I woke up with the bed spins… like I drank too much (just to clarify, I haven’t had a drop of alcohol since February). Since today was to be pretty short, I thought I could push through it, but a half hour into packing up, Galzn came to my room, and I promptly threw up the water I had drunk that morning. Interestingly enough, my dinner didn’t come up, so it was digested.
I lay back down. It got worse. At some point, I called a doctor in the US. He said that my symptoms resemble positional vertigo and gave me some head exercises to try to relieve it. I did the exercises at least three times. It got worse. No position seemed to provide any relief. The only drugs I took, on the recommendation of the doc, were Zofran and Valium. Next morning, at first light, I knew I was in trouble. I couldn’t functionally move. I was convulsing and dry heaving pretty regularly at this point. I felt like I was dying. I called for a helicopter.
I’m going to guess that the Heli arrived around 8 AM-ish. Galzn packed my stuff up and dressed me and put on my shoes. I was carried to the heliport about 200 feet away. I was dry heaving as the Heli landed about 6 feet from me. I flew down to Lukla with my eyes closed.
Since I’m writing this a week later, I’m going to go off on a tangent here: As a former NY State EMT, and current WFR, we’re regularly trained in the use of supplemental oxygen as a literal lifesaving drug to be administered to the injured. Now, since I was an EMT in college, I couldn’t resist cracking the O2 and taking a hit. I am human, after all. Well, if you’re wondering, taking a hit of oxygen when you’re healthy does nothing at all… you don’t even notice it… And if you think about it, this is perhaps a really, really, really good thing, as it means that when that ambulance arrives, those oxygen bottles will all be full.
Now flashback to January 2011. I’ve just broken my leg skiing out of bounds at the Jacksonhole Mountain Resort. It’s a bad break. I’m know that I’m in shock because my hands are bone white. A ski patroller arrives, one who had a locker right next to mine. He didn’t chat me up. He didn’t ask me what my chief complaint was. He just said “hi Tom, I’m going to put some oxygen on you”. I must have looked like I needed it. When he did, I could feel my level of consciousness rise… almost immediately. After all my first aid training… after all the talk about taking supplemental O2, I got to experience it myself, and it turns out, supplemental O2 works.
When I landed in Lukla, at 9000’ above sea level, 5500’ lower than Gokyo, I could feel my level of consciousness rise. It was the exact same sensation.
I still convulsed heavily on the tarmac when I got out of the helicopter in Kathmandu. And I made quite the entrance at the emergency room at the CIWEC hospital (basically a medical clinic for westerners in Kathmandu). They sent whatever involuntarily came up out of my stomach to the lab, and sent me to get an MRI. I spent the first night in ICU, and then moved to a regular hospital bed. I saw every doc on staff, plus maybe a few more. It was hard to keep track. They all wore masks. They all wore nametags, but not in an alphabet that I can read. Mostly, they all asked me the same questions.
My violent symptoms went away very quickly. I don’t think I dry heaved again after my entrance. The spins and nausea went away quickly. I can’t give you a timeline on that because it’s just too much of a blur, but maybe a couple of hours????? I know that when they took me for the MRI, they tried to seat me in a wheelchair and that didn’t work, so they put me back in a gurney.
An ENT (Ear Nose + Throat) surgeon came by and twisted and threw my head around… nothing. Whatever was triggering my vertigo up in Gokyo had gone away within 24 hours.
Two days later I was released from the hospital. I could have stayed longer, but I wasn’t really sick anymore. I’ve spent the last week at the Yak and Yeti Hotel.
So, how do I feel now? Do I feel healthy? The answer is no. I’m not a pot smoker, but what I feel at this moment – a week later – is comparable to having smoked some pot, and the high is coming down, and you just want to sleep it off. In this case, sleeping doesn’t make it go away. When I walk the streets I feel like I have mild tunnel vision, and I feel slow. And worst of all my appetite hasn’t come back yet. If I have to feel stoned, at least make the pizza taste good. It doesn’t.
Something happened to my brain up there. I don’t know what it is. My symptoms don’t fit any classic altitude illness. With each passing day, it is getting better, but my day to day progress has slowed. I have had some very experienced doctors discuss what I have. There is no consensus. The MRI shows a “micro-haemorrhage in the left centrum semiovale”, which could be a sign of HACE, but I don’t have any of the other classical signs or symptoms of HACE. If it is HACE, it’s a one in a million case. Am I that special?
Let me just say that the diagnosis isn’t over yet. I’ll send the MRI pictures around when I get home. As previously mentioned, I’ve had some of the most experienced high altitude doctors look at my case. Nobody really knows what’s going on.
Can I go back up? If I felt fine, then it’s a fair question. A lot of people come down with HAPE (which is a different altitude illness altogether) and spend a week or two in Kathmandu, and then successfully go back up when all the symptoms have gone away. When it affects the brain, people get more cautious. HACE is much rarer, and has historically been viewed as more serious. Some would say that if I actually had HACE, that I shouldn’t go back to that altitude ever again…. But as I write this I’m hearing doctors yell at the page: “you did not have HACE!!!!” More on that perhaps in a future post. For now, I’m getting ahead of myself. Back to the question at hand…
Can I go back up? If I felt fine…. Perhaps yes. Unfortunately, I don’t feel fine. Something happened inside my noggin. Today I finally accepted the fact that I can’t go back up… not this week. Not this month. I like my brain. I have to let it heal.
Jiban, the owner/operator of the trekking company I’ve been using, was there in the Emergency room when I arrived and I think I made quite the impression on him. He’s not a doctor, but he candidly told me a few days later that it’s time for me to think about things other than Everest. I don’t know if he would fly me back to the Khumbu even if I threw a wad of cash at him. What he saw spooked him. I was sick. I was really sick. Maybe it’s time to go home and count my blessings.
Obviously, there’s a lot more going on inside my thoughts than I’m revealing in this post. Forgive me but I’m not mentally ready to confront the disappointment of it all… not yet at least. So, from Kathmandu, I’m going to sign off for today. Thank you all for supporting me on this all too short of an adventure. Cheers.
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