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Karakoram '99

Hydrate or Die!
Dispatch from the Karakoram Highway

July 31, 1999

Greg
Mortenson

Temperature: 79°F, Pouring Rain. The flight from Islamabad to Skardu has been weather-cancelled for five days, and a landslide has blocked the Karakoram Highway (KKH) at Staknalla, between Gilgit and Skardu. I have no way to contact any climbers unless I find a pair of Wellington boots and take a four-day muddy hike to Skardu.

I suspect all climbers on high Karakoram peaks are hunkered down in base camp or crammed into small tents waiting for the storm to abate. Tempestuous storms are a trademark of the Karakoram. Without a climbing dispatch to send, it's time to get creative and review a little mountaineering medicine.

"The flight from Islamabad to Skardu has been weather-cancelled for five days, and a landslide has blocked the Karakoram Highway (KKH) at Staknalla, between Gilgit and Skardu..."

Waiting out a storm, perched on a ledge in a tiny tent can be frightening, boring and wearisome. Hopefully, there is a companion to enjoy or a good novel to relish. Another important task is to tediously melt snow and ice to make precious drinking fluids. The process takes several hours a day.

Dehydration and inactivity followed by extreme physical exertion at altitude can be fatal for a climber. It is a complex physiological process, but can be explained in simple terms. In the thin air of high altitude, there are significantly less oxygen molecules floating around, compared to sea level. With reduced oxygen levels, oxygen-starved blood produces more red blood cells to grab spare oxygen molecules floating around. Oxygen then binds to hemoglobin molecules that make up red blood cells.

With dehydration, blood gets sluggish. Clots can form and lodge in the arteries (usually the calf muscles). When weather clears and climbers suddenly go from complete inactivity to extreme exertion, clots can disengage and travel up to the lungs or brain. Then bingo, it's time for a stroke or lung clot, a potentially fatal situation.

"When weather clears and climbers suddenly go from complete inactivity to extreme exertion, clots can disengage and travel up to the lungs or brain. Then bingo, it's time for a stroke or lung clot..."

The solution is simple. One: hydrate, hydrate, hydrate! Two: get out and move around every few hours, even in a storm. There are several good books on mountaineering medicine that elaborate on this.

And how do you know if you are hydrated enough? A couple of tricks my alpine mentor, Willie Prittie (now a mountain guide with Alpine Ascents International), taught me. Drink enough to force yourself to get up at least once or twice at night to urinate. Check your urine. If it's amber or yellow, you need to drink more. On a more personal note, if you are too cozy to pry yourself out of a warm sleeping bag into the freezing cold outside, use a pee bottle. For males, you can even urinate in a condom. Try it out – it works!

Some alpinists don't believe in hydrating. They take risks that us mortals would never survive. Tomo Cesen, who made an astonishing, but disputed, 1990 ascent of Lhotse's (8,501 meters) huge South Face, brought along only a thermos of coffee. Anatoli Boukreev brought only a quart of water on his incredible 14-hour round trip ascent of Gasherbrum II (8,035 meters). But they are the exception. Next time, don't leave home without your bottle.

Greg Mortenson, MountainZone.com Correspondent



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