AMS

My Demons Return, Part 2.

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As I clambered aboard my rescue helicopter, I looked around for the last time at the brown, barren landscape and windswept village of Dingboche. I was pretty sure this would be the last time I would see this scene. I can say that I wasn’t taking away many good memories. After three days and two sleepless nights of gasping for breath and shivering in the sub-freezing cold, I was looking forward to thick air and long sleeps.

One of our porters, Bhanshu, climbed aboard with me, apparently he drew the short straw. As the chopper roared back to life, we slowly rose into the thin air. One other passenger was aboard, a Nepali, who did not appear to be an evacuee. I also noticed that the pilot, a 50ish looking fellow dressed in a flight jacket and wearing a lanyard with an official looking ID, was wearing a nasal cannula supplying him with supplemental oxygen. The US FAA requires oxygen for pilots flying flying above 12,500 ft, so this made sense. The US FAA also requires passengers to be provided with the option of having supplemental oxygen above 14,000 ft. Apparently, the Nepali FAA (assuming they have one) has no such rule, or at least don’t enforce it. I was left to continue breathing the thin air. This was very surprising seeing as I was being rescued for AMS. Fortunately, I was sufficiently distracted by the adrenaline rush of flying in a helicopter, even though we briefly flew above 18,000 ft.

I know that Dip, when he called in to request the helicopter, also requested that they give me a “tour” of base camp before flying me down to Kathmandu. I was dubious that they would do this. Why waste the fuel, and why take a passenger being rescued for AMS to an even higher altitude? It became obvious that I was wrong when the pilot turned and climbed the helicopter up into the Khumbu valley.

What a ride! I may have started dying in the thin air, but with the rush of the scenery in the crystal clean sky, I did not notice. In just 10-15 minutes we flew up the valley, directly over Dhukla, Tengboche, and Gorak Shep, the villages I was scheduled to stay in over the next 3 nights, then onward to Everest Base Camp, marked by a city of hundreds of orange and yellow tents strung out for about a kilometer on the Khumbu glacier’s lateral moraine. As we approached Gorak Shep, with the viewpoint-hill of Kalapathar rising to the left behind the small collection of lodges, the enormous hulk of Nuptse hove into view, and seconds later Everest. Nuptse appeared as a giant icy black pyramid against the pale blue sky with Everest, obviously being blown by a strong wind, lurking behind. “Wow” doesn’t, begin to describe my wonder. This is a scene that will always be with me, burned permanently into my memory.

Once over Base Camp (such an inhospitable-looking campsite), we made a sweeping U-turn and retraced our path back down the Khumbu Valley. It took us only a few minutes to pass by each of the villages that were about a day’s walk apart. Down, down we went, finally pulling to the left of Namche Bazaar, over the evergreen forests we had climbed through several days before, and into Lukla, where we landed on the helipad next to the ski-jump of a runway at the Tenzing-Hillary Airport.

This was a scheduled stop on the way to Kathmandu to drop of my porter and to refuel (and drop of some small cargo items). I was told that it would be 30-45 minutes for the stop, so we climbed some steps up to the same lodge we stopped at after our landing at Lukla several days before. As we ate, I watch the clouds roll up the valley. Not good. After lunch, we rushed back down to the helipad, just in time to watch the last passenger load into our helicopter. Apparently, I had gotten bumped to the next flight, which I was told would be taking off shortly. The chopper roared to life…..but I could see the pilot looking intently down at the clouds rising toward Lukla. Suddenly, the engine powered down. The pilot got out and talked earnestly on his cell phone. He then climbed back into the pilot’s seat and shut down the engine. Apparently, no one was going anywhere soon.

After a wait of about an hour watching the fog swirl around and envelope the airport, we retreated back to the lodge to wait out the weather. It very much looked to me like I was going to spend the night at Lukla instead of Kathmandu. I was wrong though.

Part 3 to come…

The tiny trekkers village of Tengboche with the Khumbu Glacier in the foreground.
Everest Basecamp marked by yellow tents sprawled along the lateral moraine.
Everest (with snow blowing off summit) peaking out from behind Nuptse.

My Demons Return

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I am now back in Kathmandu, having failed once again to reach Everest Basecamp. As I have mentioned before, this blog gets more interesting when things go pear shaped. This year’s flameout was a bit more dramatic than last year’s walking retreat.

On April 2, we arrived in Dingboche at 4,400 m elevation. I wrote a short post that night because I felt very cold and not very energetic. That night, while trying to sleep, the demons from the year before revisited, with a vengeance. Sleep was impossible. As I lie in the the bitter cold, with sleeping bag and blanket piled on top of me, every 30 seconds or so a feeling of suffocation would overwhelm me, and I would gasp for breath. My plan for this eventuality was to pop an Ambien. Unfortunately the Ambien gained me only 2 hours of complete unconsciousness, followed by several hours of gasping and panic.

The next morning, April 3rd, I felt tired and woozy. Following a mostly uneaten breakfast, we saddle-up for an acclimatization hike up the steep mountain behind our lodge. I was very slow, constantly gasping for breathe. For most of the 250 m vertical climb, I took 3 breathes for every step, and stopped to pant every 100 steps. The day was crystal clear, but I have almost no recollection of the magnificent views of the high Himalaya. Upon our return to the lodge, I ordered a half-eaten lunch, then retreated to my room armed with two hot water bottles to snuggle with under my pile of insulation. In spite of my preparation, I shivered uncontrollably for 1 hour before my body temperature returned. But sleep eluded me. Instead, the gasping periodic breathing returned accompanied by suffocating panic.

The feeling of not getting enough air is the most scary of my life. At that moment, I wanted nothing more than to go down to where there was more oxygen. When I finally gave up trying to nap and went down to the common room to await dinner and the lighting of the stove, I had already made my decision to bail. I called a meeting with Tom and our guide Dip. After a discussion of the options, I elected to call in a chopper, provided my insurance agreed to cover the cost. To the great credit of Dip, and the owner of Nepal Hiking Team, Ganga, it was all arranged within 2 hours, including a scheduled helicopter for early the next morning, and approval from my insurance company (World Nomads). I now only needed to endure another night.

My symptoms that night included headache, lack of appetite, shivering, periodic breathing, and gasping panic. These are common symptoms of Acute Mountain Sickness (ALS). I managed about 4 hours of Ambien-induced sleep and about 5 hours of tossing and turning and trying to breathe. I finally gave up trying to sleep, packed up and went down to the dining room to await the dawn and my evacuation. I knew that I really needed evacuation when Tom called me a wimp and I agreed with him 100%.

My chopper finally arrived at about 10 am on April 4th after various delays. Little did I know that my evacuation adventure was just beginning. To be continued….

At my highest point, over 15,000 ft. I look way better than I was feeling.
Dingboche
My savior.

The Worst Night of my Life

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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.

Rest Day

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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.