Day 3: Acclimatization in Namche Bazar  

Today is an acclimatization day. Tonight for a second night we will sleep in Namche. Posters at the police check post near Namche exhort trekkers to pay heed to the acclimatization requirement.

Acclimatization helps the body to cope with the reduced amount of oxygen in the air at high altitudes as the air pressure is low. The air pressure at Namche is about 64% of its value at sea level. It will continue to drop as we ascend, and at the base camp it will be drop to 50%. At a lower pressure the air is thinner and contains fewer molecules. Therefore, at Namche a breath contains only about 64% of the number of oxygen molecules in a breath taken at sea level.

The reduced amount of oxygen in the breath makes it harder for the blood to absorb oxygen. In response, the body takes steps to maintain an adequate oxygen supply to the tissues. Immediately, the breathing is made deeper and longer, thereby, increasing the amount of air flowing into the lungs. Within minutes of arrival at a high altitude, a process is triggered in the body to increase the amount of red blood cells, the cells that absorb and carry oxygen from the lungs to the tissues. In spite of these steps, the oxygen saturation in the blood falls. To compensate for the reduced oxygen saturation, the heart pumps faster, increasing the blood flow to the tissues.

In addition to maintaining the oxygen supply, the body also tries reduce the oxygen demand in the tissues. Recent research is showing that the body lowers the metabolic activity of certain cells and increases the efficiency of oxygen usage in certain other cells. This may explain the marked differences in how people respond to high altitudes and why people who perform remarkably well at high altitudes may not have any remarkable athletic ability at sea level. Reinhold Messner and Peter Habeler, who first summited Mount Everest without the aid of supplemental oxygen, were found to be physiologically no different from sedentary people living at the sea level. It is conjectured that certain tissues of such elite high-altitude performers may be able to reduce oxygen consumption under oxygen insufficiency, an unremarkable trait at sea level where there is oxygen sufficiency.

Yet another response is to reduce the oxygen demand by preferentially supplying it to critical organs such as the brain and the heart, while suppressing the supply to less critical organs such as the digestive system. The resulting reduction in the digestion efficiency manifests as nausea, loss of appetite, indigestion, a preference for sweet rather than fatty food etc.

Some of changes in the body have serious consequences. A common problem is that  fluids start to leak from the capillaries, building up in both the brain and the lungs, for reasons not well understood. (As an engineer my conjecture: To depressurize a pressure cooker or a tire one needs to let out the steam or the air. Likewise, perhaps the blood vessels need to depressurize by letting out fluid.) A small fluid buildup in the brain causes a headache, which most people who go to high altitudes experience. An increased fluid build up in brain causes acute mountain sickness (AMS). Around 30% of the trekkers to base camp experience AMS, regardless of their age or physical fitness. The fluid build up reduces when the person stays at the same altitude for a period of time or descends to a lower altitude. A severe form of fluid buildup in the brain is called high altitude cerebral edema (HACE) and in the lungs, high altitude pulmonary edema (HAPE). Both HACE and HAPE require immediate medical attention and a descend to a lower altitude.

As explained, the body makes a myriad physiological and anatomical changes to cope with the reduced amount of oxygen in the air. If the changes are small, the body is able to safely reach a new equilibrium. If the changes are large, the body may not be able to reach a safe equilibrium. This is somewhat like a bicyclist who can maintain balance through myriad, subtle movements in response to the twists and turns and ups and downs of the pavement, but may lose balance when forced to make a rapid change such as by a pothole. Acclimatization is simply slowing down the rate of ascent, to allow the body time to adapt to the lower air pressure. Beyond Namche the rate of ascent must not exceed 1000 ft (300 m) per day and at Dingboche an extra night must be spent to give the body adequate time to adapt.

At Lukla we had crossed into a region called high altitude (8,000-12,000 ft). In Namche we are crossing into a region called very high altitude (12,000 -18,000 ft). In Lukla or Phakding I did not feel the effects of high altitude. In Namche I am beginning to feel the deeper and faster breathing and the faster heart rate. Also my movements have become slow.

We start at 8:45 am after breakfast. We wear our down jackets as it is cold outside. The painful memory of yesterday’s climb lingers in my mind; I am not looking forward to another day of climb. We walk toward Mount Everest Documentation Center above Namche for our first view of Mount Everest. It is an arduous climb. The effect of the altitude is perceptible. My pace is slow.

We walk to the viewing area at Mount Everest Documentation Center. Mount Everest cooperates. We are able to view its majestic peak, unobstructed by clouds, framed on the left by Mount Nuptse and on the right by Mount Lohtse. From this far, however, Mount Everest’s lofty height is not discernible. In contrast, the much smaller, but much closer Mount Ama Dablam appears more impressive.

Everest-banner clouds
Mount Everest at center, framed by Mount Nuptse on the left and Mount Lohtse on the right

Mount Everest was “discovered” from a mountain of data by the brilliant mathematician Radhanath Sikdar, the Chief Computer of the Great Trigonometric Survey of India. He is unlikely to have seen Mount Everest. Even if he had seen the mountain, it is unlikely that he would have recognized its preeminent stature among the mountains of the world. The 39-year old Sikdar’s feat was in computing the height accurately, accounting for the fact that light rays bend as they pass through the air that is thinning with height. When he computed the height as 29,002 feet, he realized that he had found the highest mountain in the world. That was in 1852, and the news was publicly announced two years later. The height is now estimated to be 29,029 feet. The increase in height is mostly from the increased accuracy of the computation, although the mountain is actually growing, but at a much smaller rate. The growth from 1852 until today is only around 2 feet.

I am fascinated by the clouds blowing off the mountain peaks as though they are taking a puff, a phenomenon noticeable with many Himalayan peaks. I wonder whether sublimation of snow on the peaks in bright sunlight and subsequent condensation of the sublimated vapors could play a role in forming such clouds. Later from the Internet I learn that these clouds, called banner clouds, form because of a different reason: When wind blows across a peak, air on the leeward side rises and the condensing water vapor from it forms the banner cloud.

IMG_0120
Posing near the statue of Tensing Norgay

A statue of Tensing Norgay with Mount Everest in the background is located near the Documentation Center. It depicts his victorious pose on the summit, smiling, holding his ice axe raised high, an ice axe adorned by flags of India, Nepal and UK. We pose to take pictures in front of the statue.

We sit on a low wall that surrounds the viewpoint area. There are two other trekkers sitting there with their guide. The guide’s right arm is amputated. One of the trekkers is the one whom I had overheard yesterday at the police check post. I will call him Fernando as I do not know his name. Hair is beginning to grow back on Fernando’s large, shaven head. His beard has also begun to grow. He could be in his mid thirties and from California, I think. Fernando asks, “How was the trek yesterday?” “It was hard, very hard” I reply. Fernando agrees,”Yes, I thought so too. I started wondering whether it was a good idea to have come on this trek.” I realize that Fernando was being facetious yesterday when he had suggested trekking all the way to Tengboche.

Ngima points out Kunde hospital and Khumjung School at a distance. They were established by Sir Edmund Hillary to serve the Sherpa community. I can vaguely see the buildings at a distance. Ngima points out a flat trail to Tengboche at a distance; I long for that flat trail.

Ngima takes us to a trail that goes around Namche Bazar, high above. From the entrance gate to Namche it is quite a climb to reach the trail surrounding it. Namche is built on steps made on the side of a mountain. It has soil and vegetation. Right across the valley are mountains that are rocky and barren. Namche is surrounded by towering mountains, many of them snow peaked. A stream flows through the center of Namche, where we find women washing clothes.

thumb_IMG_0133_1024
A view of Namche Bazaar from the trail above

I wonder whether Namche Bazar means Salt Market. I am not sure whether I read that somewhere. The word namche sounds similar to namak or salt in Hindi. In olden days Tibetans coming from the north through Nangpa La or Nangpa pass (5,806 m or 19,050 ft) used to bring salt and trade it for grains and other goods brought from the south. It must have been an important trading center as salt was a scarce commodity in the past, its preciousness having a lasting effect on our languages. The word “salt” is the root of the word “salary,” still precious for all working people. The word appears in a frequently made statement in old Bollywood movies. To show that they value their loyalty to their masters, the servants in the movies typically say: Sardar maine aapka namak khaya hai  (Sir, I have eaten your salt). The availability of sea salt from India diminished the salt trade from Tibet. Later Tibetans started bringing textiles, blankets and low-cost goods from China for trade. Even that has ended now as China closed Nangpa La, presumably to stop Tibetans from fleeing Tibet.

We see yaks for the first time. A Sherpa and his wife are tending to a herd of seven. A couple of them look different because they are without horns. Ngima tells us that they are also yaks, not female naks. The yaks can be distinguished from dzos by the large amount of hair hanging by the sides of their body.

thumb_IMG_0136_1024
A herd of yaks near Namche

We come to Namche helipad. It is simply a flat area, paved with broken stones. Yesterday I was wondering why Dorjee had to come for the rescue, if the patient was going to be rescued by a helicopter anyway. Now I understand: Taking a person from Namche to the helipad high above wont be an easy task.

We descend into Namche and pass through Namche market with its shops catering to trekkers’ every need. Also there are shops stocked with usual touristy trinkets.

We get back to hotel and sit down for lunch. We select the Dal-Bhat set menu. It comes with rice, lentils, one or two vegetables and papad. Everything is freshly made with locally available vegetables. The food tastes good.

In the dining room there is a framed letter of appreciation from Nepal’s Prime Minister Madhav Kumar Nepal to the owner Lama Kanji Sherpa for his help in organizing a historic cabinet meeting at Kala Patthar (18,514′) in December 2009. I wonder how many of the ministers, who are likely to be old, made it to Kala Patthar for the cabinet meeting. “Just a show,” Ngima explains. “The ministers went by a helicopter and were wearing oxygen masks.” Lama Kanji says that the meeting lasted only one hour.

We take a hot shower at a cost of $10. The bathroom is outside the hotel, and it is cold. There is only one valve to turn. Hand written instructions on the heater forbids you from changing the temperature setting. When I turn on the tap I hear a gas heater violently turning on. Water and steam gush from the shower head. The water is very hot, but soon I get used to the temperature. When I turn off the shower, steam comes from my body, making me look as though I am fuming.

It starts to rain. Thick mist obscures the view of the mountains surrounding Namche. Ngima tells us that in the mountains the mornings are usually clear, but the afternoons could bring rain or snow and winds. Ngima suspects it could be snowing in Tengboche. Ngima seems to be concerned about the added challenge we may face tomorrow because of the snow.

References

https://www.princeton.edu/~oa/safety/altitude.html

https://en.m.wikipedia.org/wiki/Effects_of_high_altitude_on_humans

http://emedicine.medscape.com/article/901668-overview#a1

Bärtsch, P. and Gibbs, J.S.R., “Effect of Altitude on the Heart and the Lungs”, 2007, DOI: 10.1161/CIRCULATIONAHA.106.650796.

Martin, D., and Windsor, J. “From mountain to bedside: understanding the clinical relevance of human acclimatisation to high-altitude hypoxia,” Postgrad Med J 2008;84:622–627. doi:10.1136/pgmj.2008.068296.

Fitbit statistics

No of steps Miles walked Calories burned Floors climbed
8,406 3.79 2,258 78
Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s