On any mountaineering adventure there are always general health risks such as falls, blisters, colds and infections to name a few. However, in the extreme cold the body protects the essential organs by restricting blood flow to the extremities of fingers and toes. It is common to suffer from mild forms of: frostbite, hypothermia and exhaustion. These all exist on Everest along with specific conditions that are directly related to and exacerbated by extreme altitude and if left untreated can be fatal.
At the summit of Everest, the atmospheric pressure and amount of oxygen is about one third of that at sea level. It is said that if a person was “dropped” at the summit of Everest they would only stay alive for a few minutes. Currently, there are over 150 bodies on Everest and most of those are over 8000m, in the Deathzone, which poses the most dangerous effects on a climber's health. The process of acclimatisation is essential in preventing the potentially fatal conditions that can occur on Everest. For the final 2 days, most climbers also use supplementary oxygen.
Mountain or altitude sickness
The speed at which a climber ascends the mountain will determine if they develop mountain sickness. The faster the ascent the more likely they will develop the illness. To aid in prevention of altitude sickness a process of acclimatisation is followed. This includes about three weeks spent at base camp and going on a number of “mini-ascents” to get the body used to spending time at altitude. The longer the preparation process the better the body is to handle the higher altitudes.
What can happen at high altitude and what acclimatisation aims to control:
1. Breathing rate increases
2. Depth of breathing increases
3. Oxygen saturation reduces: when muscles do not get the amount of oxygen they need, climbers will take more frequent rests which allows the saturation level to increase again.
4. Alkalinity or pH level in the blood increases: there are artificial mechanisms to reduce this effect.
5. Pulse rate increases, blood volume decreases because the blood moves into the tissue. Climbers increase the amount of fluid intake to help restore blood volume. On Everest Cheryl and Nikki will consume about four litres of water each day.
If a climber develops mountain sickness they will get a headache, stumble and fall, and become drowsy and experience disordered thinking. If a climber has these symptoms they must rest immediately and if they do not recover the best thing is to descent to lower altitudes and take oxygen.
Acute mountain sickness can progress to high altitude pulmonary edema (HAPE) or high altitude cerebral edema (HACE).
High Altitude Pulmonary Edema (HAPE)
HAPE occurs when the alveoli, little sacs for the exchange of oxygen in the lungs, fill with fluid. As the fluid increases the lungs are unable to process oxygen and the oxygen pressure in the blood falls, decreasing the oxygen supply to the body. The most dangerous is of course the brain. If a climber is not treated they can fall into a coma and suffocate.
A climber developing HAPE will first notice a “tightness in the chest” a few days after arrival at altitude and may also develop a cough that may show blood. They will be a lot more tired than everyone else. If the oxygen to the brain is not improved a climber will become confused or delirious. Urgent medical attention must be sought.
High Altitude Cerebral Edema (HACE)
HACE is a very serious complication, and a severe type of mountain sickness that affects the brain. A sufferer will not be able to touch their finger to their nose or walk in a straight-line heel to toe. It can get so bad that climbers will be unable to dress themselves or handle a spoon. If a climber with HACE is not treated it can cause brain damage or even death. Sufferers must be given oxygen, taken to lower altitudes immediately and eventually to hospital.
Lincoln Hall was suffering from HACE when he was found in 2006.
