FTA Khumbu Peaks & Passes - Pokalde summit bid

From Stu in the USA office
Oct 17, 2011

Lobuche Ridge

Pokalde Summit bid
Ben called in from a high camp on the far side of the Kongma La to let us know that a large part of our team had made a good effort on Pokalde only to be turned back near the top by suspect conditions. Ben, Tsering, Veronika, Richard, Mattias and Pemba all climbed quite high on Pokalde and reached the final summit ridge only to meet with a 6in/15cm covering of new loose snow on top of the loose rocks of the ridge. Had they had several feet of snow or none at all the route would have been quite good tot he true top but the loose and unsonsolidated nature of the ridge made it prudent to celebrate on the false summit and save the energies for the main prize to come - Lobuche E.


After descending from the climb back to the pass they pushed further on down the slope and tomorrow will head to Lobuche Base Camp for a summit bid expected to be on the 19th if all goes well. Ben plans to check in again when they reach base camp so we'll have an update then on the main group.

Evac from Deboche
At the same time as Pokalde was being tackled the decision was made for Seng to come on out from the trek as he was simply not recovering despite having moved all the way down to Deboche. We had hoped that descending (along with one of our Sherpa guides Geylu) to the last place that Seng felt great might have allowed him to recuperate but he awoke after his second night there feeling fatigued and with signs of potentially serious altitude illness. Rather than take any risks we arranged a helicopter ride for Seng and he caught a chopper from Tengboche straight back to Kathmandu where he is feeling better and already resting for the night. As always our Nepal agent Nima was amazing  and got the helicopter to lift off from Lukla within minutes of the decision - Thanks Nima Dai!

Prayer Flags on the Everest trek near Deboche

We'll have more news from Lobuche and Kathmandu in the days ahead but below I am adding a few thoughts about altitude illness and HAPE in particular as this was the concern we had in Seng's case.

Brief HAPE (High Altitude Pulmonary Edema) primer
For a good overview on altitude illness we recommend checking out the CIWEC clinic and the SOLO Wilderness Medicine blog

CIWEC: http://ciwec-clinic.com/articles/altitude_illness_advice_for_trekker.php
SOLO: http://wildernessmedicinenewsletter.wordpress.com/category/hape/

The most crucial thing about treatment of any suspected HAPE is that descent is the definitive cure. No matter what medications or equipment you have, it is getting much lower down that will allow one to recover. Sometimes this can be as little as a few thousand feet and other times it may mean 10000ft /3000m or more.  HAPE can sometimes be slow to progress and other times quite fast and it is highly and rapidly debilitating and exacerbated by exertion at altitude.

All of this is therefore problematic for someone in Deboche (at approx 3700m) with signs and symptoms of HAPE is that they are unable to descend a nice smoothly downward sloping trail - like one might find going from high on Aconcagua to one the the two main base camps. Instead they must surmount a small rise to Tengboche (approx3850m) drop steeply down to the Dudh Kosi river at Phunki Tanga (3250m) and then then ascend again a few hundred meters before finally reaching a somewhat flat but undulating trail to Namche (at approx 3500-3600m).  This trek takes perhaps 4-6 hours for an acclimatized person feeling well and is not an insignificant trek.

If someone with altitude sickness was to make the effort to go over the hill and down to the river and then find themselves without the ability to climb back up to the trail it could be very serious indeed. In the end it simply makes no sense to attempt such a walk out if there is a good alternative. The most rapid and valuable is a helicopter ride all the way back to Kathmandu. In a matter of hours one can be back to the oxygen rich environment with minimal exertion.

Serious symptoms late in the progression of HAPE are easy to spot as they include awful things like patients coughing up pink frothy sputum, ashen having altered mental status (from confusion to unconsciousness) and patients needing assistance to move or being unable to move on their own.

The crucial thing is to see the early signs and react with caution. Headaches that do not resolve after some rest and drinking (or even some aspirin, ibuprofen etc), lack of recovery of energy after resting, personality changes (more reserved, more anxious, more cranky) and so on. It is very common for trekkers and climbers to feel the effect of altitude and that often means feeling winded while working hard, having a mild headache or being a bit off your game. But these things should all go away when resting or after a good night sleep. If they do not then then best thing is to stay at the same altitude or descend until they resolve.

The vast majority of people who have mild acute mountain sickness (AMS) recover just fine with going back to the last place they felt great or taking an extra night where they are. Sometimes even with these precautions the altitude illness progresses and people need to get down and out of the hills and come back another day.

Have any questions about altitude illness? Be sure to send them to us at "info@fieldtouring.com" or drop the question on our Facebook wall.

http://www.facebook.com/pages/Field-Touring-Alpine/112088355565506