Dehydration and Summit Fever
Day Thirteen-Summit Day-01/01/2015 My recall of a lot of this is fuzzy at best…so here goes. Woke up at 1am and took a while to get ready. I eat and drink slower than everyone but still get my fill before the departure at 2:19am. Nema and Forrest shoot way ahead quickly and before long, Forrest waits for me and demands to take all of my excess weight (double plastic boots, harness, crampons). We aim to hit the snow field by dawn at 6am. Glove liners are not quite warm enough but I had left my down mits in the tent (stupid move). I am moving crazy slowly, and I am belching tuna burps from the night before. The taste is too much and I hunch over around 18,000ft and throw up a pile of black water, probably tinted dark by the chocolate bars I ate. My stomach definitely doesn’t agree with tuna and candy bars, something that would probably make me vomit at low altitude. However, it’s hard to find the type of food that I would normally eat here in Nepal so we opted for calorically dense candy bars. I have no headache or dizziness, but the taste of each belch is straight out of the depths of hell. Nema gives me a trekking pole, clearly worried about me potentially falling over but I am not feeling unstable at all. The rock scrambling is definitely exhausting. We reach the snow field later than intended due to my lagging behind. We gear up and follow Nema across the rock solid alpine ice, I regret carrying avalanche gear even more. Snow climbing is fun, but the weather is rapidly worsening. We had 12 days with only a single cloud in Namche Bazaar and now flurries are descending upon us and the wind is picking up. By 9:45am we reach 5,784m (18,976ft). As we all gaze at the 1,000ft head wall to approach the summit we see one very small dot of a climber ahead of us. We have been climbing for 7hrs and 20min and there is no way we can get to the summit before the storm becomes too much. A long journey, but definitely time to turn around.
We retreat below the snowfield and take off our crampons and other gear. On the descent, I throw up two more times, one after the other. I stare down in horror seeing that all of the water that should be pumping through my veins is instead on rock below me. Pieces of honey stinger waffle, snicker’s bars, and a bounty bar all sit within a black pile. Fearing that the horrible sounds were from a fall, Forrest and Nema pop back around the corner and demand that I hand over all of my weight. Forrest runs everything down to basecamp while I take hours to descend to the tent with a trekking pole in each hand. I rush to the outhouse with explosive diarrhea. I try to eat the dinner of spicy noodles and pound some tang, but my upset stomach is unhappy with the acidic mess of food.. I immediately worry that the snacks before basecamp were the first foods that I ate that were not cooked, or pre-packaged and begin to worry. I eat fried bread and porridge instead and try to take some antibiotics since it feels like I am contaminated with something. I also take some dexamethasone orally, and my next dose of Diamox. I put on my parka, expected the urge to diarrhea and vomiting to return soon. I don’t have to wait long. I puke into my two food bowls without spilling into the tent and precariously hand the nearly overflowing vessels to Forrest. The pills are likely floating in the mess within those bowls. Forrest says we have to descend, but I can’t move. I am completely exhausted, and more dehydrated than I have ever been from all of the vomiting and diarrhea. Happy New Year indeed.
Day Fourteen 01/02/15: I wake up with full blown wet, thick, sputum cough. Likely high altitude pulmonary edema (HAPE). I can hardly stomach any food. Mong and Forrest take almost all my weight, and I stumble to the latrine for more explosive diarrhea. The 4hr hike that took us to basecamp takes me 8hrs to descend shakily, walking like a toddler with two trekking poles across rock trail that is now coated in snow. I have to stop twice more with horrible diarrhea on the side of the trail. I try to drink and can only get 1.5L of hydration salts down. We reach Chukkung eventually and my cough is so bad that I don’t sleep at all. I can no longer walk or stand under my own power and my bathroom trips are poorly coordinated. I piss all over myself trying to operate the complexities of my own pants. I cannot eat because I am too tired, I fall asleep during the act.
Day Fifteen 01/03/2015: My level of responsiveness drops substantially to level two, I know where I am and who I am, but that is about it. I am no longer speaking coherently or able to answer questions. I have very little memory of this day, I spend most of this time slouched in bed wearing my full down parka and in a down sleeping bag trying to stay warm. Forrest periodically hands me something and tries to shake me awake to get me to drink it and take some meds. This persists for one or two days, I’m not really sure because I remember very little. Eventually, the tea house staff rallies to drag my weak frame outside and prop me on a lawn chair. I am loaded into a helicopter and flown to Kathmandhu. By this point, I feel like I am hammered drunk and reeling even sitting still in a chair. Halfway down Forrest and I sit on a helipad and wait to be transferred to another helicopter. I am feeling slightly better, but still so very weak. Eventually, I am loaded onto an ambulance and taken to a hospital for the works. CT scan, x-rays, IV fluids, antibiotics, and antivirals. My white blood cell count is over 20,000 and I am severely dehydrated.
Day 16-18: 01/04/2015-01/05/2015: Each morning two nurses greet me between 6:30-7:30 am and examine the IV going into my hand that is supposed to replenish my fluids. “How many times did you make the urine?” I shake my head, and reply “none”. An exchange of surprise looks is followed by a painful flicking and attempt to adjust the less than ideal placement of my IV. During the days, forests large six foot frame is uncomfortably crunched on a guest couch in my room as he attempts to Skype my health insurance while I drift in and out of wakefulness. The steady flow of oxygen and bizarre array of American B movies is enough to numb my mind back into sleep. Eventually, Forrest’s Mom Debbie comes by the hospital from her nearby work with the AACC in the area and visits. She is pretty quickly alarmed by the massive swelling in my IV hand which is clearly infected and encourages a new placement by the nurses. After two days without fluids, I am finally hydrating. My first micturition smells horrible and has maple syrup like coloration/consistency, but it seems to satisfy the the nurses nonetheless. How many times did I make the urine? One. The doctors agree to release me at the end of the third day with a pile of antibiotic pills to take as well as some cream for my ballooning infected hand.
I spend the remainder of my trip either sleeping, eating, or walking short distances. There are many takeaways from this trip which are great lessons albeit hard ones to learn first hand. First of all, I am very grateful to have such amazing friends and family to care for me in a time where I was incapable of doing so. Forrest and Debbie made my experience a lot more bearable. Secondly, I am very much ashamed of my ego clouding my judgement in a way that potentially endangers myself and others. From the start, I was determined not to be another white tourist taking advantage of underpaid native guide/porter services. Realistically, Nema and Mong are stronger and more fit than myself, and my reluctance to let them do the job that they are paid for is disrespectful in its own way by not recognizing how things are done in Nepal. I avoided being carried to the top of some mountain in the Everest circuit, in part because of what a terrible stain it has become on broader implications for alpinism and mountaineering. This logic is what caused me to overtrain prior to my arrival, fail to take time to acclimate appropriately, and over-assess my ability to ascend rapidly. It was not entirely pride that caused me to deny the obvious signs of my upper respiratory tract infection prior to HAPE onset. The other factor was the large amount of money, time, and closing weather window that made bailing on the climb undesirable. The results were humbling. I have intentionally avoided high altitude ascents since that time in favor of more technical vertical climbing, who knows if I will return to Nepal anytime soon. If I decide to climb something tall again, I will definitely acclimate properly and will likely not shoot for much taller than 16,000-17,000ft since I know how my body responds to said altitude.