Never did I anticipate problems adjusting to altitude. But since Golmud and then that cold, uncomfortable, 28 hour bus trip to Lhasa, the capital of Tibet, I got progressively worse with what was AMS. I had been drained since Golmud (3000 meters) and dead since arriving in Lhasa (3600 meters). I spent the next 10 days in Lhasa, feeling like shit.
[ INFO: "Acute Mountain Sickness (AMS / altitude sickness) is caused by the reduction in atmospheric pressure with altitude, meaning less oxygen reaches the muscles and the brain, and the heart and lungs must work harder to compensate. Most people who ascend rapidly to heights above 2500 meters have a period of unpleasant acclimatisation. But individual susceptibility to AMS is highly variable. Males are more susceptible than females. Youth and fitness do not prevent AMS. Symptoms are "Headaches, dizziness, fatigue, loss of appetite, nausea and a general feeling of being unwell that is often compared to having the flu or a hang-over ... Most cases of mild AMS will improve with rest. This often takes only 1 or 2 days. Warning signs for severe AMS include: Unsteadiness on one's feet, inability to sit upright, severe headache not relieved by aspirin, shortness of breath at rest, and mild AMS which does not resolve in 2 - 3 days." ]
From my diary:
Wow, Lhasa – TIBET!! Yet my euphoria is short-lived. Something’s wrong with me. Was starving – no ‘real’ food for a few days – so I ordered a yak burger (two large steaks with fried potatoes and veggies). But as I stood waiting, suddenly dizziness, along with the feeling of a massive weight being exerted on my shoulders – like pistons pushing down on each shoulder. I sat down. Head on my hands on the table; spinning. Sally nursed me until her meal arrived. Mine still hadn’t shown – just as well, cos I’d lost my hunger.
Now, fully-clothed – thermals, t-shirt, shirt, scarf, woollen Tibetan jacket – I lie between sheets beneath an elephant-heavy duvet; and still I shiver. On the opposite bed Sally smiles, slouched casually in leggings and sweatshirt. I ask a favour of her. Sal replies – “Are you sure you’re hungry?” “Yeah, I feel okay – as long as I’m lying down; no dizziness.” Sally laughs at the idea of me lying down and eating. 10 minutes later she returned with a plate of french fries. She watched – amused, as I ate while remaining horizontal. (Who says nurses have seen everything?) A full stomach feels great.
*
Between 7.30 and 10 P.M I felt like death. A drilling gouged into the top-most part of my skull. A throbbing, needle-pricking pain in my brain as I alternated between cold shakes and wet sweats. I couldn’t decide whether to drop Aspirin or Valium. (I took the latter and was informed later that sedatives are the last things, along with alcohol, I should be taking while adjusting to altitude.) The pills kicked-in and was feeling mellow. Warm. Had stripped some of my layers off. Content, drifting gorgeously, when I farted. Straight away I knew: I reached down with toilet paper. Brown and stinky. I staggered along the corridor – out-of-it on altitude and Valium – to finish the fart. During the night my bladder ached me awake. Woke again in sweat-soaked sheets. Then needed another piss. A night of up and down the corridor, of cold and then way-too hot.
*
Walked for an hour this morning before exhaustion forced to bed. Sometime later Ross (Scotland) and Dave (Canada) arrived at our room. Lots of madness to tell me what I missed out on – they’ve had some wicked sessions with Thomas. They all went to a party held by Aussie geologists the other night. Mega FREE beer. Dave doesn’t remember pissing on a sleeping someone in his dorm. Or how he managed to pass-out beside an Aussie woman, nor did he recall her boyfriend removing him from their bed. Anyway, it’s their last night in Lhasa before they head to Shigatse, and I have to join them for a few beers … but am I up to it?
*
Woke with a busting head – and I didn’t even go drinking last night. Throbbing got so bad I took a handful of Aspirins. And then Digestics, but even these stronger pain killers only eased it slightly. Daggers piercing the top of my skull. Have lain in bed all day, wanting to shriek from the knife thrusts – but they don’t last long enough, just spit-seconds. Lightning pains. Even to cough or turn my head I get short sharp jabs. Running my hands through my hair causes discomfort.
*
Late afternoon: Aching body. Smashed head. Eyes throbbing and then the shits struck. Real task to dress, lock the room and walk to the toilets. As I squatted everything swirled. Am leaning hands against the wall, head on hands and spinning. Legs unsure as I crouch above the hole-in-the-floor. Twice I nearly fainted. Am washing my hands and looking out the window to the street of solid white-washed buildings, flower-boxes beneath their thick black window surrounds, when suddenly the scarlet robed monks, the colourful cycle rickshaws; everything’s gone grey – colorless silhouettes. Nothing but glowing white. Losing feelings … passing out … darkness.
Sally found me passed out on her bed. Soon Dave and Ross – they’d missed their bus! – arrived. Their humor and some sleep has helped. I feel okay … Woke in the night dripping wet. Armpits, chest hair, legs and face a waterfall. Sheets like baby’s diapers. Felt cold much later; put on a t-shirt. Then very much hot and wet, again.
*
Ate breakfast (first food in a day). Was feeling okay, but had trouble shaving. Black-outs every 5 -10 seconds. Sally’s gone to check another monastery; I’ve decided to work on a recovery.
Got ugly in the afternoon. Was reading Heart of Darkness with my back against the balcony railing, sitting half in shade and half in sun. But these bits either fried or froze. No happy medium. My body took me to the very extremes. Meantime others strolled in t-shirts, shorts and sandals. I went back to bed. Got cold. Covered myself with Sally’s sleeping bag and an extra jacket and duvet. I shaked, shivered uncontrollably for 30 minutes. (The creaking spring bed gave the impression to anyone outside that lovers lay bonking berserk where I lay shaking.) I muttered unflattering sentiments. Dickhead! Wimp! Weasel! Loser! And laughed. Warm went to hot and overheating fast, so I stripped down, my face the color of beetroot, my body weak and frying. Sally returned to a cold, feeble freak who wanted more socks.
*
More midnight pisses. It’s gotten to the stage where getting dressed and wandering the corridor for a pee is too much effort. I now piss in a bowl in the room, steadying myself with one hand holding the door jamb and knowing that those first few seconds I feel will feel dizzy, standing with my vision briefly disappearing; and that’s when I’m most careful to get it in the bowl – and not, on the floor or my feet.
*
Felt okay this morning. Made my way to the Nepalese Consulate by minibus. Walked the last few hundred meters and became dizzy. Rested head against street railing and threw up the soft drink I’d started. Sal led me back … to bed.
*
Another wet-night awaking induced by sweats. Drenched. Hung out the damp bedding to dry. Ate scrambled egg – needed some energy. Felt confident I’d adjusted. Walked 20 meters to buy some water.
*
This afternoon I met Katie, an Aussie who’d cycled with two male companions from Islamabad in Pakistan, up the Karakorum highway and into China, then cycled across western Tibet to Lhasa where she now rests, waiting for her companions to recover from Giardia. Their final stage is to Kathmandu, Nepal. They’ve spent a month at 4000 meters and have no need for their altitude pills (Diamox). Katie has kindly given me the bottle. I’ve dropped my first Diamox. (Apparently it alleviates the swelling – (water on the) – brain, which altitude causes. Side effects include, needing to piss alot.)
*
A massive headache. Downed paracetamol. Rubbed Tiger Balm across my forehead. Tried Chinese folk music – played at low volume on my Walkman, to soothe and distract. The pain persisted. And in desperation I prayed / meditated, fingering the Celtic cross around my neck and muttering the affirmation – “Move to the top of my skull, and into the sky. Move to the top of …” – while visualizing the pain disappearing. Something, or a combination of something’s, eventually worked.
Pilgrims at the Jokhang monastery - a holy of holies within Lhasa
I feel alright, but usually do first thing in the morning. 100%??? Or is this just another temporary recovery? Yet another sick mind game which this illness keeps playing with me?
Mid-day: I’m disorientated, dizzy, weak and have a pounding head. One of the Tibetans working in this hotel has suggested she arrange a doctor’s visit. Through the window I watched him climb the veranda stairs. He had a Red Cross badge pinned to the lapel of his tatty suit. And he put his glasses on seconds before entering the door, like he’s eager to make it known he’s a doctor (and not a black market medicine salesman). Who knows? He entered the room smoking a cigarette. He placed a thermometer beneath my armpit, counted my pulse, felt my forehead, checked my tongue. And from my answers to his questions via an interpreter, he gave me many medicines.
I’m to have 500ml of Glucose (mixed with two other solutions) pumped into my body via the needle in my arm. The Tibetan woman has used one of my boot laces to tie the plastic drip bag to the light bulb above my bed. It will take 90 minutes for me to absorb this medicine. Meanwhile, flies harass me – flying up my nose, landing on my eyes, and in my fuckin’ ears! Fuck you! (For the entire week of being in bed I’ve been dive-bombed by flies. I’ve squashed many; but there’s 100′s – and they never leave me alone.) When I’m well, I’m determined to kill them all. The only joy I have now, is to watch the air bubbles in the bag suspended above me and feel liquid pulsing into my arm, and looking out the dusty, fly-guts-stained glass, to the glaring whiteness of what I know is clear blue sky.
I believe I’m ill. The doctor’s left me two vials and a syringe to inject into my butt – I said Sally could do that, no problem. He’s also given me a host of multi-colored pills. Five different varieties. I’m to swallow a total of 27 pills daily.
*
Today, rebirth, I think. More energy. And no headaches or dizziness. The only side-effects from the feast of Chinese pills was that I felt my skin being pulled from around my eyes, and twitches and tightness. But mostly I felt sedated, mellow, calm, like a slow motion zombie.
Despite me convincing myself that I was on the mend, I met Eugene, a Dutch tour guide who said otherwise. He’s had 8 years experience in China and the Himalayan region. And according to his assessment of me – after consulting his medical manual – my condition lies between medium and severe AMS. Eugene’s advice is to leave immediately for a lower altitude, the nearest place being Kathmandu at 2000 meters and hundreds of kilometers south in Nepal.
>>>>> flash of PANIC: I’ve no travel insurance. I don’t wanna be hospitalized; don’t wanna be flown to Kathmandu or Chengdu or worse, flown home. I can’t face leaving Tibet, not without seeing Lhasa – let alone any other place – and not, after all the effort of getting here. The thought of fleeing Tibet makes me very depressed. I haven’t really improved. Am fooling myself; this recovery was merely temporary. However, I know I’m not getting any worse.
*
I don’t want to write, but I must record my feelings now, as I lay like a vegetable, again. While I’m far from dying, my body refuses my brain’s commands. Sure, I can write while lying on my side, and eat, drink, talk, read – just a little; but when it comes to standing up, showering, peeing, hanging up my towel, fetching a mug of hot water, then it becomes a task. And if too many tasks mount up, I’m totally sapped. I lie in bed unable to move – cos my body refuses. Yet my mind remains sharp. In this comatose state I’m aware of nothing around me. Well I am, but I’m not. Travel conversations drift from outside, colorfully painted rafters stretch out above me, doors and sky, they all vanish. My surroundings are dead, and I’m dying the same way; fading temporarily from life as my mind surrenders. Nothing matters. Not even the fact that, I’m on the roof of the world – in mysterious Tibet.
*
The hotel manager suggests I try traditional Tibetan medicine. The Chinese doctor’s recommended another I.V. drip. Meanwhile I try more Diamox.
*
Some progress. On the way the sun was blinding – even with shades, as I walked thru the market – sun in eyes I saw no faces, no details, just silhouettes coming towards me. My vision went completely a couple of times. I had to stop. Blind for some seconds, before walking, dodging my way with Sally leading me to the Jokhang Temple: Tibet’s holiest shrine: 1300 years old—————–but … on all the drugs, the experience became detached, surreal. I was not there.
*
I had to get out of the room. Getting crazy stuck in bed. I swallowed Diamox and felt okay as I wandered narrow, dusty backstreets – high walls of white-washed stone with black framed, deep inset windows with flowers boxes beneath sills. Many smiling, friendly faces. A few growling dogs; but most lay asleep in the sun. Saw no other foreigners. Met a local woman who invited me into her home. Drunk two yak butter teas, then she offered me stuff for sale. A large ceramic bowl, jewelery … I was starting to shiver. Ended up buying her personal knife. (A small blade with bone handle studded with bits of turquoise in an ornate sheath attached to a solid silver chain clipped around her waist.) She would’ve been in her late 20′s. She’d long black plaited hair threaded with coral and turquoise beads, and a large amber broach above her forehead. She wanted me to stay awhile longer; being suggestive … But I indicated to her – I had to go. I was beginning to shiver uncontrollably, despite it being a sunny day, despite being warmly-dressed and inside her home. Went back to the hotel in a rickshaw with a killer headache. Sal arrived later with grapes and chocolate. (This nightmare would be twice the shit without her.)
*
Dave, Ross and Thomas showed up in our room this evening, after each returning from separate trips. Ross had stayed in Gyantse and Shigatse, while Dave abandoned his plan to sneak across the border and into Bhutan. Thomas had gone to the Rongbuk Monastery near the Everest Base Camp, trekking via some villages, but on route the second day he’d unknowingly passed the village he should have stayed in that night – his guidebook was inaccurate, and he ended up sleeping on a slope that night! Luckily, he had a minus-20 sleeping bag. He said he’d froze all night, eagerly awaiting dawn.
Sally and I have said good-bye to the others, tomorrow they’re returning to China. All five of us have shared some fun times. Thomas and I were teary-eyed as we said good-bye, well knowing that out of all the chance meetings we’d had over the past 4 months, that this would definitely be the last. (He’s heading onto Beijing for the Trans-Siberian to Moscow, then home to Copenhagen.) It was a touching, see-ya-forever moment.
*
More brief vision loss and days of pill popping, feeling faint, walking slow, restful visits to the Sera Monastery and the Potala – the Dalai Lama’s fortress-palace – and I was feeling okay, not brilliant, but okay with the help of Diamox and Sally’s nurturing.
After 10 days in and out of bed, I was now desperate to travel further, to see and experience a slice of Tibet on my way to Nepal.
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