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EBC Day 11 – Everest Base Camp

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Altitude Sickness


That morning, a sad farewell took place in Lobouche (elevation : 4940m) amongst a group of hikers from New Zealand. One of the party members apparently had been suffering from a bad headache and had just begun mumbling unintelligibly. It was (wisely) decided that he would need to make a quick descent back down to lower altitudes, whilst the rest of the party continued up to Gorak Chep (elevation : 5164m). I say wise because the altered mental status (a.k.a AMS) indicated an onset of HACE.

As one ascends to higher altitudes, the saturation of the atmospheric gases decreases, which results in mild hypoxia--a deficiency in the amount of oxygen that reaches the body tissues. One's breathing and heart rate are then forced to increase in order to combat this hypoxia. The capillaries in the body also dilate, and the capillary leakage causes swelling (edema). Without sufficient acclimatisation, the signs and symptoms that one might encounter are:

Gastrointestinal issues: Loss of appetite, nausea or vomiting

Nervous system issues: Fatigue or lassitude, headaches, dizziness, difficulty sleeping

Locomotory system issues: Peripheral edema (swelling of hands, feet, and face)

Respiratory system issues: Nose bleeding, shortness of breath with exertion

Cardiovascular system issues: Persistent rapid pulse

If you encounter any of those signs and symptoms, it is important to stop your ascent and rest, and consider a descent of 500m or more. Treat the symptoms with analgesics and antiemetics as necessary, and consider the administration of acetazolamide (125 to 250 mg twice daily), otherwise known as 'Diamox'. Acute mountain sickness can progress to 'High-Altitude Pulmonary Edema' (HAPE) or 'High-Altitude Cerebral Edema' (HACE), both of which are potentially fatal.

Everest Base Camp Gamow bag
Testing out the Gamow bag at the TOPCOM conference. The Gamow bag allows medical practitioners to increase the air pressure that surrounds the patient in order to simulate a descent from altitude, which is the definitive treatment of altitude illness (AMS, HACE and HAPE).


Hape & Hace


High-Altitude Pulmonary Edema (HAPE) occurs when fluid leaks from the capillary beds in the lungs and into the alveoli, and causes swelling of lung tissue. HAPE tends to develop several days after arrival at moderate altitudes of (3000m to 4000m).

Mild HAPE: Dry cough, mild shortness of breath upon physical exertion

Moderate HAPE: Persistent cough, shortness of breath at rest, lung crackles

Severe HAPE: Mental status changes, respiratory failure, blood-tinged sputum, marked crackles

It is important to minimise exertion and to keep the patient warm before making an immediate descent. Initial administration of oxygen should be at a rate of 4-6 l/min until conditions improve, after which the rate is then lowered to 2-4 l/min. Moderate HAPE can quickly deteriorate into severe HAPE in a matter of hours, which will ultimately result in respiratory failure and eventual death. Pulmonary edema can sometimes persist for days after a descent has been made and quite often requires hospital observation and treatment.

High-Altitude Cerebral Edema (HACE) on the other hand, occurs when fluid leaks into the brain. This presents as brain swelling and an increase in intracranial pressure (ICP).

Mild HACE: Mild Headache, fatigue, nausea

Moderate HACE: Severe headache and vomiting

Severe HACE: Mental status changes and ataxia (lack of muscle coordination)

Oxygen should be administered at a rate of 2-4 l/min along with immediate descent and evacuation. Bear in mind that patients with severe HACE are unlikely to survive without aggressive intervention.

Nuptse at Everest Base Camp

Nuptse (elevation : 7861m) and the Khumbu Glacier nestled underneath

Next (Day 11) : Everest Base Camp (Part 2)
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The Everest Pyramid (evk2cnr)


The trail from Lobouche was fairly level until I reached the point where I was to branch off towards the 'Pyramid'.. which was a strange sight indeed. It is an odd three-story structure made out of glass and steel, completely incongruous to its surroundings. It almost seemed as if it fell from outer-space, part of an alien spaceship that was passing by. I walked up to the main door and gave a quick knock and was greeted by one of the staff. I was told that a kid and a staff force that were made up of six locals lived there, and that I would be given a quick tour just as long as I did not take any more photos.

I gladly obliged.

Everest Base Camp Pyramid

The EVK2CNR pyramid

Everest Base Camp Pyramid reflections

My reflection off one of the pyramid panels

After the tour, instead of making my way back the way I had come, I decided to save time by climbing up the steep hill to the east of the pyramid before dropping back down to the main trail.

Most of the sections from here were relatively gentle but there was at least one steep ascent where I bumped into the two guys that I had seen with a gopro at Katmandhu's airport, and it turned out that they had flown in to Lukla by helicopter. I just kept on bumping into people after that. One guy had been travelling with a friend without a porter or a guide, and had gone over the Kongma La pass (elevation : 5535m), the pass that I had initially planned to do. He told me that his friend did not have the endurance to make the crossing in time so was forced to stay the night. The guy could not stay with his friend however, as he did not bring along camping gear, so he was forced to head over to the next tea house for the night. I also passed by a French woman who was travelling alone and an English group that were on their way up to Gorak Chep. Everyone's pace seemed to be very slow, perhaps due to the elevation, and I passed them one by one as I made my way to the frozen lakebed that is Gorak Shep (elevation : 5164m).

I bumped into the Malaysian group once again when I arrived at the lodge. Apparently the temperature, the terrain, and the altitude had gotten to them and they were actually entertaining the possibility of taking horses up to Everest Base Camp and then pay for a USD2.2k helicopter ride back down to Lukla right after! After a quick meal, cheese egg fried rice (NPR490) with lemon tea (NPR110), I had three hot chocolates (NPR390) to warm me up before making my way back to my room to get ready to tackle the base of the tallest mountain on Earth!

Route Playback

Suunto Movescount Stats

The information from the Suunto Ambit for this part of the trip can be found on my Movescount Page

For those who also have a Suunto GPS device and would like to use the move as a route, please click on the following link : 

Check the route in

Next (Day 11) : Everest Base Camp (Part 3)
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Everest Base Camp


I think that the altitude was finally starting to get to me as the hike up to base camp felt long and draining. I tried to push the pace nonetheless as I felt much lighter, now that I was free of my heavy backpack. Despite the much lighter load, I somehow managed to go off the trail twice, but the route on my Suunto Ambit always brought me back to the trail. The trail itself slowly made its way upward along gravel, and followed a ridge that then went on to join Everest's spine.

Way to Everest Base Camp

The famous EBC signpost

As I made my way upwards, I really did not know where I was heading. There didn't seem to be any visual reference of where the base camp lay. Winter was just around the corner and that meant that there were no vibrant tents of climbing expeditions to mark the location. I prodded along, just keeping an eye on the faint trail that lay just infront of me. The view of Mount Everest (elevation : 8848m) from here was completely underwhelming, and paled in comparison to the views that were to greet me the next day.

I realised then that reaching base camp basically was all about the ticking of a box, as all that one really finds there are piles of stones with a cacophony of pictures, signs and prayer flags strung out in-between. Once the crowd of other hikers parts sufficiently, you may even be able to take that (seemingly mandatory) photo of yourself that everyone back home is expecting, before making your way up the ridge, and back towards the small village of Gorak Shep once again.

Everest Base Camp

Underwhelming EBC!

On the way back, I ended up veering off the trail once again, this time going across the moraine to a point where the rocks below my feet began to get very unstable. After checking the route on my Suunto Ambit once again, I realised that I was too far east, so decided to cut across to the trail, practically crawling up the morraine to get there. The going here was slow as I had to take great care to ensure that each and every rock that I stood on would support my weight. I made it to the guesthouse eventually, just after the sun had set, and stumbled in cold and tired, eager to dig into the yak steak rice and coffee (NPR1260) that awaited me!

Everest Base Camp Ice

Area Map

EBC Region

Route Playback

Suunto Movescount Stats

The information from the Suunto Ambit for this part of the trip can be found on my Movescount Page

For those who also have a Suunto GPS device and would like to use the move as a route, please click on the following link : 

Check the route in

Expenditure

End of Day 11 Expenditure (NPR)*

Transportation : 0

Entrance Fees/Visa : 0

Gear : 0

Food : 1350

Maps : 0

Medication : 0

Misc : 0

Internet/Charging: 0

Accommodation : 0

TOTAL (NPR)


* Excluding the cost of the flights to and from Nepal

Total

: 30650

: 10295

: 16700

: 11100

: 700

: 385

: 700

: 1500

: 3590

: 75620 

Next (Day 12) : Kalapattar
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