Musing's of a Gardener: 2018

Introduction

In November of 2018 my eldest son and I undertook the Three Passes trek in Nepal that included a side trip to Everest Base Camp (EBC), which I intended writing up, one day! I found it very useful to read other people’s accounts of their treks to ensure we were dressed correctly and carried the right equipment – so I hope this might help others. This account is a very short – I intend to publish more technical details and some anecdotes.

An outline of our itinerary is shown below.

We went with World Expeditions on a fully organised trek. There are other ways of doing it; including hiring a guide and porter at Lukla and trekking from tea house to tea house, noting we spent three days in the wilderness without access to tea house facilities. Many trek to EBC this way – being a well-worn track from Lukla, but expect very high tourist numbers in October immediately after the monsoon season – tea houses can be very crowded.

Outline of the trek

The trek consisted of trekking from Lukla to Namche Bazaar then in a counter clockwise direction some 100 km to cross three passes and to climb two peaks.

Passes:
Kongma La (5,535 m)
Cho La (5,380 m)
Renjo La (5,388 m)

Peaks
Kala Pattar (5,545 m)
Gokyo Ri (5,483 m)

The trek commenced in Lukla, which is the gateway to the Everest region of the Himalayas – the Khumbu region - which we flew into on a clear and still morning, arriving at the Tenzing-Hillary Airport just before 8 am.
Get to Kathmandu Air Port early – we arrived soon after 4 am! The scenes are chaotic – all baggage needs to be x-rayed and weighed, however, the latter process was done with such hast, there is little doubt the planes can be easily overloaded. Being in an organised group (of 9) made life easier as the guide knew exactly what to do.

Be warned: the maximum weight is 15 kg total, as of 2017, which does not appear to count clothes carried over the arm and cameras around your neck. I also put on my heavy down-coat as it weighted 1.5 kg, and my son took his camera gear on his shoulder.

We then trekked very slowly over two days to Namche Bazaar, for a rest day for the guides – it’s not a rest day for trekkers, but rather one for acclimatization – we climbed the hill behind Namche Bazaar (3800 m), hoping to get a glimpse of Everest, but cloud prevented this.
The guides ensure we walked very slowly and we remained hydrated: both very important in preventing altitude sickness. Thus the walk was as slow as 1 km/hr whereas we walked 5 km/hr or more on the return trip.

Day	Activity
Tour day 0	Adelaide to Singapore
Tour day 1	Singapore to Kathmandu: Hotel Radisson
Tour day 2	Rest day in Kathmandu - own time
Tour day 3	Cultural day: Hindu and Buddhist religions
Tour day 4; trek day 1	Fly Lukla (2800m) Trek to Ghat (2530m) walk ~2 hrs
Tour day 5; trek day 2	To Monjo (2850m) walk ~4-5 hrs
Tour day 6; trek day 3	To Namche Bazaar (3440m) walk ~4-5 hrs
Tour day 7; trek day 4	Acclimatisation day Namche Bazaar – climb
Tour day 8; trek day 5	To Deboche (3770m) walk ~6-7 hrs
Tour day 9; trek day 6	To Dingboche (4360m) walk ~6-7 hrs
Tour day 10; trek day 7	Acclimatisation day Dingboche
Tour day 11; trek day 8	To Base Of Kongma La (4800m)
Tour day 12; trek day 9	Cross Kongma La (5500m) to Lobuche (4930m) walk ~7-8 Hours
Tour day 13; trek day 10	To Everest Base Camp (5350m) and trek to Gorak Shep (5288m) ~7-9 hrs
Tour day 14; trek day 11	To Gorak Shep (5288m) and Kala Patthar (5545m) walk ~7 hrs and Trek to Lobuche (4930m)
Tour day 15; trek day 12	To Dzongla (4843m) walk ~5–6 hrs
Tour day 16; trek day 13	Cross Cho La (5420m) and Trek to Thagnak walk ~5-6 hrs
Tour day 17; trek day 14	To Gokyo (4800m) walk ~2 hrs
Tour day 18; trek day 15	Ascend Gokyo Ri ( 5483m) & trek to Renjo La Base (5130m) walk 6–7 hrs
Tour day 19; trek day 16	Cross Renjo La (5400m) and trek to Taranga (4000m) walk ~6-7 hrs
Tour day 20; trek day 17	To Namche Bazaar (3440m) walk ~5-6 hrs
Tour day 21; trek day 18	To Lukla (2800m) walk ~8-9 hrs
Tour day 22; trek day 19	Fly to Kathmandu
Tour day 23,24; trek day 20	Kathmandu to Singapore to Adelaide

Altitude climbed during treck - note that heights listed are approximate
as various sources provide differing heights

From Namche Bazaar we trekked north west to Dingboche then swung around to the north east to cross the Kongma La (5535). This was the most difficult pass to climb – our acclimatisation was incomplete and we were not as fit as laBe warned: the maximum weight is 15 kg total, as of 2017, which does not appear to count clothes carried over the arm and cameras around your neck. I also put on my heavy down-coat as it weighted 1.5 kg, and my son took his camera gear on his shoulder.ter in the trek. It was also cold due to wind and we had a little rain.

From there we crossed the Khumbu Glacier (with fear and trepidation – as it is in constant motion, and the track had been washed out a few days before), and walked to Lobuche, then onto Everest Base Camp to return to Gorak Shep. Kala Patthar is immediately north of Gorak Shep which we climbed. My son was very unwell with a cold and sun burn – chest infections kill and need to be avoided at all costs! He did climb Kala Patthar using sheer determination and walking very slowly – much to his credit. From Lobuche we crossed the Chola La, climbed Gokyo Ri then crossed the Renjo La. From that point it was downhill (mostly) all the way home (Lukla, Kathmandu, Singapore, Adelaide) taking five days. In the latter days snow had dusted all the peaks, making down-hill climbing treacherous.

Overall the trek was incredibly fulfilling, full of challenges – all surmountable. The mountains were extremely beautiful and serene. For example seeing Ama Dablam (6170 m) in the ‘flesh’ was awe-inspiring – it is a mountaineer’s mountain. All the mountains were majestic, and being from a country of low hills and vast plains, seeing these huge peaks puts in perspective the reality of the Himalaya Mountains, which I had read about since a young boy. Nepal is an improvised country – the people of the Khumu region valley were the poor of the poor – seeing these people made me realize the unspeakable richness in which I live and the things I take for granted – potable water, sewerage, schools and medical facilities.

Approximate places of interest - a photograph of a sign near Namche Bazaar

Fitness

I was as fit as I had been for decades – being the oldest member of the group in my late fifties. From March until I left on 19th September I had undertaken a serious and comprehensive training program – to lose weight and to improve cardiac fitness. I recommend anyone doing this trip to do so also – either get a fitness trainer, join a club or do it yourself. I choose to do it myself, having been a runner for much of my life, with professional input from my physiotherapist.

The journey started with getting fit enough to jog, as I was very unfit, although I had started walking four days a week, two weeks prior to deciding to go on the trip. Once fit and able to jog 5 km I included high intensity workouts – usually 100 m sprints, multiple times over a 7.5 km jog. On week-ends I usually ran 10 – 15 km, and in the last 8 weeks carrying 8 -12 kg. Also to wear in my boots which were new – I purchased these in May - I did up 15-20 km walks with a pack about weekly, usually on steep gradients. The boots were well worn in and very comfortable – I only had one blister – on the very first day I wore them, from sand in my sox.

When weather prevented running, I used a gym bike to ride for an hour or so, usually with high intensity periods interspersed with peddling against inertia. I did some weights but I bore easily doing these, so my arms were not as fit as they should have been – you need fit arms to use walking poles effectively, but this was attained before the hard climbs.

I strongly recommend getting fit. Leg fitness is required, especially for climbing down the endless boulders – the knees and ankles need to be protected – and fitness helps. My son did have knee issues, but found a brace in Nambe Bazaar that seemed to work. Getting one fitted in your home country by a professional, however, would be the preferred choice.
The weakest member of the group had done little training and found it very hard to do the climbs, although she managed all the tasks. She, being in her fifties also suffered from knee issues including pain.
Walking poles is a must for everyone – especially anyone with knee issues. They help when walking up hill and can add 0.5 km/hr to the pace, but more importantly help in weight bearing when descending a mountain.

Acetazolamide

Great mystery surrounds the use of acetazolamide (Diamox ™), and while I was in Kathmandu heard of people commencing this drug on the way from their country to Nepal, yet the pharmacology of the drug indicates one only need to dose immediately prior to when is needed (or perhaps a day prior)!
As I health professional I decided upon not taking acetazolamide until I needed it – and this never eventuated. This was based on the following:

I was fit both physically and medically.
High altitude sickness at the altitude I was going (<6000 m) is recognisable and treatable if the signs and symptoms are acted upon immediately
Acetazolamide starts to work immediately – noting that reaching the pharmacological steady- state obviously takes time.
Listening to experienced medical professions who had worked and trekked at high altitude, including at >7500 m, gave me confidence in this advice.
The trek commenced very slowly and we were all very aware of hydration and the signs and symptoms of altitude sickness.
We were with an experienced head guide who understood the signs and symptoms of attitude sickness, and the course of action to take.

Acclimatisation is accomplished physiologically by a complex, and not yet fully understood, set of changes to the person’s body as it adapts to low oxygen. I will not dwell on this here – read a professional medical text on the subject to find out more about it – don’t merely Google it as the information is sure to be wrong! I will say this: importantly two things need to happen – the oxygen carrying capacity of the body needs to improve – this is accomplished by increasing the number for red cells in the blood stream –which takes at least 10 days to commence, and the body needs to re-set its chemical triggers to recognised low carbon dioxide in the blood. The latter was demonstrated while climbing Kala Patthar when my heart rate rarely exceeded 60 bpm, which was totally inadequate, although my respiratory rate was very high – mostly due to the low carbon dioxide level in my blood. This occurred because my lungs were efficient in removing CO₂ with only 50% in the air compared with sea level, and my rapid respiration rate which blew off the CO₂, thus my heart seemed to think it did not need to beat faster.

Two people on the trip took acetazolamide, until acclimatised, and no-one suffered altitude sickness of any kind. One lady in her fifties did take acetazolamide for part of the trip, due to headaches in the early days, indicating altitude sickness could be occurring, as did the youngest member of the group who could not differentiate migraine from altitude sickness, which commences with headache and nausea – thus he took acetazolamide so this differentiation would not be required.

Our guides were very good and understood the need to rehydrate when on acetazolamide and ensured both group members drunk at least 5 litres a day. Ladies – this necessitates learning how to urinate behind a small rock that barely hides your modesty without freezing – although in reality there usually were rocks the size of cars to hide behind and group members were very considerate (we had 4 women and 5 men). We all had to deal with toileting in the open – a challenge initially for those who had done little bush walking.

Health

I suffered no real health issues, however, two in the group caught very bad colds. Respiratory illness can put an end to a trek and needs to be avoided. Use plenty of alcoholic hand rub, especially while flying – every seat-back down an isle of a long-haul plane will be contaminated with bugs – which can affect the gut or the lung!

Sun burn did occur on those that did not apply 30+ (50+ is better) to EVERY exposed bit of skin including nose, fingers and hands - including the triangle between thumb and first finger – exposed if using walking poles without gloves (I used cycle gloves unless too cold).

Sleeping was a big issue for me – I had a lot of trouble getting to sleep although once asleep usually slept 3-4 hours. I did take a dose of diazepam one night due to muscle spasms, which did not return; however use of these tranquilizers are not recommended.

By son and I did find that taking oral-rehydration tables (we used Hydrate™) with water as per instructions did help with muscle cramp at night – caused perhaps by electrolyte imbalance after sweating all day, and every day, for three weeks.

We all had headaches and muscle soreness from time to time, probably more from dehydration than altitude and we used a lot of paracetamol (acetaminophen) and ibuprofen. The Nepalese know this – it was more expensive to purchase paracetamol than antibiotics such as amoxicillin in Namche Bazaar!

Weather

We arrived on the supposedly the last day of the monsoon season, which did not really finish until two weeks after we had completed the trek. This meant we had beautiful clear mornings from before sun up until about 9 am, when the mist would roll up the valleys, with many days ending in light mist or snow. This meant we did not get good views of the mountains from late mornings onwards.

Cold

I over estimated how cold it was going to be, and under estimated how warm the first week of trekking was going to be – and took too many thermal wear and insufficient temperate weather day-wear. I could have done with an extra trekking long-sleeved shirt (take long sleeved, as the UV will burn you in less than an hour’s exposure at midday including the fingers!) swapping with both a long-john and under-shirt thermal wear.

We only wore the entire cold weather kit two or three times – once when impacted by wind, and twice when it snowed, but in no cases did anyone suffer from the cold, even at night. On freezing nights I tended to sleep in thermal wear plus beanie (merino and possum hair from NZ), but often got too hot (I also used a silk inner liner to the sleeping bag).

Rain, snow & wind

We did little trekking in either rain or snow – this mainly fell at night, and we only had wind that bother us on one day – and in this case I put on my outer shell which was sufficient to prevent wind chill.

Trek organisation

World Expeditions did an excellent job in organising the trip. The guides were well trained and very profession. Language generally was not an issue although some porters and cooks understood little English. They knew the route and most had done it multiple times before.
Fitting into a small group such as ours could have been problematic – nine people, if chafing against each other can cause grief for the chief guide. Indeed, on the final speech of thanks to the guide (which I made) I mused on the professional way in which he conducted the trek and how smoothly it had run. And he responded saying that the hardest groups to deal with were those where intra-group conflicts arose, of which we had none. We did meet one group at Namche Bazaar, where it appeared the group had split into two due to conflict.

Things done well

Fitness: training from mid-March through to September, leaving Australia on the 19^th, was well worth it (usually 6 out of 7 days per week). I returned as fit as I was some 20 years younger (and 10 kg lighter!), and did a personal best on a track I had never before had been able to run the entire distance due to the steepness. I must add here – my haematocrit would have been much higher than at any other time in my life, thus my oxygen carrying capacity gave me an advantage I had hitherto not ever had, had!

Choosing a totally catered trek – there was no need to find competent porters or guides (there is no sound system to determine whether a guide you hire at the airport is competent – some have only done the trek once themselves.) The guilds ensured we walked slowly in the first days and were always well hydrated – which I believe prevented any group member developing altitude sickness.
The added advantage is the cooking is done in a manner which avoids food poisoning – we had no bug induced diarrheal disease, although diet change did cause a few days of loose stools. All water in Nepal must be considered contaminated with faecal matter, along with all vegetables. Everything needs to be boiled or cooked. This meant we drank cordial made with boil water – which is quite nice at 5000 m and when its -2°C! They also sourced the food – with potatoes forming the major carbohydrate source (Nepalese also eat rice, but potatoes were in season). Protein was in short supply for the entire trip – although we had both vegetable and animal proteins, but no large steaks!
The showers at Namche Bazaar were fantastic – but don’t expect to shower more than 2 or 3 times for the entire trip!