| February 16, 2004 Deep Survival! | |
 | Last night I had the pleasure of meeting Laurence Gonzales, author of Deep Survival: Who Lives, Who Dies, and Why -- during his address to the Wilderness Medical Society winter conference in Jackson, Wyoming. His talk was inspiring and the subject intriguing. In Deep Survival, the author explores how all survivors of tragedy make the same psychological transformation -- enabling them to transcend seemingly hopeles situations -- for the first time describing the science of survival. I sat in the audience with several of these survivors -- many nodding in agreement, some feeling like their personal story was being told by another. Mr. Gonzalez was captivating, and his book is even moreso. From the book jacket: "Deep Survival is not going to teach you how to build a fire or find water, but you will be far better prepared to survive any challenge you face. The principles Gonzalez uncovers are universal, applying not only to survival in the wild, but also to survival in relationships, in the death of a loved one, in running a business during uncertain times, even in war." A must read! |
| February 11, 2003 Breashears Everest recount | |
 | Last night in Big Sky Montana I had the opportunity to attend a talk given by renowned climber and filmmaker David Breashears in which he recounted the making of the IMAX Everest film and the 1996 disaster on Everest. Nearly everyone has heard the story, and most of us have heard it several times from several different viewpoints....nevertheless, the crowd sat spellbound and revelled in the beautiful photography and personal insight from Mr. Breashears. I had the opportunity to speak with David before his talk to hear about his upcoming project on Everest this spring -- Hollywood goes to Everest? Read more about this exciting project in a recent Outside Magazine article "Everest Climbers to Shoot Footage for Hollywood Movie" -- internet link www.outside.away.com/outside/news/20040122_1.html. We hope to trek up to EBC next month with Mr. Breashears and his team to provide medical support as needed (as logistics permit.) At base camp, it will be a real privilege to be in the company of some of the icons of Everest. |
| January 28, 2004 DR DOWN GOES TO BASE CAMP! | |
 | The generous folks at Dr. Down have custom made 2 patient care wraps for our EBC clinic and shipped them off to us yesterday. To the left is a photo of one of the bags, which they also silkscreened with our logo. The Dr. Down rescue wrap is a self-contained insulated bedding system that is even better than a super sleeping bag because it allows caregivers 360 degree access to an ill/injured patient, and while doing so allows the patient to not only maintain body temperature, but be externally warmed. Thanks Dr. Down! Have a look at their exceptional products, which have become industry standard for cold weather rescue and transport: www.doctordown.com.
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| January 10, 2004 More altitude research findings | |
 | From the pages of High Altitude Medicine and Biology: 4(4), 2003 A comprehensive review of how pre-existing eye conditions may or may not be affected by altitude exposure by Drs. Mader and Rabin is an up to date reference for lay people and physicians alike. The authors review just what we know about altitude and conditions such as dry eye syndrome, monocular visual loss, post-refractive surgery procedure, and retinal and optic nerve diseases. I'll be bringing a copy with me to base camp this season... (Mader TH, Tabin G. Going to high altitude with preexisting ocular conditions. pp419-430.) In a brief report, Austrian scientists studied "elderly" mountaineers (these authors define elderly as over 35, which is a little disconcerting!) who were taking beta-blocking antihypertensive medications on a trip to moderate altitude. The subjects underwent cardiovascular testing at 1480m and again at 2311m and those on beta-blockers were found to have reduced exercise tolerance. This study was limited by small sample size, the findings are interesting. LOTS of folks take beta blockers, which limit the heart's ability to beat faster. Since an important part of acclimatization at altitude is increased heart rate, it would logically follow that exercise at altitude might be more difficult without the capacity to develop higher heart rate. This should spur some larger scale studies in the future. (Faulhaber M, Flatz M, Burtscher M. Beta blockers may provoke oxygen desaturation during submaximal exercise at moderate altitudes in elderly persons. pp475-478.) |
| January 4, 2003 More altitude research findings | |
 | From the pages of the latest journal, Wilderness and Environmental Medicine 14(4), 2003: A study of trekkers in Iran proved, once again, that quick ascent to high altitudes can be hazardous. Using the Lake Louise questionnaire, these researchers evaluated 459 trekkers traveling from 2900m to 5671m (Mt. Damavand) and found that 60% of them suffered from acute mountain sickness. They looked for risk factors associated with an increased incidence of AMS and found (not surprisingly) that risk of AMS was higher in folks who: lived at elevations under 900m, had less trekking experience, had a previous history of AMS, had faster rate of ascent, slept longer at high altitude and had a longer rate of descent. The researchers found NO correlation of AMS illness with sex, history of smoking, body mass index, weight of backpack, or age. (Ziaee V, Yunesian M, etal, Acute Mountain Sickness in Iranian Trekkers Around Mount Damavand (5671m) in Iran, pp 214-219.) Another interesting case report tells us of the unusual but real hazard of increased blood coagulation at altitude. On day 45 of an expedition on Gasherbrum 1 (8068m) a climber developed difficulty speaking and walking and subsequent visual problems that progressed to being unable to stand durning the 10 day rescue operation. His colleagues correctly assumed HACE (which is much more likely) and treated him accordingly. On further evaluation in hospital, he was found to have an unusual blood clot in the brain called cerebral sinus thrombosis. This case reminds us that altitude acclimatization can increase the blood cell volume and that if we don't take care to remain well hydrated those blood cells can turn on us by clotting and creating other hazardous and life threatening problems. (Saito S, Tanaka SK, A case of Cerebral Sinus Thrombosis Developed During a High-Altitude Expedition to Gasherbrum I, p 226.) If you're interested in reading the complete articles and more interesting wilderness medical literature, follow the links to the journal by visiting the Wilderness Medical Society website at www.wms.org. Happy New Year! |
| December 18, 2003 THANKS, AIRSEP! | |
 | Our new oxygen concentrator, the AirSep Lifestyle, arrived yesterday on my doorstep. This machine is amazing, and critical to our successful clinic operation at Everest base camp. You may remember that we credited this little dynamo with countless "saves" on Everest last spring -- it is a 10 pound machine that we were able to power off of our solar panels via a 12V motorcycle battery. It quite literally replaced hundreds of oxygen bottles, saving us both the money to fill those bottles and the time and money to have them filled and portered up and down from Kathmandu. This machine concentrates oxygen out of atmospheric air, and can deliver up to 5 liters per minute. Last spring we borrowed one from my hometown hospital, but when I told AirSep how well their machine performed (they never dreamed of this extreme application for their product) they hopped on the sponsorship wagon and donated one for us to use for seasons to come. Thank you AirSep! (For more info on the AirSep Lifestyle, visit their website, www.airsep.com) |
| December 15, 2003 Big SAVE today at Big Sky | |
 | A scary story with a happy ending today at the ski resort at Big Sky, Montana. I just happened by the first aid room, where I volunteer on days off, to meet Josh and hear his amazing story. This morning Josh was out doing some avalanche control with other patrollers. He threw off a few "shots" -- explosive ammo designed to loosen snow and create a controlled slide -- to make the resort safer for skiiers. The rounds unintentionally caused the entire ridge to slide, carrying Josh with it. He was completely buried in avalanche, with no equipment or any part of him visible. He struggled to create an airpocket in front of his face, but said his mouth kept filling with loose snow. He lost consciousness. Quick reacting patrollers did a beacon search, and 6 minutes later a probe struck Josh -- and that's the next thing he remembers after blacking out. Rescuers found him buried 2-5 feet under an amazing rubble pile. Josh was shaken but uninjured and is the first person ever to be rescued alive in an avalanche at Big Sky. Avalanche is a common cause of death in mountaineers, and a hazard for anyone venturing into the backcountry -- even in a "controlled" resort setting. Regular scheduled practice with beacon and probe searches is credited for the good outcome in this case. Anyone who ventures out in avalanche territory should take proper precautions, equip themselves wisely, and PRACTICE using that equipment with others on a regular basis. You just never know when you'll need those skills.... |
| November 15,2003 Santa comes to EBC clinic.... | |
 | We at Everest base camp medical clinic have some new best friends....those wonderful folks at ZODI Outback Gear (www.zodi.com) have sent us a high performance propane shower set up and shower tent. This lightweight set up will allow us 40 luxurious HOT water showers at base camp, run on D batteries and a couple of propane tanks. The technology is amazing, yet simple...heats water in seconds and pumps that warmed water through a showerhead. I set it up on my porch today, it took me all of 60 seconds (hooking up to propane might add another minute!) and made me almost giddy....the idea of a warm shower is gonna make life at basecamp downright comfortable, something you couldn't get me to say last season. THANKS a million, ZODI! Show your appreciation for their generosity by visiting their website, and purchasing a shower system for your next outback adventure! |
| Cold fingers? | |
 | A few weeks ago I got an interesting question from "Johnny M" asking my advice about cold hands on a winter expedition. I thought I'd share the question, and the answer from my friend Dr Gordon Giesbrecht , a world expert on hypothermia and professor at University of Manitoba. You may remember reading about the affectionately dubbed "Professor Popsicle" in an Outside mag article earlier this year. Question from Johnny M Re: "Cold hands after a rest" "A year or so ago, two of us did a long ski trip, 7-9 weeks, and about 750 km. When we stopped for a short break for a rest and bite to eat, our fingers are warm, and are OK during the entire rest stop, however, as soon as we started on our way again, our fingers would get very painfully cold, or FINGERS WOULD NOT GET COLD DURING THE REST STOP; that would not happen until a short time after we started moving again. It happened to both of us, and it took us a while to realize the circle of events. Temperatures were -20C to -30C. If someone has an explanation, it would be appreciated...thanks." And the answer from Dr. Giesbrecht: "I experience this after every break on my expeditions. The foremost mechanism here is the competition for blood flow between the fingers (just for warmth) and the newly exercising muscles of the legs and arms (for oxygen and fuel.) At the start of exercise, blood flow is diverted to the muscles. After awhile the body starts to warm up and calls for heat loss. If the exercise is not too high a level and there is some cardiac output reserve left, extra blood is now sent out to the fingers and toes to allow heat loss (this blood also warms the fingers while it is there.)" |
| More altitude research news October 28, 2003 | |
 | Some new research findings hot off the press: Acetaminophen (eg Tylenol) and ibuprofen (eg Motrin, Nuprin) are equally effective for the treatment of mild headache at altitude, according to a study done in the Khumbu. The researchers used a 1000 mg dose of acetominophen and 400 mg of ibuprofen. Recall that it is safe to take these medications for the headache, but care should be taken to assure you are well hydrated and rested and headache is completely resolved before any attempt at continued ascent. And if a trekker at altitude with headache begins to have trouble with balance, it should be presumed that high altitude cerebral edema has set in and that the patient must immediately descend. Reference: Harris NS, et al: High altitude headache: efficacy of aceaminophen vs. ibuprofen in a a randomized, controlled trail. J Emerg Med. 24:383-7 2003. More on fertility issues at altitude: In a study of 3 male climbers to 7821m, serum testosterone and sperm counts were decreased at 1 and 3 months after expedition but returned to normal by 2 years. In addition, sperm were abnormally shaped at 1 month but returned to normal at 3 months. LImitations of this study? Only 3 subjects (sample collection might be a "hard" sell in cold hypoxic conditions?) but this data certainly suggests that further research is needed to define this potential problem. Reference: Okumura A, et al: Change in male reproductive function after high altitude mountaineering. High Altitude Med and Blol:4 (3) 349 2003. |
| WE HAVE OXYGEN! October 13, 2003 | |
 | AirSep corporation has just signed on as a major donor to our EBC clinic by providing us with a Lifestyle oxygen concentrator unit. This is the same device we used so successfully in 2003 that was loaned to us by our friends in the Bozeman Deaconess hospital. Now we'll own our very own unit and it will be instrumental to our operations on Everest. Lifestyle is extremely suitable for a highly mobile/traveling oxygen-dependent patient -- as well as a highly mobile oxygen-requiring CLINIC. It obviates the need for expensive bottled oxygen (and the portering fees to get that oxygen up to 17,600 feet!) This unit provides continous oxygen generated from concentration from the ambient air, and it is thrifty because it only delivers that oxygen with an inhalation -- avoids wasting oxygen. It can be powered by a traditional AC outlet, and even more useful for us at basecamp, a 12V battery powered by solar panels. Best of all, this little dynamo only weighs 10 pounds, making it extremely portable (and yak-able). We are thrilled to include AirSep corporation in our growing list of sponsors. Visit their website for more information on their innovative products at www.airsep.com. |
| October 2, 2003 More loot from Dr. Down! | |
 | ...And the donations continue to roll in....the latest from Dr. Down (thanks to Mike Tayloe of Katabatic consulting, who made the connections for me). Dr. Down makes a self-contained insulated bedding system that is better than a super sleeping bag. It allows caregivers 360 degree access to an ill or injured patient, and while doing so allows the patient to not only maintain body temperature but be externally warmed. (Critical stuff for our clinic ops!) Last season we made do with personal sleeping bags which were often inadequate and sometimes trashed inadvertently. The folks at Dr. Down are custom designing a couple of systems for our use at EBC clinic, and we thank them in advance. Visit their website for more info on their innovative products. www.doctordown.com. |
| Generous donations! September 29, 2003 | |
 | Fabulous news for our Everest Base Camp Medical Clinic! Some very generous donors have contacted me in the past week indicating the intent to donate the following equipment, worth well over $150,000: Hansen Weatherport and Alaska Airstructures are custom designing and building large canvas tents to house our clinic and our communications facilities. Horizon Mobile Comms will donate a satellite phone and airtime. Zodi will donate a propane powered/heated shower system (Yahoo!) But Santa Claus came to visit me at Yellowstone on Saturday in the person of Dr. Ben Ho. Ben is the father of HRA volunteer Dr. Chris Ho, and was so impressed with Chris' experience with HRA and Everest base camp, that he went on a philanthropic mission on our behalf. What he gave me last week is well over $60,000 of donated medical equipment as follows: 3 12 lead EKG machines form Marquette 1 AccessAED (smallest lightest portable defibrillator in the world!) 2 Precision QID glucometers 1 battery-powered suction unit 1 Propaq Encore monitoring system (allows us to continuously monitor heart rate, blood pressure, oxygen saturation and more in one battery-powered machine) Oxygenation and blood pressure monitoring equipment I am thrilled, inspired and in awe of the generosity of Dr. Ho and his benefactors. Thanks so much for making this clinic a continuous presence on Everest for all. |
| Dalai Lama in NYC September 21, 2003 | |
 | Friday in NYC -- had a terrific meeting with Tom and Tina at Explorers Web HQ, spent the afternoon brainstorming about fundraising and finding corporate sponsorship for our EBC medical clinic and planning to pep up this webpage. Plans to make it more user friendly and cutting edge. Stay tuned, it will all look different very soon. Saturday and Sunday: dates to hear the Dalai Lama speak. Saturday at the Beacon theatre, where teachings covered Geshe Chekawa's seven point mind training (methods by which we open our hearts and assume responsibility for our fellow living beings, making constructive use of adverse conditions in life) and Root verses on Indian Philosphies, recognizing the qualities of differing philosophical viewpoints. In Sunday's public talk for NY, the Dalai Lama discussed the Bodhisattva's Jewel Garland, a spiritual guide to life for followers of all faiths. It was a beautiful day, not a cloud in the sky with a light breeze -- quite a contrast to the hurricane that blew through just days before. Inspirational. Photo collage courtesy www.beliefnet.com, where you can link to see a web broadcast of the Dalai Lamas message to New York today. |
| September 15, 2003 Katabatic Consulting helping us out! | |
 | I made a great contact at the WMS meeting in Whistler....Mike Tayloe of Katabatic Consulting. His company (www.katabaticconsulting.com) specializes in setting up medical systems in "special environments." Tayloe's connections with companies he has worked with to help set up ops in Antarctica may help us better provision our clinic at Everest, and his willingness to help our cause is inspiring! Stay posted....I'll hopefully be signing in soon with new sponsor announcements. Friday will be meeting with the home office folks with Explorers Web, looking forward to a good weekend in NYC, including attendance at a talk by the Dalai Lama. Namaste! |
| August 20, 2003 | |
 | Just in from Whistler, BC at the Wilderness Medical Society Mountain Medicine conference....experts from all over the world agree: Acetazolamide is the most effective medical agent for prevention of AMS. (Graded ascent is still the best prevention.) The jury is still out on Gingko Biloba. To date, noone has completed a study with adequate numbers in which Gingko was given for adequate duration before ascent. I'm hoping that study will be done this spring on the Everest route to answer the question once and for all. (Many of us believe it works to prophylax against AMS in our anecdotal experience.) NIfedipine is very useful for HAPE treatment and prevention. More work needs to be done on Sildafenil (Viagra!) for treatment and prevention of HAPE, but the preliminary work (some done on Everest by Austrian doctors this past spring) looks very promising. Advances have been made in the diagnosis and treatment of AMS in very young children. (For instance when they are too young to tell you they have a headache!) The avalanche "airbag" is the most effective agent for survival in avalanche burial, and the Avalung has been used successfully in a few survival cases following burial. On the horizon: studies to determine the BEST dosing for some of the above medications, viagra for HAPE, timing and dosing of Gingko for AMS prevention. |
| Mountain Medicine Conference in Whistler | |
 | This weekend the 4th World Congress on Wilderness Medicine, in beautiful Whistler, BC, will be kicked off by a preconference on Mountain Medicine. Chaired by Drs. Hackett and Oelz, experts from all over the world (Kriemler, Berghold, Swenson, Brugger to name a few) will speak on topics ranging frrom Update on HACE to Circulation at Altitude to Drug Abuse in High Altitude Climbing to Controversies in Avalance Rescue. It promises to be an educational and timely symposium for anyone interested in medicine up high. I'll be attending and will be sure to pass on the highlights to our readers, so stay tuned.... (For more information on the conference and it's topics and faculty, visit the Wilderness Medical Society website, www.wms.org or hit the link to your right.) |
| Reproduction at Altitude -- Keeping you updated on scientific findings in altitude research | |
 | The latest issue of High Altitude Medicine and Biology focuses on scientific advances in the study of problems with fertility, pregnancy and birth at altitude. It comes as a surprise to some that the effects of as little as 2500 meters can have substantial effects on reproductive success and outcomes. Some of the work published in this latest issue helps doctors and scientists sort out the fact from the fiction... -- Drs Vitzthum and Wiley find no clear negative effect of altitude on fertility rates and argue that although fertility rates are lower at altitude, this may be due to factors such as adaptation, natural selection and developmental processes as well as cultural influences. -- Dr Moore reiterates that birth weight falls with increasing altitude because of hypoxia. But in some populations adaptation via growth and remodeling of the uterine artery permits higher uterine artery blood flows and protection against altitude-associated intrauterine growth retardation. -- Drs White and Zhang tested this human observation by Dr Moore on pregnant and non-pregnant sheep and guinea pigs exposed to chronic hypoxia and found enhanced uterine artery blood flow in sheep but not guinea pigs. -- Dr Niermeyer finds that cardiopulmonary transition in infants at high altitude is diesrupted and can result in high altitude pulmonary hypertension and may be partly responsible for increased infant mortality at altitude. Reference: High Altitude Medicine and Biology, volume 4, number 2, summer 2003. |
| Documentary features about Everest Clinic? | |
 | I've been contacted by two different production companies interested in shooting footage to be used in documentaries about our Everest base camp clinic -- this is exciting for a couple of different reasons. First, we're interested in increasing our exposure -- good for recruiting sponsors and donors and for making our cause more attractive to them. In addition, TV documentaries help us get the word out to potential expeditoners that we are a fixed entity in base camp -- that they don't need to bring along their own physicians -- which gives us more work to do, increasing our clinic budget, therefore sustaining us for future seasons. Media exposure also helps us acheive our mission of educating the public and preventing the serious consequences of altitude travel. One of the companies would focus on education and science, the other on medicine in non-traditional venues and out of the way places...can't get much more out of the way than Everest. We're excited to have the opportunity to work with these exciting projects! |
| June 23, 2003 Some new research findings on AMS prevention | |
 | As I review the latest literature on altitude and expedtion medicine, I'll pass on the tidbits to you on the website.... Just out this spring is some research done on preventative use of acetazolamide (trade name Diamox) by my friend Dr. Buddha Basnyat et al. The group studied 197 healthy trekkers in the Khumbu, enrolling them in Pheriche 4200m (starting them on acetazolamide or placebo) and interviewing them again in Lobuche 5000m to look for signs and symptoms of acute mountain sickness (AMS). They found that people who took diamox 125 mg twice daily had HALF the incidence of AMS, and of those who got AMS, the ones on acetazolamide had a much less severe case and higher pulse oximetry readings. Good news for folks who suffer at altitude! To read the full article, see: "Efficacy of Low Dose Acetazolamide (125mg BID) for the Prophylaxix of AMS" in High Altitude Medicine and Biology, volume 4 number 1, 2003, pp 45-52. |
| June 19, 2003 Thanks, Outdoor Research | |
 | I'm sending out a public thanks to Outdoor Research -- our EBC clinic was lucky enough to get support early on in our planning from Todd at OR, who sent us 2 expedition medical kits and 4 large Tashkent duffle bags. The Tashkent tarp duffles are waterproof (endured snow and heavy rains on our trek in and kept our medical equipment dry and happy), planeproof, yak proof and endured rough treatment and ropes by our porters too. I can't say enough about these duffles except you oughta get one if you need durable protection...perfect for a long expedition! The expedition medical kit is a lightweight compact well apportioned kit that is fully stocked with all the stuff you might need for a longer trek/expedition. It even had room for expansion with prescription medications and advanced equipment that I added. It's well thought-out and organized...read more about it on the website, www.outdoorresearch.com or follow the link to sponsors on the right of this page. Thanks again, Outdoor Research for your support! |
| June 15, 2003 THANKS, CHINOOK!!! | |
 | Last July, when the idea of a clinic at Everest base camp was barely a dream, I pitched the idea to Carl Darnell of Chinook Medical Gear who was staffing his booth at the Wilderness Medical Society meeting in Colorado. I was thrilled when he said he thought that a new HRA base camp clinic was a good idea and that he'd like to help. Not a surprise, as his company has been supportive in the past, having donated a Gamov bag (portable hyperbaric chamber, see link below) for our use at the Pheriche clinic. Chinook was generous, donating more than I even dared to ask for -- a canvas banner (see photo), a large expedition medical bag, an ear nose and throat kit, a fingertip pulse oximeter, a larygoscope and accessories ... and the Gamov bag. All of the equipment is lightweight and durable, designed to perform in wicked conditions (and it did, without one glitch!) So if any of you are outfitting your camp with medical gear, the Chinook catalog of equipment is a must-see. Follow the sponsor link to the Chinook website to have a look at all they have to offer. Thanks again Carl and Shannon and all the folks at Chinook for your support! |
| June 12, 2003 Thanking the sponsors... | |
 | Our inaugural 2003 spring season was a success, in large part, to the credit of generous sponsors who provided critical equipment for our operations. Today I'd like to pay tribute to Horizon Mobile Communications, who loaned us an Iridium 9505 satellite phone, airtime, solar panel charger and other accessories that allowed us to communicate with the outside world. The medicine was challenging in this remote clinic, but reliable communication was crucial. Imagine -- we work hard to save a life, stabilize our patient....now the real test begins...we have to get them down to definitive care where no roads or motorized transportation exist. The logistics are complicated, there are language barriers..... we're talking potential nightmare! Enter HMC, who took a chance 6 months ago to support this brand new clinic idea. They saw it as a way to try their equipment in some of the most urgent and remote situations while supporting a worthwhile cause. And it worked! We were able to simply pick up the phone, dispatch a helicopter, speak with recieving physicians in Kathmandu, and coordinate otherwise complex evacuations with ease. When our computer crashed, I was able to phone in dispatches to Explorers Web, who updated our webpage and kept all of you informed. And when we got a working computer, we were able to link it via cable to the satphone to make dispatches directly to the website. Thanks, for your support, HMC! |
| June 10, 2003 Back home, where do we go from here? | |
 | Ahhh, the running water, the ice cream, the WARM SHOWERS! Being home, I'm appreciating all that we take for granted and hoping that I continue to be grateful for all of the comforts of home. But still, despite the cold and 2 months of tenting, I miss the small town of Everest base camp. The beauty, the excitement, but most of all the people. I'm already planning the next trip back.... ...Which brings me to the next point....where is this project headed, what will become of the website, is there any point in visiting basecampmd.com between now and next spring? As I mentioned in the last dispatch, the HRA board has approved an Everest Base Camp Clinic for spring 2004. This is a temporary approval because we need more sponsorship. I have between now and next spring to come up with 2 volunteer doctors, sponsors for 4 tents, an oxygen concentrator, a satellite phone and some $ for smaller but very important power supplies and medical equipment. If you have connections to apotential sponsor company and can get me the name and number of that connection, I have a prepared donor pitch to give them! Leave me a message on the "Ask the Doc" message board and I'll email you for the contact info. I won't be making daily updates, but I will make a dispatch every week or so with sponsor news, recent altitude research findings, and comments on other climbing/mountaineering medical ailments. So please check in with us....and let me know what we can add to the website that will make it more useful to you. If you're planning a high altitude adventure, feel free to send me any health questions you might have. If I can't answer you, I'll find a resource that can. Thanks for your support! Tomorrow....thanking the sponsors. |
| June 2, 2003 | |
 | I am thrilled to report that after a long meeting with the Himalayan Rescue Association executive board, that we will continue an HRA Everest Base Camp Clinic every spring climbing season for the forseeable future! Although the clinic lost a bit of money overall, the clinic was a success for Nepal and for the tourism and climbing industries, and we feel sure that once we are established, more expeditions will rely on our medical care and leave their more expensive personal non-climbing physicians home. It makes sense....they will get a secure presence, dedicated and altitude-experienced doctors, and can commit their energies (and $) to their climbing goals. Three photos tonight. One of the HRA award dinner at Rum Doodle, in which all of the HRA doctors from Manang, Pheriche and EBC were thanked by the board. Second of John Baker officially signing in as an Everest summitter at Rum Doodle. Third of our friend Irish expedition leader Pat Falvey, who is enjoying a taste of his 46th birthday cake at Yak and Yeti and celebrating his Irish team's Everest expedition. |
| June 2 John signs at Rum Doodle | |
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| Happy Birthday Pat! | |
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| May 31 2003 | |
 | Last night HRA medical director Buddha Basnyat and his wife Gita hosted myself and Pheriche doctor Kirsten (Denmark) and NIC doctor Linda (Canada) for dinner, a traditional Nepali meal. The company was great, we strategized about future medical research opportunities, and celebrated yesterdays Lancet printing of Buddha's altitude review article (a REAL labor of love for Buddha) .... see www.thelancet.com/journal. Congrats, Buddha! |
| May 30 RUM DOODLE SIGNING! | |
 | After recieving a beautiful service award and gifts from the Himalayan Rescue Association, I was invited to lunch and to design and sign a plaque commemorating our first clinic at Everest Base Camp (now posted on the walls of the Rum Doodle!) The RD, a real icon in Thamel, offers free food and drink to all successful Everest summitters. (Therefore, where climbers hang out in Kathmandu?) I was honored to sign my name on the wall amongst all the famous folks I admire!
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| May 30 2003 Everest Award | |
 | I was invited to the Everest Summiteers Association program to award the Everest Award and Ghatal Sagarmatha Purskar Award this morning. Among the distinguished guests were the Nepali Minister of Tourism, Wongchu Sherpa, Tashi Tenzing, Jamling Norgay, David Breshears, and many other accomplished climbers. Many awards were delivered to journalists for coverage of Everest issues, to the youngest and fastest summitters and even to John Baker of England who has covered the (unofficially) biggest change in altitude by diving to 250 meters below sea level, then summitting Everest last week. More to follow.... |
| May 29 Golden Jubilee celebration | |
 | Just back from a really well done celebration including Sir Edmund and Lady Hillary, the Tenzing Norgay family and notable climbers from all over the world. The evening was comprised of many ceremonies honoring the work of Sir Edmund, traditional Sherpa dancing and singing, and even a 50 year old bottle of Chivas Regal presented to Sir Ed by the Duke of Argyle. It was a chance to meet some mountaineering greats (first time I've had cocktails and made small talk with folks with freshly frostbitten faces and toes -- felt like I was in a hospital ward at one point!) and reconnect with friends from base camp. The Hillary's looked like they were holding up well but must be exhausted as they've been whisked around town for days now. Tomorrow I'll attend a ceremony dedicating a statue to Babu Chiri, previous summit speed record holder. |
| May 29 Helicopter tragedy at base camp | |
 | As we trekked down from base camp yesterday we noticed a flurry of heli activity -- I presumed preparations and travel for the celebration today in Tengboche and transport of climbers. I was right, but never dreamed that the many military aircraft I saw were evacuating the victims of a helicopter crash in base camp. I watched in horror last night as I saw the BBC report in the tea house in Lukla....and felt great compassion for the family and loved ones of one of the dead who traveled to Kathmandu on my flight this morning. Helicopter flight at high altitudes is risky; at extreme altitudes like base camp, it's downright dangerous in all but the best conditions and with the most experienced high altitude pilots. On more than a few occasions, I had conversations with folks in base camp who thought that the idea of helicopters in base camp for anything but life or death emergencies was frivolous and tempting disaster. I have to admit that this was my position early on. But like many, I was lulled into a sense of security as I saw flight after flight landed safely, for reasons of ease of provisioning or VIP transport. I even went as far as to look into the feasibility of flying out of EBC myself this morning,to enable our clinic to stay posted longer. But I was told that the helis were booked, due to the Golden Jubilee celebration....that was okay with me, I like the trek, and I had an uneasy feeling about flying anyway. It just didn't seem right. I chose to close the clinic a few days early to allow us to trek down for meetings in Kathmandu. And now disaster has struck, the same helicopter that carried 3 of my patients to safety caught it's wheels on the stone kitchen structure I sat in on more that one occasion, and the unthinkable happened. We shouldn't be tempted to take the easy way out. We should respect the severe environment of Everest and use our airspace in emergency situations only....now more than ever. |
| May 28 | |
 | We're on the road again, from Namche to Lukla, where we hope to catch a flight tomorrow morning to Kathmandu. It's a cloudy rainy day in Namche as we set off. Next dispatch likely from Kathmandu on the 50th Golden Jubilee anniversary. This photo is of the newly constructed and commemorated (May 9) chorten dedicated to Tenzing Norgay and the Sherpas of Everest ... it was erected 15 outside of Namche by Tenzing's grandson Tashi and his family and supporters. It's a spiritual spot to rest along the trail. |
| Lhakpa Gelu's new Everest record... | |
 | On May 26, Lhakpa Gelu DUSTED the previous Everest speed ascent record, held only for a few days, by shaving hours off both the ascent to summit and round trip EBC to EBC records. I've attached video shot of his triumphant return down the icefall on 5-26. |
| May 26, 2003....left him in the DUST!! | |
 | We recieved word, via cheers at 4:56 am, that Lhakpa Gelu Sherpa has let Pemba Dorjee Sherpa have the Everest speed ascent record for only a few days. This morning he set the new and amazing record of 10:56 to the summit.....and that isn't all. By all accounts, he descent is continuing just as quickly and he will most likely set the round trip EBC record sometime after 11am today, WOW. Many of our friends are leaving base camp today -- most of them hoping to catch a heli, but Lhakpa and I will trek out mid morning. We'll stay in Pheriche tonight, boxing and organizing clinic supplies for a hopeful 2004 season. I think my head will need three days on the trail to reenter civilizaion. I'll sign in from the trail.... |
| May 25 update 2 | |
 | An emotional day. An exhausted team brought Karma down the icefall, and reinforcements were recruited to carry his body to the helipad. All told, about 12 hours of carrying and climbing by some very selfless folks who cared about Karma and his team. All of our thoughts and sympathies are with Karma's family and team tonight.... Just had tea with Wally Berg, and an insightful conversation about the future of Everest from someone who's seen it through some changes. The HRA was featured in an article online by our friend Oliver from Germany. You can read (and see) us at www.spiegel.de (look on the right column for Everest news.) Lhakpa Gelu Sherpa left EBC at 5pm Nepal time, attempting to strip Pemba Dorjee of his speed ascent record. Safe travels, Lhakpa! Lots of teams packing up camp, the whole landscape is changing. Tonight the Irish are hosting a goodbye party, which promises to be, well, a party. The movers have arrived, see video, so it must be time to get packed up, we're planning to get going tomorrow down the hill to Pheriche to pack up supplies for next spring (we hope!) |
| May 25 | |
 | I'm very sad to say that the patient I waited for into the evening last night died during his rescue in the icefall. I've just completed a CISD -- critical incident stress debriefing with the key rescuers, Willie and Damian Benegas and Luis Benitez, and Team Everest 03 camp manager Christine. The deceased was a climbing sherpa who became ill with abdominal pain and vomiting and became progressively more dehydrated over the next few days. Damian and WIllie, who had just summited Nuptse, and Luis from camp 2 helped assist the sick sherpa to camp 1, gave him fluids and sugar and organized a carry down through the very treacherous icefall. Finally, after recruiting volunteers from EBC to come up with supplies, they proceeded with carrying a now unconscious victim with ropes and ladders through the dark. Luis called down to say that despite vigorous efforts by many tired and hard working people, Karma Sherpa stopped breathing and was unresponsive to CPR and was pronounced dead by his team and myself at 7:45pm We are all greiving, but during our CISD we committed to not making this death another senseless loss. We all commit to making change for the better: organizing SAFE rescues at Everest performed by people. I'll keep you posted with the progress of this new working group. Namaste. |
| Belgian summitters... | |
 | The Belgian Everest 2003 team celebrates the summit of 4 climbers (1 sherpa), who summitted on 5-23, arriving in EBC yesterday 5-24. Alexia Burgerer, a Swiss woman climbing with that team, is the first and only woman yet to have summitted Everest from the south side in 2003. Do they know how to celebrate or what??? The Belgian team physician, Jack donated some supplies to our clinic today, as their team packs up to leave base camp for Kathmandu tomorrow. Thanks Jack and congrats to the Belgian team. Did I mention that our Peak Promotions climbers also summitted on 5/23? John Baker, Kami Sherpa, Nima Tashi Sherpa and Chyamba Sherpa returned to base camp today after 5 days without radio contact....we weren't sure where they were, but now we know....cloud 9! I'm monitoring the radio progress of my next patient being carried slowly through the icefall and will keep you posted... |
| May 24, 2003 SLEEPLESS | |
 | There's lots to write today but too much work to do to stay at the computer long. Last evening a climbing Sherpa with the Korean expedition came to our clinic extremely ill after having descended from 8500m. He was very weak and complaining of severe abdominal pain, unable to eat or drink for 4 days. It became clear that our patient was suffering from a perforated visceral (abdominal) organ -- perhaps a ruptured appendix, the formal diagnosis will likely be made in an operating room in Kathmandu today. I stayed with our patient all night - neither of us slept - him because of pain, myself because of trying hard to diminish that pain for him. He recieved intravenous fluids and antibiotics and was evacuated by heli this morning. Unfortunately, wires got crossed about the time of arrival of the Nepali Army helicopter, so we waited for 2 1/2 hours at the helipad. Luckily, our South African friends were also waiting for their heli and Mark, a paramedic, helped me out by giving more pain medications while we waited (photo). The weather was good for the flight, see video clip. Now I hear there is a rescue underway with 2 more climbers en route, one carried, from camp 1. I'm going to go catch a quick nap to get ready! |
| May 23 update #3 | |
 | EBC gathered at the icefall at 2pm Nepal time to welcome Pemba Dorjee Sherpa back with 2 new records .....not only the speed ascent, but the return trip to base camp in 21 hours. An amazing acheivement.... |
| May 23 update 2 | |
 | 12:10pm Nepal time and we are hearing more jubilant sounds, this time from the Team Everest 03 camp, ecstatic at the summit success of Gary Guller and 3 of their sherpas. Just had a visit here at the HRA clinic from the Miura basecamp leader, son of 70 year old Yunictuiro Muira, the (unofficially) oldest Everest summitter as of yesterday. HIs son tells us that dad is skiing the south col right now, and should be down tomorrow. I post a photo of this amazing man tomorrow on his descent. Other news: Sean Burch successfully summitted yesterday, much to the delight of his wife Gabrielle, who has been a champ, watching and waiting with the rest of us in base camp. ....And remember the Japanese climber with biliary colic we treated last week? He led his team of 5 Japanese and 4 sherpas to the summit yesterday! What a recovery! Medical news is scant....thankfully I've seen only about 2 or 3 patients each of the past few days, with minor problems. I hope it stays that way. And to close, GREAT BIG THANKS to the South African and Canadian firefighter teams, both of whom made BIG equipment and medication donations as they prepare to leave EBC. In fact, they left us so well stocked that we'll forward much of the equipment on to the hospital at Kunde. We are, as of today, almost completely stocked for NEXT season! Thanks again for all your generosity, folks! |
| NEW EVEREST ASCENT SPEED RECORD SET!!! | |
| At 5:45am this morning, Pemba Dorjee Sherpa set a new Everest summit speed record of 12 hours 45 moinutes, well eclipsing the last record of 16:56 set by the deceased Babu Chiri Sherpa in 2001. Lhakpa Gelu Sherpa will attempt his own new speed record on 5/25, so stay tuned, if speed is your thing.... As I write this entry, 9:30 am 5/23, we know that many teams are stacked up attempting to summit. The SPCC tells me that thier official summit list includes about 46 climbers as of this morning. Luckily the visibility is good and the sky is clear. We hear there is a bit of wind slowing people down. Yesterday our good friends the Irish expedition had 2 successful summits and we hear all are doing well and descending to EBC today. Sadly, the South African team has cancelled thier summit bid, having been turned around by weather one too many times. We'll have a goodbye party tonight to see them off. I'll keep you posted with more summit success stories as the day reveals them.... |
| March 22, 2003 Indian Army on TOP! | |
 | I was awoken to the joyous sounds of celebration at 6:20 this morning, as the Indo-Nepali Army camp at EBC first heard of it's 5 successful summits. Heads popped out of tents all over camp as other teams heard of their members successes, and jubilant yells continue to be heard...what a nice change from yesterday, when all of base camp wondered if anyone would EVER summit! From chatter on the radio (therefore unconfirmed), we have heard of the 5 Indian Army summitters, 4 French, the 70 year old Mr. Miura summitting this am. Another report from the South Col described "many teams" still heading up. I will post more news as I hear it -- it's great to hear about climbing success while having an empty clinic and I hope it stays that way! |
| March 21, 2003 Shut down at 8500m | |
| It is a confusing, busy, hectic morning here at EBC. Last night the weather looked promising and somewhere between 50 - 100 climbers left camp 4 to attempt their summits....on the heels of Lhakpa Gelu Sherpa, who left EBC at 6pm for his speed record attempt. (See video clip). Chomolungma, however, had a different plan. Winds, predicted to be mild, instead became so severe that progress became impossible. I hear this morning that some teams are turning back, that Lhakpa Gelu went back down to camp 2, and that some are waiting it out at camp 4, hoping for another chance to summit tonight. It is very difficult, even with supplementary oxygen, to spend more than 2 nights at the south col, in the "death zone." To make things more confusing, weather in base camp is snowy and those camps relying on solar energy are without. The internet cafe, having blown through 2 generators, is trying hard to serve it's clients, from base camp managers frantically trying to get the latest weather forecasts to their teams, to reporters trying to get the news out to the rest of the world. The Swiss German team has loaned their generator to the Internet Cafe, allowing all of us to communicate. THANKS OLIVER!! Medically, I am hearing reports of snowblindness in climbers at the high camps, many of them reporting that their glasses were obstructed by snow/ice and removed -- see discussion on snowblindness on the website. I also hear of a few climbers with altitude sickness, but no particulars. So, I, like the rest of camp, and indeed, the world, sit here waiting..... | |
| May 20, 2003 Forced to wait some more.... | |
 | Lhakpa Gelu Sherpa, 9 time Everest summitter, was forced to delay his bid for the speed summit record yesterday because of delays fixing the route to the summit. The BBC got into town yesterday, and it took them no time at all to get a camera on the reserved and shy Lhakpa. An unassuming star of Everest, Lhakpa is attempting to break the deceased Babu Chiris previous speed summit recort of 16 hours 56 minutes. Lhakpa is aiming for 12 to 15 hours. We wish him well. Not only was Lhakpa delayed yesterday, but a few climbers planning to begin their summit bids were stuck waiting at camp 4, not a comfortable (or safe:) place to spend much time. We hear ropes are being fixed today to allow many to begin their final push to the summit tonight. More waiting.... A Swiss climber was stricken with HACE&HAPE at camp 3 yesterday....immediately several icefall doctors, the expert sherpa climbers who fix the icefall route, were dispatched to assist the climber down to EBC after he spent time in a Gamov bag at camp 2. The Swiss team has its own doctor, and I was told that the patient is much better this morning at base camp and will not require evacuation. Follow up on yesterdays marathon ..... one runner who came up to base camp before the race far too quickly became quite ill within an hour of the race start. He was assisted down to our HRA hospital in Pheriche at 4200m and treated for HAPE. The winner of the marathon is a Rai cook who works in Lobuche and his time, unconfirmed (Ive heard several versions) was 3 hrs 34 minutes. Wow. |
| May 19th 2003 Everest Marathon! | |
 | This morning's early start to the 42 km Everest Marathon was a misty one....29 runners gathered in a patchy fog to start with the whistle at 7am. A few last minute entries added 2 women (Americans!) and representative runners from Canada and South Africa. The majority of the entrants were, of course, native Nepali. Lots of EBC onlookers gathered to cheer them on....see video clip. Last night my dinner invitation to the South African tent was interrupted by a patient call...an Italian climber just descended from camp 2 with pleurtic chest pain (pain on inspiration), cough, fever, and shortness of breath. After further history taking and examination it became clear that this experienced climber was suffering from pneumonia, a condition that hospitalized him a few years back after an 8000m climb as well. He recieved intravenous fluids (quite dehydrated from his descent) and antibiotics as well as antiinflammatory pain medications and a salbutamol inhaler for his wheezing. I advised that he descend, at least for a few days (time is running out for summit bids!*) to try to heal. Lhakpa and I have been invited to a tea/sendoff for Lhakpa Gelu Sherpa, who will leave EBC at 6pm tonight in attempt to break Babu Chiris speed ascent record of Everest .... he's hoping to do it in only 12 hours. And Ive just heard that Glenn Edwards, of the Canadian firefighters, intends to go for the summit tonight from camp 4. We hear many teams are poised at camp 3 today, hoping to move to 4 tomorrow for a 21st summit day!!!!! |
| May 19th 2003 Everest Marathon! | |
| This morning's early start to the 42 km Everest Marathon was a misty one....29 runners gathered in a patchy fog to start with the whistle at 7am. A few last minute entries added 2 women (Americans!) and representative runners from Canada and South Africa. The majority of the entrants were, of course, native Nepali. Lots of EBC onlookers gathered to cheer them on....see video clip. Last night my dinner invitation to the South African tent was interrupted by a patient call...an Italian climber just descended from camp 2 with pleurtic chest pain (pain on inspiration), cough, fever, and shortness of breath. After further history taking and examination it became clear that this experienced climber was suffering from pneumonia, a condition that hospitalized him a few years back after an 8000m climb as well. He recieved intravenous fluids (quite dehydrated from his descent) and antibiotics as well as antiinflammatory pain medications and a salbutamol inhaler for his wheezing. I advised that he descend, at least for a few days (time is running out for summit bids!*) to try to heal. Lhakpa and I have been invited to a tea/sendoff for Lhakpa Gelu Sherpa, who will leave EBC at 6pm tonight in attempt to break Babu Chiris speed ascent record of Everest .... he's hoping to do it in only 12 hours. And Ive just heard that Glenn Edwards, of the Canadian firefighters, intends to go for the summit tonight from camp 4. We hear many teams are poised at camp 3 today, hoping to move to 4 tomorrow for a 21st summit day!!!!! |
| May 18, 2003 | |
 | Yesterday I sent a video clip of runners for the Everest Marathon practicing their start from the icefall. The REAL race is tomorrow morning and I'll be sure to send a better quality video....sorry for the mixup. Last night a Japanese climber came to the clinic around midnight complaining of abdominal pain and vomiting. He is a 6 time 8000 meter summitter and last week succcessfully summitted Lhotse with his team .... as if that's not enough, he is planning an Everest bid this week too. So you might understand why he was very disturbed by this new illness and the havoc it might wreak with his team's plans. The patient was writhing in pain, very nauseous and pointing to his right upper abdomen. After further questioning and examination, I felt as sure as I could (without conventional hospital testing) that he had biliary colic, a very painful condition that occurs when a gallstone obstructs bile flow from the gall bladder. We treated him with intravenous fluid replacement, pain medications and anti-emetics and he improved but remained hospitalized in our clinic tent for the night so I could keep a close eye on him. He felt completely back to normal this morning and his team was so grateful that his team gave us a nice donation. We are happy to contribute to whatever climbing successes they may have! Now here's a strange story.....there has been a ziopku (half cow, half yak) milling around base camp for the past week or so. He looks old and thin, and I was worried he had been abandoned or lost by owners and was starving. Turns out, he's a clever old fella -- the Sherpas call him Ropku, and they say he walks up from his home in Dingboche every climbing season in search of premium scraps that are discarded by climbing camps. I had no idea a bovine could be so smart! |
| May 17, 2003 Everest Marathon Practice start | |
Today a meeting of the runners in the Everest Marathon and a practice start. These (all men) are amazing athletes! | |
| May 17th Summit bound | |
 | Early this am our campmates John Baker and Kami Sherpa left for the summit, as did many other teams -- at 6am my first view of the icefall revealed strings of climbers peppered through the icefall, intent on realizing their dream. It has been a long wait requiring patience and setbacks, but most are well acclimatized and ready for this ultimate challenge. Now, once again, we watch and wait with nervous anticipation back in base camp. Tomorrow I have agreed to check out all of the runners coming into EBC for the 50th anniversary EVEREST MARATHON -- yes, you read it right -- runners who have trained from all over the world will compete in a 26.2 mile race that begins in the icefall and terminates in Namche Bazaar. Most of us have trouble walking this route with all of the hills, thin air and tumbling rocks, but a brave few elite athletes see this as the ultimate runners challenge. I hope to check in at race time 5-19 am with videos of the race start, so stay posted! |
| May 16, 2003 And they're off......again! | |
 | Gorgeous day in base camp today to welcome trekker Dr. Martin Wilcox, Pheriche doctor who celebrated his 64th birthday yesterday by summitting Kala Pattar. Wow. Hope I can do that when I'm 64! Lots of sun today, so much that we even broke out the t-shirts! Lots of melting and rockfall and avalanche too, mother nature put on a show for us. Camp is melting too and we've found some of our tents in small ponds by the end of the afternoon -- including our clinic. Lhakpa did some creative engineering and built a drainage stream right past the entrance of the clinic, diverting flow from our medication supplies and patient cots and sensitive electronic equipment. One climber came to clinic today (making this the second case this week) with a diagnosis of sciatica. Sciatica is a painful condition involving the nerve that gets inflamed as it passes through the pelvis. The muscles work fine, but patients complain of a terrible ache that radiates down the leg and worsens with sitting, and certainly climbing. I have been tasked with treating these climbers with medications strong enough to knock down the pain and allow them to climb, yet not interfere with crucial respiratory function at high camps. Several teams left for the summit this morning, and many many more tell us they'll do the same late tonight/early tomorrow am. The conventional wisdom predicts summits beginning May 21st as that is when the wind is supposed to let up on top. We wish them all well! |
| May 15, 2003 | |
 | Only one patient this morning, but a busy busy day nonetheless... Dr. Chris Ho left us this am, and he just radioed to let us know he arrived safely in Pheriche. Thanks once again for all your help, Chris! (He even left me some chocolate as a surprise -- Sherill, you have trained him WELL!!!) A porter arrived WITH OUR REPLACEMENT COMPUTER BATTERY AND CORDS today too! Thanks so much, Sten Yondt! I am writing a contact dispatch from the comfort of my tent now....and will hopefully be able to get to answering some of the questions from the message board. Thanks for your patience! The Nepal Mountaineering Association has an instructor class at EBC this week and the whole class dropped by for an impromptu visit and lecture on altitude illness this afternoon....which I was, of course, delighted to deliver. After the lecture they presented me with a pin. An enthusiastic group of folks who hope to help out with future rescues -- maybe at base camp? Immediately after the lecture, one of my favorite friends dropped in for a visit too -- Tashi Tenzing, grandson of Tenzing Norgay. He trekked to EBC with a group of folks from his home in Australia. Tashi not only has famous lineage, but has racked up some mountaineering feats of his own, and owns his own trekking-expedition company as well. Last year he released his book "Tenzing Norgay and the Sherpas of Everest", available on Amazon.com -- a great book if you have interest in the history of Everest from the perspective of the Sherpa culture. THEN I went with Tashi to meet and have tea with the Everest legend Henry Todd, who is quite an engaging and interesting fellow. Wrapped up the evening having dinner with climber Gary Scott and watched the movie "Ronin" at the internet cafe. Nice day.... |
| May 7, 2003 | |
 | The wind is gone and teams are assessing their equipment losses up high and
preparing for summit bids. All of us are excited and hoping all goes
well....But that isn't the fun news....
Yesterday a Russian climber was arrested by the liason officers at EBC after climbing over Lho La pass (yikes, very risky ice climb over a thick overhanging slab of ice and snow about to fall adjacent to Everest's west ridge) -- anyway, he was climbing in front of hundreds of onlookers, including the law, without a climbing permit. Lots of curious EBC folks watched as the climber apparently decided to go back up and over to Tibet in order to evade the LO's -- alas he came down just before dark. Quite the excitement for us a base camp. He was joined by his new buddy who hiked into base camp yesterday telling his story of having recently been voted off Global Extreme, intending to climb Everest and meet his buddies on the summit. He also has no permit and no equipment and has left everyone scratching their heads wondering exactly what he's thinking..... A couple of trekker patients came to clinic yesterday with gastrointestinal ailments -- no major problems....good news. I have to close by thanking my good friends at the Internet Cafe here in EBC. They've come to our rescue providing us with AC power for our oxygen concentrator when our battery died, helping us try to solve our myriad computer nightmares, and just being good neighbors. You can find out more about their honorable mission by visiting their website: www.linkingeverest.com. Here's a photo of the guys..... |
| May 6, 2003 | |
| Today I was lucky enough to meet a mountaineering legend -- he came to see
me about a persisting cough -- same one everyone else seems to have, the
Khumbu cough -- anyway, he has summitted all 14 of the 8000 meter peaks of
the world, has l0st many fingers and toes in the process, and is attemting
Lhotse for the 2nd time. Very interesting character, we talked about what
keeps him climbing --
The raging wind continues on Everest for I think the 4th day in a row. i'm not whining about a cool breeze -- were talking about 40 knots, really difficult, cold, we've lost 3 tents in base camp just due to winds. Just imagine how bad things are up high on the mountain? We here that the winds are so strong that noone can travel above camp 3 and that at least 36 tents are missing from camp 1 alone. We had some climbers visit yesterday worrying that if their tents -- with all of their high altitude equipment -- are gone, then their expedition is over. Either limited budgets or limited supplies.... So here's my philosophy for the day -- take it or leave it. I think Chomolungma, goddess of Everest, doesn't like the crowds. she doesn't want so many people on this mountain. So shes blowing tents with supplies right off the mountain. which when you think about it is much more humane than blowing people off the mountain.... Climbers laugh at this philosophy, but you gotta wonder. | |
| May 5, 2003 | |
 | Busy day yesterday, 3 medical evacuations from EBC. We told you about the
climber with HACE yesterday morning -- later in the afternoon a Japanese
trekker arrived with profound shortness of breath and hypoxia (pulse ox of
42%) and a diagnosis of HAPE. After several hours of treatment (and while
waiting for a helicopter) she remained very ataxic, unable to stand or walk
on her own. Though she denied the presence of headache, we were worried
about coexisting HACE and treated her for both. We were told this morning
that she made it back to Kathmandu and symptoms were improving last night.
We expect even more business shortly as film crews and on looking trekking groups are arriving by the hundreds -- even if everyone ascends slowly, some are bound to become ill -- this altitude is simply not tolerable for many. |
| May 4, 2003 | |
 | Yesterday while sending our dispatch, we were summoned to our clinic tent to
attend to a very sick climber who became ill yesterday at Camp 3 (~7500m) with HACE. Assisted by his loyal teammates, he was able to descend the icefall despite several syncopal episodes (A brief loss of consciousness caused by a temporary deficiency of oxygen in the brain) and made it to the HRA for treatment. He was profoundly dehydrated, not having had anything to drink for over 24 hours, and suffering from HACE with ataxia. He responded immediately to treatment with IV re-hydration, oxygen, intravenous dexamethasone and 2 trips into the GAMOV bag for simulated descent. A raging wind kept us awake all night, and then we awoke to a dense snowfall that delayed helicopter rescue. I'm happy to report that our patient made it onto the helicopter safely and is under close observation in Kathmandu. On our way back from the helipad we met the Nepali army with a patient they were evacuating as well. As climbers ascend to high camps, altitude seems to be taking its toll.
Today we'll nap and recover as will everyone else who couldn't sleep last night.... Erick made it down to Pheriche last night .... more about his study - he interviewed every English speaking Everest climber in camp this year, making him hands down most recognized face in base camp. At any rate, our quest is to see if we can find what factors -- diet, supplements, medications, weight loss, illnesses might impact on a climbers' summit success (or lack thereof). (Photo of Erick in front of Everest from Pumori ABC.) |
| May 3, 2003 | |
 | All night long, the SOUNDS of Everest base camp....half the camp coughing
fitfully, punctuated by rock and snow/ice avalanches. The icefall is moving
more and more with warmer days --lucking being negotiated safely by
climbers. Nevertheless it SOUNDS terrifying. Sadly the whole Peak Promotion/HRA clinic crew saw Erick off this morning, headed downhill with his porter to resume his trip home to San Francisco and medical school at UCSF. We'll miss him alot....more about Erick tomorrow where I'll describe his research activity for the last month. Today we treated an Italian climber and a trekker, but basecamp continues to be kind of quiet. We continue to be amazed at the incidence of Khumbu cough in camp and have nearly run out of medications to help treat this lingering condition...see discussion at left for more info. Many teamsare resting at lower altitudes preparing for thier summit bids, the rest up getting acclimatized at high camps. We've heard that the first teams are hoping to catch a weather window and try to summit as early as May 8th.....weather permitting, of course. Congratulations to Sloaner and Colleen on thier new arrival -- we understand Chris made it home with only moments to spare....lucky timing! |
| May 2, 2003 - Erick's last day | |
| Erick will head down to Pheriche, bound for San Francisco tomorrow--will sure miss his daily pma--we took a walk to Pumori advanced base camp today (I turned short but got a big old beautiful view anyway....)
Happy to report we saved a life yesterday, the porter with HACE revived, walked with assistance down to Pheriche. His own mom met him there and walked him home to Khunde this morning. Amazing save, as he was completely unconscious and unable to stand when we found him. Makes us feel good. Will send a photo tomorrow if the viruses clear from the Internet cafe. | |
| May 1, 2003 | |
| Treated a Sherpa porter who had a bad case of HACE today. We were able to get him from not standing on his own to walking and able to descend down to Pheriche - good teamwork. We are looking for Reinhold Messner, we hear he was due in base camp today, but nobody has seen him yet - So we're on the look out. If we were to take omens we would be packing up and leaving now. Another things broke; we think our oxygen concentrator is on the blink. We are down to bootstraps, but are still able to treat cerebral edema so we'll keep going! | |
| April 30, 2003 | |
| Photo of Dr. Chris Ho using our Slishman femoral traction splint. Everyone seems to be either going down for rest or up on the mountain, so it's pretty quiet now. We are making daily house calls to a sick Sherpa cook in the Muira camp with pneumonia, but think we have him on the mend. One of the Canadians went down to Pheriche with presumed HACE, treated by a bystander physician who for some reason didn't send him to our clinic first - we're working on our PR here.
In regards to the fees that the base camp clinic charges: We have to charge for Nepali healthcare at base camp or we would go bankrupt. We charge 50% for Nepalis, which works out to 25 US per doctor visit. A lot of our profits *we will NOT make a profit at base camp because our overhead is too high (anyway all profits provide free health care for the more needy Sherpa people in the rest of the Khumbu. Climbing Sherpas are employees of expeditions, and most of the expeditions will pay for their Sherpa modest clinic fees. |
| April 27 | |
 | Education day in base camp -- slow day, only 2 patients, so Erick took a few hours to orient Lhakpa and Kristina to our Gamov bag operation, basic vital sign measurement, operation of our pulse oximeter, and gave an altitude physiology lecture. Thanks Erick! We had several visitors in camp today, Gary Scott down from Camp 3 told us of route conditions, weather, etc. Says everyone seems to be doing well at the high camps. Then we had tea with the Indian Army majors who came to visit with Kaji Sherpa and issued a lunch invitation for tomorrow -- yippee, fine Indian food! They are happy to report that they've had great participation from most of the expeditions and have recieved commitments for the supplies and manpower needed to finish the job of setting ropes to the summit. They entertained us with the story of the "Everest Masseuse" and his exit from base camp -- basically an unusual French fellow who wandered base camp looking for clients and found few -- we'll leave it at that, but he was definately a colorful character and a bit of a player in this "circus" at EBC. Yesterday the Internet Cafe transmittor got hit by lightning in a storm, so we all had to wait 24 hours to get our transmissions out -- you just never can count on anything in this extreme environment. Just have to be thankful for ANYTHING that works! |
| April 26th Life at basecamp....bath day | |
 | Yesterday's expedition leader's meeting, hosted by the joint Indian-Royal Nepali Army Expedition was well attended and gave us all a chance to meet, greet, but more importantly gave the climbers a chance to plan for safety and success in their summit attempts. The Indian Army Colonel graciously allowed me to speak on behalf of the HRA, introducing our clinic and it's mission to the whole camp. The leaders then proceeded to collaborate to set ropes above camp 4. As of yesterday, ropes were established, we were told, up to camp 4, and a steep and treacherous areas, allowances for increased numbers of climbers were made by double and sometimes triple roping areas in order to avoid congestion and crowding. Because of a predicted storm, all are holding back from setting summit ropes until about 4-30....weather permitting, of course. Many teams told us that their members have completed acclimatization and have already left for a rest at lower altitudes. Back to the day to day life of base camp, though -- a quiet day, allowing us all to take a bath -- this is a gross generalization. What we can do is take a bucket of warm water to an empty tent and sponge off and wash hair about every 3 days. Not too glamorous, huh? Because we awoke to a warm and sunny day (should have guessed it wouldnät last, as it is now pouring snow while the thunder roars) Lakpa chose to take his bath outside. Ahhh....but it didn't last.... |
| April 25th, 2003 | |
 | The test worked! We're excited to be able now to send direct dispatches to our webpage with photos. Back to the life at basecamp theme, we have had 2 entertaining visitors in our camp the past 2 days -- Bill and Hillary (no, not what you äre thinking) -- Hillary Liss is a physician from Seattle with her boyfriend Bill who have set up a clinic in Machermo, cheifly for porters who become ill while trekking with their clients in the Gokyo valley. They were full of great stories, some gut busters, some tragic but all good dinner conversation. They were good sports when Erick (aka Richard Simmons-Jack LaLanne) made them join in for our afternoon calisthenics. In this photo, Hillary, Erick, Bill and Kristina are flexing their muscles with some Khumbu Glacier rock for you.... Gotta run, camp expedition leader meeting this afternoon -- am hoping to answer any questions our community may have about our clinic. Will sign on again soon! |
| April 25, 2003 - a test of our (NEW) computer! | |
| Kristina, our Swedish nursing student has safely arrived in base camp and has brought us a new computer. We're getting it set up now and should be able to easily send daily messages very soon (with photos, etc)
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| April 22, 2003 A day in the life | |
 | We'll try to fill in a description of what its like to live at basecamp this week-- starting with a photo of our little sprawling village taken from the icefall. Our days USUALLY (except today!) start with clear skies and warm sun, progressing to clouds and wind and snow nearly every evening. The challenge is to get your body and/or your clothes dried before the wind sets in, or everything just freezes....more photos to demonstrate this in future dispatches.
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| April 19, 2003 - MD and DDS | |
 | our business is picking up. tomorrow i'm scheduled to extract a carious (diseased( and fractured molar from a climibing sherpa -- tomorrow because today is his birthday and he'd rather celebrate today -- extraction is a challenge at 5400m with limited equipment, even if i were a talented dentist -- but the sherpa wants to give me a try, my being 2 days walk closer than the nearest fully equipped dentist. we heard yesterday of a hepatitis outbreak, we think, in two sherpas one reported to khunde hospital with fulminant liver failure--a real scare--we've been |