Monday, 27 August 2012
Following our return from base camp the previous afternoon, we had enjoyed a slightly better sleep and were ready to enjoy a pleasant walk to the thermal springs. Following a leisurely hearty breakfast of porridge, fruit flakes and tea (many thanks to our surrogate mum Cath), we got our swimming cosies ready and packed our day sacks with more crackers for lunch. It was about 11.30, and we were almost ready to leave the hostel, when Damien came to find us ‘there’s an emergency on the mountain’. The guide with our group had contacted the hostel owner Marcello. There was a male on the mountain who had suspected HACE and had fallen unconscious. This later became a female who was drifting in and out of consciousness. They were making their way back from the summit and were now at approximately 6200m. How were we going to get to them? Would we be able to get oxygen up the mountain? If we did get to them, how were we going to get them down? Would we get sick too? An action plan was hatched! Another guide was already en route to help the guide already up there bring the patient to a meeting point. We would be taken up in a 4X4 ambulance to 5200m, along with 2 paramedics from the ambulance. The local health centre could give us a supply of oxygen. I packed my bag with the remainder of the drugs to treat HACE from the medical kit left at the hostel, along with a few cannulae and some fluids which I had been trying to warm in my down jacket! Whilst we were up on the mountain, Marcello would arrange for an ambulance to meet us at the Bolivian Chilean border to take the patient back to a sea level hospital in Arica, once off the mountain. We set off from the hostel around 1pm. We (myself, Damien and Mark) squeezed in the back of the 4X4 along with 2 ‘paramedics’ and a doctor called Marybell, who spoke broken English, from the health centre. In the front was the driver, his wife the ‘nurse’ and their small child! We travelled along the main road for a few bumpy kms, passing some of our group on their way back to the hostel after camping out by the lake the night before, until we turned off right up a steep mixed dust and rocky track. After a few even more bumpy and hairy manoueveres in an attempt to negotiate a sharp steep rocky section, the engine stalled. We all jumped out of the back, and watched as the driver, after a few attempts, managed to negotiate the rocks. We all squeezed back in. Unfortunately, after only a few more hundred metres, the same thing happened again, only this time we jumped out to the pleasant aroma of a burnt out clutch! The driver had a look under the bonnet, whilst making a few grunts and groans, as all men seem to do in these situations. There didn’t seem to be any sense of urgency with these guys, so I suggested maybe we should start to walk. The paramedics started to gear up, although they didn’t have much to put their gear in. They borrowed Marks rucksack to put the oxygen cylinder in, and my head torch. We explained to Dr Marybell what dose of dexamethasone should be given and nervously handed over the drugs and fluids, along with the cannulae, to the ‘paramedics’ too. We were reassured that ‘they know what they are doing’. The ‘paramedics’ and Dr Marybell, dressed in her leather fashion boots and silver fashion ‘space jacket’, as Damien called it, set off up the path towards the mountain. From the position that we had stopped, the mountain was only just in sight, so I also started walking to see if I could reach a point with a better view. After about 20 minutes of puffing and panting up the hill, I reached the car park, where the 4X4 was meant to have stopped, to find the ‘paramedics’ and Marybell stopped once again. One of the paramedics was changing his trousers. I gestured to the other, that maybe if he wore his mountain boots he may not have to carry so much weight. He looked at me and smiled, as if to say ‘no estiante’. They set off once again, approximately 14.15 after saying that they were going to be 3 hours, although I wasn’t sure if this was for them to reach the patient or for them to return back down the mountain. From the car park, which was high up on a moraine, (which turned out to be about 4900m and not 5200m as we first believed) with base camp below to the right, the steep cliffs of Sajama in front, with the summit ahead in the distance, I could see the traverse of the mountain and the route up to high camp. I could make out little black dots of people on the mountain, but couldn’t make out who the little black dots were – if only I had borrowed Tom’s binoculars! Mark had decided to follow me up the path too. He had brought up my rucksack with some fluids, snacks and warm layers. We sat for quite a while trying to make out where the paramedics were on the mountain. They had disappeared from sight. We saw many people walking off the mountain towards base camp but never saw anyone walking up. It was about 16.30 when we decided to walk back down towards the jeep. It was getting a little nippy and we were wondering whether the jeep was ever going to make it up to the car park. On our way back to the jeep we saw what we thought to be a small mammal stood on a prominent rock peering up the mountain, almost meerkat like in appearance. As we got closer, we soon realised that it was in fact Damien! We still had no news of what was happening on the mountain. The ambulance driver had given up on trying to get any further up and had taken 20 minutes to turn the jeep around. We stood talking for around a further 30 minutes before we saw a Sajama national park ranger truck heading up the track towards us. It continued passed us, so clearly the driver was doing a better job than our own driver! About 5 minutes later, the jeep was on its way back down. We gestured and they stopped. In the back of the truck were the 2 ‘paramedics’ and Marybell. It was a ‘false alarm’ ‘False alarm’?? Marybell said that the patient was well and walking back down to base camp. The remainder of the group were ok and also heading back to base camp. Amid much confusion on our part, the ‘paramedics’ handed over our kit, drugs and fluids, and headed back down the mountain in the jeep with the national park guys. We jumped in the back of the clutchless 4X4 ambulance, with Marybell, and headed back too, still not really sure what had been happening on the mountain. After another rather rocky and bumpy journey we made it back to the hostel as dusk fell. We arrived back at the hostel to hear about the actual events on the mountain that day!
The journey from base camp to high camp wasn't as arduous as I'd expected. Not because I was any less out of breath as I struggled up the scree slopes, but because I was getting used to feeling like I was perpetually sprinting, and starting to realise that eventually the guide would stop for a breather. The porters had gone ahead and erected our tents on a precipitous ledge at around 5700m. Spirits were high as we arrived and began melting down penetentes for drinking water (ice spikes unique to these mountains). Preparations were made for a 6pm bed time and a 1am start for the summit attempt. Sleep was illusive mostly due to nervous excitement and I was fully awake before midnight. The 18 of us had organised ourselves into rope teams of 3 for the summit but one of my team became increasingly ill with AMS during the night and decided not to attempt the summit. I moved to join the guide on his rope team. A slight delay in departure left the guide impatient to get going. We started out with crampons and ice axes but not roped together. The first hour was an arduous slog through penetentes and steep scree to the start of a narrow ridge where we all huddled from the icey wind whilst we roped into our teams. Head torches lit a small patch of snow in front of each climber. I was aware of my team mates but very alone with my fear on the snow ridge. The blackness of the night was the main saving grace allowing me to pretend that there were no plummeting drops either side of me. The ridge steepened and the suddenly rose into a snow and ice climb. This was the long section where we had been promised that a fixed line would be in place making the climb much easier and safer. The fixed line wasn't there. About 10m into the climb I had a sudden and very cold realisation that I was totally out of my depth. I was endangering myself and the team because I didn't have the necessary skills to do this climb even in daylight and with normal levels of oxygen. We hadn't prepared for this. My crampons were in danger of cutting the rope, I couldn't get the ice axe to grip the wall, I was cold, nervous, tired and would have to down-climb this slope if I continued. I turned to my rope partner who had been recently starting to feel nauseous and said 'do you think it would be a massive inconvenience if I told the guide I was not feeling safe?' To my immense relief his reply came 'I'm right with you buddy'. The guide quickly untied the two of us and replaced us with 2 more experienced climbers. This new team of 4 was the only one to go on to the summit. The down climb and ridge crossing in the dark and now gusting wind proved that I had made the correct decision. We picked up another climber on the way down to make a team of three and luckily our decision had very little adverse effect on the others. We passed another team on the way down who told us that we had reached 5950m, higher that Mt Kilimanjaro, not bad for a first summit attempt over 6000. The route back to high camp was harder than expected. Thankfully there were 4 people already there one of whom had hung a tiny glow stick on his tent, without this I'm not sure we would have found the camp. We followed the red glow down the scree and across the penetentes with a few heart stopping falls and eventually we literally collapsed into our tents at around 5am. I woke to the sound of another team returning and it was daylight. They had turned back at around 6300m due to the cold and altitude effecting one of the team's vision. After a bit more sleep I left the tent. The base camp group was transfixed watching the mountain and one of our teams who were visibly stuck and not moving at the top of the climb section. They were mainly stationary and would occasionally move one way and back across the top of the climb. We speculated for hours as to what might be happening. Were they lost, injured, ill from the cold? All we could do was prepare high camp as best we could. Those who were ill at high camp went on down to base camp. Eventually the team on the mountain began to make moves down the slope, some climbing, some abseiling. A team of 3 medics from high camp decided to go up to the ridge to meet the descending teams taking fluids and medication with them. Eventually and after some help from the medics the remaining 9 climbers trickled back to high camp around 13 hours after we set-out. They were met with snacks, fluids and TLC. It transpired that the group we had been watching on the slope had had one of their team members almost completely blinded due to the altitude. This had massively slowed their return once they had realised the seriousness of the problem and they had then had to wait for reasonable sight to return before attempting the down-climb of the steep section. At high camp priority groups were organised to return to base camp whilst the rest of us and the porters packed up the camp. The last bedraggled team member arrived into base camp after 5pm, 16 hours after setting out from high camp. All recovered to health and full eye sight after a day or so. For some of the team to have summitted was an achievement shared equally among the whole team at high camp, base camp, Sajama village and back in the UK even though we weren't all stood on the summit with them. It was an adventure that will stay with me forever as will the feeling of connectedness with the team members.
Our last day in Parinacota started in much the same way as previous days, with the standard Chilean greeting of “TE, CAFE, EXTRA?” from the ‘Gruffalo’. We were all getting the hang of the Chilean breakfast scene and the sight of pale circular meat products did not course much alarm, though the announcement from Victor and his female colleague that we must be on the bus by 08:30 (~10minutes time) caused a slight panic. By 9 we were on the coach and moving, with my day being improved somewhat by the driver mistaking me for Leonardo Dicaprio. After a short stop at Lake Chungara which consisted of a group photo of us all trampling over protected habitats we were at the Chilean border crossing. A few cheeky manoeuvres got us past the queue of around 40 trucks and were in the no-man’s land between the two crossings. It was at this point that Luke decided his contraband smuggling reputation must go no further and he launched around a kilo of Chile’s finest cheese out of the window and into the desert. This turned out to be an unnecessary manoeuvre as it was discovered a bar of chocolate and a wink is enough to get 30 people’s worth of expedition nosh through Bolivian customs! We were greeted in Sajama by Marco who had organised our guide, accommodation and equipment for Sajama and the team quickly busied themselves with preparations for the climb. Things get serious tomorrow as we begin our ascent of Sajama – good luck to everyone!
Day 12 started with a much appreciated lie-in and late breakfast. With most people’s legs feeling the effects of yesterday’s big climb – a gentle walk to the lakes was planned. Most of the gang took this option whilst a small number decided to stay behind and do some washing!! Missing their mothers, no doubt! Half the ‘lakes’ group headed off with Carlos, choosing an undulating route which allowed us our first glimpse of Sajama. Carlos proved to himself, yet again to be an ‘exceptional’ guide by getting us lost! Navigation along the clearly marked path was handed onto Paul who led the group to a beautiful lakeside beach for lunch. The other ‘lakes’ group chose the flat more direct route and soon joined us for some chilled out holiday beach time. So that I add a little detail to this diary – the name of the lakes was “Hagunas Cotacotan” part of “Reservon de la Biosfera Lalica.” From our beach, many went for a further walk to explore the lakes, others enjoyed some bouldering whilst the remainder (incl myself) messed around the beach getting some great jumping pics, and sand in every orifice (ask Jen for further details of orfices!) After returning to the hostel and de-sanding we all got together for a rope skills session. I think it is fair to say that the majority of us started to feel quite apprehensive about Mount Sajama. At dinner Rich D gave us the low down on the catalogue of events that had occurred at the hostel. First of all the copious amounts of clothes washing that we had been doing over the last few days had blocked the sinks. Then in an attempt to get a warm shower a certain boy was informed that if the cold sink tap water was left running then the shower would run hot. Of course doing this with a blocked sink resulted in flood carnage. To complete the trio of disasters - probably the gentlest man on the trip managed to break the glass on the dinner table top with his cup. A freak accident that ended up in us paying 40,000 pesos. It is clear that the owners cannot wait to see the back of us! A game of cards cheered us up before bed. Bolivia tomorrow!!
Day 11 started with day 2 of the “eggstra breakfasts”. For those of us who ordered extra food we had muchos bread and muchos eggs (very very fried!) and those that didn’t had bread and what was apparently cheese... After breakfast, the group set off to summit a nearby mountain called Guaneguane (“Wanny-Wanny”): a respectable peak of 5050m high. It soon became apparent that some people were walking faster than others (I was in the slow group). We split into two groups – ours, the slower group was terms, ‘Team Sensible’. Team Sensible was led by Mark, who took us to the opposite side of the mountain as the other team. We enjoyed zig-zagging up for a little while, as well as debating what zig-zagging meant. Does zig mean turning right? Does zag mean going left? Or is zig the first way you turn? Answers on a postcard please. We stopped for lunch after zig sagging. A lot more salami was consumed as well as chugging down a carton of juice. We said goodbye to small group who summitted smaller peak as we plodded up Guaneguane. ‘Team Sensible’ eventually reached the summit (having been beaten by the OTHER team by only about 20 minutes!) and we looked around at what we achieved. We were standing in Chile & could see the valley, Peru and Bolivia – not a bad view! Unfortunately, nature called atop the peak and I joined the 5000m club (i.e. a very high number 2!) - a very exclusive club... We took some photos with Parinacota + Pomerape in the background and renamed our group ‘Team Condor’. The condors assembled and we started our descent. The descent included an INCREDIBLE downhill jog on some scree (loose rock). A cross between jogging and skiing, we dubbed it screeing. It was more fun that we had had in a long time (if not a little dusty). The rest of the journey was relatively non-eventful (apart from losing Anna in a bog up to her thighs). Unfortunately she got helped out before we could get some photos – we’ll never forget the smell though and neither will her boots... We all helped each other home as we were all completely shattered (thanks folks!). We got back tot he hostel and showered, drank litres and litres of water before settling in for dinner & bed. A great day out!
Today sees the last of the experimental tests conducted at our make-shift high-altitude laboratory, Parinacota Hostel, based at 4,600 m. It’s been a long haul and we’re excited at the prospect of completing a unique study that has built on the best part of 10 years worth of research. In essence, we’re trying to understand precisely what makes the female brain more resistant to the inspiratory hypoxia (lack of oxygen) of high-altitude. Much to the chagrin of the macho-male mountaineer, females seem to cope better at high-altitude and suffer with less acute mountain sickness, a syndrome characterised by the dreaded “hangover-headache” and associated symptoms. We’re slowly unravelling the mechanisms that allow them to acclimatise so much faster than us (lesser!) males. There are clinical parallels to be made too; females outlive us males and the incidence of brain disease is far lower. Could there be a common link explained by their superior ability to preserve oxygen delivery to the brain? It all sounds quite intuitive though you can never under-estimate the challenges posed by field research. My colleagues Dr Julien Brugniaux and Luke Liddle (baptism of fire as a research student!) turn up to the Brain-Lab dressed ready for action; hats, mits, down-jackets and Sportivas! It’s freezing and equipment and experimenter alike don’t take kindly to a cold start! Our participant is sitting quietly with eyes closed (still snoozing!) as we busy ourselves around her. Electrodes to monitor heart rate (electrocardiography), optodes on the forehead to measure changes in cortical oxygenation (near infra-red spectroscopy), a finger cuff that measures beat-by-beat arterial blood pressure (photoplethysmography) and the joys of freezing gel at the side of her head (not for the purposes of hairstyling) to measure cerebral blood flow (transcranial Doppler ultrasonography). Ten minutes later and our participant looks like an extra out of Star Wars! First challenge is to simply keep her rested, eyes closed (no brain activation) as Luke whispers “breathe through your mouth” to avoid the complications of carbon dioxide retention and prevent blood flow to the brain from bouncing up and down. We’re using a technique known as transfer function analysis to assess cerebral autoregulation, a test that will reveal how well her brain buffers acute surges in blood pressure. We know that the male brain’s “shock-absorber” doesn’t work quite so well at high-altitude which may be tied in to their increased susceptibility to acute mountain sickness. Flanked by Julien and Luke (since most of the males become faint), we ask her to stand as part of an orthostatic stress test and note the initial drop in brain blood flow and oxygen, encouraged by such a rapid recovery to baseline. The males’ recovery is way more “sluggish” as we move on to the next challenge; an ambitious 45 second breath-hold designed to measure how reactive her (cerebral) circulation is to carbon dioxide. Brain blood flow increases with every passing second and then comes the heavy-breathing challenge; three minutes of controlled hyperventilation designed to swing carbon dioxide in the opposite direction and see how quickly brain blood flow drops. Again, it’s clear to see that her circulation is impressively “reactive” as we recover her back to baseline prior to de-instrumentation and then on with the next slew of complementary tests designed to assess arterial stiffness and mental agility (to determine if females have floppier vessels and improved cognitive function). All-in-all, the various tests take the best part of 4 hours and participant compliance is quite impressive! We’ve completed all experimentation and the research objective has been accomplished. Our data set is quite impressive. We’ve modelled the (male versus female) brain’s acute response to simulated high-altitude (4,600 m) in the environmental chamber based at the University of Glamorgan and its longer-term ability to acclimatise to the same hypoxic stimulus to the terrestrial high-altitude of Parinacota, which incidentally is far more aesthetic (see Jess Christley’s blog of her sobering experience as a research participant in what she affectionately coins the silver-lift!). With the science complete, an enduring question percolates through the camp. Will these physiological tests be able to predict our group’s summit success on Mt. Sajama? Will the females “outperform” the males? Only time will tell...though male nerves are already jangling for fear of being outgunned!
After the first night sleeping in sleeping bags, the group awoke at the “Albergue Uta Kala Don Leo Parinacota” (hostel). The first challenge of the day was the dangerously wired showers. Luckily, these were negotiated without any fatalities! However, the water was not always hot... A single bread roll for breakfast prevented anyone overeating. The rest of the day consisted of more testing, with some of the groups going off on small walks around the village area. Two members of the group appeared to be suffering from ‘flu-like’ symptoms but most of the group appear to be acclimatising well at rest.