Friday, November 30, 2012

Nepal 2012 Rock Star Hogus

We reached Gudel in the dark last night and immediately went to our tents. In the morning we woke to an amazing sight- a huge Welcome banner and children hiding in doorways, shyly waiting for us to get up. When Hogus and I first wandered through the village adults were not visible and children quickly scattered.
But they soon warmed to us and Hogus became very popular, very quickly. Fortunately for me Delanie, Elise, and Jackie rescued me and helped Hogus entertain the children. The reason for their shyness and curiosity became apparent later that day as Ganesh told us that only 3 foreign tourists had been to the village of Gudel before our visit.

Where is Hogus in these pictures?

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Wednesday, November 28, 2012

WEGO Award Nominations

We were humbly surprised that our FaceBook page has been nominated
for a WEGO Health Activist Award ... Best in Show: Facebook

There are 100s of excellent blogs that inspire, motivate, share, and educate.
You can nominate any worthy blog (even this one) for any of the 12 WEGO Award Catagories
(like Rookie of the Year, Best Kept Secret, Unsung Hero ...)

Tuesday, November 27, 2012

Nepal 2012 Running on Empty

I ate a full supper then went to bed, and within minutes felt a growing nausea. I had just seconds to unzip the tent and vomit ... all over my boots. Next morning I was nauseas and coudn't eat any breakfast. It was tough climbing that morning on an empty stomach. Knowing I had to eat for the fuel to climb I carefully and hesitantly overcame the gagging reflex and swallowed 2 small bits of potato. The result was instant projectile vomiting. Although the symptoms were non-typical I started taking Cipro (prescription medication to combat intestinal bacterial disorders). We were puzzled at why I was the only victim as we all ate the same food, drank the same water, and climbed the same route. What made me different? Best conclusion was that I had poisoned myself with Fecal-Oral contamination caused by the previous 4 consecutive days of flange-failure cleanups and my inconsistent use of hand sanitizers.

I trekked 2 hard 11-hour days on absolutely no solid food even while others who were eating full-meals were struggling. Legs had no power, knees and ankles refused to balance, brain was losing the concentration to pick each step carefully, and eyes lost focus. The stepping-stone rocks were mirage-like. I was already struggling to select stepping stones and to plant my feet accurately, but now the rocks seemed to move. I stumbled several times. I was weak and exhaused when we arrived at our lodge. I stripped off my sweaty clothes and crawled into my sleeping bag falling asleep instantly. Over the next 2 days the Cipro worked its majic. I persisted in eating as much as I could, without losing it all, and I grew stronger. These days have been a challenge with mind saying GO and body saying NO.  But stopping never really was an option.

Many times during these days, Jackson Browne's song 'Running on Empty' played in my head. The 'running on empty' seemed to fit the situation but the song also played to thoughts of years gone past, the aging process that relentlessly deteriorates the body's power, and how we can get so absorbed in routine day-to-day living that we forget about really living. 

"Looking down at the road rushing under my wheels
Looking back at the years gone by like so many summer fields
In sixty-five I was seventeen and running up one-on-one
I don't know where I'm running now, I'm just running on
Running on-running on empty
Gotta do what you can just to keep your life alive
Trying not to confuse it with what you do to survive
Everyone I know, everywhere I go
People need some reason to believe
I don't know about anyone but me"

During these days I could 'get down and keep down' liquids but not any solid food ... not even the easily digestable pastas. Always problem solving it occured to me that a spaghetti smoothie would be a practical way to get down the much-needed carbohydrates.  Of course we had no blender (no electricity) there, but since then at home I have made spaghetti smoothies and successfully consumed them.

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Friday, November 23, 2012

Nepal 2012 Ostomates Only - Heat Induced

Only Ostomates are likely to relate to this post. The experience is all real but if it makes you uncomfortable then quit reading and move on to other stories that are less-revealing.

Most days we are unaware of our ostomy except for a 3-minute bag change. But daily 'flange failures' without cleanup facilities can certainly consume some mindshare. The following is my experience log while trekking in Nepal.
I use Convatec Durahesive flanges (normally good for 6 days) with closed-end pouches. 

My terminology:

  • Seal Failure - stool seepage past the seal and into the tape adhesive.
  • Tape Failure - stool seepage outside the tape adhesive and stool now exposed.
  • Total Flange Failure - more than 50% of the flange is not attached to the skin and stool spreads well beyond the flange area.

Day 6 ... We trekked a hard and hilly 11-hour day in +31degree Celsius (87.8 degree Fahrenheit) carrying a loaded backpack with hip-belt. By noon of the next day I noticed Seal Failure. With no cleanup facilities it was impractical to change flanges so I just added a band of micro-pore tape around the perimeter of the flange hoping it would last until we arrived at our campsite that night, then just continued trekking. I had Total Flange Failure during the afternoon so a cleanup was due by the time we reached camp that night. No shower. No hot water. In my tent I used a cup of cold water, liquid soap, and the top of a wool sock for cleanup. Stoma didn't cooperate as it was active at the time, prolonging the cleanup and re-flange procedure. This was no problem, just a minor inconvenience that was easily fixed.

Day 7 ... Total Flange Failure at noon. Toughed it out all afternoon on a gruelling 855m or 3000ft climb. When we camped I discovered the worst mess in my ostomy lifetime. From a full belly-button, down to mid-thighs and everything in between (if you get what I mean :)). I removed the flange that was holding by only 1 corner, washed in a cold mountain stream, then rushed back to my tent to dry off and apply another flange.

Day 8 ... Very similar to day 7, with Total Flange Failure and a nasty cleanup. My best theory now is that I am not rinsing the soap well enough and the soap film residue is causing the premature Flange Failures. I must solve this soon - not only for the innconvenience of mid-day Flange Failures but also at this pace I will not have enough flanges for this 34-day trekk, and there is absolutely no opportunity to re-supply. I mentally designed a zip-loc bag and duct-tape contingency plan that would be uncomfortable to our entire team, but would allow me to complete our trekk. While I acknowledge this daily Flange Failure is an inconvenience, I remain positive and thankful. Without the Ostomy I would not be in Nepal, as my cancer and colostomy was the wake-up call that made me LIVE my bucket-list rather than just dream my bucket-list. Without the ostomy I would not be alive.

This is my perspective for my life and it works for me.

Day 9 ... Total Flange Failure by noon again. I really must resolve this very soon. Trouble-shooting skills, developed over 35 years in the computer business, need to be deployed. I start by identifying all potential causes then eliminate all those potential causes ... immediately.

  • No more soap when washing to eliminate possible soap film.
  • No more Karia Powder as that may start to break down the skin-seal near the stoma.
  • Eliminate many of the vegetables in my diet as they add to the volume of stool and gas.
  • We are working hard carrying a load in a hot climate. Sweating under the flange is a problem. I can't control the temperature nor the 11-12 hour trekking-days but I can reduce the weight of my pack, walk slower, and stay in T-shirt and shorts even during the cool mornings and evenings.
  • I know the backpack hipbelt is tight (to put weight on my hips rather than shoulders). The rubbing and pressure of the hipbelt combined with 1000s of deep knee bends and the slight rotating force with every step... all contribute to the peeling effect. So tomorrow I will loosen the hipbelt and carry my load entirely on my shoulders.

Changing everything worked. I had a quiet smile on my face for the next 5 days as the flange held in place and did it's job. With cooler weather and a loose hipbelt I am back to 5-6 days for a flange and my ostomy reverts back to virtually no mindshare. Nepal and its people are far too beautiful to allow such ostomy inconveniences to detract. I am so happy to be back to my ostomy-normal!

Read about my other ostomy-related challenges on this adventure.

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Thursday, November 22, 2012

Nepal 2012 GoogleEarth 3D Maps

Overview Map of our Nepal 2012 Adventure.  
We will trekk from Tumlingtar to near Mount Everest BaseCamp 152miles (244kms) 
and climb Gokyo Ri, Kala Patthur, and Island Peak

We will CLIMB a total VERTICAL of 16miles (25kms)
(the equivalent of 31 trips UP the tallest building on the planet)
(or the equivalent of 7 trips from Everest BaseCamp to Everest Summit)

Trekking Days [1-5] Tumlingtar to Gudel  
Climbing 20,638ft (6,290m), covering 31miles (50kms)

Trekking Days [6-10] Gudel to Phakding
Climbing 26,996ft (8,228m), covering 37miles (59kms)

Trekking Day [11] Phakding to Namche
Climbing 2691ft (820m), covering 3miles (5kms)

Trekking Days [12-15] Namche to Gokyo
Climbing 7806ft (2379m), covering 14miles (23kms)

Trekking Day [16] Gokyo to Gokyo Ri to Dragnag
Climbing 2697ft (822m), covering 3miles (5kms)

Trekking Day [17] Dragnag to Chola Pass to Loboche
Climbing 2691ft (820m), covering 5miles (8kms)

Trekking Day [18] Loboche to Gorek Shep
Climbing 1104ft (336m), covering 3miles (5kms)

Trekking Days [19] Climb Kala Patthur
Climbing 1376ft (419m), covering 1miles (2kms)

Trekking Days [19-20-21] Climb Kala Patthur, then trek Gorek Shep to Dingboche
Climbing 1925ft (587m), covering 10miles (16kms)

 Trekking Day [22] Dingboche to Island Peak BaseCamp 
Climbing 2713ft (827m), covering 7miles (11kms)

Trekking Days [23-24] Island Peak BaseCamp to Summit & return to BaseCamp
Climbing 3690ft (1124m), With Slopes of 64%, covering 2miles (3kms)

Trekking Day [25] Island Peak BaseCamp to Namche
Climbing 5096ft (1553m), Descending 10075ft (3071m), With Slopes of 74%,

covering 18miles (28kms)

Trekking Day [26] Namche to Lukla
Climbing 3937ft (1200m), Descending 6368ft (1941m), With Slopes of 61%,

covering 10miles (16kms)

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Tuesday, November 20, 2012

Nepal 2012 Penalties for a day off

Yesterday we stayed at Tumlingtar to wait for our food that was delayed by Buddha Airlines. So we were 4 trekking-hours behind our original plan. Today we made up that 4 hours with a long 12-hour day. It seemed like a rough orientation to Nepal Trekking but it was a fabulous day.
The landscape is overwhelmingly beautiful.

Santos and his helpers prepared an amazing lunch along a river.

Here's a few of the new friends that Hogus met.


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Friday, November 16, 2012

Nepal 2012 Sorry Chicken

Santos, our cook, makes some very special meals in very rustic kitchen spaces with very simple equipment.  The portable stoves burn kerosene. 
The local village people help with preparing the food. Tonight Santos made a special meal for us which would be considered a luxury - chicken.
But there is no refrigeration in the countryside and teamleader Tami has had some very bad experiences with food poisoning. On a prior trek 2 young men had eaten some meat and got so violently sick that they considered a medical evacuation flyout. But 3 days of serious discomfort and being left behind the group to recouperate then several hard days to catch up to the rest of the team and the boys were OK. So Tami 'highly recommends' we eat vegetarian during the trip.
An unfortunate miscommunication - our cooks prepare a luxury meal, that most of our team reluctantly declines to eat. Our team felt badly for our cook's disappointment. 
Fortunately the chicken was not wasted - the guides and porters ate well that night. Being properly built with an ostomy and having a 'cast iron stomach' I ate my chicken anyway. 
Updated a day later ... I had no ill side-effects from the chicken.
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Tuesday, November 13, 2012

Nepal 2012 No food at Tumlingtar

The Kathmandu airport was chaos but our guides helped us through the maze of people and the process.


There was a long discussion at the check-in counter about our group being overweight by 180 pounds (our packs, not our people :) ).  We were each allowed 38 pounds for our personal gear but we also had tents, cooking equipment, and food. We passed through security and onto a bus that drove us to the plane. But our food bags had to be delayed until tomorrow.
Our only food was the eggs that Santos carried so carefully.

It was an amazing flight low and below the clouds seeing the mountainside terraces that have taken hundreds of generations of people to carve, all with simple tools.


So on day 1 our itinerary changed. We would have to stay overnight in Tumlingtar and wait for our food bags to arrive next day. We wanted to tent but there was no land available so we stayed at a fine lodge.

It's good to be adaptable.

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Friday, November 9, 2012

Nepal 2012 My Child

Today was a much easier day traveling just 8 hours rather than our 11 hours from the days before. But it was stair-climber steps all day long. As we climbed above the clouds the mist rose past us and exposed spectacular near-vertical rugged terrain.

We stopped for lunch in a small village where men were mixing mud to cover the stone walls on their house. These working men notice Hogus, and through a pantomime compared Hogus with each of their faces and joked at who was Hogus's father.  Then each of the men held Hogus, laughed, saying 'My Child'.  I took pictures and showed them, causing more laughter.

Near the end of the day we crossed a high ridge and the 'pissing down' rain started. We all arrived at our tent-village wet and cold. We changed into dry warm clothes and nestled into our sleeping bags to regain some body heat. Soon Santos arrived outside my tent saying 'Yes please Paul, tea for you'. What a luxury to have hot tea delivered right where I layed in my sleeping bag.

Elise lost a lot of body heat, and being very adaptable she used a giant pot of hot water as a heat source.
Hogus and I stayed warm in our sleeping bag and wrote this post.

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Wednesday, November 7, 2012

Nepal 2012 Monkey Temple

The Monkey Temple in Kathmandu is a place where BOTH Hindus and Buddists worship at the same place. Prayer wheels are everywhere every time they spin prayers are wafted up to the gods.

Stupas are also everywhere. The eyes mean 'all seeing, all knowing'.

There are monkeys, who eat the rice and maise offerings people leave

Holy men congregate to talk


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Tuesday, November 6, 2012

Nepal2012 New Friends for Hogus

Hogus rides on Paul's backpack where he has great view and doesn't have to do all the hard work of trekking. Children notice Hogus and always smile. Most children want to hold him. Here are pictures of a few new friends.

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