Climbing a high altitude mountain may be possible if you are psychologically prepared and if your body cooperates. But since I had never climbed a mountain higher than Mt Washington (6,288 feet) in New Hampshire, I had no idea if my body would allow me to climb Mt Kilimanjaro in Africa.
My 30-year-old son, however, wanted an adventure. Chris and I had been hiking the White Mountain high peaks in New Hampshire for the past 3 years. There are 48 high peaks above 4,000 feet in New Hampshire, and our goal was to complete that list and become members of the Appalachian Mountain Club 4000 Footer Club. I am 60 years old, and I had to find out if my physical fitness would allow me to get to the top of these mountains. Our hikes included some winter hikes, but a hike in the winter (and, frankly, even in the summer) always depends on the weather. Sometimes the weather conditions are just too dangerous to be on exposed mountain ridges with wind, rain, and/or snow.
In 1994 when I lived near Saratoga Springs, NY, I had finished the list of the 4000 foot high peaks of the Adirondacks and had become a member of the Adirondack 46ers. Now living in the Boston area, Chris and I made many weekend trips to New Hampshire to work on the New Hampshire list, and I figured I would also try to finish the list of the Northeast 115 high peaks. This list includes Maine, New Hampshire, Vermont, the Adirondacks, and 2 peaks in the Catskills. I completed most of those hikes alone, and during the summer, I was able to finish the NH 4000 footers and the Northeast 115. Hopefully, this would help my conditioning for Kilimanjaro.
We planned a trip to hike Mt Kilimanjaro in Tanzania for September, 2013. At 19,341 feet, it is the highest mountain in Africa. The mountain is only 4 degrees south of the equator, but there are glaciers at its top. The trails, however, do not involve ice hiking or ropes and it can be climbed without special mountaineering skills.
My concern was the high elevation. I am a physician assistant in the Internal Medicine Department of Harvard Vanguard Medical Associates in Burlington and knew I needed to get prepared. I began to read about high altitude medicine and made an appointment for a physical exam with my primary care provider. I also had a Travel Medicine Department consultation appointment. I had immunizations for my trip, and I had prescriptions for Diamox and Malarone; Diamox would theoretically give my blood better oxygen-binding capacity at the higher altitude and Malarone was to prevent malaria when we went on safari during the second week of the trip.
We deliberately planned a 7-day trip on the mountain. For the body to adapt to high elevation, it is best to climb high during the day, and then sleep at a lower altitude for the night. Trying to go directly up the mountain without allowing time to adapt to altitude leads to a 50% failure rate of reaching the summit.
The dangerous effects of high altitude can lead to acute mountain sickness, high altitude pulmonary edema (HAPE) and high altitude cerebral edema (HACE). HAPE causes fluid to accumulate in the lungs, and the climber starts to drown in his own fluids. The lungs are not able to absorb oxygen. HACE causes swelling in the brain. The climber becomes disoriented, confused, vomits, has headaches, and finally can go in to a coma. Dexamethasone, a steroid, can help these conditions, but the real solution to the problem is to rapidly get the climber to lower altitude. This will require others to assist the climber.
Kilimanjaro is a National Park in Tanzania, and the government requires all climbers to contract with a guide and a climbing company. Chris and I had a support team of a guide, an assistant guide, a team of porters to carry equipment, and our own cook – a total of 13 people supported the 2 of us on our climb.
On day #2 at 10,000 feet elevation, I vomited during the late morning. The guide observed me closely, and we both agreed that I was not digesting the eggs that I had for breakfast. This worried me; I was having altitude effects at 10,000 feet. For the remainder of the climb I no longer had eggs or complex proteins for breakfast. At lunch that day I just ate noodles. The following 3 days we camped at 11,811 feet, then 14,210 feet, and back down to 12,713 feet. The night at the 12,713-foot elevation had deliberately been scheduled in case we were having any problems with the altitude.
The night we went to the summit, it snowed while we rested at a camp elevation of 15,357 feet. We left for the summit at midnight. 5 hours into the night we were still climbing a very steep section, the temperature was 20 degrees and there was a 30 mile per hour wind; it really was cold. But since Chris and I had winter hiked in New Hampshire, we had all the proper layers of clothing. At 18,000 feet, at the rim of the volcano, I vomited twice. Now the air was thin, it was cold, and I felt very fatigued. Again I was worried that my body was not tolerating the high altitude. But psychologically I had no intention of quitting the climb. I had to rest frequently after hiking short distances, but 2 hours later, we made it to the actual summit.
I saw 2 other climbers being escorted back down the mountain with the assistance of others. One person had to be moved on a stretcher (and fortunately the next day was feeling well at a lower altitude).
It took 2 days to get back to the base of the mountain, and at 2 sites at lower elevations, we saw rings of white painted rocks marking where helicopters land to do medical evacuations. (The helicopters cannot reach the higher altitudes.)
I am so grateful to have reached the summit. And I am very fortunate to have shared this experience with my son. We are already kicking around the idea of trekking in Nepal to the Everest base camp region. We’ll see.