Today’s post is written by ‘Take Photos Leave Footprints’ contributor, Ashton (a.k.a. ‘my wife’) in which she fondly recalls her recent battle with Acute Mountain Sickness (AMS) on our trip to Everest Base Camp:
At 12:08pm on 20th March 2018, I had completed the long trek to the doorway to the top of the world – Everest Base Camp in Nepal. For me personally, it was the achievement of a life goal and sparked a long dormant enthusiasm for all things trekking and mountaineering. For years I had longed to do this trek, but I kept putting it off. The heart said, yes go for it, but the mind said, wait – aren’t you the woman who sits at the pub with a glass of wine and a cigarette telling yourself you will most definitely maybe go to the gym tomorrow? Yes, you’re the woman who buys expensive, colour-coordinated gym clothes because that will most definitely motivate you to actually show up to that Pilates class you signed up for. Sigh. My mind had been doing an awful lot of the talking lately. So, on a whim, I let my heart decide. Our holiday this year would be a trek to Everest Base Camp. I felt elated and (I’m ashamed to admit it) eager to casually work into conversations my next holiday was a trek in the Himalayas. My smugness, obvious to everyone, wasn’t so casual. Actually, I was secretly terrified of changing my mind. The more people I told, loudly and confidently, the harder it would be to back out. I am Sir Edmund Hillary. I am Reinhold Messner. Channeling the spirit of Mallory, I would reach Everest Base Camp….because it’s there! Am I the kind of person who has to trick myself into fulfilling a life goal? Yes, yes I am.
In hindsight, it was quite fortunate no issues presented themselves that would have forced me to turn around from reaching my goal. No food poisoning, no mudslides or avalanches, no sprained ankles, no fatal encounters with yaks. So, how was it that on the morning of 21st March, the day after I reached Everest Base Camp, I found myself lying in an old ambulance, hooked up to a machine that kept beeping until the paramedic surprisingly just turned the whole machine off as though my vital signs were merely nice to know but largely unimportant? As the ambulance careened through central Kathmandu, I tried to recall how the hell I got myself into this predicament. But trying to pinpoint one’s thoughts whilst suffering a bout of Acute Mountain Sickness or AMS is like trying to nail jelly to the wall.
Rewind a few days. We were in Namche Bazaar at an altitude of 3,440 meters, which should theoretically be child’s play, but my head was starting a low-level throb, I kept confusing my words – referring to my sleeping bag as a futon, and my appetite was nil. Trying to eat the largely untouched Sherpa Stew in front of me was sapping all my willpower and eating in general was becoming my new “Everest”. Someone should seriously market a high-altitude weight-loss camp. Anyhow, my trek guide suggested I increase my dosage of Diamox, a drug that is commonly prescribed to counteract the effects of high altitude AMS on the body. It’s also a very effective diuretic. Exposing my bare bum to the elements more than was absolutely necessary was no small thing. It’s hard enough for a woman to pee outdoors without adding in the additional stress of having to pee every hour. There were signs in the airport and practically everywhere warning hikers of the dangers of AMS, High Altitude Pulmonary Edema (HAPE) and the deadliest of them all, High Altitude Cerebral Edema (HACE). So, I bought an extra toilet roll and increased my dosage. And it worked! My symptoms evaporated. Unfortunately, just like a trailer for a major motion picture, my symptoms were only a preview of the main event awaiting me.
Blissfully unaware at the time, the main event was only a few days hence. The AMS symptoms started again only moments after we made it to Everest Base Camp and started our descent back to a remote outpost called Gorak Shep. My head was throbbing again, and I was cold – too cold. I lost my hat a few hours before, and the wind was whipping snow against my face and neck. I fought back the urge to vomit and focussed on my breath. Having suffered through migraines over the last 17 years, I was well versed in the art of pain management. The basic trick is to focus on your breathing and try to relax. I was so focused on my breath and forcing myself to take just one more step, that I hadn’t even noticed when we arrived at the tea house. Most of our group went inside, but a few gathered outside with the guide to celebrate our success. As I trudged up to the gathering, I felt a hard wave of nausea hit me and quickly retreated to a small, nearby alleyway. Propping myself up on my trekking poles, I retched into the snow-covered street. Wave after wave of nausea hit me in succession. I forced myself to stand, more out of embarrassment than anything. I knew I had tears streaming down my face, and my hands were shaking. I assured my guide I was fine (he did not look convinced), and I started to panic. What if I have cerebral edema? What if it’s serious? Fortunately, we had a nurse in our trekking group, and before anyone fully realised what was happening, she tore open her rucksack and gave me some anti-nausea medication. I was very grateful in that moment, and quite frankly, very impressed by her quick thinking.
Despite her, my husband’s and our guide’s best efforts, my condition deteriorated through the night. Although severe, I could handle the painful throbbing in my head. I couldn’t stop the vomiting, and I became more and more dehydrated as the night wore on. I drifted in and out of painful wakefulness and something akin to sleep until morning sunlight filtered through the ice-caked window. I don’t recall it being cold, although I know it must have been as my water bottle froze during the night. Usually, when I’m suffering through migraines, I can still function a little as long as it’s in very small batches interspersed with rest. That morning, I remember telling myself all I needed to do was get up and find my toothbrush, then lay back down. Next, get up and find the toothpaste, then lay back down. First, visualise walking to the sink with toothbrush and toothpaste, then do it. The morning went much in this fashion. I had an amazing group, and they offered to carry all my gear and were encouraging me onwards. I think they could see how much I wanted to go. I felt myself starting to waver though – I was utterly exhausted, still in pain, and my husband was offering me a way out. We could evacuate by helicopter and it would all be over! In less than an hour I could be in Kathmandu and would feel ten times better. Am I being an idiot for even thinking of continuing onward?
My mother says I always do things the hard way, and so when faced with a 9 hour day of trekking in front of me or quitting, I figured it was no time to test out a new way of thinking. The hard way it is. I turned to my husband, adamant that I would be completing this trek. My husband starts to nod okay, but I can tell he’s gearing up for a compromise. Under different circumstances, I would have been secretly patting myself on the back for winning the round, but I was actually feeling just as dubious as he was. He said if I could walk around the teahouse, then he would stop asking me to call it quits. At the time, this made perfect sense to me. Yes, if I can walk around the teahouse then I can absolutely do a 9 hour trek through rocky terrain. I look out the window. It’s a glorious, sunny day. I resolutely stand up and walk out onto the patio. A few steps in and I vomit the last of my electrolyte water over the low stone wall encircling the patio. On this occasion, my husband musters the compassion of a saint and refrains from saying I told you so (manipulative arse). He helps me back to my sleeping bag.
I don’t want to say goodbye to the group. I’m too embarrassed, too tired, and too sad to wish them off. My husband comes to collect me when the helicopter is near. I give into the pain and the nausea – I’m too tired to hide it or fight it now, and there’s no point anymore. We walk out onto the patio and my guide and two Sherpas escort us up a small hill to the helicopter pad. Just a few steps in, and I fall on my knees in a pool of my own vomit. My guide and a Sherpa practically carry me up to the landing pad and into the waiting helicopter. I notice they’re randomly unloading Coca-Cola from the helicopter. I notice the pilot has an oxygen tube in his nose. Then nothing. I must have fallen asleep. When I awoke, we were descending into Kathmandu Airport. I climb down from the helicopter onto the runway, and I feel…better! The nausea is gone, my headache is gone, the fog over my eyes has lifted! I immediately wanted to gather our gear and go back. I wanted to tell my group – wait for me, I’m coming with you! But by this point, I was very weak and very dehydrated, plus it would cost more to helicopter back to join my group than it cost for the entire holiday. I’m told I’ll have two days of being poked and prodded in a hospital. My husband will book us into the nicest hotel in Kathmandu when I’m released. I can sit by the pool and finally have a diet coke, a hot shower, clean clothes, a glass of wine! I crawled into the ambulance. I must have looked a bit pale, as my husband still looked rather worried as we careened to the hospital through Kathmandu traffic, sirens blaring.
Whilst exceedingly frustrating, in retrospect, I’m grateful I descended when I did. I heard stories of people who weren’t so lucky with AMS. I’m grateful I got to stand at Everest Base Camp, look at the Himalayan Mountain Range around me and feel as small and impermanent as I have ever felt in my life or ever will. I’m grateful I bought helicopter evacuation insurance. I’m grateful I have a husband who booked us into an amazing hotel within close walking distance of the Thamel shopping district. And finally, I’m grateful for the kind hospital porter who slipped me cans of diet coke when my nurses weren’t looking.