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BaseCampMD - Khumbu cough, HAPE and chilblains on Everest's South Side
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Apr 28, 2005 15: 42 EST
BaseCampMD is a joint project started by Luanne Freer, ExWeb, and the Himalayan Rescue Association. Besides treating sick climbers, saving a few lives and printing ExWeb's free weather reports, the clinic offers daily info on the current health status on the mountain. In April, most problems have involved the Khumbu cough, colds, and pulmonary edema.

One in four has the Khumbu cough

In spite of a quiet month this far, the clinic is as busy as ever: "We're seeing a lot of patients (27% of our census to date) with viral upper respiratory complaints (sore throat, nasal congestion, headache, aches). The common cold is tough to fight at high altitude, and can slow down an expedition quickly! As expected, the dreaded Khumbu cough has slowed down 22% of our clinic visitors as well."

HAPE doesn't have to be the end of the rope

"We've seen 4 cases of high altitude pulmonary edema (HAPE), all of the HAPE patients have been treated and were able to descend on their own power to lower altitudes to recover. We've had good experience with folks who are alert to the signs and symptoms, come in early for treatment, and get down to lower altitude to convalesce. Many of these HAPE victims are then able to re-ascend slowly and ultimately carry on with their expedition -- and some of our patients have gone on to successfully summit that same season."

Cleaner cooking habits?

"Thankfully for all, our camp seems to be keeping their gastrointestinal tracts in good order -- only 2 visits for stomach and intestinal problems (recall the epidemic of devastating vomiting and diarrhea in 2004 that left many dehydrated and weak and kept us busy!) ...We hope this trend holds!"

Chilblains?

Early this week, cold weather hit the mountain. Thanks to the medical website, the chill became an opportunity to learn what to expect from the cold at high altitude:

"At the least, cold can make us shiver, drive us to our tents, and make us downright uncomfortable. At the worst, cold can cause serious conditions like frostbite and deadly hypothermia. In between are the more mild irritations that result from cold exposure. One of our campmates is sporting a classic case of chilblains."

"The dermatological description of chilblains is: bluish-red, edematous, painful nodular inflammatory swellings which arise as an abnormal reaction to cold. They occur especially on the dorsal aspects of the fingers and toes, the lower legs, thighs, nose and ears. Chilblains tend to start in spring and autumn, especially in individuals working in the open air in the early cold morning hours. Women are affected more often than men. Other terms for chilblains are erythema pernio, pernio, and perniosis."

"Prevention is the key for this uncomfortable disorder. Keep feet, hands, ears dry and warm (change socks, gloves as needed.) A dry, warm massage is the treatment, and elevation afterward helps keep edema to a minimum. Non-steroidal anti-inflammatory medication (like ibuprofen or aspirin) may be helpful. I've seen "chilblains cream" on the market but there's no scientific evidence that it makes any difference in treatment."

"Till later...stay warm!"

In 2003, ExplorersWeb helped to set up the first-ever Everest Base Camp Medical Clinic - a pilot project of the Himalayan Rescue Association, and the brain-child of Dr. Luanne Freer.

Everest's Top Doc, Luanne was recently elected the First Woman President of the Wilderness Medical Society. A board certified emergency physician, wilderness medicine expert, and veteran volunteer for the HRA, Luanne heads the altitude-experienced medical staff, which treats all climbers/support staff at Everest Base Camp, as well as trekkers visiting Base Camp.

The Himalayan Rescue Association is a voluntary non-profit organization formed in 1973 with an objective to reduce casualties in the Nepal Himalayas. The HRA will use proceeds collected from trekkers and climbers for their medical care to fund it's continuing mission to provide low cost/free health care to the native Nepali people.

Images of the clinic tent and "Chilblains", live over Contact 3.0, courtesy of BaseCampMD.



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