The things that worry me on the way to the mountain, and on the mountain.

Concern 1

The dreaded diarrhoea!  This is my number one concern.  Having been unlucky enough to be caught out with a severe instance (of 30 days straight –suspect Giardia) I am worried about getting a bug or repeated bugs.  The ‘big D’ can take all your energy away and cause cramping and water loss.  It effectively cripples your expedition.  This time I have come better prepared.  After talking to my Dr we agreed on a standard approach to treatment of diarrhoea.  It is important to talk to your doctor about your particular case and what medication will work for you.  I am not providing any medical advice whatsoever, I am only going with my own approach (Norfloxacin, Tinidazole and Azithromycin).  I will use Imodium if all else fails.  If I cannot stop the diarrhoea at its cause, then I will have to try to slow the digestive system down until I can get the climbing out of the way.  I have heard of some mountaineers being on Imodium for many days straight...urgh.  Doesn’t sound too comfortable at all.  But you need to do what you need to do.

Concern 2

Exhaustion –This comes on very fast.  I was surprised that one minute you can be pacing nicely and then all of a sudden your body just stops.  ‘Hitting the wall’ is a nightmare as you stand there not having any energy left to even walk.  This happened to me as a result of the above, and it took 20mins just to power down some sugars to get the energy to walk 20m to my tent.  The problem was exacerbated by not eating more frequently throughout the day.  I should be snacking at least every hour (carbs or sugary drink).  So much energy is expended at altitude that consumption needs to be increased significantly.

Concern 3

Diet at high camps is all about being able to stomach whatever you have.  I shall be food shopping with my Sherpa for high camp food.  I remember being provided with freeze dried healthy food at higher camps, but neither my tent buddy nor myself could stomach it.  The healthy ‘gruel’ was very bland and tasted like cardboard.  My approach is to decide on what I can stomach and then buy TASTY food before leaving Kathmandu, not necessarily health food.  At high altitude you tend to lose some of your ‘taste buds’ and many foods taste bland.  If you cannot enjoy your food then you will not eat it, thus no energy to generate heat or move.  Taste is everything!  For the healthy freaks out there...get over it.  Throw down some food that has high sugar, high fat, high salt etc.  Yum yum.  Time to buy a tiny bottle of soy sauce to give taste to the infinite amount of eggs that will be eaten on the mountain (yes, you get sick of eggs).  If all else fails then befriend an Italian...they always carry nice food.

Concern 4

Frostbite - Not much you can do here except to eat lots, drink lots, keep all skin covered and layer for warmth.  Toes are a big concern as you need your boots snug enough that your feet do not slip/move yet not so tight that circulation is restricted.  Your boots are always in contact with the snow so warmth is critical.  There is no coming back once your toes (and to a lesser extent your fingers) go very cold...it is not easy to remove your footwear to deal with issues.  To try to mitigate toe frostbite I am using a vapour barrier layer (VBL) to keep sweat from soaking my socks and adding an extra insulation layer over my mountaineering boots –adding a 40Below neoprene overboot over my La Sportiva Olympus Mons boots.  This hopefully will form a warmer combination without relying on electronic food heater insoles (more batteries and chance of failure) or chemical insoles (hit or miss success rate given low O2 in boot).  I’ll let you know how it goes.

There are always things that people can be concerned about, whether it be in mountaineering, personal adventures or life in general.  The best tactic to dealing with them is to be sensible and think it out logically, plan for the event/mitigation and then execute when required.  Things may or may not work out for you, but you can only do so much.  Don’t let fear hold you back - keep moving forwards :-)