#40 Day 15: Pheriche, Nepal

Monday 10 April 2017

My headache didn’t get better so at around 3.30am I woke up my room mate (sorry Amanda!) and we went to see Kay. The headache was right at the back of my head, I’ve had one like that before when I went to India and didn’t sleep for 3 days! so in my mind the headache was from lack of sleep. However at that height – over 4,200m – you can’t be too careful. My sats were ok but I could tell that Kay was worried. She advised me to take two paracetamol and said she would come and see me at 6am. My headache was still not gone by then and my sats were quite low, she got a second opinion from a colleague and suggested I start to take half a diamox (acetazolomide) in the morning and evening as a preventative measure against AMS. I  was instructed to rest and have a lay-in, no testing for me today, and she would see how I felt in the evening. We were to stay in Pheriche for 3 nights as it is one of the places to stop to acclimatise so I had a couple of days to get better.

I didn’t want to take the diamox but she kind of indicated that if I didn’t follow the medical advice it might end up with my journey finishing in Pheriche, so close but yet so far. I felt fine, apart from the headache and my cold, and I didn’t have other symptoms of AMS e.g. dizziness, lack of appetite, rapid pulse, so I wasn’t personally convinced I had it. However, propped up in bed alone in my ‘cell block H’ cold room (there was ice on the inside of the window!) with a bowl of porridge that Amanda had kindly brought me I had a bit of a crisis of confidence. What if I did have AMS and it got worse and I really did have to go back down the mountain? I was so tired and knew that if I let my mind continue in that vein I would end up convincing myself I wouldn’t be able to do it. I took the pill and ate my porridge and tried to rest however we were right near the helipad and loads of helicopters kept coming and going, someone was doing some DIY in the courtyard so there was lots of banging and crashing and the yaks kept milling around under my window so all I could hear in the gaps were the yak bells … eventually I got annoyed at being in bed and got up. I figured this was a good thing, if I was really ill I would have stayed in bed!

At this height water (let alone hot water) is in short supply so you have to pay for a shower. As it was nice and warm in the lodge I decided to have a shower and sorted out some washing. I sat in the communal area for the morning waiting for my hair to dry and doing a bit of reading. I managed two bowls of lunch, which was a soup that contained pasta and potatoes (our usual staples!), and felt better. When we were in Namche you may remember I agreed to take part in the research being done by the Harvard Division of Wilderness Medicine: the cognitive tests and eye ultrasound. The second, and final, tests were to be here at Pheriche with the lady leading the research. She had limited availability tomorrow so I did my tests – last time I got 30/30 and this time I got 29/30 so I don’t think my brain is too impaired …

At Pheriche there is a Himalayan Rescue Association (HRA) medical centre. The HRA is a charity that provides medical services to trekkers (for a fee) and to locals (for a much smaller fee) and is a life-saver for many people. At 3pm each day the staff give a talk on AMS so a group of us went along. Even though we were thoroughly schooled in how to recognise AMS by now, many of the group were medics and were interested in seeing the medical centre and learning more about how they deal with emergencies and the range of medical issues the staff are presented with. The talk was interesting and it was nice to while away part of the afternoon learning about the HRA, and helping the charity by buying the merchandise. I bought a patch to add to the collection on my rucksack 🙂

Next to the medical centre is the Everest Climbers Memorial, an art installation dedicated to the 280+ climbers who have lost their lives on Everest; each name is detailed on the memorial (see the cover picture for this post). The shape is an upside-down cone, cut in half vertically, and it’s made of stainless steel and filled with rocks from Everest. It was designed to reflect the mountain not compete with it, and the “space between the two halves is like a crevasse or doorway or hiding space. In there you are forced close to the names of the dead, and the closeness feels like a kind of intimacy”. The memorial does indeed capture the beauty of the mountain as well as illustrating its perils.

After the little outing I had another rest before dinner and was feeling well enough to play cards afterwards – although I avoided the Irish snap game this evening!

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