How to get a free ride to Tengboche

8th Apr 2017

After a long period of rest in Namche Bazaar we were off on our way to Everest base camp again.  I was walking along the trail with Brad, with only a couple of the team ahead of us.  We stopped for what we thought was going to be a quick water stop just beside the first lodge along the path.  I noticed two Sherpas heading towards us dragging a man who looked pretty unwell.  They stopped on the path opposite us and I quickly headed over to see if I could be of any help.  

About 7 months ago I completed the UIAA Mountain Medicine Diploma, so it was time to put some of the knowledge and skills to the test for real. I found a middle aged male, who was struggling to answer basic questions about himself.  It seemed that he'd been at altitude for a few days not feeling too good and suffering from a headache, before continuing up higher to Pheriche.  He was part of a larger trekking group who were on a trip to cross the three high passes and had been sent down with the Sherpas due to being unwell.  He could remember that he'd taken 125mg
acetazolamide (Diamox) that morning, but couldn't tell me whether he'd had any other of the symptoms of acute mountain sickness (AMS).

Judging by the dried vomit down his chin I think it was fair to say that he had gastrointestinal symptoms of AMS.  He was also unable to properly walk heel-to-toe and so I diagnosed him with high altitude cerebral oedema (HACE) or swelling of the brain secondary to altitude.  I treated him with 8mg dexamethasone and an additional 125mg of Diamox.  I also started getting him to drink some fluids and eat some sugar as I was sure he was well behind on fluid and food.   My thoughts turned to the evacuation plan of this man.  The Sherpa informed me that the only way was to walk him down to Namche Bazaar and pick up a helicopter evacuation from there.  At this point there was no way that he was going to be able to do this, although he did start improving very quickly.  

Our team started walking past at this point so I grabbed Chris Imray, with his years of mountain medicine experience, to help me with the ongoing management plan of the patient.  Chris was quick to read the situation and thought that we could probably get a horse from the nearby lodge and evacuate the patient this way.  As luck would have it it turned out that the Sherpa who owns the lodge had a helipad tucked away on a rocky outcrop just above the lodge.  After a few phone calls the helicopter was on its way, although it wasn't quite clear to us how long it would be.  

Fortunately during all this time the patient was gradually improving.  After about an hour and a half we assisted the patient up to the helipad.  We wondered at this point whether we should get going to try and catch our team up.  We were pretty happy that the patient was improving and that the helicopter would not be too much longer.  Brad had already positioned himself on a rock to take photos and we decided to wait.  Half an hour later and the helicopter came in to land.  We got some great shots of the helicopter coming into land with Everest and Ama Dablam as a back drop.

The Sherpa and his family emptied some shopping and an elderly family member out of the helicopter.  He was then frantically waving at us to come over and we were told that we were getting on the helicopter to ride to Tengboche.  So with much excitement Chris, Brad and myself all piled into the helicopter and had an amazing ride up to Tengboche, avoiding the big hill that the rest of the team were about to start slogging up.  The helicopter then went to Pheriche, prior to returning and picking the patient up.  

We celebrated with a coffee and lunch at the bakery in Tengboche whilst the events of the past few minutes caught up with us.  We got piled into the helicopter in a bit of a hurry and completely unexpectedly.  We were treated to clear blue skies, stunning views of Everest in the distance, and the monastery at Tengboche as we were coming in to land.  There were high-fives all round as we got off the helicopter, not only had we had a trip to remember for a very long time, we'd also helped out a pretty sick patient and had seen him start to get better prior to his transfer to hospital.

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