February 2, 2006: Day 2 Ascending through the heath zone

Although I managed to get up early to see the sunrise, by the time everyone else rolled out of their sleeping bags and we all had breakfast, most of the other trekkers were long gone. We just didn't see the need to move any faster, as we knew we had plenty of time for today's hike.

For the first time, we felt the warming rays of the sun as the cloud cover was temporarily absent. The destination for today was Shira camp. Our hike would take us up another 900m in elevation (roughly 2500 feet), about 2/3 of the elevation gain that we made on Day 1. The majority of this elevation gain would be in the first half of the hike, which proved to be the steepest climbing thus far. The path often consisted of slickrock, which fortunately for us had started to dry from the previous nights rain. Otherwise, the ascent would have been more difficult given the steepness and slippery nature of the rocks. We took it slow. Waking up with a resting heart rate of 100 bpm told me that my body was still adjusting to altitude. Otherwise we all felt fine, and we enjoyed the open views that the lack of clouds afforded us.

Stedman's: Kilimanjaro Guidebook, 2nd edition

The best Kilimanjaro specific guidebook that I have seen is Henry Stedman's 1st edtion (blue cover) "Kilimanjaro, A Trekking Guide to Africa's Highest Mountain." The second edition is scheduled to come out in June, 2006 (green cover). It will be interesting to see what addition/changes have been made. Definitely worth the investment if you plan to make this trip in the near future

February 2, 2006: Morning, Day 2

Insomnia is often an indication that altitude is affecting your body. Fortunately, that wasn't a problem for me, at least at this point. It seemed as if it was still dark outside when I woke to the sound of pots rattling and clanging as the cooks began to prepare breakfast. The air was cool, but the moisture inside our tent hadn't frozen, indicating that temperatures hadn't dipped much below freezing, at least to any significant extent.

I rolled out of the tent to see what morning had brought. I wasn't disappointed. The clouds had lifted from the previous night. The rising sun cast a pink hue across the high flying cirrus clouds. Looking to the northeast, Kibo, the peak of Kilimanjaro, appeared for the first time since we had started our climb.


[Photos, top: looking northeast, Kibo is visible to the left of the picture; bottom: the glacier streaked Kibo, sitting 9000 feet above our current position at Machame camp]

Mount Meru again served as our beacon to the west (below)

Moonscape over Mount Meru, viewed from Machame Camp

Although the peak of Mount Kilimanjaro remained shrouded by clouds on our first night, the first spectacular view materialized like a spectre as the sky opened up to the west. As the sun set behind it, Mount Meru came into view for the first time. This jagged peak sits 14,000 feet above sea level. Although it would easy for Meru to be overshadowed by Kilimanjaro, as we rose higher and higher in the upcoming days, this peak seemed to rise with us. It seemed as if Meru grew larger and closer as we hiked up the western flank of Kilimanjaro.

February 1, 2006: Evening at Machame Camp

Jen and Ajay break into the biscuits and popcorn snack before dinner while Jeremiah finds that inflating his ThermaRest at 10,000 feet elevation to be a challenge. As the first day on Kilimanjaro passes, we have dinner by candlelight in the mess tent.

Diamox baby: I'm high as a kite and you make me all tingly inside

In the last post, I indicated that upon arriving at Machame Camp, 10,000 ft, we were all doing well. That's not entirely correct... we were all jacked up on diamox (acetazolamide) and were experiencing numbness and tingling to various degrees, a known side effect of this medicine. Ajay thought that these neurological manifestations were due to potassium loss, also a side effect of this diuretic. Not exactly sure if I believe that, boss, but just doing a brief search for the mechanism of action didn't turn up anything quick explanations. So the jury is still out.

Many people are aware that diamox is used in the prevention and treatment of altitude illness.
We were all taking the higher doses suggested in the medical literature (see below), 250 mg three times a day. Our guide, Bruce, who's opinion and experience I certainly respected when it came to anything about being on a big hill like Kilimanjaro, stated that these were higher doses than most climbers used. He felt that higher doses like 750mg/day of diamox was a dose for treating (after one develops symptoms) severe altitude sickness, rather than preventing the occurence of AMS (acute mountain sickness). He thought we should be taking about half of this dose.

Although the paresthesias (numbness, tingling of extremeties) caused by diamox aren't considered serious (ie life threatening), they did eventually get bad enough for Jen and Ajay, to the point that Jen was having difficulty holding her trekking poles. They both eventually titrated down a bit on the dose and this seemed to help improve the parethesias. Jeremiah and I continued to take the same dose. With the exception of the summit day, none of us had any significant problems with altitude during our climb. On the summit push itself (starting at 15,000 ft- Barufu Camp), Jen and Ajay definitely felt the effects of AMS. It's impossible to tell whether this was due to the fact that they backed off their dosage of diamox; more than likely it was coincidental...I think any of us could have potentially ended up with more severe altitude illness... it's just the way the cards were dealt.

In addition to diamox, we took daily gingko as well (120mg). There have been case reports suggesting benefit of gingko in altitude acclimatization, but I think most of this is still heresay at this point. Our feeling was it couldn't hurt and we all could use a little improvement in our memory.

We brought along dexamethasone, and nifedipine as well for treatment of possible HAPE (High Altitude Pulmonary Edema) and HACE (High Altitude Cerebral Edema), but fortunately this was not needed (see New England Journal of Medicine article below).

My hypothesis as to why we all did so well in terms of avoiding altitude sickness for the most part, is that we took our time ("pole, pole"), and just soaked in the trip every second and every step that we were on the mountain. Altitude, not fitness, is by and far the biggest reason people fail to summit Kilimanjaro. And the best way to avoid the effects of altitude is to ascend as slowly as possible... the human body can adapt if given a chance.

Although there's lots of good medical literature about altitude illness out there (check www.pubmed.gov and search "altitude illness and review" some of most useful articles that I found were:

West, JB, et al in Annals of Internal Medicine, 2003. One of the best reviews on the pathophysiology of altitude illness (http://www.annals.org/cgi/reprint/141/10/789)

Barry, PW, et al. British Medical Journal, 2003. A good clinical review. http://bmj.bmjjournals.com/cgi/content/full/326/7395/915

Hackett, PH, et al. New England Medical Journal, 2001. Although it's a bit old, its a classic, and not much has changed in our thinking about AMS anyway. This article's got it all: clinical signs and symptoms, diagnosis and treatment, pathophysiology. The one article to read before heading up into thinner air. http://content.nejm.org/cgi/content/extract/345/2/107

One of many cool websites: High Altitude Medicine Guide.

I'm starting to sound a bit like an Amazon Book review.

February 1, 2006: Machame Camp

The transition from the rain forest to the heath zone was rather abrupt. As the late afternoon rain quickly tapered to a drizzle, we emerged onto a plateau where the vegetation suddenly converted from the giant moss covered camphorwood trees to the shorter heather bushes. The mist and fog still hung heavy over us, obscuring any view of the landscape around us. Our hike had taken about 6 hours and we had ascended 1800 vertical meters (>5400 feet). This would be the larger gain in elevation that we would do in any single day. Within minutes, our first campsite, Machame Hut, appeared in view.


Our first task upon arriving was to sign in at a small hut. We waited in line briefly to do this behind a large group of loud but otherwise jovial french folk. The hut also had a small scale where the porters reweighed their cargo in order to assure that they were not carrying a significant amount of weight over the dictated limit.
























[Photos: The French wait to sign in; Ajay and Jen with Living, our assistant guide; signing in; Machame Camp)

We wound our way through the various campsites to find our tents that had been already set up by our porters.

We all felt well. At 10,000 feet of elevation (3000m), the only real indication of altitude at this point for me was an elevated baseline heart rate.

February 1, 2006: The Rain Forest (cont)

Our chief guide, Bruce, was MIA the first day, apparently back assisting green porters. His half brother, Living, stepped in to answer the barrage of questions we had regarding the mountain. We didn't think we would stay dry forever, and as we began to approach the highest boundary of the rain forest zone, the skies finally opened up, albeit briefly. We quickly pulled out our rain gear as our 9 mile hike brought us toward our first campsite, Machame camp.
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Impatiens

[Impatiens psuedoviola and Impatiens kilimanjaro]

There are close to 1000 species of plants belonging to the genus Impatiens (aka "touch me nots," since the mature seed pods explode when touched sending seeds meters away). Two of these can be seen on the rainforest slopes of Mount Kilimanjaro, Impatiens psuedoviola and Impatiens kilimanjaro. The latter is unique only to the slopes of Kilimanjaro itself. Shaped like a small tuba less than 0.5 inches in length, the yellow and scarlet flowers line the lengths of the trail and form a striking contrast to the earthy green vegetation that otherwise dominate the landscape of this mountain zone.