Mountain sickness: A case of acute cerebral oedema or brain swelling at 4950m
- 10 Sep 06, 12:15 PM
Our first serious challenge came from one of the other groups on the mountain. A 58year old Japanese climber and a superfit triathlete, had ascended too quickly. He had developed severe shortness of breath and became ataxic (unable to walk unaided) and was semi-comatose when we were asked to help.
Hi, my name is Chris Imray. In the UK, I am a surgeon at University Hospitals Coventry and Warwickshire NHS Trust, and have a particular interest in stroke prevention in patients with narrow neck vessels (carotid artery disease) but I also have an interest in the blood supply to the brain at high altitude.
We arrived at the Chinese Base Camp, which at 4950m is higher than anywhere in Europe. There are a large number of tents with groups from all over the world. Amongst our own expedition, despite the relatively slow ascent profile, there were still a few of us with mild acute mountain sickness (AMS). Headache, nausea, loss of appetite and shortness of breath are all common symptoms.
However our first serious challenge was a 58 year old Japanese climber and a superfit triathlete who had ascended too quickly. He had developed severe shortness of breath and became ataxic (unable to walk unaided) and was semi-comatose. His friends said he had appeared blank for long periods of time and that he had also been unable to move his left side. Untreated, this situation is likely to deteriorate rapidly. Denny Levitt and I treated him with oxygen, intravenous steroids and nifedipine. Three hours later he was considerably better, he was able to talk and move all four limbs and was evacuated by jeep to lower altitude later that day. After a night in a Kathmandu hospital he has gone on to make a full recovery, but clearly it was a sobering lesson about the need for sensible ascent profiles in the high mountains.
On a lighter note, I struggled to master the art of the pee bottle last night. I thought all went well as I filled my 1 litre bottle at about 2.00 am. I carefully sealed the container and placed it outside. It was only the next morning when I went to empty the pee bottle it became apparent that my spare sunglasses were still in the container!
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Dear All, The Bloggs and pics are Fantastic! We 'home crew' here are hanging onto every word and its great to see that everything -people and kit are working so well. Love the pictures of science at CBC and views of Cho Oyu which floods back memories of last year. Hope all are over the health niggles and we excitedly look forward to more pics later on the mountain. Be safe. Love to all. Paul
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Riddy and Xand,
You silly fellows. I know you are both very photogenic, get your scruffy selves in more pictures!
By the way, I am enjoying a fabulous Northern Italian Gewürztraminer with foie gras...
Love,
Allin
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Good to hear from the team via the blog and from Chris on the answerphone at home. More impressed with the assistance given to the Japanese climber than Chris' exploits with the pee bottle! I hope they weren't his best designer sunglasses! It was fortuitous that the gentleman found himself on the same mountain as a group of doctors with an interest and expertise in AMS. Hope he is okay. I have 2 questions (one via a child) - did the pee freeze or were the sunglasses viable after a rinse? The other, probably more sensible question, from a friend who asked why you are climbing Cho Oyu in the Autumn when the Everest expedition is in Spring 2007? Is there such a large 'seasonal' or weather difference in various parts of the Himalayas? She added 'What season is it now on Cho Oyu and what temperatures do you expect to encounter as you ascend?'. Keep up the good work, you are all in our thoughts and prayers.
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To Chris Imray
Have followed all the blogs with great interest- especially your entry on 10th. Hope things continue to go well and look forward to further entries and photos.
Cathy
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Chris - Not to worry - I've heard that a urine coating on sunglasses is very effective at cutting out all UVA and UVB.
NH
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Just a note to wish the team all the very best and well done to my brother, Chris, for keeping all entertained! Very much hope all is going well.
Frances
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Another note from yet another sister of Chris's (I bet he keeps quiet about just how many females there are in his family). Wonderful to read about your exploits - and to sit here in the balmy weather in England feeling EVER SO PROUD!
Take care, lots of love and best wishes to you and the rest of the team.
Alison x
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