Asia

Bhaktapur temple in Nepal

grey Bhaktapur temple in NepalWith all our shopping done Bish and I were driving to visit a major tourist attraction near Kathmandu called Bhaktupur in the Kathmandu Valley. I should properly introduce Bish, because we are spending the next 40 days in close proximity he will pop up again. Bish, (Andrew Bishop) and I went to University together, in that we spent a year at the same residential college along with 200 other horny, drunk university students. He has a warped sense of humour, one ‘must-have’ item on extended high altitude sufferings. Bish is a geologist who describes himself as a bipolar.

 

grey Bhaktapur temple in NepalHe takes tours at both the arctic and the antarctic where he explains the geology of the regions to camera toting guests, while stopping them from kicking Penguins. As I alluded to in my last post, Bish is a big guy. At 6 foot 4, he wears size 50 boots that have to be ordered specially and he looks ridiculous folded into the back of a Suzuki swift Thamel-taxi.

Our driver Arnil was happily chatting away while swopping in and around trucks, motorbikes buzzed around our little Suzuki swift like flies. Bish and I were hanging out the window giggling like little school girls and filming the chaos of Nepali traffic.

Pulling into the car park outside Bhaktapur Arnil introduced us to his ‘friend’ Robbie who fortuitously also happened to be a tour guide. I remember this trick from my 2010 visit here. Without much ado, grey Bhaktapur temple in Nepalwe thought ‘bugger it, when in Rome…’ Robbie gave us a wonderful 3 hour tour of Bhaktupur, explaining the significance of each temple and so forth. $5 aus saved us having to refer to Lonely Planet all day and provided us with a very thorough tour.

Bhaktapur is overrun with 300 year old temples covered in exquisitely detailed wood carvings all around the outside which hardly show their age. Clearly our favorite temple was the fertility temple which is covered in erotic carvings which would make Hugh Heffner blush.

grey Bhaktapur temple in NepalDespite the slightly pushy marketers, Bhaktapur is quite an amazing place. Robbie is a local to Bhaktapur as is his father and his father’s father. Taking us away from the  touristy part of town we saw locals drying their chick peas and beans on woven mats in the street. They have shady rest areas where people come to hang out, enjoy the quiet and share a game of cards. I was invited by a potter to try my hand on his wheel, literally a car wheel spun by hand, after attracting the attention of many fellow tourists I managed to make a little bowl which resembled a dropped pie.

Following this, Robbie took us to an art school. The paintings here are so detailed that most are done with one hair brushes. They mainly depict Buddha’s life and Samsara – the road map of reincarnation. Bish was quite taken by one particular painting and, following some half-assed bartering, he is now the proud owner of an authentic student-painted Samsara painting. These paintings are special, it takes between 3 and 30 months to complete one, from the detail in the paintings, you would believe it. The masters use actual melted gold in their painting and one mistake ruins the whole thing, start again!

Leaving Bhaktupur we struck out for the Monkey Temple, a tall Buddhist temple perched in the smog on a hill overlooking the Kathmandu Valley. The Monkey temple, in itself would be quite spectacular if you removed all the touts and the tourists sticking their big lenses in the Monk’s faces. Monkeys bounce from Stupa to Pagoda while orange-robed Buddhist monks bang gongs, or just sit and enjoy the view. We didn’t spend long here, just enough to enjoy the view, get sick of touts and become fearful of a rabid monkey attack. Tomorrow we are planning to spend our last free day visiting Boudhna and the cremation place. After this we will be out of civilization, away from showers, non-solar electricity and touts for forty days…and I cannot wait!

grey Bhaktapur temple in Nepal grey Bhaktapur temple in Nepal
grey Bhaktapur temple in Nepal grey Bhaktapur temple in Nepal
grey Bhaktapur temple in Nepal grey Bhaktapur temple in Nepal

Equipment for Mountaineering

grey Equipment for Mountaineering

Mountaineering gear

 

Recently I have been insanely busy with organising my book launch. Stupidly I have arranged it to be held a mere week after I return from Nepal. The last time I returned from an extended climb I spent one and a half months huddled in a corner of my Danish writing lair rocking backwards and forwards, being spoon fed energy rich food by my gorgeous (now) wifie and watching day time television… yup, those motivational poster photos come at a cost! (Note: I may have exaggerated a bit there…I mainly rocked forwards).

Anyway, so I have not gotten around to packing until last Sunday, which was a rainy day. I got a Skype message from Mal saying that, as I am arriving early, I will have to send my gear to Lukla ahead of the expedition. This sent me into a flurry of opening storage boxes, rifling through my outdoor gear, and trying not to dwell on how much money I have spent over the years on this stuff.

To give you an idea of the logistics involved in climbing, here is a quick summary of what’s going to happen with my gear:

  1. Arrive in Kathmandu
  2. Buy more gear and pack it into three different bags (Trekking&Kathmandu, Climbing Ama Dablam-more technical gear-and Climbing other mountains)
  3. I send my climbing Ama Dablam and climbing other gear to Lukla where someone (?) will look after it until we arrive.
  4. We fly to Lukla
  5. Climbing Ama Dablam gear is tied to a yak and sent up one valley to Ama Dablam base camp.
  6. Climbing other gear is tied to another yak who will follow us as we climb Mera Peak, Island peak, and then abseil down the Amphu Labsta pass towards Ama Dablam BASE camp (as they don’t have opposable thumbs, Yaks cannot abseil, he will have to go the long way!)
  7. Have a teary reunion with our Ama Dablam technical climbing gear.
  8. Climb Ama Dablam
  9. Have a cup of tea and a shower.
  10. Second teary reunion with wife in Australia grey Equipment for Mountaineering

I dusted off my packing list from Manaslu, made some adjustments, and came up with this comprehensive gear list for climbing Ama Dablam :

grey Equipment for Mountaineering

Mountaineering gear

Ben Gear List: 

Climbing:

  • La Sportiva Spantik boots
  • Crampons
  • Orange helmet
  • Harness (light)
  • Mitts
  • Ascender on short ropes
  • 2x Slings
  • 4x Prussic loops
  • Figure eight
  • Locking carabiner x3
  • Snap link Carabiners x3
  • Goggles
  • Socks – thick wool x2
  • Fleece balaclava
  • polyprop balaclava
  • Nalgene bottle (yellow-pee)
  • Nalgene bottle (clear – drink)
  • Toothbrush!
  • Petzal Reverso Belay Device.

Sleeping:

  • Therma-rest Pro-light
  • Therma-rest neo light (basecamp)
  • Sherpa brand 4 seasons sleeping bag
  • Sherpa brand 3 seasons sleeping bag
  • Polyprop liner (reactor)

Trekking (+/- climbing):

  • Big rucksack (Red!)
  • Gor-tec jacket
  • Waterproof pants (light)
  • Bib and brace pants (gor-tec)
  • Soft shell jacket
  • Primaloft jacket
  • Trekking shorts
  • Trekking shirt – quick drying
  • T-shirt or 2
  • Merino legs (200 and light)
  • Fleece pants
  • Softshell pants
  • Fleece Beanie
  • Gloves – Polyprop contact x 2
  • Sunglasses
  • Sun hat
  • Sunscreen
  • Head torch
  • Waterproof liner for rucksack
  • Merino underpants x5
  • Toiletries
  • Swiss army knife
  • Para-cord
  • 3 mtrs of 4mm climbing rope
  • Trekking poles
  • Towel
  • Coupla stuff sacks

grey Equipment for Mountaineering

Misc:

We will have the option of both 12v and 240v on the trek and then using the same system at BC as Manaslu + goal zero system at AD BC

  • Pelican case
  • Camera (+charger)
  • Memory cards
  • Go-pro (+spare battery)
  • Steripen (+batteries)
  • Solar monkey (USB charger)
  • Music player + earphones
  • USB battery charger (AA + AAA)
  • SPOT (+batteries)
  • Cables
  • Mac-book
  • Leatherman tool (small)
  • First aid kit (basic)
  • Aquaseal
  • Duct tape (Or Mal bringing?)
  • Drugs (See below)

Drugs:

(As the token pharmacist I bring a lot of drugs)

  • Azithromycin 500mg x 2
  • Metronidazole 200mg x 21
  • Ciproflox 750mg x 14
  • Ciprofloxacin 500mg x 14
  • Paracetamol/codeine x 8
  • Amoxycillin875mg/Clav125mg x 10
  • Chlorpheniramine 2mg x 6
  • Diclofenac 25mg x 18
  • Diclofenac 50mg x 50
  • Ibuprofen 200mg x 14
  • Metoclopramine 10mg x 25
  • Temazepam 10mg 25
  • Cold and Flu, Day/night – 1 box 
  • Diamox x 90
  • Fucidin 2% Crm – 1 tube
  • Menthol foot powder
  • Clotrimazole crm
  • Throat lozenges
  • Gastrolyte
  • Alcohol hand wash

To buy:

Kathmandu:

  • Black diamond guide gloves from Shona’s like Mals
  • Ice ace
  • Venom Ice hammer
  • Lip balm
  • Sunscreen
  • Sleeping mat – foam
  • 6x Barrels for Mal
  • Poly-prop socks x3
  • Trekking, mid-warm socks x 5
  • Codeine (cough suppress)
  • Dexamethasone  (oral + intramuscular – AD kit)
  • Locking Carabiner x 1 more

Australia:

  • Batteries for steri-pen
  • Batteries for SPOT
  • Batteries for headlamp
  • Suduko book

Now, did you see how many electronic gadgets I am bringing? This is purely so that I can blog from the  wilds of Nepal, so, I would hugely appreciate any sharing, link-love or comments as we go.

 

grey Equipment for Mountaineering

 

 

 

 

 

Altitude sickness prevention

 

grey Altitude sickness preventionIt is really hard to put into words how extreme altitude affects you but I shall try: Imagine waking at 3am inside a refrigerator with the worst hangover of your life. Inside the fridge is a treadmill. Run on this for 12 hours straight…with a plastic bag over your head.

Some of my most vivid memories were formed inside a high altitude torture chamber; climbing Island Peak (my first Himalayan mountain), trekking the Inca Trail with my parents, trekking parts of the Andes with a donkey and finally returning to Nepal to climb Manaslu, all involved various degrees of altitudinal discomfort. Don’t be put off though, I am going back this October for some more high altitude suffering with some good friends so it can’t all be bad news…right? Dealing with altitude can be seen as just a regular part of adventuring at the really good places.

So why does altitude affect the normal functions of your body?

As altitude increases, atmospheric pressure drops, this means that less oxygen is delivered to your body with every gasped breath. After some time the body responds by producing more red blood cells (to transport the limited oxygen) in a process called acclimatisation. There are also some changes in how the body manages its fluid.

grey Altitude sickness preventionGeneral rules for altitude sickness prevention are as follows:

  1. Go up slowly. When above 3000 meters try not to sleep more than 300 meters higher than the previous night and take a rest day every 3 days, or for every vertical kilometre gained.
  2. Take planned acclimatisation walks. On a rest day climb about four to five hundred metres then descend and sleep at your original altitude. This shocks your body into making more red blood cells. It is a proven method and is how climbers can survive at extreme altitudes.
  3. Remember the old adage “climb high, sleep low” Don’t sleep on top of a high pass if there is a chance to sleep lower in a valley. It is the altitude you sleep at which tends to dictate your risk of altitude issues.
  4. Drink lots of fluids. One thing that many people don’t realise is that you will pee a lot at altitude, this combined with exertion and dry air sucking moisture out of your system can lead to dehydration. Maintaining good hydration levels helps the body to acclimatise.
  5. Be honest with yourself and your trekking partners. A niggling headache or slight nausea can be your body’s warning that AMS (Acute Mountain Sickness) is just around the corner. Rest and take it easy if you are feeling poorly.
  6. Have an altitude profile to plan your trek or climb (see image below). This will help you to plan your altitude gains and to factor in rest days at clever intervals.
  7. Drugs. Some people use them, some prefer not to. Diamox (Acetazolamide) is a diuretic drug which is commonly used to treat and prevent AMS. It is generally only used if a person is going straight from sea level to around 3000 meters or if someone is planning to climb (and sleep) at more than 600 meter altitude gains per day. This drug speeds up acclimatisation but takes a day or two for the full effect so is not super helpful in cases of acute AMS. A dose of 125mg once or twice daily is commonly used to aid acclimatisation, starting 3 days before going high. Higher doses are commonly used in cases of acute AMS. More detail can be found in the footnote*.

AMS has stages, almost everyone who visits areas at high altitude will suffer some or many symptoms, I sure haveplenty of times.    The most common symptoms include: Headache, breathlessness, insomnia, nausea and loss of appetite. Keeping a close, honest track of these is very important in monitoring and managing your acclimatisation. There is a great worksheet here which helps in tracking and monitoring progress of symptoms.

If in doubt, descend and don’t push yourself too hard.

Below is the altitude profile of a climb to extreme altitude. It shows a lot of up and down done to shock the system into acclimatising as well as possible. Most treks to high altitude have available altitude profiles where you can plan rest days, acclimatisation walks and see which days to watch closely with regards AMS risk.

grey Altitude sickness prevention

(Reproduced with permission from Mal Haskins @ Speedfly8000)

 

HAPE and HACE

Many of the serious health issues that occur at altitude stem from water’s nasty habit of shifting location as we go up in the world. At sea level much of the body’s fluid spends its time helping out in our circulatory system, moving red blood cells and nutrients about and flushing away toxins. This arrangement is rather agreeable for survival. At high altitude the water can go where it’s not wanted or needed. The fluid not being where it is meant to gives rise to the symptoms many trekkers suffer at altitude. If too much moves to the brain or lung cavity it can cause serious, often fatal, conditions such as HAPE (High Altitude Pulmonary (lung) Oedema), and HACE (High Altitude Cerebral (brain) Oedema). Yes, Australians spell Oedema differently to the rest of the world, deal with it! The mechanism is similar to how ankles can swell on long haul flights but much more serious.

Don’t cancel your adventure just yet though guys, HACE and HAPE rarely occur below 8000 metres and only ever kicks in after you body has given plenty of warning signs. It can occur much lower at altitudes as low as 3000 metres but usually this is due to a rushed or non-existant acclimatisation plan.

I will not go into details here on treatment of HAPE and HACE, treatment involves rapid descent if possible, Adrenaline, Dexmethasone and oxygen given by qualified physicians.

HAFE 

HAFE is another uncomfortable part of trekking at altitude. Gasses expand at decreasing pressure, this also happens in the bowels. This expansion, combined with a trekking diet commonly high in carbohydrates can lead to High Altitude Flatulent Extravaganzas. There is no cure for HAFE. It can be managed by walking separately from the group from time to time and by leaving the tent open a bit at night.

Sun Smart 

grey Altitude sickness prevention

Recent research has confirmed a long held belief that people get sunburn more readily at high altitudes. UV-B levels, the most damaging UV band, have been proven to be around 60% higher at 2500 meters than at sea level. Higher UV-B levels combined with snow reflecting the sun’s rays can lead to sunburn in some interesting places, like under the earlobes! I once ended up with a seriously sunburnt and swollen tongue after an extended climb at altitude. It happened after gasping with my mouth open for too long. I could hardly talk let alone eat properly and it was absolute agony. This is one experience I certainly do not want to repeat. It is crucial to cover up and regularly apply a high SPF (Sun Protection Factor) sunscreen while up high.

The dry air and harsh sun can lead to cracked lips so buy, and regularly use, a high SPF lip balm as well. I have a special top with a little pocket in the sleeve near my wrist which just fits a lip balm. Remember guys, it is not seen as dorky to use lip balm above altitudes of 2500 meters.

 

 

 

Above: The author being very sun smart after suffering a sun burnt tongue.

Altitude affects everyone differently. Some unfit people will spring along without an issue while some super-athletes can struggle at the slightest elevation. One person’s response to altitude can differ from trip to trip as well. Once I was in the Andes trekking at around 4500 meters and had to spend an excruciating 24 hours in my tent, curled in a foetal position with a pounding headache, nausea and no chance of descent; yet the next time I went high I got to 7000 meters before even getting a slight headache. The main rule is to be gentle with yourself and to descend if in doubt.

So, if you are smart, plan your height day by day and don’t push yourself too hard, you can have a healthy and most importantly fun time playing in the world’s high places.

Much more detailed information on this topic can be found here: Medex Book English Version and Guide to High altitude medicine

Thanks to Mal Haskins for his input into this post. Mal does loads of cool stuff in extremely high places. Check him out here: Vertical Resources 

———————————————————————————————————————————————————-

*Acetazolamide.

Action: This drug works by forcing the kidneys to excrete bicarbonate which leads to a slightly more acidic blood. Our bodies monitor levels of (the slightly acidic) Carbon Dioxide (CO2) by detecting the blood’s acidity. Making the blood more acidic fools the body into thinking that CO2 levels are higher than they actually are. This triggers an unconscious deeper and faster baseline breathing rate. By breathing deeper and faster more oxygen is taken in.

Acclimatisation: I eluded in the text above that a low dose of Acetazolamide can be used to aid acclimatisation. The normal dose is 125mg twice daily. This only speeds up normal acclimatisation processes, hence if acclimatising to a certain height normally takes 24-48 hours, Acetazolamide can reduce the time by 50%. Stopping the drug will not reverse acclimatisation, the rate will just return to pre-dose speeds. Being a diuretic or fluid pill Acetazolamide also ‘concentrates’ the blood, that is, less fluid in circulation means there are more oxygen carrying red blood cells in every millilitre of blood.

AMS While the mainstay of AMS treatment is rest and descent if possible, Acetazolamide can be used in higher doses to treat the condition. The dose is much higher than for prevention at 250mg every 4-6 hours. The diuretic effect reduces over the course of a few days (by which time you should be feeling comfortable again)

Cheyne Stokes Breathing: Gasping rapidly at altitude means the lungs are clearing CO2 faster than Oxygen is being taken in. As mentioned above, the body ‘listens’ to CO2 levels more closely than to oxygen levels when setting baseline respiration rate. Having the body clear CO2 so efficiently can lead to a drop in respiration rate to nil in some climbers during sleep (as the body reads a low CO2 level and assumes a relative high oxygen level). When the breathing stops during sleep a climber will wake up desperately gasping for air and rather upset about the while situation, not to mention tent-buddies waking to find a friend lying there peacefully not breathing! By artificially increasing respiration rate, a low (125mg) dose of Acetazolamide before sleep can counter this whole scenario.

Random fact: When you drink a carbonated soft drink whilst on Acetazolamide you can feel but not taste the bubbles (which are CO2 and acidic). I have no idea exactly why this is but guess it is due to the blood being more acidic, closer to the pH of the bubbles of CO2 and harder for the taste buds to pick up. It is a really, really weird sensation, try it if you get the chance!

grey Altitude sickness prevention

Insurance for Mountaineering – read the fine print!

grey Insurance for Mountaineering   read the fine print! grey Insurance for Mountaineering   read the fine print! grey Insurance for Mountaineering   read the fine print!
grey Insurance for Mountaineering   read the fine print! grey Insurance for Mountaineering   read the fine print!
grey Insurance for Mountaineering   read the fine print!

 

I’ll begin this story with a happy ending…I think I may have found a way to get mountaineering insurance coverage for my upcoming climb in Nepal.

In short, the only way I could arrange this is to get regular, everyday medical and travel insurance, then to fork out a sizeable sum to a second company that covers medical evacuation only. This is because every company I spoke with, and there were heaps, have exclusions on insurance for “mountaineering using specialist equipment.”

At first I thought I could do what I did last time and insure with BUPA, one package. But things have changed since 2011 when we climbed Manaslu. See the (somewhat farcical) conversation I had online with a rep below:

Please wait for a Customer Consultant to respond.

You are now chatting with ‘Jeanette Jacobsen’

Jeanette Jacobsen: Welcome to ihi Bupa live chat. How may I help you?

Ben: Hi there, I am mountaineering in Nepal this October-Nov. Do you cover this sport?

Jeanette Jacobsen: one moment please

Ben: No worries

Please wait while I transfer the chat to ‘Johanna C. Kreiss’.

You are now chatting with ‘Johanna C. Kreiss’

Johanna C. Kreiss: Regarding mountaineering, we need some questions to be answered from you regarding your trip and coverage.

Ben: Okay, are these questions in the application form when I go to sign up?

Johanna C. Kreiss: we need you to send us an e-mail with the following to travel@ihi.com:

  1. A travel description of the expedition you are going on; for example route, whether you will be trekking or climbing from e.g. south, north etc.
  2. The mountains you will be trekking or climbing as well as the exact altitude.
  3. The kind of equipment you will be using, oxygen, crampons, ropes, harness etc.
  4. If you will be using a guide/sherpa and/or porter?
  5. If you are planning to stay over night during the mountaineering expedition?

Ben: No worries, shall do

Johanna C. Kreiss: Yes, and we need to look further into your trip. please be aware that we do not cover mountaineering that requires specialised climbing equipment

Ben: What is specialised? As in carabiners, ropes, ice axes

Johanna C. Kreiss: yes, exactly

Ben: Okay, that’s me out then, thanks for your time!

Johanna C. Kreiss: You are welcome sir

The Oxford dictionary defines mountaineering as “the sport of climbing mountains.” When saying  they “cover mountaineering” they are technically correct…but, by that rational, you could technically walk up the nearest hill and call it mountaineering expedition. Saying that you cover mountaineering, but not with ixe aces, crampons, ropes etc is like saying a Facebook status update is computer programming, or riding a bike to the French patissere down the corner is Tour de France training.

So, reading around a few helpful blogs  I discovered that many climbers split insurance and have one for travel/medical and one for medical evacuation. Two main options here:

Global rescue:

Looking around I found a guy on the Lonely Planet forum who described a trek to Everesst Base camp. He developed HAPE, and very wisely, his guide got him on a helicopter and straight to a hospital in Kathmandu. When he contacted the company (within 24hours like they want, still a very sick man) he was told that in the product disclaimer it says he needed to contact them first. As Yaks were available (yet completely unrealistic given his condition) they said he will not be covered. The Nepalese embassy took his passport, effectively locking him into the country until his bill was settled…this is only one mans experience and I don’t want to base my decision on this alone but, it does not look promising.

Many helicopter companies do not send out hep until they have insurance details and I don’t fancy being stuck on a mountain trying to argue with a company via Sat phone about if I need a chopper or not, I would want to just get out!

On top of this Global rescue are expensive. Due to the length of the trip I would require to sign up for a year-long membership which would set me back a cool $655. Compared to the thousands of dollars a helicopter trip would cost, and considering they would likely not send one to an uninsured climber, this may be my best bet…

GEOS – leading provider: 

Currently for the evacuation insurance these guys are my leading option. I just need to confirm a little detail in their exclusions. See my enquiry below:

Hi there,
I am leaving for Nepal in 2 weeks for a climbing trip to Ama Dablam (6856 mtrs). Have medical and travel insurance but need Medical evac. Wondering if I would be covered as a client on a mountaineering expedition as I found this in the exclusions:

any Member taking part in or training for:
(a) expeditions, time trials and/or record attempts where an expedition is defined as “an organized journey or voyage for a
specific purpose: especially but not exclusively for exploration or for a scientific or military purpose and organized by a third party or an organized journey requiring a permit”.

Specifically wondering about the “organized by a third party or an organised journey requiring a permit” part…

I will update this post when I get a response and let you know the outcome of all this research.

The main takeaway message from this post is to READ THE FINE PRINT. I would hate any of you guys to be stuck in a bad financial or life threatening situation because the insurance product you bought is not what you thought it was.

Blue skies and happy feet,

Ben

UPDATE 23rd September –  GEO never replied to my enquiry,  have booked medical evac with Global resuce, individual cover was not too bad price-wise without the security update (trust a war will not break out in the Khumbu). https://www.globalrescue.com

Note: information in this post was accurate at the time of writing. This is intended as a personal memoir of my experiences and in not meant to replace your own research and information. All decisions relating to insurance are yours, and yours alone.

Cool trees

You have got to hand it to them; trees never judge, bitch or moan, and they make oxygen, which is amazing when you think about it. Every tree in the world, no matter how ragged or sad-looking, is busily making the earth more habitable for you, so go on, give ‘em a hug!
Here are 29 of my favourite trees from around the world:

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