Sam: This is it.
Frodo: This is what?
Sam: If take one more step, it'll be the farthest away from home I've ever been.
Frodo: Come on Sam. Remember what Bilbo used to say, "It's a dangerous business Frodo, going out your door. You step onto the road, and if you don't keep your feet, there's no knowing where you might be swept off to."

Saturday, April 19, 2014

Day 8 the fear of AMS

Day 8 the fear of AMS
Dingboche acclimatization day 1
Elevation gain 0 

Today we went on a hike to about 4800 or 4900m on a peak from the village at 4350m for acclimatization. I was personally happy with that altitude for acclimatizing purposes because the next village is 4900m. 

The threat of Acute Mountain Sickness is a constant worry of mine. Each village along the way to EBC is higher than the one before so the risk never goes away. We had a couple acclimatization days, basically a day where we sleep at the same altitude but during the day go on a hike to higher altitude. The recommendation is to gain max 300-500m sleeping altitude each night. 

The more acclimatization days the better. That is why my EBC trek is three days longer than the standard trip if I had booked with a trekking company. But there's no saying who will get sick and at what altitude. I've read blogs where people felt fine until 4900m, which is our next stop. 

On day 5 we met a man who was descending from Dole 4040m. We first saw him on the trail, a fit middle aged white man who was carrying only a Nalgene and a porter trailed behind carrying a large backpack, obviously his. Most men of similar physique and age we saw on the trail were not only fast but carrying huge packs too. We chatted with him and found out that it was the 4000m mark that did it for him. 

Tonight at the dining room another woman in her 20s was talking with some other guests about getting AMS. I'm not sure what altitude it was that she got sick. But she described being half carried by guides down the mountain. She didn't look well either. 

It is hard to tell sometimes if I'm just tired or if I have AMS. The hallmark is headache. I direct you to the Lake Louise criteria for the symptoms and diagnosis. I think I felt AMS twice but only briefly, at Namche (3450m) and Khumjung (3790)m. Each afternoon I was tired and had a headache at night but felt better the next morning. 

I have a prescription of Diamox with me. The typical regimen is the prophylactic regimen where you take it 24-48 hrs before ascending and continue the whole time until you descend. I opted not to do this. I'm not sure what an American trained doc would say about this but the Himalayan rescue association thinks it's okay to start taking it when you feel symptoms. The reason I didn't take it was to avoid the side effects which also don't make you feel that good even though they prevent the real dangers of AMS: high altitude pulmonary edema and cerebral edema. 

The main side effect is increased urination. If you read my post about how cold it is, you can imagine how painful it is to get up in the frigid night. It also interrupts your sleep even as Diamox relieves the AMS headache that might have kept you up.  

But today I personally felt disappointed that I didn't get higher on the peak because I wasn't adequately dressed for the cold wind. Around 11am the wind picked up and I didn't bring my thick coat or thick gloves.  Trekmate and i decided it was just too cold. 

Each day we are higher and closer. I hope my health keeps up and the weather is relatively mild. 

1 comment:

  1. Very cool Chen. Somehow the topic of Everest came up on the ride home from work (an off-shoot from a convo on adrenaline junkies come to think of it) and I told my co-workers you were there!