April 30 BC

Today was a rest day in BC. I never realize at the time how much being up high is taking out of me. I did not feel well at all so I wondered up to the Himalayan Rescue Association tent and got a check out. This is the best deal on the mountain. You make a $100 contribution at the beginning of the season and they will see you an unlimited number of times. I think their web site is Base Camp M.D. You can Google it. They do a great job and have been here for years. I trust them on all things altitude related. There has been a lot of evacuations this year. I assumed they were pulmonary issues and a number of them have been but they are seeing more issues with blood clots and circulatory issues. An Indian climber had a stroke – he was 31 – and finally succumbed when he got home. He probably did not receive adequate care after he left BC. He had no insurance and once his family finally raised the $20,000 medical evacuation insurance he had follow on problems.

A lot of people are using artificial means to simulate altitude exposure before arriving here. The most common technique is sleeping in an “altitude tent”. This is like an oxygen tent that goes over the bed except is has a piece of equipment attached that takes O2 out of the air going into the tent simulating higher altitudes. The long term effect is to raise red blood cell counts – legally. Elite athletes as opposed to climbers are the primary market.

Making red blood cells in advance sounds like a great idea and if a little is good then a lot should be great right? Wrong. To many red blood cells is also a problem and can lead to increased risk of, drum roll please, stroke and blood clots. Most people are not aware that Sir Edmund Hillary’s (he and Tensing Norgay firs climber Everest in 1953) climbing career ending early in his 30’s because of a high altitude stroke. I have had two friends who have had strokes on the mountain. One of those friends came back the next year after his minor paralysis resolved. However he brought a medical kit for testing RBC and when his RBC got to high a team doctor “bled” him and put back a pint of saline. That’s demonstrates the extremes some will accept to climb this mountain – not me. In any case at some point it also causes a decrease in performance because of poor perfusion at the capillary level – call it blood sludging. Granted I am not a doctor but I did stay in a little yellow tent last night.

I heard a guy bragging about having spent three months in an altitude tent before he came and how even his doctor had commented on his high RBC count. I asked if he had any concerns about polyceathemia (sp?) but he seems to think Americans lack his sophistication so he ignored me. Of course so do Czechs, Canadians, Eastern Europeans, Nepalis and everyone over 40. This guy keep offending people he may get help with a little blood letting himself. Either way I tried to warn him.

I have begun to feel much better over the course of the day. I was probably just dehydrated. The HRA doc had told me all my vitals were great. When you are my age you always wonder if you detect a sense of surprise in their voice. “Wow you are doing okay for such an old guy”. I had walked up to HRA with a friend who was feeling bad a couple of days after I got to BC. While I was there I showed him this giant bruise on my leg around some kind of bug bite. It was obviously healing but he was so impressed he wanted to take a picture. That makes you feel a little weird to be a medical oddity.

Weather is turning worse on the mountain. It was to be expected. Yak happens.