Showing posts with label Acute Mountain Sickness. Show all posts
Showing posts with label Acute Mountain Sickness. Show all posts

Friday, 26 October 2012

The Thorung La

Though 5416 metres above sea level, the Thorung Pass is sill about 400 metres lower than Kilimanjaro.  In spite of this the climb has its unique challenges, the biggest of which is the profusion of “false summits” that play havoc on the trekker’s morale.  The stone halfway house one encounters at dawn for example, looks very much like the structure at the summit though it is still several hours shy of it.   In addition, the undulating hillocks and saddles are so shapeless and void of definition that one can easily become disoriented.  Indeed, I have only dreamlike memories of that morning. 

In an attempt to assess ideal fitness requirements for this leg of the circuit, I had spent hours sifting through online reports and blog postings of people who had done it.  Much like the endless speculations that circulated on how to deal with altitude, I found there was no consensus on the toughness of the climb or just how much physical training was required for it.  Some younger, fitter trekkers minimised the physical demands while others – lulled into a false sense of security by their fitness levels - had gone too fast and found the day torrid.  Older trekkers had a more sober-minded approach and while they made no bones about the toughness of both climb and subsequent descent, they at least made it sound possible.  With hindsight (but with plenty of training behind me), I would describe the traverse of the Thorung La as challenging but fun.

A 3/4 moon hung high in the western sky as we fell into the shuffling procession of trekkers heading up the pass.  There was none of the cheerful banter that characterized the previous mornings, instead only laboured breathing and the squeak of boots on powdery snow.  The moon cast just enough light to pick up the faint outlines of the neighbouring peaks but to stay on track the use of a headlamp was essential.  When I stopped at the top of the first rise to look back, the bobbing line of tiny lights looked like a giant Christmas decoration on the move.  This was the first time in days that our team walked as a unit, checking on and encouraging one another, each reminding the other to drink.

The smiles didn't last much beyond sunrise!

Memories of the four-hour climb, such as they were in that shapeless moonscape, have collapsed into a vague though heady collection of highlights: golden clouds boiling up darkened valleys, coppery mountain peaks penetrating the milky predawn darkness, desolate boulder strewn draws encrusted with snow.  Two hours out from High Camp, the procession had fragmented somewhat and for extended periods, we walked in solitude.






Soon however, our slow and fairly deliberate pace seeded us with a number of trekkers that were more or less in our age group or fitness level.  Most were struggling but were philosophical enough to know that the strain could be leavened by a liberal dose of humour.  Occasionally we would encounter someone who was clearly suffering from mountain sickness.  One such person was a Chinese lady who had become separated from her husband and who was staggering upwards, heavily burdened with camera equipment.  Possibly because of the language barrier but maybe because of delirium, she was impervious to our encouragements to rest and drink.  One got a slight insight into the heart-rending dilemmas faced by climbers in the Death Zone who can do little or nothing for ailing comrades.  While I would never say that 5400 metres warrants an “every man for himself” attitude, helping a sick person without compromising one’s own chances would have been very difficult indeed.  Mercifully, the Chinese lady prevailed and seemed to be doing fine by the time we reached the summit. 

One person who wasn’t doing well was Sandra.  By now she was quite unresponsive though complained periodically about a cracking headache.  At one point, on hearing that the summit was still two hours away, she had sat down in the snow and wept with frustration.  Thus, when we reached the summit at about 9am, we resolved to make our stay as brief as possible.  

There was a certain elation associated with getting to the top…countless photos were taken interspersed with plenty of high-fiving.  Afterwards, we crammed into a small stone house for a hot cup of tea.  Judging from the number of customers, I imagined the owner was making a small fortune from this venture.   But the place was so crowded, the smell of gas so overwhelming, I made a claustrophobic dash for the door.  It was pretty cold outside: twenty minutes later when we were getting ready to leave, I discovered that the pipe of my Camelbak had frozen solid.  We also discovered to our horror that someone had stolen Martin’s trekking poles, a disaster considering that the worst part of the route still lay ahead of us.  In light of Martin’s knee injury, the implication was that one of us would have to surrender our own poles.  As the crowd of summiteers thinned out however, it appeared it wasn’t a case of theft after all but rather one of mistaken identity.  We took a seemingly unclaimed set and after checking that the owner was nowhere, appropriated them.  This was a huge mercy – without them the walk down would have been close to impossible.

The summit at last - from left Rissam, Ram, me, Raj - kneeling is Kisna

I started this piece claiming that traversing the Thorung La was “challenging but fun”.  As we began our descent, it quickly became clear that the fun part was behind us.  While blogs described the descent as tough, many were quick to point out that it was a lot better than negotiating the pass in a clockwise direction i.e. from Muktinath to Thorung Phedi.  Only two categories of people, it seems, do this – local traders on horseback and the certifiably insane.  One reason is the absence of any suitable lodgings so acclimatization is nearly impossible.  Another reason is the unrelenting steepness of the path.  If the descent seemed endless, I shudder to think what the 1500m ascent might be like.

A look back up the trail
Buoyed up by the euphoria of having reached the summit, we began the walk down in a cheerful mood.  It wasn’t until midday however that the desperate nature of the retreat began to dawn on us!  Though the snow gradually thinned out and the pathway became less slippery, the steepness intensified.  We took a rest on a remote pasture, a brief “landing” in the unending staircase of switchbacks.  From this vantage point, we looked down into the arid swathe of the Kali Gandaki Valley, to Muktinath and Kagbeni, gateway to the fabled region of Mustang.  In the distance stood the imposing bulk of Dhaulagiri, the world’s 7th highest mountain.  

Our destination still seemed miles away.  And though we’d descended at least 900 metres, the dangers of altitude had not diminished in the least.  High on the path above the meadow, I watched Lil staggering downwards, retching uncontrollably, clutching her head and complaining that she must have caught a bug.  Had we been more attentive to the talk on AMS at Manang, we would have known that many cases of altitude sickness present several hours after leaving the summit.  Also, we would not have lingered in this exposed position.  Ignorantly however, we sat around for nearly an hour trying to get Lil to swallow Super C’s and headache tablets.  Imagining that he would be welcome the money, we asked a passing horseman if he would escort her down on his pony.  Strangely he was hesitant – the path was too steep and either she would fall or the horse would stumble and hurt itself.  Instead, the man opened his bag and produced a bread roll.  “Perhaps if she eats she will feel better”, he said in Nepali.  We declined but were touched by the simple gesture.  With Martin, Sandra and Lil on the brink of exhaustion, we redistributed their packs between the three of us and resumed the bone jarring descent, stopping only to eat at a grimy establishment in Charabu.  A photo taken there shows the sorry and mostly humourless state of the team.

This section of the descent was probably the toughest - the path was surfaced with stones the size (and shape!) of a rugby ball and played havoc on the ankles

A humourless lunch at Charabu

By now I was impatient with our slow progress and itching for a hot shower.  After lunch I shouldered the packs and powered down the slopes.  As I approached a suspension bridge over the Thorung River, I saw Ram, Rissam and Kisna moving up the slope towards me.  Earlier that day, they had rushed on to Muktinath to secure hotel rooms.  Now, freshly showered and dressed in casual clothes and flip-flops, they were retracing their steps to help us down the mountain.  It must have been a tough day for them too but they were showing none of the outward signs.  A half hour later I was luxuriating in a hot shower at the North Pole Hotel in the sacred town of Muktinath, a sublime relief after 5 days of not bathing.  Two hours later, the rest of the team limped down the high street – shaky but in fairly good spirits.

Martin and Lil limp into Muktinath, sans luggage

That night, we celebrated the crossing over a meal of sizzling Yak steak and a shot of the region’s famous apple brandy, served hot alongside a cup of ginger tea.  It was a memorable end to an even more memorable day.  In truth, it was a half-hearted celebration.  The pass had taken its toll and it was doubtful we could proceed with the journey as planned.

Sunday, 21 October 2012

Manang District

I was standing on the bank of a rushing river that flowed perpendicular to a rocky scree.  Somehow the path had petered out and I was wondering where I should cross.  On the far side, a fellow trekker shouted words of caution above the roar… “Don’t try to cross!  Use the bridge further down!  If you cross here you will definitely drown!”  I weighed up his words and decided to ignore the warning.  There was no way I would drown, after all, just how deep could the water be?  No sooner had I thought this however, I remembered a friend who had drowned whilst on a trek in Alaska a few months before.  I remembered my shock at the news and the outpouring of grief from his friends and family.  Even in light of this I decided that the bridge 200 metres below represented too big a detour and that the risk was worth it.  

I waded in.  

In an instant the glacial melt enveloped me and sucked me under.  Swirls of bubbles and eddies of gravel rose up to fold me deeper into the river’s clutches.  The water was suddenly not clear at all.  Instead it was a milky suspension in which there was neither up nor down.  I bounced and rolled downstream, my breath failing.  How long could I hold on?  But then a last sliver of hope – a tree trunk lodged between the rocks.  If only I could grasp it…

I awoke in a chilly veneer of sweat, my head buried deep inside the hood of my sleeping bag.  I was gasping for breath as though I’d been holding it for at least a minute.

Cheyne Stokes breathing.  According to Wikipedia – “an abnormal pattern of breathing characterized by progressively deeper and sometimes faster breathing, followed by a gradual decrease that results in a temporary stop in breathing called an apnea”.  Cheyne Stokes breathing, coupled with hallucinatory nightmares, is a common condition amongst trekkers and climbers who have gained altitude too quickly.   Since setting out from Sangye, we had gained over 1600 metres in two days though technically we weren’t really high enough to be feeling the full effects of altitude.

Such a rapid gain in altitude is generally not a problem below 3000 metres, though cases of altitude sickness have been detected as low down as 2200 metres above sea level.  Higher than 3000 metres however, trekkers are advised to observe something called the “rule of threes” which, simply put, prescribes the following:  over 3000 metres never let your net gain in altitude (between sleeps) exceed 300 metres per day – and every 3 days take at least 1 rest day.  In addition, never drink less than 3 litres of water per day – in fact, try to drink a good deal more if you can.

Complying with the latter injunction is a good deal harder than it sounds in Nepal where, in spite of its surfeit, very little water is fit for human consumption.  In cases of glacial melt, the liquid is too saturated with minerals and extensive filtering is required.  In the case of the deceptively limpid mountain streams one can never rule out the existence of a village somewhere above where one is drawing water.  In fact, it is safe to assume that no matter how high up you may be, there is always someone higher up than you are who is polluting the system.  One may go to bed feeling on top of the world but when morning comes and the clouds have parted, one invariably catches sight of some isolated hamlet clutching tenuously to the hillside higher up.  

In light of my discomfort over the use of bottled water, I found it a constant challenge to keep my Camelbak hydration system suitably replenished.  Also, the higher up you go, the cost of a litre of water begins to spiral radically out of control.  Take bottled water as a yardstick:  in Kathmandu, a traveller can purchase a sealed 1L bottle of ozonated water for as little as 15 Rupees (R1.50).  Now as we entered the Manang district, the same bottle had skyrocketed to 200 Rupees a unit (R20).   A litre of boiled water procured from a tea-house kitchen (by no means a failsafe solution) could cost anything between 100 and 150 Rupees.  Invariably, the answer was to draw water from a nearby spring and treat it with chlorine and a portable UV device called a Steripen.  Another option – by the far the best but not always available – was to buy ozonated water from community run filter stations which a New Zealand non-profit installed recently to combat the bottled water problem.  At 40-50 rupees a litre, this was competitive but a number of these were temporarily closed due to breakdown and lack of spares.  In short, proper hydration was not only a gamble but also a constant preoccupation.

Another challenge associated with water was consuming it in the requisite quantities – and then dealing the obvious implications. Because many teahouses had fewer than 3 toilets, the queues that formed outside these were often sizeable.  This, added to the woeful prospect of a nighttime visit to these noxious pits, meant that many trekkers simply resorted to alternative arrangements.  The result was that the surroundings of many pristine and beautifully appointed lodges smelled overwhelmingly of stale urine.
*
As we walked deeper into Manang district and passed through towns like Koto, Chame, Pisang and eventually Manang itself, we encountered more and more of the Buddhist influence in the lives of the local people.  As we sat down for breakfast in Koto for example, an acrid smoke wafted into the dining room and before long had us choking.  “Sort that bloody smoke out before it ruins my breakfast!” someone shouted rudely at our host.  It turned out the smoke was emanating from a tiny ceremonial burner on the stone wall outside where juniper branches were being burned to ward off evil spirits.  It was a practice we saw frequently over the next week and I became quite comfortable with the fragrance.

Ornate prayer wheels in Lower Pisang - the ancient bronze wheels have been beautifully crafted.  As they break they are often substituted with Nescafe coffee tins


Nepalese Children are very cute indeed!

In addition, a large and ornate Buddhist Chorten heralded the entrance to every town.  A brightly decorated archway containing copper prayer wheels followed soon afterwards.  The expectation was that travellers, pilgrims and residents would spin the wheels as they passed through, thus activating the prayer inscribed on scroll contained within. 


Buddhist Chortens - these should be passed on the left

*
Before leaving SA, I’d read about the region’s much-maligned road building projects and had pushed for a change in itinerary to avoid the worst sections.  Now that we encountered them however, it seemed we’d over-reacted.  A muffled “boom” the previous afternoon had advertised the presence of teams blasting their way along a particularly steep hillside that flanked the river.  But in spite of the use of dynamite, the scale and pace of the effort was so small and slow as to be almost non-existent.  Mostly, we encountered terribly undermanned and ill-equipped construction teams, seldom numbering more than 7 or 8 people, many of whom were feeble children and undernourished teenagers.  We found them in the most unlikely places where almost no geographical feature was too big an obstacle.  Stubborn rocks and boulders that remained after blasting were systematically broken down - first by the application of fire and then the old fashioned way – by hammer.  We encountered dazed, exhausted road builders, shrouded in chalky dust and with gazes so vacant they looked more like phantoms.  Every now and then, we would pass young men, no more than 16 or 17 years old, carrying head loads of fine gravel and sand weighing at least 50kgs.  It’s impossible to say when the road will be complete to say nothing of what its full effects on the area will be.  For now, it is man in his most primal state contending with the greatest mountains in the world.  Will the Chinese soon step in to dramatically escalate the scale of the undertaking?  If so what will remain of the circuit?

This section of road was once a vertical cliff-face.  There's very little that a stick of dynamite can't sort out...