I didn’t even have to volunteer for the headache study – I’ve already gotten myself on Diamox. Last night I came down with some good altitude symptoms: splitting headache, rapid and shallow breathing, and very little sleep. I waited until morning and got some ibuprofin from Gaye, but she suggested I start taking the Diamox as a precaution against a worse condition developing. Today (the 15th) I was feeling very tired, and after I took the Diamox I was feeling a little woozy. Once the jagged stake had receded from my skull I went out for a mini-hike on the hill above Pheriche. The rest of the group set out earlier and they were aiming for a much higher elevation. I got a great view of the washed out river valley here. Apparently this area has seen some high run-off waters in the past. We’re also above the tree line, so the landscape is starting to get a bit more barren. There’s just some very short grass and bushes. Interestingly, the lodge where we’re camping (ironic, we’re sleeping in tents outside of the lodge) uses sections of the dried out sod as a floor covering along the hallway. This short grass makes thick roots, so it makes something nicer to walk on than jagged rocks or mud. Another interesting aspect about our Saturday here is that the stereo in the lodge was playing an “ohm mani padme hung” song on continuous loop. I guess that’s a way of getting your quota of prayers in for the day, but it started to drive me crazy after a couple of hours, even from outside while I was in my tent. It’s hard to get it out of my mind.

As I mentioned before, this lodge is stocked really well. Maybe to break some of the routine I think it would be fun to indulge in some fine chocolate or something, but I have to stop and think about the prices. The chocolate bars sell for 300 Rupees, which is over US $4. Actually I’ve already spent most of my Rupees and I don’t have the convenience of my debit card or any other plastic to fall back on. Technically I could buy one candy bar, but then I’d be literally Rupee-less for the next two weeks. I just have to remember how numb I feel when I go shopping at Wal*Mart back in the US. With all the of the selection of things I don’t need or even want, I don’t need to make a big deal out of missing one chocolate bar our here. What I will soon miss is the toilet paper, which is also an expensive item. Each roll sells for aout 200 Rupees up here, and it sure gets used (passively implying that I’m too proper and polite to use it). What I must admit to using now is the pee bottle. Now that I’ve started on Diamox it’s a losing battle to keep myself hydrated because the fluids pass through me, especially in the middle of the night when it’s pop-cicle weather outside of my sleeping bag. This is TMI, but it get’s pretty unpleasant when one large bottle is not enough to last the whole night.

I spent the day feeling very groggy from my bad altitude headache and from the lack of sleep. I noticed on the pill bottle that it says “May Cause Drowsiness or Dizziness.” Yes, I had a pretty good “stupid” feeling going on. Other than a mini-hike I spent the day in the tent vegetating, which I was secretly hoping for anyway. I’ve wanted some time for my leg muscles to heal up – they were sore all up and down. Even though we were loitering with our tents behind the lodge, named the Khumbu Lodge by the way, they did let us lounge inside the dining room next to the stove. We met some very interesting fellow trekkers, and we spent the evening talking with them and sharing stories and family pictures. We met David and Hillary, a couple from Ontario, Canada. David is a retired law enforcement officer, though adamantly not one of the Queen’s Cowboys, the Royal Canadian Mounted Police. He is also a liscenced pilot, so he took great interest in how the pilots handled the approach to Lukla. He got a seat right behind the pilots, and he thought it was amazing to see the altimeter reading 12,700 feet as they were barely clearing moutain ridges. In Canada, of course, that altitude is restriced airspace and the pilots are required by law to have 02. Also, as the pilots were approaching the landing strip in Lukla, even before they touched down, they threw the propellers into reverse to make a sharp braking move. He says if you do something like that you have to be pretty sure you know what you’re doing.

We also met a few MD’s who were running a study on High Altitude Headache (HAH) effects. They’re taking volunteers for the study Headache Evalutaion at Altitude Trial (HEAT) to take unmarked pills as they trek from Pheriche to Lobuche. The pills are either Ibuprofind, Diamox, or sugar. The study is to take data on which medication does the best to prevent the headache that forty to sixty percent of hikers experience in the region at Pheriche and above. Dr. Grant Lipmen, one of the researchers in the study, took a moment to explain to me the cause of HAH. First, at higher elevation the body’s pain threshold lowers; second, with the decreased oxygen available, the respiratory system picks up and blood flows heavier; and third, the body chemistry causes streching/inflamation in the brain where there are some tender nerves. The effect is a lot like a hangover or a migraine. Ibuprofin acts as a good anti-inflamatory, but the benefit of Diamox is that as a preventative measure it helps avoid the headache. Dr. Lipmen says it’s a pretty good policy to take a half pill (half of 250 mg) at bedtime, and it is just as effective without as much of the side effects. Maybe I could make it through the night with just one pee bottle then.