Pick Your Poison

In preparation for the trip to Nepal and the Tenzing Hillary Mt. Everest Marathon, I've been reading up on how to prepare, what to bring, what to expect, the Nepali language and culture and so forth. A good reference is the Lonely Planet, Trekking in the Nepal Himalayas. My copy is a bit dated (2001), but provides plenty of information about Kathmandu and several of the more popular treks (including the Everest Base Camp trek which is generally what we will be doing).

So I'm reading through the book and they have page after page of all of the different ailments you can get (and their suggested preventative actions or treatments). I guess it's their "buyer beware" message. Everyone thinks about the exotic culture and glorious alpine scenery from such a trip but not about the discomforts of living three weeks in an environment with no transportation (except your own two feet), limited communications, bare bones accommodations (camping or lodges -- indoor camping for the most part), cold weather, poor food and "hygiene challenges".

The two biggest health issues that we will face are the effects of high altitude and, how do I say this delicately, gastrointestinal "stability". A lot has been written in the Nepal travel guides about altitude sickness and how to deal with it. Some people are more susceptible to altitude sickness and more extreme altitude problems than others. It's difficult to predict who might be affected. It really doesn't matter how young or old you are or even how physically fit you may be. Marathoners are not immune. It's all a matter of how your body will adapt to the thinner oxygen levels as you go higher.

When you fly in a plane, the cabins are pressurize at about 10,000 feet. For our trip, the trek begins at Lukla at 9,400 feet and goes up to 17,600 feet at Everest Base Camp (we take a quick side trip up to the Kala Pattar peak at 18,200 feet). Of course, the people who climb Mt. Everest start at Base Camp and go up another 11,400 feet to 29,000. To them Base Camp is oxygen-rich and where they come to rest and recover!

The standard method for preventing or minimizing altitude sickness (headaches, nausea, difficulty sleeping) is to limit the the amount of altitude gained each day and to build in rest days to acclimatize to the higher altitudes. You can take drugs (Diamox) as a preventative measure but there are side effects. If you get altitude sickness, you have to take extra acclimatization days or, in severe cases, go back down to a more comfortable altitude until the symptoms subside. The body will eventually adjust to the thinner oxygen levels; it might just take a little longer for some individuals. I have a prescription for Diamox but I'm not sure yet whether I will use it.

The second, very common affliction for many trekkers are the various gastrointestinal distresses. Things we take for granted in the West -- clean water supply, toilets and sanitary systems, hygienic food preparation practices, quick access to medical care -- are limited to non-existent when you get into the mountain regions. Of course, where you have primitive sanitation, the likelihood of illnesses through contaminated food and water is quite high. Lonely Planet has several pages on these problems and issues. (I never knew there were so many types of diarrhea -- viral, bacterial, protozoal. It's all the same to me!) The probability is that you'll get something at some point during the trek. You just need to be prepared for a few days of discomfort (and misery).

So why is it again that we're going?

Good question. For me, a big part is just facing the physical, mental and emotional challenges of being in such a different and foreign environment. I've done marathons, ultras and mountain trail races which I think are more of a mental than physical challenge. But can I do this with the environmental and cultural issues thrown in on top? Can I handle it? How will I react?

It's a risk-reward thing, as well. This will be one hellava experience if we can pull it off!