Over the course of these first few days, too much snow is not my only concern. Altitude sickness is an ever-present concern, and it’s unpredictable how bodies will adjust in thin air. People across the world can (and do) die every year from severe altitude sickness, generally because they ignore the signs & symptoms and continue to ascend.
On trek, early treatment of everything from blisters to altitude sickness is essential. I monitor everyone’s health closely, and it’s rare that people get seriously sick in Bhutan. Most of the group was healthy throughout the whole trip. We generally max out around 17,000 ft on the highest treks in Bhutan, and more often around 16,000 ft (compared to 18,500 on the Everest Base Camp trek in Nepal), so altitude conditions are also generally very manageable, and the schedule is built for gradual acclimatization. All that said, sometimes bodies don’t adjust well to high altitude–and the decision to descend instead of climbing higher can really be life-and-death in the remote backcountry.
This season, amidst the blocked pass and rerouting around deep snow, one client has preexisting conditions that are magnifying the challenges of altitude. She is clearly suffering and in pain. Even with a full rest day (while everyone else did various hikes), her body is not adjusting to the high altitude. We are camped at over 13,000 ft, and the path ahead includes repeated climbs to 16,000 ft and rarely drops below 12,000 ft.
It’s difficult for anyone who has been looking forward to a big journey to find themselves too sick to continue. However, she’s showing classic signs of altitude sickness, and it’s dangerous for her to ascend any further. As I re-route the main group to head west instead of east and find an open pass, I also plan a medical evacuation. More discussions in the kitchen-tent-turned-office….
We finally come up with a viable plan, balancing the timing and support of the main group with the evacuation. At dawn, we contact our main office on spotty SAT phone service that has me walking around yak fields searching for the perfect combination of cloud break and mountain gaps to allow the signal to hold. Our assistant guide and a horseman-turned-porter will walk the client down 7-8 hours to the road. A staff member from our office will drive 7 hours to meet her at the end of the dirt road and then turn around to drive 3 hours more back down the valley for the night (and on to Thimphu the next day). The main group will hike down and up, returning to Laya. Our trekking staff will turn around the following morning and hike back up 3000 feet, covering in one day what our group hiked in two days. They can do it–and we need to reclaim them before crossing beyond the next pass where they can no longer catch up. We still have almost 2 weeks ahead and can’t lose 2 key members of our support team.
The client fortunately begins to feel much better after dropping 10,000 ft in a single day. She sleeps low in the valley (4000 ft) and then returns to the capital (7600 ft) to get checked out at a hospital and to rest. After 3 days, she’s back in good health and ready for a new adventure. Our office plans a private tour for her, heading into the middle of Bhutan for a week to explore with one of our other guides…and staying low at ~8,000 ft.
Meanwhile, we retrace our steps to the village of Laya and familiar faces. After dancing and talking with us a few nights ago, the women now have easy smiles and greetings for us. Clients walk comfortably through town or are welcomed in for a cup of tea in a nearby kitchen. In our own kitchen tent, we are working to get new permits issued for our revised route and are finally all set with our new plan. Onward!