Ruinsara Tal to Kiarkoti Basecamp (4,100m); May 5

Photo: Our first good view onto the Kiarkoti glacier (Kalanag is off to the right out of view)

Photo: Yveline and Elisabeth - waiting at Basecamp for the porters to arrive with the gear. They move fast! The weather is closing in... sleet turning to snow... The big boulder is the center of our campsite.

We crawled out of the tent to see a light accumulation of snow, and gray skies. The weather was not looking promising... we could see some high mare's tail clouds typical of a heavy moisture front on the way.

Breakfast was very light for me; and Chris ate nothing. For me, it was a bit of that low appetite response to higher elevation... Chris may have had that plus some residual bug from the day before. In any case, the next trek was not too severe... only about 8km and a gain of 1,000' or so.
We set out at around 9AM... taking our time and enjoying the mountain meadows and the lake at Ruinsara Tal. Chris was not that strong and fell behind the trekking. Yveline and Elisabeth moved ahead quickly and I was in the middle someplace. I was not dressed for a cold day, and had not carried much in the way of warmer layers. So, as the wind and snow increased later that morning I had to move fast to avoid getting too cold. I arrived at the site for our Basecamp... and met up with Raja and the French women who were waiting for the gear to be unpacked. Chris arrived about an hour later... tired but no complaints... he went right to sleep as soon as I had the gear unpacked and in our tent.

The snows and low ceiling continued through the afternoon, so we never got a good look at Kalanag until that evening. Basecamp had a good feel to it... large boulders with some markings from prior expeditions... and the view of the glacier just below us.
At dinner that night we discussed the upcoming climb and our itineraries - planning for two separate teams... Yveline and Elisabeth on the first team and Chris and myself following a day behind to avoid congestion at the higher camps. I had hopes that Chris would feel better after a day of rest, so that we could climb together... but also had some doubts about this (and about the difficulty of the climb ahead given the trouble on the trek - the 'easy' part).

Here's some insight into acclimatization and AMS in case anyone is wondering how all of this works.

The concentration of oxygen at sea level is about 21% and the barometric pressure averages 760 mmHg. As altitude increases, the concentration remains the same but the number of oxygen molecules per breath is reduced. At 12,000 feet (3,658 meters) the barometric pressure is only 483 mmHg, so there are roughly 40% fewer oxygen molecules per breath. In order to properly oxygenate the body, your breathing rate (even while at rest) has to increase. This extra ventilation increases the oxygen content in the blood, but not to sea level concentrations. Since the amount of oxygen required for activity is the same, the body must adjust to having less oxygen. In addition, for reasons not entirely understood, high altitude and lower air pressure causes fluid to leak from the capillaries which can cause fluid build-up in both the lungs and the brain. Continuing to higher altitudes without proper acclimatization can lead to potentially serious, even life-threatening illnesses. In the extreme, if fluid builds up in the lungs, we develop High Altitude Pulmonary Edema (HAPE) and if it is in the cranial cavity we develop High Altitude Cerebral Edema (HACE). Many mountaineers have lost their lives to these effects of altitude... basically drowning or losing brain function as the pressure builds. Both are deadly.

Acclimatization:

The major cause of altitude illnesses (Acute Mountain Sickness or AMS) is going too high too fast. Acclimatization is the process of moving up in elevation at a rate that is slow enough to avoid AMS. One rule of thumb is 1.000' per day above 12,000' or so - another guideline is to climb high and sleep lower - i.e. move up to a higher elevation and then descend for the night... then move up higher and stay... repeating until acclimatized to the needed elevation for a final summit push. Given time, your body can adapt to the decrease in oxygen molecules at a specific altitude. This process of acclimatization generally takes 1-3 days at a specific altitude - but each change in elevation requires this new adaptation to the higher altitude. For example, if you hike to 10,000 feet (3,048 meters), and spend several days at that altitude, your body acclimatizes to 10,000 feet (3,048 meters). If you climb to 12,000 feet (3,658 meters), your body has to acclimatize once again. A number of changes take place in the body to allow it to operate with decreased oxygen.

Effects of altitude on the body:

• The depth of respiration increases.
• Pressure in pulmonary arteries is increased, "forcing" blood into portions of the lung which are normally not used during sea level breathing.
• The body produces increased concentration of red blood cells to carry more oxygen,
• The body produces more of a particular enzyme that facilitates the release of oxygen from hemoglobin to the body tissues.

To ease the symptoms of altitude during acclimatization, many climbers use Acetazolamide (Diamox), a prescription medication in the USA (but available over the counter in India and many other countries with high elevations). I do use Diamox, but do not recommend it for inexperienced climbers who may be unfamiliar with AMS and its symptoms and effects. Diamox does NOT increase our ability to acclimatize per se; but instead lessens the uncomfortable symptoms of shortness of breath, increased respiration that cause sleeplessness etc. So, one school of thought is that it increases the danger of AMS by masking the symptoms.

In any case, once AMS symptoms reach a prominent level, it is time to get down, as quickly as possible.