BEWARE OF ALTITUDE. IT KILLS!

I have been travelling to high altitudes of Nepal for eight years now. I have come through two incidents in connection with altitude sickness till date. The first happened in October 2010 at Lobuche (4900 m asl), Sagarmatha National Park.  Two of my friends had suffered it but the magnitude was mild. Since the incident took place in a hotel, it got an easy settlement!!

The second one took place in Dec 2013 at Thini, Mustang, Annapurna Conservation Area. It happened inside a jungle, nearly 4-5 hours far from any human settlements, with just two of us to rescue the victim. The magnitude was larger. Being the first of its kind in terms of severity, it urged me to share the happening with all my friends concerned with high altitude.

The narrative:

Early in the morning we left Thini village (2855 m asl) and ascended towards Ghasung forest in search of musk deer signs. 

Thini village

I was accompanying a friend of mine for his M.Sc. thesis field work on musk deer. We had hired Mr. Bal Bahadur Thakali (55) as local field guide.

We had a distant view of the Dhaulagiri range and ascended up. 

Dhaulagiri range, a distant view

My friend was coming up very slow as it was the first time he had come to this elevation. At 3700 m asl, he complained of mild headache. I suggested him to drink as much water as he could. We halted for lunch at 11:30. At 12:15, we hit upon a resting site of musk deer. Soon the search progressed interestingly, musk deer pellets were observed at many places. 

Taking the field data of musk deer pellet

We spent almost two hours at the elevation of 3800 m asl.

At 14:00, we started to descend. After a while, we reached near Chemaso lake. 

Chemaso lake

Right then, my friend suffered a severe headache. As he sat down to rest, he complained of difficulty in breathing. I offered him some water. We tried to put him in comfort by telling that everything will be okay once we descend further. When we were about 300 m far from the lake, he gave up the effort of descent and lied down on the ground. I checked for water but the bottle had gone empty. So, I rushed towards the lake to fetch water, keeping him under the care of our field guide.

When I hastily reached near him with water in the bottle, he was lying down with his whole body stretched to the ground. I could not see our field guide nearby. My heart skipped a beat upon seeing this. I scanned the surrounding; the field guide was leaning back on a stone about 5m away. I sighed with a little relief.

As I approached him, he was almost unconscious. We made him drink water, that too with difficulty. We fed him some energy biscuits and some pieces of garlic. He would blink his eyes with difficulty and mostly preferred to keep them closed. I almost ordered him to keep them open. I took off his bag and carried them on the top of my own bag. We suggested him to rise up slowly, but he could not do that on his own. So, each of us took hold of a hand of his and almost dragged him down. After a while, he managed to walk a little, but still needed our support!

Upon descending about 400 m, he showed signs of improvement. We made him eat 2-3 chapatis and offered more water. He was well off now but the headache was still on. By the time we reached the hotel, I ordered a bowl of garlic soup for him. Drinking it gave him more comfort. After the dinner, he was back to himself again.

My Say:

Altitude sickness may envelope anyone. There is no any hint as to segregate who will suffer from it and who will be immune to it. During my research trip to Sagarmatha National Park, I was told by a trekking guide that a French traveler who did not suffer altitude sickness for ten Everest Base Camp (EBC) expeditions suffered it during the 11^th and passed away. Altitude sickness turns a killer when we neglect it.

Based on the scholarly consultations and individual experience, I list some important points to consider (Additions will be highly appreciated):

·     1. As soon as you realize symptoms like headache, dizziness, nausea, difficulty in breathing or imbalance in walking, descend down at least 300m. DO NOT HIDE YOUR PROBLEM. Make sure that you do not descend alone.

·         2. Maintain a slow and consistent rhythm of ascent. Going up with additional speed at easy terrains and resting longer afterwards may also trigger it.

·         3. Drink enough fluids.  These will maintain the supply of additional oxygen. But, do not ever drink alcoholic beverages in the name of having fluids. These will make blood circulation faster and thus increase the demand for oxygen hence leading to depletion in oxygen level.

·       4. Do not ascend with empty stomach. Carry chocolates and other easy carbohydrate sources. Keep eating from time to time.

·         5. Garlic, turmeric and Zanthoxylum (timur) are good natural medicines.

·         6. Always carry a first aid kit.

The final line:

Never underestimate altitude, the fascinating high altitude landscapes would turn into a killer if you do not comply with the natural rules they have set!