches or other typical symptoms of altitude sickness. It also explains why my sleeping troubles began at just 2500 m – it wasn’t the altitude alone, it was primarily the cold dry air. If I had brought the inhaler…..anyway, it’s done now. I have no regrets about turning back.

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The narrow streets of Lukla.  No motorized vehicles except for planes and helicopters.
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The picture does not capture the true slope of this runway.

I arrived at Lukla about 4:30 pm after hiking in the light rain for several hours. The lodge was literally 50 meters from the runway. Lukla’s airport is unique in that it is not level. It slopes wildly in fact – more than 11 degrees! It looks more like a ski jump than runway. Planes land uphill and take off downhill no matter the wind. Planes landing have only one chance to get it right because an aborted landing is made impossible by the mountain rising of the end of the runway. Many consider this airport the most dangerous in the world.

I bought a few beers for my guide  Bhakta and my porter Gokul. Gokul had a few more than a few, and was very loose by the end of the night. Apparently he had a reputation as a brawler in his younger days, he could take on 4-5 others with no problem. Good to have him on my side!

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Bhakta, Gokul and me celebrating the end of the trek in Lukla.

The next morning, after an E-ticket takeoff, and a scenic flight back to Kathmandu that brought home just how high and immense the Himalayas really are, Bhakta and I arrived safely back in Kathmandu (Gokul turned around and went portering back to EBC from Lukla with a new group of trekkers). Thus ends my adventure. I am back in Kathmandu for one night already, and though the flights are full I will try and get back to Thailand tomorrow. I will be writing another post in the next few days on the equipment I brought that might be useful to future trekkers.

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Walking to our specially designed short take off and landing Sita Air plane for the flight back to Kathmandu.

So what next adventure should I start planning for in 2019? 1. Patagonia? 2. Cruise to the Galapagos? 3. Cycle New Zealand. 4. Golfing in Ireland. 5. Drive the Alaska Highway? 6. Something else?  Leave me a comment with your suggestions.

Back to Namche

Written March 20th, USA time.

It’s amazing how having an additional 3000 ft of air over your head can improve your respiratory system. Also, I ditched the diamox. The result was only two trips to the loo, and 6 whole hours of sleep last night . I think when I return home I will sleep for a week!

I was feeling refreshed, but I could still not stomach the breakfast of a single “cinnamon and sugar” pancake. Really it was just fried dough with a few grains of cinnamon powder and no sugar that I could tell. Did I write yet that the food while trekking sucks? Most of the time while hiking, my brain is perusing menus of 5 star restaurants. I can’t wait to eat my first pad grapow when I get back to Thailand.

Our goal for the day is Namche Bazar, which is quite a long distance, but except for one short and one moderate climb, is all downhill. You can easily hike twice as far on the return as you could going up. Our lunch stop came, after a long down hill from Tengboche, at 11:00 am at a small lodge next to the Dudh Koshi River. I ordered a pile of fried noodles which I consumed in about three impolite bites.

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Another in a series of dizzying suspension bridges above Tengboche.
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The enterence to the ancient monastery at Tengboche.
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These dudes are tough….

The afternoons hike included the last long uphill segment, about 400 m up and over the divide down to the basin where Namche Bazar lies. The skies had turned cloudy, although I suspect at higher elevations it was clear, and a cold wind blew. But the site of Namche Bazar nestled below as we came around a bend warmed my heart.

At our lodge, I had a fantastic 38 degree C shower, then headed out to Himalaya Java. Alas, the last brownie of the day was ordered in front of me. The chocolate cake made a passable substitute. Later after dinner at my deserted lodge, I wandered over to the Irish Pub, said to be the highest such establishment in the world. I order a $6.00 beer, and watched groups of very loud young trekkers celebrating the end (almost) of their trek. Some won’t enjoy there march to Lukla tomorrow. I was tucked away in bed by 8:00 pm.

The Worst Night of my Life

 

Written on March 19 USA time will be posted when internet is available.

Just when you think things are under control, and your goal is in reach, WHAM!

Last night I was feeling pretty good, in spite of the frigid and windy weather. I hung out in the smoky dining room until about 8 pm, then went up to my tiny room. I took two bottles of hot water with me as insurance against the cold. Once under the sleeping bag and warm, I played with my phone for a few minutes then turned it off and tried to sleep. Back came the irregular breathing that has plagued me off and on for the last week or more. Every time I thought I was drifting to sleep I would sit up gasping for air. This was compounded by having to pee every 20-30 minutes, thanks to the diamox. I brought a pee bottle into my room to avoid the long trek down the hall, but even getting up to pee in the bottle left me freezing in the sub zero temperature (close to 0 F). Throughout the ordeal the breathing issues continued.

 

About 4 am I gave up and turned on my phone and pulled up the NYT crossword in the hopes doing a crossword would calm me down and help me get at least an our or two of sleep. However, I found I couldn’t focus at all, my mind was a swirling miasma, I couldn’t even solve the easiest clues. I gave up and lay there gasping, waiting for the the frozen dawn to come.

Reality really hit me that morning when I returned from a trip down the hall to empty my now full pee bottle. When I arrived back at my room, I couldn’t figure out how to take of my slip on sandals. I stared down at the confusing straps for several moments like they were some escape artist’s invention. Finally, I figured out all I had to do was to just pull the Velcro strap. NOT good.

Dawn finally arrived. I found Bhakta in the dining room, I ordered a breakfast that I could not eat (another pertinent symptom) and we discussed what to do. I basically had two choices: 1. Head downhill. 2. Try staying another night at Lobuche at 5,000 m or 16,500 ft and see if I can shake these symptoms. The most common symptom of altitude sickness is a severe headache, which I curiously did not have. But the breathing issues, insomnia, loss of appetite and mental confusion were. I considered option 2….Another night in this god forsaken frigid lodge, with the disgustingly frozen toilet, living in a 3 m x 3 m cell with a window the size of my iPad was not appealing. What if my symptoms get worse? Then I would be potentially looking at a chopper evacuation. If my condition stayed the same, I might be looking at walking out in an even more exhausted condition than now. In the end, the decision was easy, I would turn my back on Everest Base Camp and self evacuate while I could.

Perhaps surprisingly, I was not really disappointed by missing the chance to visit Everest Base Camp, and only slightly disappointed to miss seeing the view of Everest from Kala Patthar. For me the journey is the goal, not the end of the journey. I didn’t want this one to end in a helicopter. The cause of my illness could be any of a number of things, and I may address that in a future post.

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Periche lies off in the distance at the end of this endless outwash plain.

Down I went, stumbling and bumbling my way down the rocky trail back towards Periche. I moved very slowly, and Bhakta was never more than a step or two away. I’m pretty sure that if I dropped dead, he would catch me before I hit the ground. Finally we reached the part of the trail that dropped down off the moraine, thus losing about 300 m of elevation. We paused at the small lodge at the bottom of the moraine for some hot chocolate, and I ate a half a bag of my homemade gorp. After that I felt considerable better, but still weak, as we marched down the long outwash valley between the moraine and mountains. We stopped for lunch at Periche,  and that further revived me. Our goal was the lodge-village of Pangboche (elevation 3930 m or about 13,000 ft). This would give me more than 3000 m of elevation relief. But the descent from Periche was exhausting. We arrived about 3 pm and I managed about a 30 min nap before dinner without any issues. Hopefully, I can get a good sleep tonight. I will continue my descent to the airport at Lukla in the hopes of catching an earlier flight to Kathmandu. I have no stomach for going back up any time soon.

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In spite of my condition, I couldn’t help admire the view of Ama Dablam.

The Home Stretch!

The post is being written on March 18 USA time.

The day dawned bright and sunny with only light winds, but bitter cold. I felt good enough to move on, but my sleep was not the best.  After my typical breakfast of fried eggs, a couple of pieces of toast (no butter), and some fried potatoes, we headed up the trail at about 8:15 am. Today was a fairly short day; our distance was limited by the placement of the villages, and limiting elevation gain so as to allow acclimatization. I also walk very slowly at this altitude.

The route continued to follow the dwindling Dudh Koshi and initially contoured high on its left slope. We gained elevation gradually, but you could still feel the lack of air in my lungs. Thankfully, my cough has subsided somewhat, but soon the bitter cold air made my throat scream. The land was brown and punctuated by soaring icy peaks. I will let some photos do the talking here:

After our lunch at Tukla, we made a right turn and began a 1 hour climb up a towering moraine of the Khumbu Glacier, the glacier that originates in the cirque between Lhotse and Mount Everest. When we reach the top, we encountered a virtual graveyard. Not actual graves, but memorials to the scores of climbers who have perished trying to climb Mount Everest. I would have liked to spend a couple of hours looking at all of them, but it was damn cold and my lungs were searing. About 40 minutes later we arrived at Lobuche; an early day as we arrived before 2 pm.

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A line of memorial cairns at the entrance to the Khumbu.
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A colorful memorial facing the Himalayas
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A memorial plaque to a lost Russian climber.

The lodge here is not too good. I have a long march down a hallway to the toilet. I solved that problem; I procured an empty plastic bottle, so no trips to the loo. The lodge was packed, there are only a few lodges here, so all the lodges are pretty full. The staff are mostly young Nepali who work here during the trekking season. When the yak poo fire wouldn’t start, these kids made an attempt to get it going with a few pieces of wood and kerosene. They managed to get it going only after filling the room with smoke and the strong odor of kerosene. I fully expect a terrible headache tonight from the fumes, but the alternatives meant being somewhere far too cold. Thankfully, I spend only one night here.

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Guides and porters gathered around the stinking yak poo fire.

Tomorrow, the plan is to hike to Gorak Shep that last village before base camp. After a snack there, we will continue onto EVEREST BASE CAMP! Lungs and legs willing.

Dingboche

Written on March 17 USA time…

I had another miserable night last night, triggered I guess by the altitude gain and the urine productIon caused by the diamox. I think I only had about 2 hours of sleep. I also saw a return of the irregular breathing issue I had back in Namche Bazar. I was happy when dawn came, but I was exhausted. My appetite was gone too.

Nevertheless, I geared myself for the morning acclimatization hike, up the adjacent mountain about 250 m. I joined the procession of a couple of hundred trekkers snaking up the mount under a bright sun and stiff frigid wind. I forced myself to keep going, resting every one hundred steps. Counting my steps kept my mind off my misery. After reaching the turn-around point marked by a cairn supporting a prayer flag, we turned around and had an incredible view of Lhotse, Makalu (over 8000 m), and Ama Dablam towered over us across the village of Dingboche.

Here are some pictures from our view point:

 

After the brief photo op, our decent was quick. I sat in the dining room of the lodge in near total exhaustion. My lunch came, but I had little appetite. Still, I forced my self to eat the entire bowl of Sherpa stew. It took me nearly an hour to finish it, then I staggered back to my room, which had warmed in the sun, and crawled beneath my sleeping bag. I fell asleep within minutes, and slept soundly for 2 hours. That was my longest sleep since Namche, and also the longest I have gone without peeing. I felt much better after the nap. I spent the rest of the day hanging out in the lodge dining room in front of the yak poop oven, talking with the other trekkers.

If I can get a decent sleep tonight, I will move up the trail, otherwise I will spend an extra day here. Everest base camp is only a two days march from here, but the air gets thinner. Tomorrow morning will be decision time.

Cold at 4,400 m

No internet here, so although I’m writing this on March 16 USA time, I won’t be posting until a future day.

I had another terrible night of sleep, ruined by frequent trots down the hall to pee – a side-effect of the Diamox I am taking to prevent altitude sickness – and bitter cold seeping into my sleeping bag from below. The dawn was clear, but gathering clouds greeted the start of the day’s hike. To top it off my breakfast of a cheese omelet didn’t have much cheese, and two eggs was just not enough.

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Clouds gathered around the peaks, and a cold wind began to blow.
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We were now up in the alpine tundra, too cold for trees…and humans.

The hike actually was not difficult, except for the altitude, but I had very little energy. The route followed the Dudh Koshi, with two suspension-bridge crossings. I trudged along at a snail pace, and felt a bit better after my lunch of fried potatoes, cheese, and egg. I’ve had very little meat with during the trek, just some buffalo stew lower down.  I’ll be ready for a big old steak when I get home.

After lunch, the sky had become overcast and a cold, cold wind blew.

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Cold at our morning tea stop at Pangboche 

We were now over 4,000 meters high (about 13,200 ft) and no trees broke the wind. The land had turned brown and tundra-like. Then it started to snow lightly. By the time we reached our destination, Dingboche, the wind was bitter cold and the temperature well below 0 C (probably in the low 20s F), and by nightfall a dusting of snow had accumulated on t he frozen ground.

Fortunately, Dingboche (4400 m high) is a fairly large village catering to trekkers and yaks, so I have a relatively nice lodge, with en suite squater so no cold trots down the hall tonight. In the lodge I met two young Americans, Carter and Justin, who had quit there jobs and were roaming the globe. We had a couple of hours of good conversation around the yak dung fire. Tomorrow is an acclimatization day, so I’ll be here a second night. Tomorrow, Bhakta wants me to hike up the mountain to 5100 m and back, I will only commit to 4450 m. So we I’ll see.

Healthwise, I feel like I’m handling the altitude ok, except for having to walk very slowly, one step, one breath, sometimes two. I still have the Khumbu cough, which turns into a very sore throat while breathing in the cold air. I’ll probably bring that back to Chiang Mai. My main worry is the upcoming bitter cold around Everest base camp – I’m freezing here and still have another 1000 m (or 3,300 ft) to go, which translate into somewhere around 5 to 7 degrees C colder than here. It will help if the wind stops and the sun stays out.

On the Trail Again

Last night I slept fairly well except for a very bad fit of coughing about an hour after getting in my sleeping bag.  It finally calmed down by itself.  It’s really hard to lose this cough when you spend all day in cold air breathing through your mouth.  At least it doesn’t seem to be getting any worse.  Also, I think I figured out something about this feeling of suffocation – I think these episodes are self inflicted. They only occur when I am lying still trying to sleep.  My mind starts to worry about the altitude, and I start breathing voluntarily, rather than just forgetting about breathing and let my brains/lungs do their job.  When I take over, I tend to breathe too deeply, thus triggering the loss of CO2 from my blood stream, which in turn lowers the urge to breathe.  Then the cycle starts again.  If I lie there doing something like playing with my phone, I just breathe normally, with no issues at all.  My theory is backed up by the fact that I had no issues while hiking today, and feel fine now even though I am over 3800 m (12,500 ft).  Of course it could also be because I started taking Diamox.  Or maybe it’s a combination.

Speaking of Diamox, One of its side effects is frequent urination.  Both last night, and today while hiking, I must have stopped to pee every 15 minutes on average.  Fortunately, I bought a new hydration bladder at Namche so I was able to keep hydrated.

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Fir trees and towering peaks floating above the clouds.

Today’s hike started with a stiff climb out of Namche, then a 2-3 km of contouring, before plunging down a few hundred meters to cross the Dudh Khoshi on another vertigo-inducing suspension bridge.  From there it was up up up about 600 meters or 2000 ft vertical to Tengboche, the location of a famous large monastery.  I passed by without even a picture, I guess I’ve seen one to many Buddhist temples in my time. The weather was sunny for the most part, in spite of clouds swirly about the high peaks.  It is impossible to describe, and photos don’t capture, how dramatic it is when you are hiking directly beneath icy peaks that are more than 2 miles above you.  A mountain will appear impossibly high as it peaks over a diffuse cloud.

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The yaks are coming the yaks are coming…..

On the part of the trail above Namche, the donkey trains have been replaced by trains of lumbering shaggy yaks.   They kick up a dust storm as they plod by.  The vegetation has also changed with the pines below Namche giving way to tall fir trees.   Tomorrow, we will climb up above treeline, which should yield unobstructed views, but I fear the cold wind.

Tonight, the lodge’s dining room is filled with trekkers, including a large contingent of Koreans who brought their own food, compete with plates, chickens and chopsticks.  I had horrible spaghetti with tomato sauce and cheese where the tomato sauce was a splash of ketchup.  Ah well, I am not here for the cuisine.

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My lodgings tonight – typical tea house room, a bed and not much more.

Rest Day

Last night I had a bit better sleep.  I still had some episodes of suffocation, and spent the first half of the night cough badly.  The cough subsided finally and I got a couple of hours of sleep.  Before getting out of my sleeping bag I decided to take a rest day today.  This rest day most likely means I will have to cancel the add-on part of the trek to Gokyo Lakes, which is probably for the best the way I’m feeling anyway.  I will focus on getting to Everest Base Camp and then see what happens.

Given that I am having issues with altitude at Namche Bazar at only 11,500 ft, I will need to proceed slowly and with caution.  I have plenty of time, my flight from Lukla back to Kathmandu is not until the 26th of March, 11 days for what is normally a 8-9 day trek to base camp from Namche.  One day at a time.

I spent the day mostly lying in my sleeping bag, doing NYT crossword puzzles and dosing off and on.  I had only minor episodes of the periodic breathing that plagued me the last 2 nights.  Additionally, I’ve started taking Diamox, the recommended drug for the prevention of altitude sickness.  Downside is it makes you pee a lot.  Won’t be fun getting out of a warm sleeping bag a few times every night.

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Gokul, Bhakta and me sitting around the heater.  What you can’t see is that behind the camera WrestleMania is on the big screen TV behind me.

Its now evening and I’m sitting around the electric heater (only source of heat in the building) with Bhakti my guide, and Gokul, my porter.  They take care of my every need, and I am confident I am in good hands.

Suffocation

Written on March 13 USA time

Just when I thought I was better and was handling the altitude, Wham! I had the most miserable night so far on this trip. Every time I just about fell asleep, I would be slammed awake with the feeling of suffocating. I few deep breaths later, and I was fine…and wide awake. This is actually a normal response to a fast increase in altitude. The panting of climbing in the thin air reduces ethe amount of carbon dioxide in your blood. Since breathing is mostly to get rid of carbon dioxide, the brain signals your body to slow or even stop breathing. When your oxygen level then also falls, your brain says: oops! and you gasp for air. In addition my cough and sore throat got worse through the long night. By the time it was ready to get breakfast and go on an acclimatization day hike, I was already exhausted.

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Namche Bazar from above

The route of the day hike took us straight up about 400 m above Namche Bazar. Every step was a chore. I started counting 25 steps, then resting. I stuck with it, and eventually I rose above the village, and dramatic peaks began to emerge. I reached the dirt air strip far above town which is the highest airstrip in the world, although now it is seldom used.

Our goal was a lodge situated on the hill above Namche at 3850 m, with views up the Khumbu Valley. Sure enough, I rounded the corner of the lodge where a magnificent view of Mount Everest, Lhotse and Ama Dablam appeared. We spent 20 minutes or so admiring and photographing the view, before heading back down. The return trip was much faster.

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My first view of the tip of Mount Everest and Ama Dablam 
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Mount Everest close up.  It’s a little windy up there.

I spent the remainder of the day resting, doing some shopping for minor supplies, and having a coffee and brownie at Himalayan Java. My cough has not subsided, so I am seriously spending an additional day here at Namche. Hopefully with a good night’s rest, I will be good to go.

Namche Bazar

Note this post was written on March 12 USA time.

 

What a difference a good night’s sleep makes! I went to bed the night before thinking I might have to take a day off to let my feet heal and my cold to subside. The night before I got the tea house to fill one of my water bottles with boiling water, and I put that in my sleeping back. I was toasty warm and slept very well. I woke up still coughing some, but felt energized enough to get back on the trail.

Today we made the climb up to the famous Sherpa trading post of Namche Bazar. The day dawned with a bright blue sky.

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As we walked up the river, we began to see some magnificent peaks.

The trail continued to follow the Dudh Koshi River northward, staying close to the valley bottom. We passed a series of villages catering to the hordes of trekkers heading toward Everest Base Camp. As we approached one of these villages from below, I realized we had reached a significant milestone: The end moraine of the Wisconsin glacier in the Dudh Koshi Valley.  It was pretty hard to miss actually as we had to climb to its top to reach the next village.

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Glacial till – the first I have seen.  Presumable from the maximum glacial advance of the last ice age.

Just north of Monjo, another trekkers’ village, a significant tributary, the Bhoti Koshi River, enters from the northwest, and Namche sits high above the “V” made by the intersection of the two streams. The trail was surprisingly graded, with many switchbacks, and crossed the main valley on a dizzying suspension bridge. I felt pretty good thanks to having lived at or above 2300 m for the last week. I reached Namche, elevation 3440 m (about 11,400 ft) by 3 pm, well ahead of schedule.

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Namche Bazar

Namche is a large and hugely prosperous village catering to the trekkers. Shops, cafes and bars line the narrow streets. There is even an Irish pub here, touted as being the highest in the world. I am planning on visiting for a high altitude Guinness on my return nearly 2 weeks from now. Tomorrow is an acclimatization day, we will do a short day hike to a higher altitude, but sleep in Namche again. Hopefully this nagging cough subsides soon.