Friday 22 June 2012

A Photo Essay

Arrival Day!

A view of the Pyramid from above

Nima, one of our guides next to his photo of him on the summit of Everest

Busy place. Loads going on all the time... 14 hands at a minimum

Neck line processes

Good luck sleeping during the sleep studies!

Happy Birthday Sam... can't believe they made a cake without an oven!

Vascular function on high-altitude natives (one of our guides, Tsering)

Vascular function testing

Arterial line #57

Cardiac function on some high-altitude natives

Jugular line... no problem

Trans-esophageal thermister... not so fun.

Keaton Murphy (UBC undergrad student), drawing blood from his classmate Ryan Hoiland. Don't worry, Dr. David MacLeod is in the background supervising.

Echo Mike working hard to find my heart

Brain blood flow (yellow box), echocardiography (Echo Mike), blood samples (the white mat), ventilatory control (blue tube in my mouth)... An easy day!

I wasn't the only one who was sick!

Sunrise over Everest

Khumbu Glacier with base camp on the left- you can see loads of yellow tents

5600 m

Proof that I made it and a shot of the beard.

The Everest Massif- it's the black one in behind

Kala Patar with Everest in the background

All done!

The crew on the last day, right before we started to head down. 
How are we going to get this stuff back home?

No planes, no problem. Helicopters all around!

Leaving Lukla by helicopter

Agriculture. Everything is hard in the Himalaya!

A few of us got left behind on the first trip... the middle of nowhere (Lamidanda) and we weren't sure if anyone was coming back for us.

Coming back into Kathmandu via helicopter

Home with my little ladies (gotta have a down jacket from Nepal!)

Friday 1 June 2012

The Trek Down

One of the things that amazes me most about the Himalaya is the shear size and distance of things. Of course there are a number of the World's 8,000 m peaks and a bunch in the 7,000 m range (remember our home for the past few weeks at 5,000 m is a kilometre higher than the highest point in the Canadian Rockies and 5,000 m higher than anywhere in Holland!), but the distances are something to be admired as well. We sat around (clearly and understatement) for 3 weeks doing relatively little exercise. However, on our way down we covered about 65 km in 3 days! Plus we lost 4,000 m in elevation (although it still always seemed like we were going uphill).

Day one was from the Pyramid to Pangboche, which is a place we stayed on the way up. A relatively good day and relatively short. My knee was pretty sore, but no choice to go on the next day. Day two was from Pangboche to Namche, where there was a Sherpa Festival. Kurt and I walked together and I did surprisingly well- relatively no knee pain and we made a good pace. A few of us spent the afternoon in a coffee shop and checking out the festival. It was a little hard to understand and it was also the first festival (something about celebrating the end of the trekking and climbing season). After dinner a few of the lads went back down to the festival and celebrated with the Sherpas (our guides included). I think things went well as they were moving slowly the next day. The music went into the late evening and we could hear the 'disco' beats and North American pop in our guest house... you can't escape Beiber no matter where you go! Day three was huge. Namche to Lukla. You have to go down for about an hour when you leave Namche and it feels like you make it all back coming into Lukla. It was hot and humid and my knee hated every minute!

When we came over the ridge to Lukla things were different. The weather was not as nice and the town felt depressed. Apparently there hadn't been a flight out for 5+ days. This presented an interesting problem to us- sit and wait (and maybe miss our international flight home) or find some helicopters to take us down at a premium cost. We spent the night and talked a little about it. The next morning we were up at 5:30 (we had a first out ticket, so if planes were flying we'd leave early). By 10:00 nothing was moving and it appeared as though the weather was only going to get worse. I felt like I could afford a few days, but didn't want to be stuck for a week. The decision was made to try to charter some helicopters for 20 people and 750 kg of gear. We felt that if we stayed we'd spend a hundred or two on food and additional lodging as well as the costs to change our international flights, plus we would still have to figure out a way to get our gear down as the backlog in travellers would have affected it's transport and if it would have had to been shipped back to Canada it would have cost huge dollars. As our fearless leader said many times... "What could go wrong". Needless to say, a little disheartening after such a successful trip.

Now for the adventure:
3 B3 Helicopter trips to get bodies and "most" gear to an airfield in the middle of nowhere- Lamidada. Hang out for a couple of hours waiting for a different helicopter (some big Kawasaki) to come get us and the gear. Realize that 750 kg of gear is not a problem, but the volume of the Pelican cases is! Dump all the gear out of the helicopter and leave it in the middle of nowhere, while the helicopter takes us 45 min to Kathmandu. No gear the next day. Finally a fixed wing is able to get into Lamidada to get the gear, which arrives at Kathmandu Guest House the morning of our international flight! Cost to Phil and the research grant- let's guess $15,000. Cost to each member $500. Flying through the Himalaya in a helicopter- PRICELESS. It was too cool and I was able to snag the front seat for the long flight, so definitely a highlight. Cue "Highway to the Danger Zone", by Kenny Loggins... "Talk to me Goose". (A boy can dream, even if it is about F14's rather than cargo helicopters!)

It was an all day adventure and we were back at the guest house in late afternoon. The plan was for a little rest and shopping over the next day and then off to home late Friday night. As usual the airport in Kathmandu was crazy, although we're used to it by now. We got on the plane and had a night flight to Hong Kong. Am now sitting in the lounge typing away, but Kathmandu wouldn't let me go without a fight, and what would an update be without a sickness comment from me... again the GI has set in :(
I've won the name sick note as I've always seemed to be a little bit ill, so fitting I suppose.

Watch in the coming days as I settle back in to life in Canada- FAMILY, work, fun as I'll do a bit of a photo essay as the pictures have been few and far between as a result of slow internet. I've managed to grab everyone's photos, so I have over 100 GB of images to go through. Hopefully there will be one good one in there!

Also, if you're in the Okanagan there will be some speaking engagements that I will keep you updated on.

Saturday 26 May 2012

Top of the World

We have a couple more days at the Pyramid as the timing of trekking and flights with the completion of work had an extra “in case” day built in, but we were so efficient and nothing went wrong that we finished early.

A group of us decided that it was time to visit the Top of the World. Hold on, we didn’t make an attempt on Everest, but went to a place called KalaPatthar (5545 m). It’s an outcrop/cliff/hill across the valley from Everest. You get a 360 degree view of all the peaks in the area. Absolutely incredible- a place everyone should visit. However, it’s a difficult climb. It took me an hour and a half to get from the bottom to the top. I was travelling just fine until ¾ of the way up. Then the altitude, lack of fitness and sickness took hold. One of our Sherpa guides (Kalden) was already at the top and he came down to help me. He told me I didn’t look so hot and took my pack for me. I managed the rest of the way and was rewarded for my efforts.

We spent about an hour up there and met some interesting folks who are running in the Everest marathon in a few days time! Crazy people running 43 km from base camp to Namche Bazar. They’ve been training for about a month and expect to complete somewhere in the 8 hr mark. The local Sherpas haven’t been training, will show up on the morning and do it in 3.5 hrs! Nuts.
We took some incredible photos (again, internet takes too long to upload them, so you’ll have to check back in a week when we’re back in Canada) and then headed down and back to the Pyramid. The day started at 5:00 a.m. and we were home for lunch. I then spend the afternoon in bed (so did everyone else). It turned into nap day!

Another nice dinner and cake to celebrate our leaving, some packing, a last chat with the girls for a few days and then off to bed. We’re off to Pangboche tomorrow, Namche the next and a final big push to Lukla. A night in Luckla and then a flight back to Kathmandu. A few days there to sort things out and then home!

What a trip!

Experiments- DONE

I can’t believe it! We actually finished this thing. The last few days have been spent finishing off some sleep studies. 4 people spend the night in the lab with all the sleep gear attached to them (really hard to sleep with it all on). In these last ones we were changing acid-base balance of the blood using a couple of drugs (acetazolamide and bicarbonate). The bicarbonate was infused midway through the night. In addition, arterial blood gasses were drawn. Immediately upon waking (6:00 a.m.) the subjects had to do a ventilatory response test. So, those of us that were done had to be up early to perform those tests.

The afternoon was spent packing up the lab. We managed to get everything back in the Pelican cases and ready for the porters to carry down. We’re actually leaving with less than we came with. We used a bunch of consumables, donated the consumables that we didn’t use to the hospital in Kunde (this is where Echo Mike scanned the kids) and managed to leave some things here (we donated some things to the Pyramid as well). This lightens our loads and saves us some money! Both important at this time in the trip. It was quite an afternoon of cleaning, but we got the Pyramid back in shape.

The late afternoon was spent washing up (had been a few days since my last shower), reading and napping! Some well deserved down time!

Today was also Sam Lucas’ birthday, so a few of the group went into Lobuche for some beers. As usual I was not feeling the greatest, so I decided to pass. They came back with some big smiles from 2 beers (gotta love the altitude) and then we had a nice dinner, followed by a birthday cake that was excellent (they don’t have an oven here, so they steam the cake!)

A great end to the work!

Tuesday 22 May 2012

The Experiments Continued- The Bike

"Bike" Mike Tymko- Mount Royal University, Calgary, Alberta

I first met Phil last summer when I was working in Trevor Day's lab (my physiology teacher) at Mount Royal University. We have been in contact with Phil and his graduate students throughout the summer as we were doing similar work as them. Rachel (Trevor's other research assistant) and I decided it was time to meet the Kelowna crew late last fall, so we picked probably the worst weather conditions possible to drive out to Kelowna and away we went. Rachel and I got to Chris' place quite late (thanks again Chris) had a few beers and then headed to bed. As soon as I woke up the next morning, I got an email from Phil asking me if it was possible to build a Supine exercise bike that can be tilted at a 45 degree angle, portable (to bring up to the pyramid lab), adjustable (to accommodate different subjects) and would have to be able to measure wattage output and cadence...after I mended my alcohol induced headache, I agreed to take on the challenge!

After the winter semester had finished and I was back from my ski trip early January, I started sketching out how I was going to build a supine exercise bike. I spent about a week planning how I wanted to approach the build and I also bought a small Mig welder with some scholarship money I earned. It had been a while since I had welded last, so I practiced on some scrap steel until I had the right heat settings and technique down. I began by buying roughly 20 feet of 2 inch channel steel (very light) and used this for the frame. I made sure to cut the frame in separate pieces small enough to fit into a suitcase. I then went to WalMart and bought their finest mountain bike, I cut the bike in half, leaving the pedals, gears and rear tire attached. I then mounted the rear half of the WalMart bike onto the supine bike frame.

After a couple of trips to Kelowna showing them the progress and getting feedback, Chris suggested that I use a Lemond bike trainer since it would be able to measure what was needed for our experiments. Time was running out as it was the end of January at this time and the bike would be needed for baseline testing mid February. As soon as I got back to Calgary I ordered one of the Lemonde bike trainers and it arrived at my house in about a week. After a bit of thinking, I was able to mount the trainer to the bike frame...the light hunk of metal could now officially be called a supine bike!

That weekend my friend Nathan and I drove out to Kelowna to present my supine exercise bike. We had a little bit of a scare as when we arrived the bike did not produce the amount of resistance needed, so after talking to Gord Binsted that night (the bike guru) he came to the conclusion that the problem lied within the WalMart mountain bike I bought (who would have thought!). It seemed that the gear ratios were not optimal, but thankfully Gord was able to take the supine bike into a local bike shop and got the issue sorted out...finally, the supine bike was finished with only a day to spare.

I'm going to say it right now...the bike has its flaws! The biggest being that it is about 3 times heavier that we wanted it to be, but we were able to get the baseline data we needed to get, and we are now only a couple experiments away from being finished with it here up in the pyramid lab. Although the supine bike build has been a bit of a pain and I now hate the drive from Calgary to Kelowna, it has been awesome to get to know everyone that has played a role in Nepal expedition. Also, big thanks to Phil, our fearless leader, for inviting me on this expedition as it has been an incredible experience.

Sunday 20 May 2012

Time Flies

So here we are, 5 days from the end of our time at the Pyramid. I must say that most people are ready to head down, but at the same time the experiments are moving along at a fantastic pace. We’ve managed to find a great system to keep things flowing.

The two undergrads arrived two days ago in good spirits (my apologies to their parents for causing a bit of a stir when I mentioned that only one more brain a-v test would be done- this is because of time constraints not because one was hurt or injured). They’ve brought a new life to some of the tasks, so a few of the ‘veterans’ have been able to give up some of the duties to them. They ascended a little quickly, so we’ll see how the AMS treats them.

Today’s schedule has some squat-stand studies, some Diamox ventilatory-response tests and Nia and I have one more arterial stiffness subject. Tonight brings some more sleep studies and tomorrow we have some more Sherpas coming in to take part in a number of studies. We have been blessed with some great Sherpa guides who have managed to arrange for more Sherpa subjects for us. Nowang had a treat of being brought up by helicopter from Pheriche this morning (but it likely only saved him 20 minutes of walking time J).

We’ll have a couple of busy days of testing and then things will wind down. A few of us will make the trip up to Kala Patthar and Everest Base Camp (some sad news from Everest today- 6 died and 3 missing at Camp 2, so a big rescue operation is underway), while others start the pack up. It will be interesting to see how much stuff we have used up and how much stuff we can leave behind. Apparently Gord got worked over in Kathmandu with overweight charges. I’m hoping that all the souvenirs I bought don’t put me over the top- I may have to ship them home to save some money and hassle.

I’ve been trying to add photos to the posts, but it’s been difficult with the slow internet, but I’ll keep trying and if all else fails I’ll do a photo post towards the end of the trip (maybe from Hong Kong) as I’ve managed to collect most peoples photos so far.

Keep your eyes peeled for more guest posts in the coming days.


The Experiments Continued

“Echo” Mike Stembridge University of Wales Institute Cardiff

Although I’m involved with two studies being headed up by Glen and Andy, I have three studies running of my own. One of these has already been completed and that’s the one I have decided to share with you!
Before Phil got in touch with my supervisor about the trip, my PhD was mainly focused on the development of cardiac mechanics around maturation. Although the opportunity to study the effect of high altitude on cardiac function was extremely exciting I was also keen to continue my maturation theme.  Therefore, I raised the idea of examining the effect of high altitude on cardiac function in the native Sherpa children with Phil.  Phil then (after me nagging him via email from across the pond) managed to make contact with a research collaborator from a previous trip who is the Director of the Khunde Medical Centre, Dr Kami Sherpa.  We invited him to join our research team looking into the effect of increased pulmonary artery pressures on cardiac function and he graciously accepted.

The first stage of data collection actually started in Kathmandu. A contact who previously worked in the University Hospital, Cardiff and now lived in Kathmandu put me in touch with a friend who could arrange for us to visit a school in Kathmandu that had a Sherpa population. So, one morning Joe, Nick and I jumped in a cab and headed across Kathmandu following Tashi on his motorbike. We arrived and the school and managed to get cardiac images using ultrasound on 12 children.  

The second phase was at the hospital in Khunde. After a 4.20am alarm Joe, Nick and I hiked up from Namche Bazar to Khunde where we met Dr Kami. He had done all the hard work by arranging subjects and had us set up in our own room, which we quickly turned into an echo lab. The locals were queuing up waiting for us to scan men, women, boys, girls, dogs and yaks…. But after carefully considering a Yak research project we decided to maintain course and continue with the adolescent boys (If I had scanned a Yak I would have had one up on my colleague from Wales, Eric who was scanned a Shark and a Giraffe). We managed to take ultrasound images of the heart on 26 boys that day and got another 4 the next morning. I’m genuinely excited to analyse the data for what will hopefully be a great study.