Increasing Business, Decreasing Temperature

Thursday April 7, 2011

4:23PM

In the past week business has started to pick up, especially in the last 2 or 3 days. The large climbing expeditions have started to roll through town, which, for the most time, make the village seem a little more alive. I expect the expedition traffic to continue for another 1 to 2 weeks before tapering back down to trekker traffic, which has also increased.

With the large expeditions comes a lot of “personalities”. I’ll leave it there as I don’t want to pass judgement. Just to give you an idea, the questions during our altitude lecture have transitioned from curiosity regarding side effects of altitude medications to wanting to know how many liters of oxygen a face mask should be delivering above 8000 meters in order to achieve adequate oxygen saturations for summit success. Hmmmm....... not sure anyone has that one worked out quite yet. My thought was give yourself enough to stay awake and give the rest to your Sherpa, so he has plenty of energy to carry you to the top. Not all have been quite so aggressive, and it has been nice talking to the guides as well as many of the climbers. I’m looking forward to going up to basecamp where I can get to know them a little better.

With increased traffic comes increased patients and we’ve had a few more in the recent days. We flew out two patients today, one of whom had strange vision loss in her left eye along with AMS, so I suspect that it was mainly due to the elevation and perhaps some variant of cerebral edema. She didn’t really cooperate with examination and there wasn’t a lot we could do for her anyway, so the answer was to fly her down. I gave my card to her guide so he could send information back to us when her condition had been treated. The other was a trekker with mild pulmonary edema who could have been treated here, but I think he had had enough of the Nepal highlands. Otherwise, I feel sure that I have now seen every person in the villages of Dingboche and Pheriche and several have been seen twice. At one point today, I thought about hanging a box of tylenol and cough drops out front next to a sign with the definition of a cold that instructs the local population to take each of the medications for at least three days before coming to the doctor. I have seen one patient three times in the last 2 days: once because he wanted his blood pressure checked, once because his left ear felt full and again today because his ear still feels full a whopping 18 hours after I told him it would get better with some time. 

The nice thing about having patients, even when they aren’t really all that sick, is that it breaks up the day. We’ve started taking them out to the “sunroom” to be seen as you can’t see more than two in a row in the clinic before your hands don’t function from the cold, not to mention that I feel terrible asking people to take off their 4 layers of clothes for an examination when it’s 25 degrees INSIDE.

In regards to the temperature, I’m tired of being cold but at the same time I've grown pretty used to it. My hands and feet stay cold most of the day with the exception of the morning in my nice warm sleeping bag. The hot water has also now gone from broken to fixed to broken to fixed and, we believe, now permanently broken. It’s a painful experience coming back from a run in the snow to bathe inside a freezer with a small pitcher of hot water. Actually, it’s even more painful if there is no preceding exercise as you start off even colder. Thus far, I’m the only one to attempt bathing since the water broke and I’m pretty sure my blue lips and intense shivering deterred the others. Eventually, though, they’ll break down too.

I might be tired of being cold, but Lauren is on a completely different level. We have a gas heater that, if one sits a few inches away from its front, can warm you reasonably well. Last night it ran out and we have to conserve our remaining gas for cooking. That must have been the final straw, because a short time later she came in the kitchen and very sternly asked, “Is there a solution?”. Her question received the silent response of confused looks from our Nepali counterparts, but Alun and I both knew what she was thinking. She continued with “If we can’t get wood or dung for the stove heater, gas for the other heater, or working hot water, I’m going on holiday to Namche until something gets done.” Obviously, nothing got fixed today and Lauren has yet to emerge from her sleeping bag.

In the next few days. I’m going to head out again to reattempt the Cho La Pass. The husband of one of the basecamp team is spending the next few weeks wandering Nepal after his expedition insurance lapsed thus canceling his plans to climb Ama Dablam. I think both of us are happy to have some companionship while trekking through the mountains. The plan this time is to go over directly from this side and then to spend a couple of days hiking up Gokyo Ri and to Cho Oyu basecamp before coming back across the pass. Things will surely go better this time, and I’ll definitely carry a little more gear to assure staying warm and dry.

Unfortunately, I’ll have to stop this entry here. I have more to say, but my fingers aren’t working too well and I can’t feel my toes, so it’s time to add a few more layers.