Acute Mountain Sickness

Before our trek began, James made a presentation to the team on acute mountain sickness (AMS) outlining the risk factors, causes, symptoms and preventative measures. Young males suffer AMS at a increased rate in comparison to other groups. As the case may be, our expedition was no exception.

During our initial climb from Monjo (2835m) to Namche (3440m), I began experiencing mild headaches. The following day I took a rest while the team set out for an acclimatization day hike. With sleep and hydration, the headaches subsided and I had no difficulty reaching Tengboche (3867m) the following afternoon. In the morning, we set out for Dingboche (4400m), taking a less traveled path through a rhododendron forest which is home to Musk Deer, Himalaya Pheasant, and Snow Leopards. The size of our group probably startled any wildlife, as we found only deer scat.

Just before the exit of the forest, I cracked my head on a low hanging rhododendron branch, nearly knocking myself out on my feet. After James inspected my scalp and tested my pupillary reflex for signs of a concussion, we continued on. As the team descended down to the river, I developed nausea and a worsening headache. Stopping in Pangboche the symptoms seemed to lift, and I played a few rounds of durak with Daniel, Bryan, and Shodmonov over lunch.

Following lunch, we continued our ascent to Dingboche. Arriving at approximately 4100m, I suddenly took a turn for the worse and began vomiting. Shodmonov and James descended with me to the Everest View Lodge at Pangboche, while Praveen continued up to Dingboche to alert the group. Assessing the situation, James determined that I should begin acetazolamide (Diamox) and spend at least two more days acclimating before continuing my ascent. Shortly thereafter, I fell asleep.

I was awoken several hours later by Deepak Rai, the trekking manager, who had run down from Dingboche carrying a med kit and gamow bag! Here my memory is a bit hazy. I drank some garlic soup and fell back asleep — sleeping for a total of 14 hours. Sometime during the night one of the porters ferried down my equipment (apart from my electronics, which the media team happily pinched, ahem!) Using the satellite phone, I called my parents in the US to appraise them of the situation before sending the phone back up to the team with detailed usage instructions.

Later in the day I was joined by Dipak Rai, one of the porter-guides, who had hurried down from 5100m. Dipak waited with me in Pangboche to see if I could ascend. Despite the rest and medication, I was unable to eat and awoke at 4am with labored breathing. We made the decision that I would evacuate to a lower altitude under my own power.  If this wasn’t possible I would be flown out.

Around 6am we set out for Namche, making two days progress in a single push with Dipak carrying both our packs the entire way. Before we reached Tengboche monastery we saw a rescue helicopter coming through the fog to retrieve someone less fortunate than myself. In Namche, the air felt thick for the first time. Seven hundred meters down, my symptoms subsided entirely, other than a peripheral tingling sensation brought on by the acetazolamide. Along the way we spotted the wildlife that had eluded us on the way up — Himalaya Pheasants and Himalaya Tahr. After a day of rest, we made for Lukla and in the morning I caught a flight back to Kathamandu. It turns out that the departure from Lukla was even more thrilling than the landing!

What went wrong?

I didn’t listen to my body soon enough. I should have started on the Diamox in Namche. By the time I had reached the road to Dingboche, it was too late to be of benefit. I should have halted my ascent at Pangboche when I felt ill, rather than pressing on to Dingboche.

I became dehydrated. It’s surprisingly difficult to stay hydrated on hot water and tea. I’m used to hiking with a 3L hydration pack. At 4000m, I simply wasn’t strong enough to hike with photographic gear and an ample water supply.

Yes, I’m disappointed that I didn’t make it to Imja, but it’s evident that pressing on would have been foolhardy and dangerous. I am very grateful to Deepak and Dipak, without whose help I would still be in Pangboche; James, Shodmonov and Praveen for leading me to safety and summoning help; Dhananjay and his team at Himalaya Research Expeditions for rebooking flights and providing hospitality in Kathmandu; and Guy and Emma, a pair of Brits madly rushing up the trail, who were good company while I was laid up in Pangboche.

It’s great to see that my altitude-addled instructions to the team were clear enough to keep the information flowing from the lakeside. For now I’ll join the rest of you as a spectator and wish the team the very best.

– Brendan