Diamox...or Hashish?

Diamox is a drug that is highly recommended for high altitude sickness, caused by a lack of oxygen. Initially diamox was used to treat glaucoma, an affliction of the eyes. What diamox does is squeeze out water from the blood, which is passed out as urine so that you're left with a thick, hemoglobin-rich solution. Since hemoglobin carries the necessary oxygen to the cells of the body, at high altitudes, where oxygen is severely limited (because of lack of atmospheric pressure), diamox helps to maintain an oxygen-rich supply to the body's cells. However, there seems to dissenting opinion on diamox use.

That German geneticist I met in Namche said she would never recommend taking it. If, for example, one had circulatory system problems, or a history of heart problems, taking diamox might cause coronary thrombosis (heart attack) because the blood is thickened.

So, although us in North America swear by its use, those in continental Europe are a little dour about using diamox as a prophylactic.

I took diamox twice--once en route to Cherko Ri (5,035 m, 16,514 ft) in Langtang, and then again en route to Lobuche (4,900 m, 16,072ft) in the Everest Region.

In Langtang I didn't notice the effects of diamox, but in Lobuche, I had a horrible night. It might have had to do with the pea-sized windowless cell I stayed in, plus the freezing cold (-5c) and then again it was dark, moonless night, so going outside didn't help at all.

Diamox sure makes you pee-- I passed about 2 litres of urine in a 4 hour span, and that made me feel thirsty. It's almost impossible to sleep when you have to pee, are thirsty, and freezing... and then this lack of oxygen problem. When I relaxed enough to try to sleep, my breathing rate would drop, and in a few seconds I found myself gasping for air, as if there was a large rock compressing my chest so I couldn't breathe. Then there are the notorious high-altitide mindscapes-- for some reason, thoughts and dreams can take on grotesque forms, and you watch them take place, but you can't stop them. I had a feeling I was trapped forever in a little box under the ground, and life would be lived in this manner until I eventually died. What a way to go. No amount of meditative concentration would allow this thought to escape my consciousness, and irrationale fear grew more and more as the hours ticked away. Since I retired about 8 pm (being in the mountains one tends to retire very early and wake up before dawn) every hour was a semi-conscious nightmare of dying a slow death, unable to breathe, in a box, and any other thoughts I tried to cull together just wouldn't come up. I tried thinking of sex, friends, warm places, happy memories, baseball-- but nothing would release me from the feeling of a rock compressing my lungs and I was suffocating.

Counting each minute until dawn, I was so relieved at 4:45 am when I got up, packed my gear, and started walking to Gorak Shep, the very last outpost before Everest Base Camp (5,300m, 17,384 ft) and Kala Pattar (5,600m, 18,368 ft).

It's hard to imagine what it's like up in high altitudes--those that have been there know this feeling--the littlest exertion, and you are breathless. Each step requires a deep breath, as if you just finished running 100 m very fast. You can easily burn 10,000 calories a day, just walking and breathing, and so it's a real workout at high altitude.

I like to walk alone at my own pace, which tends to be pretty fast. I made Gorak Shep, a recommended two and a half hour trek, in about an hour. Once all the diamox was out of my system, I felt great-- no headache, no problem breathing (other than gasping at each breath, which is natural), and no bad thoughts. Having been imprinted on a sleepless night at altitude, I feared another horrible night at Gorak Shep.

An organized trekking group I met en route finally made it to Gorak Shep a few hours after I arrived. There were a few Canadians, Europeans, and Americans in their party. I took to the two guys from Dallas, young yahoos who were on a round-the-world trip, this being but one of the many stops on their way. They had already done Thailand, Laos, and Cambodia, and were cool guys. One guy had some blonde, pollen-like hashish and a pipe with him. Since I didn't want to take diamox anymore, I thought I'd join him in a bowl. I didn't feel too wired after a bowl or two, rather very relaxed and my breathing became deep and refreshed. One thing I noticed was the smell of the high Khumbu. This is high above the trees, the landscape is more like Mars or the Moon, with no plant life except for some varieties of brownish moss. But the smell! The air was clean and fresh--like a forest. As I focused on the air and the smell of the moss, I felt very clear-headed.

That afternoon the two Dallas boys, their treking group, and I headed for the Everest Base Camp. It was tricky walking on the Khumbu glacier...this is not solid and it moves and flows constantly, so you have to be careful about where you step. It looks like sandy ground, but just under the surface it's ice, and can be dangerous should you slip. The hash made it possible to concentrate, breathing was deep and good smelling, and we arrived after a tough two hour walk to what seemed to be a circus.

There were about 20 camps of tents waiting to summit Everest this year. Some people said there were 39 groups, but I didn't count more than 20. All together, there were about 600 people camping on the Khumbu Glacier, waiting for the window of opportunity to climb the treacherous, crevassed-face of the Khumbu and onto the Western Cwm, up Lhotse Shar, the South Col, onto the Hillary Step and finally the top, some 2,500m (8,200ft) higher than where we stood.

I was told there would be a massive rubbish pile that first greets you at Base Camp, but I didn't see any trash...they must have been working on removing it this year. There were all sorts of colored tents, boxes, flags, and booths...there even was an Internet cyber cafe--at a buck a minute, it was a novelty more than anything else.

A half hour after reaching Base Camp, the weather started to change for the worse. We saw the clouds rolling up the valley and knew it was time to head back before we got stuck there. The weather changes rather quickly up there, and then the winds began to pick up and it got very cold. A few short moments earlier, it was sunny and almost t-shirt temperature. Now it was near freezing, dark, and windy.

We made it back in a swirl of snow, but made it back safely. At the lodge, we ate massive quantities of food--recall one can burn 10,000 calories a day--mostly fried noodles, soups and fantastic french fries (high country potatoes are small and sweet--delicious).

That night (bedtime was 7 pm) I had a dreamless, perfect sleep. I awoke at 5 am, got out of my sleeping bag and dressed. I headed up to Kala Pattar, the peak from which you get the best views of Everest (best views for such close proximity--some argue the further west Gokyo Lakes are another great vantage point). The estimated time to climb Kala Pattar is 2 hours. The record ascent is 34 minutes. I made it up in a respectable 55 minutes, and was the first person April 30, 2003, to summit Kala Pattar and admire the vista. It was a perfect morning, a few clouds, that constant stream of clouds and snow blowing off to one side of the Everest peak, and spectacular views of Pumori, Lhotse, the South Col, Nuptse, and further afield the magnificent Ama Dablam.

I took time to reflect a bit at the top, meditate a moment, send metta to all beings, and started down.

Mission accomplished!

It took 8 days to walk up along the Dudh Khosi river to the Khumbu, but it took me only 3 days to walk back--through some real bad weather--freezing cold and snowy.

I got to Lukla and arranged my flight out. The next morning I took off and in 35 minutes was back in the tropical heat of Kathmandu, with all the shops and restaurants to indulge in.

While it is essential to acclimatize to altitude, that is, you need to walk slowly enough in the mountains to ensure your body gets used to the lack of pressure and oxygen at your own body's rate, one thing is for sure--next time I trek at altitude, I'm bringing a nice stash of pollen-like hash with me, and leaving the diamox behind ;-)