Entries By melissa arnot
May 15, 2009
Waking up at 3:30 a.m. is never easy, especially at 17,500 ft. Somehow though, as the alarm went off yesterday morning, it was easy to rise. The wind was blowing gently, making the tents speak - I think they were saying “get outta here.” As I began crunching through the icefall, the normal adrenaline kicked my pace up a notch, but also the excitement for what is ahead. Even though I have been through the icefall many times, this time it feels different. I am hopeful that when I come back down, I will not have to go back up again - this is our summit push.
As I wind through the ice blocks and snow-covered crevasses, I have to admit I am filled with a new kind of trepidation. Mt. Everest is the tallest mountain on this earth, and even in normal conditions it would hand me a challenge. This year has been different though, as it has been filled with some extra challenges. I wanted to attempt to climb without supplemental oxygen, and that certainly added an unknown element to the trip. I have had many questions for myself since I made that decision, the biggest of course being: “Is it possible?” Early on in the trip I injured my ankle and that has really slowed me down, not just physically but mentally as well. I really feel like I need to be 100% to try to climb without O2, and as the trip has gone on, it has become clear that this isn’t the case. At any rate, climbing Mt. Everest will still give me a great challenge and there is still so much work to be done.
As I lie in my tent resting at Camp 2, I think about the climbers surrounding me. It is certainly humbling to be around some of the world’s best (and strongest) mountaineers, as well as the cameramen who work twice as hard as any of the climbers. It is also pretty special to see Erica attempt to tackle a goal so large. At times I have to remind myself that she is really one of the only people here who isn’t climbing for a profession, and I admire her strength and adaptability to work with this group.
Today is a rest day, and my mind is already playing with the thoughts about summit day - how will the weather be, will I feel strong, how can I be an asset to the team… But summit day could still be days away, so for now I will quiet my mind, rest my body, and let the gratitude I feel for where I am right now wash over me.
The chatter of Sherpa staff waking up and getting going is the first thing I hear, then the sun hits the tent and it is time to get up. Basecamp is a busy place, but I always think of it as the place that is ruled by the rise and set of the sun. As soon as the sun hits, it is too hot to stay in the tent and once the sun recedes, it is too cold to stay out. I like the simplicity of that; I don’t have to think too hard about where exactly to be.
If all goes well and the weather holds, this will be our final rest before the summit push. There is still so much to do, but plenty of time. At Camp 3 on the last rotation, it was a great test of how things will work, and what still needs to be done. Today, I look through the gloves that I can choose from for the summit bid. I scan my climbing clothing, seeing what needs to be washed one last time and what is ready to go. I count out the energy gels that I will use for the summit push, and tuck in a few packages of fruit snacks for good measure. Looking at all of this equipment, it is hard to imagine that in less than a week it will be tucked onto my body and my back, on my way to the summit.
Of course, so much has to line up. A week seems close, but in reality, it is still a world away. The weather has to be good, but also we have to feel good as climbers. Your body has to be strong and your mind open to the challenge that is ahead. On the summit push, I need to stay healthy, avoiding any stomach bugs or head colds that might be trying to come my way. If everything does line up, then you have to be open to the mountain’s terms. If I have learned anything, it is that you have to come prepared with health and strength but also humility and openness. Nothing is assumed. You have to be prepared to take this experience and enjoy each step of it, knowing that the mountains will give you exactly what they want to - that is the beauty of it.
These are the thoughts that are roaming through my mind as final preparations are being made for the summit. Somewhere between being aware of what the mountain is telling us, and which gloves I should pack, I realize that all the preparations (the mental and the physical) are the part of the experience that I value so much, the part that I can take with me on the next adventure. But for now, I will focus on this adventure.
April 23, 2009
It always amazes me how much of a temperature extreme you can experience in the mountains. The last few days have been really good for me, as I left Basecamp and made my way to Camp 2. At 5 a.m. this morning, I woke up at 21,000 ft. to the sound of wind whipping at the tent door and a light frost coating the inside of the tent from my nighttime breath. As I sluggishly pulled my boots on and fidgeted with the frozen ends of my crampon straps, I shivered a little and squinted out to the first morning light, hitting the glacier well below me. A cup of spiced cider, and a small internal battle about whether or not to leave my Igniter Jacket on (I shed it), and I was out the door, crampons communing with the ice in a way that makes me smile to hear. The crunching is like a secret language that the crampons speak to the ice in, and though I don’t always understand it, it is something familiar and comfortable for me, a feeling of moving and being stable at the same time.
This morning ended my first rotation to Camp 2, and I am finally feeling that the climbing is starting now. My preparations for this trip started so long ago, when Camp 2 was only a small glimmer in the future, and a memory from last season. Now it is fully upon us, and this season is forming its own voice each day. I am here this year with a different eye and a different attitude than what I had last year. I enjoy thinking back to my trip and all of the joys and learning that it provided me…but this year is shaping up to be quite different.
About two weeks ago, on the first few days of our trek in, I twisted my ankle. Frustrated, I tried to remember that this expedition will last for months, and certainly there is time in there to heal. As the weeks have snuck up on us, I have been reminded that things don’t heal so fast at 17,500 ft. My first morning walk out into the Icefall I turned back, the pain in my ankle causing me to wonder if I was doing more harm than what was needed at this early point in the trip. A few days rest were followed by another failed attempt to get to Camp 1, and a whole new round of frustration. I came down to Basecamp and went to the Himalayan Rescue Association Clinic for a professional opinion. I know I am stubborn, but as far as I can tell, there is no need to hurt myself to climb this mountain. The kind and professional doctors at the clinic did an exam, while I held my breath, and they hypothesized about the injuries…sprain, bone chip in my foot, and most surprisingly, a possible crack in my fibula. Fortunately, none of those injuries warrants a complete stop in activity. Little can be done up here, and as long as the pain is tolerable, I received the go-ahead to keep climbing. The boots that I am using are actually providing good support and, interestingly, the climbing downhill is the least painful and most stable.
With this news, and a new humbled attitude, I finally made my way to Camp 1, a little slower than I would have liked, but without further harm to the ankle. Once I was in the tent at Camp 1, I took a deep breath and a grateful glance at the mountain surrounding me. A small smile captured my mind, as I looked at the ramen packages littering the tent. It is easy to forget about the ankle as I start to melt snow for my first of many packages of dehydrated, salted noodles. The tent is so hot in the midday, even at 19,800 ft., that I have to sit in the snow to keep cool. I laugh a little to myself as I think of what climbing means to me, and how silly this must look to anyone who hasn’t been here. My day at camp is made up of eating noodles, sitting in the snow, and reading candy bar wrappers to see which ones are gluten-free (so maybe I can share with Dave Hahn, who is gluten-intolerant). I go to bed at 6 p.m. and then wake up twelve hours later to get to Camp 2. Peter, Ed and Jake are already at Camp 2, a few days ahead of me due to my change in plans. We spend a day there together, before they head down to Basecamp. I need one more day to acclimatize before rejoining them. My day spent alone at Camp 2 was a lot like the day at Camp 1, making piles of food that I have read the wrappers for and ones that still need to be investigated. The wind picked up in the afternoon, forcing the hot daytime temperatures to merge into a cold evening. I close my eyes in the tent, and wait for the alarm at 5 a.m.
On my way down to Basecamp this morning, I passed by Dave, Seth and Erica, poking their heads out at Camp 1. The morning light is still well below them, but they are getting ready to go for a little walk. I poke my head into the tent and see the ramen packages, this time smiling because I don’t have to eat them today. I continue my way to Basecamp, mostly in the shade of the mountains around me. The last 30 minutes, the sun wins the battle, and the temperature suddenly becomes unbearably warm. I stop to put on some sunscreen and take off a layer, happy to have only a few minutes left until I reach Basecamp and glad to have finished my first rotation.
April 5, 2009
Today is a beautiful and sunny day in Pheriche, at 14,200 feet. So many of the tea houses look and feel the same along the trek, it is easy to forget exactly where we are, but as I walked down the narrow dirt path after breakfast, I could feel exactly where I was. My lungs started moving a little faster and I could feel my heart rate increase, even with my slow steps on the relatively flat trail. As my nostrils expanded to take in the available oxygen I remembered that I am now at high altitude. I know, some of you that live just above sea-level are thinking that we have been at high altitude all along, but it is here that my physiology now agrees with that. Between 8,000 and 14,000 feet our bodies are undergoing some major changes to compensate for the increasingly more obvious loss of atmospheric pressure. Today, my lungs have to work a little harder, and my heart is pumping a little faster to get all of the new red blood cells around my body. I am thankful for all of the things that my body is doing to adjust to living in a world with less atmospheric pressure to keep all of the oxygen molecules within my breaths grasp, but mostly I am thankful to the red blood cells. They are the porters of my blood, carrying around all of the oxygen my lungs will grab onto. If all things go well, my blood pH will alter, and that will increase my respiratory rate telling my lungs that they need to expand and contract more times to achieve the same effect that they had at my house in Idaho. My blood will produce more of those invaluable little porters (the red blood cells) so that every time my ventilation is effective (the simple mechanical act of air rushing into my lungs) respiration will be effective (the actual exchange of gases deep inside my lungs) and then perfusion can happen (the red blood cells delivering the oxygen to all of my tissues). It makes me feel a little tired just to write that, I can only imagine how my body is feeling repeating this cycle over multiple thousands of times per day. When put this way, it is easy to see why we need so many rest days. Our bodies need to get used to this exhaustive act at this elevation before being challenged by the next increase in elevation.
Today, the team feels good. As I look around at Dave doing crosswords, Seth reading Rolling Stone and Erica sipping tea I can tell that they are all acclimatizing well. There are a variety of reasons that one might not acclimatize so well, and surprisingly, the reasons are not so easy to predict. Some people have a physiological make up that slows the adjustments inside of their body as they get higher in elevation. It is hard to find a correlation between this response and much of anything- especially fitness. There are of course some more obvious factors that will prevent your body from getting all that work done. If someone is sick already, maybe even just a head cold, the body is already working overtime and it decreases the resources that can be used for altitude acclimatization. The same is true if someone is dehydrated or under extreme physical exertion. That is certainly part of the reason that we take a nice even pace on our move days, we don’t want our hearts and lungs fighting to keep up, because eventually they will not be able to catch up with us, and will let us know. Likely in the form of acute mountain sickness.
Acute mountain sickness is usually the first sign from your body that you need to slow down and stay at the elevation you are currently acclimatized to. Basically, your physiology is saying ‘hey, wait for me!’. Consider this a warning, because your body will be persistent if you do not listen, and give you a louder reminder, one that you cannot ignore. Acute mountain sickness (AMS) can start with a variety of symptoms, the most common being a headache. It can be hard to know if it is from dehydration or sun or actually the altitude. If I am at a new elevation and I do experience a headache, I will start by drinking 1/2 a liter of water and consciously taking a few extra deep breaths as I rest. That first altitude headache often sets in after a day of moving and then coming to rest. While moving, we are naturally breathing a bit harder than when at rest. Once that movement stops and our respirations drop the whole process slows, making your brain a little hungry for some more oxygen. I don’t mind taking little Ibuprofen or Excedrin for this headache, but I am very aware that the medication is what is making the headache go away, not the fact that the problem is gone…I will keep alert for other signs of AMS. My dinner might look horrible (lack of appetite), I might feel a little more tired than normal (lassitude), the room may spin as I toss my cookies (nausea and vomiting). If I stand to walk and feel uncoordinated or dizzy (ataxia) I know that it is time to act. Actually, I might not know that it is time to act if my mental status is decreasing, that really is one of the great dangers of AMS. Fortunately, I am traveling with an amazing team and we are all looking out for the signs that someone isn’t acclimatizing well. So, what to do if these symptoms appear? Well, the best thing would be to descend 2000-3000 feet. As you go down in elevation, the positive effects are almost instant. At just a few thousand feet lower, I can start to feel better. The key now is to rest at this elevation and let my body catch up before going higher again. It also helps to hike a few thousand feet during the day, but sleep at the same altitude for a few nights. That gives my body a chance to taste a higher altitude while still recovering at a lower one (you will notice this once we embark on our climbing schedule at ‘extreme altitude’).
High altitude illness will not likely go away without some action from you (DESCENT)! Conversely it often progresses and gets worse. You can get swelling and fluid accumulation in your brain that will cause further changes in your level of consciousness, possibly even causing you to go unconscious or stop breathing. That is called cerebral edema, a brain injury caused by increased intracranial pressure secondary to swelling in the brain. It can even look a lot like a stroke or traumatic brain injury, just with a different cause. This is a serious and life threatening emergency, and this person needs descent (which can be complicated if they aren’t conscious), oxygen and steroids to decrease the swelling in the brain. Bad news bears.
The other life threatening altitude emergency is pulmonary edema, which is fluid build up in the lungs. As the pressure outside decreases, the pressure inside of our pulmonary vessels increases and sometimes the leak into the spaces in our lungs that are vital for gas exchange. This is basically a pneumonia and will cause difficulty breathing, and difficulty absorbing the oxygen (which could precipitate cerebral edema). This is another one where we need immediate descent and oxygen as well as some medications that can reduce the causes of the fluid build up.
Here in Pheriche there is a medical clinic staffed and run by the Himalayan Rescue Association. There are western trained doctors working there (often volunteering time away from their own medical practices). This clinic is open to climbers, trekkers and porters. They do an altitude talk each afternoon and they do an amazing job educating people on the above mentioned dangers and the importance of listening to your body and being conservative. As a medical professional, I am thankful that the clinic is here. So many people feel sick and assume they just needed to do more training when realistically, their bodies aren’t adjusting to the altitude. The clinic helps to educate people and reduce the trepidation about descending if you aren’t feeling well.
Our group is experienced, yet that doesn’t guarantee that we are safe from altitude illness. What it does do is ensure that we are paying attention, and we have created a schedule that will allow our bodies to physiologically adjust to the rigors we are presenting. So today, as I watch Dave complete crosswords with impressive speed, Seth is reading Rolling Stone and Erica excitedly orders and eats her second helping of food for the day, I can say we are looking pretty good physiologically, and it is a beautiful day at 14,200 feet in Pheriche.
March 31, 2009
People always ask me what the hardest part of an Everest expedition is. I only have one Everest expedition behind me, but I suppose that is all it takes to know what is hard and what is not. Surprisingly, it isn’t summit day and it isn’t the Khumbu ice fall. For me, the hardest part is rest days. Writing that feels a little strange, as resting is something good, restorative and needed, but it is really hard indeed. I am the type of person that enjoys movement, enjoys physical challenge and the constant change that traveling provides. To that end, being asked to rest for roughly 1/3 of the expedition is no easy task. I feel like I have been moving forward constantly since I was a kid, and now slowing down to let my physiology catch up with my mind is a challenge for me.
How do I accomplish the task of resting? Reading is a good start, but I cannot read anything related to adventure, otherwise my feet start to twitch and I feel the need to go for a walk. Card games are a good way to rest, they bring laughter and allow your mind to engage, while your body is absorbing the much needed down time. Perhaps the best way to rest is to eat. At the start of one of our many rest days, I look to the teahouse menu. I think about how many meals I can eat today, and if there is anything new that I would like to try. By midday I have rested my way through boiled eggs, tibetan bread, cornflakes, chicken momos, popcorn, fried potatoes, chicken soup, pasta, and if I am feeling really bold…a yak steak. I know, it sounds like it wouldn’t be so hard to sit and read, laugh with friends and eat, but the truth is, that is why I climb…because it IS hard to do the other stuff.
When you are moving on a trail, and breathing hard and feeling all the blood move through your body, well, for me that is the easy part. Making dinner after a hard day climbing, a day that starts before dawn, that is restorative in its own way. Maybe it is an illness, feeling more rested after a hard day of climbing three thousand feet than a day lounging in the sunshine and enjoying tea. I suspect it is really good to experience days that just force me to slow down and look around. These days are good for letting me think about the days behind us and renew the excitement for the many days that are still ahead of us. So today, I will practice my resting. I will go walk around the small, but busy, village of Namche and look over at the people who seem to be resting easily, perhaps I will even stop and inquire how they do it. For now though, I have another order of eggs to dig into and a small sunny spot to go sit in.