The Pyramid (sit down, it’s a long post)

We had a few days in Pheriche to acclimatize to a higher altitude and to allow for the staggering of people up to the Pyramid. We stayed at Nowang’s family’s Teahouse. We enjoyed wonderful hospitality and great food (I still can’t get behind dal bot- rice and lentils), but the higher we’ve gotten the more ‘difficult’ the accommodations have been. Colder rooms, stranger toilets, yak dung fires rather than wood and of course, all the symptoms of AMS (Acute Mountain Sickness). At these altitudes it really hasn’t been that bad other than increased rate of breathing (I’m still planning to do the physiology post) and maybe some difficulties sleeping.

I was “lucky” enough to be in group 2. This meant that I didn’t have to rush up to the Pyramid to set up the labs! So, I stayed an extra day in Pheriche. We watched a movie, did some reading and I worked on my annual report for work (hopefully it came out ok- if not, I blame AMS!). We had very limited internet access, hence the lack of posts. I decided I’d take the rest rather than go on an adventure with some of the others, as they decided to head off for a hike near Pheriche. Following the extra day Group 2 started the trek up to the lab. My partners were: Gord Binsted (Dean of Health & Social Development at UBC), “Echo” Mike Stembridge, Dr. Dave McLeod, Katie Burgess (sleep tech), Kate Sprecher (sleep tech) & Akke Bakker (medical technology student from Holland). We tackled the first bit with ease (it was flat) and then made a steady climb up to Dhugla. I have to say it was rough- about 400 m elevation in a short distance. We then had some tea in Dhugla. Now, tea in Nepal consists of black tea (what you’d expect), orange tea (think warm Tang) and lemon tea (think Neo Citron). We chose lemon tea. Following tea we tackled another very difficult hill (harder than the first) of another 400 m in an even shorter distance. A break at the top of the hill at the Everest memorials (stone structures in honour of those who died on Everest). Then it was a straight line to Lobuche where we met Nima to take us to our final destination. Another 30 min and the Pyramid was in site!

I have to reiterate that I can’t for the life of me figure out how I got here. Sure, I put my name on the whiteboard and it didn’t come off, but when I think about it really hard I still have difficulty figuring out why it stayed on. I don’t bring a ‘special’ skill like a lot of the members of the expedition. I’m not a student in need of data. If anything I’m a generalist whose area is neither brain blood flow nor altitude! But perhaps that’s what I bring to the table. I’ve had a lot of experience in the lab doing a variety of projects from ultrasound (a huge component of the projects), to respiratory work (Neil Eves’ PhD projects), to exercise testing of every sort. I’ve trouble shot (shooted?) a variety of issues and I don’t really lose my cool in the lab. I’m sure there isn’t too much left for me to see in the lab, but I’m always looking for these new opportunities. I was speaking to Gord last night about my position at Okanagan College being essentially a full teaching load and here I am half way around the World, 5000 m up doing research. At first we both found it a little strange that I would put this much effort into something that doesn’t really make up my job description. But after some reflection I think it’s the opposite. The knowledge that I’m gaining on this expedition will serve to improve my teaching immensely. I’m gaining new expertise and experiences that I can pass on to my students, which I hope will spark them into wanting to gain more knowledge. As Trevor Day often says “Science is cool”. And on this trip there is no denying that. Hopefully I can pass some of that on. Okay, enough with the self-reflection, but it has to be said again… Thanks Phil Ainslie for keeping me on the roster as it would have been quite easy to ask me to step aside for someone else. And thanks to Okanagan College for supporting me in this crazy scheme of coming to Everest.

Back to the story… To reach the Pyramid you come up this narrow valley into a wide-open space (it only takes a few minutes to get there from the main trail). But the Pyramid sits in a calm, protected space with the Lobuche Glacier on one end and Mt. Pumori (Pumo- daughter, Ri- hill- so is Daughter of Everest) behind. The facilities are AMAZING… like a fine Italian shoe or car. The rooms are spacious, with working lights and heaters (a big deal after 9 days in teahouses). The dining hall is cozy (dinner was minestrone soup, margarita pizza and this banana cooked in liquor for dessert). There are flush toilets and showers (enough hot water that you can have on every 4 days). Peter, our host, is so accommodating and wants us to succeed. He has been here for multiple months every year for 23 years (since the Pyramid’s inception). He is a mountain guide and an engineer, so has already been helping us work out our power issues. The lab itself is excellent. It is in the shape of a Pyramid (yes, surprising I know). With multiple floors and multiple lab spaces, so we can have a number of studies going at once. Since I was in group 2 I’ve had relatively little work to do with the set-up and was able to jump right in to testing with Nia when we arrived (she will be contributing to the Experiments post in the next day or two, so you’ll get an idea of what we’re working on). We are in the top lab, so it was quite warm (we’ll see how cold it is in the morning).

A lot of the team have been feeling quite sick with symptoms of AMS. I survived until about 4:00 without much trouble and then the headache came on. It’s a good one, but not as bad as some. I hope tomorrow brings milder symptoms. It really is difficult to be at 5000 m. Here comes some cool science stuff or as I often say to my students “I’m about to science geek out”. At this altitude the barometric pressure is nearly half that of sea level, but no matter where you go on Earth the concentration of oxygen in the atmosphere is 20.93 %. Let’s do a little math as physiology is all about math no matter how hard we try to avoid it:

Sea Level: Barometric Pressure 760 mmHg x 0.2093 = 160 mmHg (or so)

Pyramid: Barometric Pressure 380 mmHg x 0.2093 = 80 mmHg (or so)

Now, it’s late and I can’t quite remember the barometric pressure at 5000 m, but I think you can get the picture.

Remember, oxygen travels from high pressure to low pressure and if we come to altitude we essentially cut that high pressure in half! This doesn’t bode to well for getting oxygen into the lung and then into the blood to get to the muscles. So, we compensate for this drop in “driving pressure” by what’s called the hypoxic ventilator response (hypoxia means low oxygen or low pressure of oxygen). I won’t do the math for this one, but there are ‘sensors’ in our neck (carotid bodies) that sense a decrease in oxygen and cause us to ventilate (breathe) more. When we ventilate more this allows us to bring in more oxygen to help combat the drop in driving pressure (allows us to get more oxygen into our blood). Now it’s a bit more complicated than that, but I need to make sure my mom understands!

So, think about having to breathe harder at rest just to get enough oxygen into your blood to maintain resting function and then add walking up steep stairs to the Pyramid, climbing the stairs and ladders in the Pyramid and in a few days, doing maximal exercise tests. It’s going to be fun to say the least!

The goal over the next few days with the blog is to update it with some more details about the experiments and then to follow up with some photos and thoughts about how things are going. It’s the start of a long 3 weeks and we’ll be at it from dawn until dusk, but I’ll do my best to keep up with the blog.

Thanks to all who have been visiting and the comments link is now active, so you can leave your thoughts.

Cheers