Some Basic
Climbing Tips:
 Footwear: Make sure you
get a pair of lightweight shoes that can take a lot of abuse, with good
grips and good cushioning effect. I heard some climber's shoes got torn because
of the rain. So get a pair of sandal in case it rains.
Warm clothing: Get
a pair of jersey, fleece jacket and tracksuit bottom for the final ascent; avoid
cotton clothing due to sweat absorbent, slow drying effect and produce excessive
body heat loss. For the first day, casual clothing is more confortable. Warm clothing may be too
warm at lower altitude so, bring along a raincoat. The weather varies from sunny to misty to rainning and windy within
few minutes as you trek through
different parts of the forest and altitude zones. Weather condition is
truly unpredictable at Mt. Kinabalu peak.
Drinking
water: One and half litre water bottle should be enough. There are at least six shelters along the way to Laban Rata Rest House where you can refill
your bottle with drinkable mountain water. The second part of the journey you may want to bring more water
as there is no source where you can refill your bottle and you may want to bring a termos to keep warm water
since it is really cold at the peak before sunrise.
Food: Just bring
along some
high-energy stuff like chocolate, nuts, raisins, glucose sweets, etc. For lunch, dinner and breakfast you can buy from the
canteen at Laban Rata Rest House. Prices are a bit steep, at least twice the price you pay at the base of the mountain but when you see the locals
carrying gas tanks up the mountain you will know why the food becomes expensive.
Torch Light or Headlamp: Bring one that
is ultra bright and light; bring spare batteries. 6-LED headlamp using 4
AA batteries is most suitable as it can light for 4 to 5 hours. Some are
4-LED lights using 2 AAA batteries with lower brightness. If case you
cannot find 6-LED headlamp in your area, you can refer to my tips
modifying the 6V headlamp bulb for 6-LED lights. I was using the modified
6-LED headlamp during my last ascent without encountering any problem.
Some climbers encounter failed torch lights due to batteries failing in
cold temperature. So the headlamp casing must be waterproof or damp proof.
Gloves: Get a pair of
gloves that is insulated for comfort. If available, use waterproof
shells as water and cold temperature are expected.
Trekking
Poles: This is useful when descending the Low's Peak to Timpohon Gate.
You can buy the trekking stick (wood) at the Kinabalu National Park for
RM1.00. For light-weight trekking pole, bring it along and you will
never regret it.
Face Mask: You may need one that can
hide your entire face use unless you don't mind the wind "biting" at your
face and inhaling the cool breeze directly. I encountered nose
"watering" due to cool breeze sweeping over my face.
Medicine: Headache tablets
are the most useful, after a heavy rain or when you get headache. Diarhea and vomit prevention tablets are useful too.
Climbers will experience variations in atmospheric presure and unpredictable weather. People with high blood presure and other health
problems are advised to refrain from climbing but no one is going to stop you from
climbing; just be careful and know when to quit.
Plastic Bags: Put all your
things in plastic bags unless your bag is rain/water proof.
Miscellaneous: Bring along a whistle
for the emergency call for help. Bring along second pair of dry cloths,
socks, tissues, plastic bags, etc.
Travel Light: Make all
effort to lighten your backpack for the climb. You can leave the
unimportant things at the Kinabalu National Park's office. For the final
ascent, you can leave the un-neccesary things at the rest house or hut you
put up for the night. A 7-kg backpack will be heavy as 10-kg when you ascend to Laban Rata Resthouse.
For Comprehensive Climbing Gear Checklist. Refer to Climbing Gear Checklist
Survival Tips:
All climbers have to take note that the sudden swing of weather has been
responsible for the past loss of lives at Kinabalu Peak. Moreover, the
last 1,455 feet of the climb which starts at 12,000 feet altitude is made
up of slabs of granite rockface which all looks alike. Even with various
landmarks around it is still possible for an experienced climber to lose
their way. This situation is only made worst when the mist moves in.
You will notice that the hired guide will start to persuade people to turn
back if they cannot reach the summit by 7:00am or 8:00am, it is because
this is when the mist usually starts to move in by 10:00 am daily.
In case you want to take the risk, I recommend that you inform everyone in your group
before the climb to meet at Sayat-sayat to do a head count. This way you
can know if someone lost their way as early as possible. Why meet at
Sayat-sayat? because on the way down from sayat-sayat it is quite
unlikely for someone to loose their way whereas from sayat-sayat
upwards is where most people can lose their way (including me).
Sometimes it is difficult to wait for people because everyone moves at a
different speed. This is especially true if you have a big group. Let us say
you have a big group (like 10 people) you can split them into two groups
one fast and one slow. By the time you reach the rest house during your
ascent you should know who are the fast ones and who are the slow ones.
These two groups can each do a head count at Sayat-sayat and the regroup
at the rest house on their way down. Once you reach the rest house on your
descent its quite relaxing because the tough part of the climb is over,
you can have sweet time, take a cup of tea and a short nap at the rest
house before descending the rest of the mountain.
You will notice that along the way up from sayat-sayat there are a lot of
ropes to help you on the way up. These ropes can help you find your way
in a mist. On your way down you discovered that you
need to purge some bodily fluid and/or solid. So you ran off to look for a
location that offers you some privacy only to find that you are stuck in
the mist with no ropes or indicator rock in sight. Visibility can be
down to a few meters in heavy mist and torch light is of no use. So what
can you do? Don't move unless you are very sure of where you are
going or know how to get back to where you are. Try blowing the whistle to get
people's attention to lead you back on track. Take note that by the time
the mist moves in most climbers are well on their way down past
Sayat-sayat, few people are there to help you. That is why I recommend
meeting at Sayat-sayat to do a head count. Once people know you are
missing they will back track to find you, make sure you don't stray too
far away from the track; a compass is useful to find the right
direction in the mist. If you cannot hear someone shouting for you
that means you are too far away. Remember that the air is thin up there so
sound don't travel as far and the horizontal rock surface tend to
reflect sound up into the sky while others reflect in various directions
causing echoes. In other words you have to blow much harder for people to
hear you and your echoes might confuse people looking for you, but at
least people know you need help. If you are going no where make sure you have
enough food and water to last until help comes which could be hours or
even days depending on how far off the track you are and the weather
condition to be cleared.
How
to overcome Acute Mountain Sickness (AMS) at High Altitude? Mt. Kinabalu can
pose the danger that trigger Acute Mountain Sickness because it is classified as
"Very High" category under the classification of High Altitude by Princeton University.
Some people can adapt to the thin oxygen content in
the air at high altitude more faster than others. But with the practice of
acclimatization, climbers can tolerate the high altitude. Here is a good article for more information about this
subject.
Outdoor Action Guide to
High Altitude: Acclimatization and Illnesses
by Rick Curtis,
Director, Outdoor Action Program
Traveling at high altitude can be hazardous.
The information provided here is designed for educational use only and is not a
substitute for specific training or experience. Princeton University and the
author assume no liability for any individual's use of or reliance upon any
material contained or referenced herein. This paper is prepared to provide basic
information about altitude illnesses for the lay person. Medical research on
high altitude illnesses is always expanding our knowledge of the causes and
treatment. When going to altitude it is your responsibility to learn the latest
information. The material contained in this article may not be the most
current. Copyright © 1995 Rick Curtis, Outdoor Action Program, Princeton
University.
High altitude-we all enjoy that tremendous view from a high summit, but there
are risks in going to high altitude, and it's important to understand these
risks. Here is a classic scenario for developing a high altitude illness. You
fly from New York City to a Denver at 5,000 feet (1,525 meters). That afternoon
you rent a car and drive up to the trailhead at 8,000 feet (2,438 meters). You
hike up to your first camp at 9,000 feet (2,745 meters). The next day you hike
up to 10,500 feet (3,048 meters). You begin to have a severe headache and feel
nauseous and weak. If your condition worsens, you may begin to have difficulty
hiking. Scenarios like this are not uncommon, so it's essential that you
understand the physiological effects of high altitude.
What is High Altitude?
Altitude is defined on the following scale High (8,000 - 12,000 feet [2,438 -
3,658 meters]), Very High (12,000 - 18,000 feet [3,658 - 5,487 meters]), and
Extremely High (18,000+ feet [5,500+ meters]). Since few people have been to
such altitudes, it is hard to know who may be affected. There are no
specific factors such as age, sex, or physical condition that correlate with
susceptibility to altitude sickness. Some people get it and some people don't,
and some people are more susceptible than others. Most people can go up to 8,000
feet (2,438 meters) with minimal effect. If you haven't been to high altitude
before, it's important to be cautious. If you have been at that altitude before
with no problem, you can probably return to that altitude without problems as
long as you are properly acclimatized.
What Causes Altitude Illnesses
The concentration of oxygen at sea level is about 21% and the barometric
pressure averages 760 mmHg. As altitude increases, the concentration remains the
same but the number of oxygen molecules per breath is reduced. At 12,000 feet
(3,658 meters) the barometric pressure is only 483 mmHg, so there are roughly
40% fewer oxygen molecules per breath. In order to properly oxygenate the body,
your breathing rate (even while at rest) has to increase. This extra ventilation
increases the oxygen content in the blood, but not to sea level concentrations.
Since the amount of oxygen required for activity is the same, the body must
adjust to having less oxygen. In addition, for reasons not entirely understood,
high altitude and lower air pressure causes fluid to leak from the capillaries
which can cause fluid build-up in both the lungs and the brain. Continuing to
higher altitudes without proper acclimatization can lead to potentially serious,
even life-threatening illnesses.
Acclimatization
The major cause of altitude illnesses is going too high too fast. Given time,
your body can adapt to the decrease in oxygen molecules at a specific altitude.
This process is known as acclimatization and generally takes 1-3 days at that
altitude. For example, if you hike to 10,000 feet (3,048 meters), and spend
several days at that altitude, your body acclimatizes to 10,000 feet (3,048
meters). If you climb to 12,000 feet (3,658 meters), your body has to
acclimatize once again. A number of changes take place in the body to allow it
to operate with decreased oxygen.
-
The depth of respiration
increases.
-
Pressure in pulmonary
arteries is increased, "forcing" blood into portions of the lung
which are normally not used during sea level breathing.
-
The body produces more red
blood cells to carry oxygen,
-
The body produces more of a
particular enzyme that facilitates
-
the release of oxygen from
hemoglobin to the body tissues.
Prevention of Altitude Illnesses
Prevention of altitude illnesses falls into two categories, proper
acclimatization and preventive medications. Below are a few basic guidelines for
proper acclimatization.
-
If possible, don't fly or
drive to high altitude. Start below 10,000 feet (3,048 meters) and walk up.
-
If you do fly or drive, do
not over-exert yourself or move higher for the first 24 hours.
-
If you go above 10,000 feet
(3,048 meters), only increase your altitude by 1,000 feet (305 meters) per
day and for every 3,000 feet (915 meters) of elevation gained, take a rest
day.
-
"Climb High and sleep
low." This is the maxim used by climbers. You can climb more than 1,000
feet (305 meters) in a day as long as you come back down and sleep at a
lower altitude.
-
If you begin to show
symptoms of moderate altitude illness, don't go higher until symptoms
decrease ("Don't go up until symptoms go down").
-
If symptoms increase, go
down, down, down!
-
Keep in mind that different
people will acclimatize at different rates. Make sure all of your party is
properly acclimatized before going higher.
-
Stay properly hydrated.
Acclimatization is often accompanied by fluid loss, so you need to drink
lots of fluids to remain properly hydrated (at least 3-4 quarts per day).
Urine output should be copious and clear.
-
Take it easy; don't
over-exert yourself when you first get up to altitude. Light activity during
the day is better than sleeping because respiration decreases during sleep,
exacerbating the symptoms.
-
Avoid tobacco and alcohol
and other depressant drugs including, barbiturates, tranquilizers, and
sleeping pills. These depressants further decrease the respiratory drive
during sleep resulting in a worsening of the symptoms.
-
Eat a high carbohydrate diet
(more than 70% of your calories from carbohydrates) while at altitude.
-
The acclimatization process
is inhibited by dehydration, over-exertion, and alcohol and other depressant
drugs.
Preventive Medications
-
Diamox (Acetazolamide)
allows you to breathe faster so that you metabolize more oxygen, thereby
minimizing the symptoms caused by poor oxygenation. This is especially
helpful at night when respiratory drive is decreased. Since it takes a while
for Diamox to have an effect, it is advisable to start taking it 24 hours
before you go to altitude and continue for at least five days at higher
altitude. The recommendation of the Himalayan Rescue Association Medical
Clinic is 125 mg. twice a day (morning and night). (The standard dose was
250 mg., but their research showed no difference for most people with the
lower dose, although some individuals may need 250 mg.) Possible side
effects include tingling of the lips and finger tips, blurring of vision,
and alteration of taste. These side effects may be reduced with the 125 mg.
dose. Side effects subside when the drug is stopped. Contact your physician
for a prescription. Since Diamox is a sulfonamide drug, people who are
allergic to sulfa drugs should not take Diamox. Diamox has also been known
to cause severe allergic reactions to people with no previous history of
Diamox or sulfa allergies. Frank Hubbell of SOLO recommends a trial course
of the drug before going to a remote location where a severe allergic
reaction could prove difficult to treat.
-
Dexamethasone (a
steroid) is a prescription drug that decreases brain and other swelling
reversing the effects of AMS. Dosage is typically 4 mg twice a day for a few
days starting with the ascent. This prevents most symptoms of altitude
illness. It should be used with caution and only on the advice of a
physician because of possible serious side effects. It may be combined with
Diamox. No other medications have been proven valuable for preventing AMS.
Acute Mountain Sickness (AMS)
AMS is common at high altitudes. At elevations over 10,000 feet (3,048
meters), 75% of people will have mild symptoms. The occurrence of AMS is
dependent upon the elevation, the rate of ascent, and individual susceptibility.
Many people will experience mild AMS during the acclimatization process.
Symptoms usually start 12-24 hours after arrival at altitude and begin to
decrease in severity about the third day. The symptoms of Mild AMS are headache,
dizziness, fatigue, shortness of breath, loss of appetite, nausea, disturbed
sleep, and a general feeling of malaise. Symptoms tend to be worse at night and
when respiratory drive is decreased. Mild AMS does not interfere with
normal activity and symptoms generally subside within 2-4 days as the body
acclimatizes. As long as symptoms are mild, and only a nuisance, ascent can
continue at a moderate rate. When hiking, it is essential that you communicate
any symptoms of illness immediately to others on your trip. AMS is considered to
be a neurological problem caused by changes in the central nervous system. It is
basically a mild form of High Altitude Cerebral Edema (see below).
Basic Treatment of AMS
The only cure is either acclimatization or descent. Symptoms of Mild
AMS can be treated with pain medications for headache and Diamox. Both help to
reduce the severity of the symptoms, but remember, reducing the symptoms is not
curing the problem. Diamox allows you to breathe faster so that you metabolize
more oxygen, thereby minimizing the symptoms caused by poor oxygenation. This is
especially helpful at night when respiratory drive is decreased. Since it takes
a while for Diamox to have an effect, it is advisable to start taking it 24
hours before you go to altitude and continue for at least five days at higher
altitude. The recommendation of the Himalayan Rescue Association Medical Clinic
is 125 mg. twice a day (morning and night). (The standard dose was 250 mg., but
their research showed no difference for most people with the lower dose,
although some individuals may need 250 mg.) Possible side effects include
tingling of the lips and finger tips, blurring of vision, and alteration of
taste. These side effects may be reduced with the 125 mg. dose. Side effects
subside when the drug is stopped. Contact your physician for a prescription.
Since Diamox is a sulfonamide drug, people who are allergic to sulfa drugs
should not take Diamox. Diamox has also been known to cause
severe allergic reactions to people with no previous history of Diamox or sulfa
allergies. Frank Hubbell of SOLO in New Hampshire recommends a trial course
of the drug before going to a remote location where a severe allergic
reaction could prove difficult to treat.
Moderate AMS
Moderate AMS includes severe headache that is not relieved by
medication, nausea and vomiting, increasing weakness and fatigue, shortness of
breath, and decreased coordination (ataxia). Normal activity is difficult,
although the person may still be able to walk on their own. At this stage, only
advanced medications or descent can reverse the problem. Descending even a few
hundred feet (70-100 meters) may help and definite improvement will be seen in
descents of 1,000-2,000 feet (305-610 meters). Twenty-four hours at the lower
altitude will result in significant improvements. The person should remain at
lower altitude until symptoms have subsided (up to 3 days). At this point, the
person has become acclimatized to that altitude and can begin ascending again.
The best test for moderate AMS is to have the person "walk a straight
line" heel to toe. Just like a sobriety test, a person with ataxia will be
unable to walk a straight line. This is a clear indication that immediate
descent is required. It is important to get the person to descend before
the ataxia reaches the point where they cannot walk on their own (which would
necessitate a litter evacuation).
Severe AMS
Severe AMS presents as an increase in the severity of the aforementioned
symptoms, including shortness of breath at rest, inability to
walk, decreasing mental status, and fluid buildup in the lungs. Severe AMS
requires immediate descent to lower altitudes (2,000 - 4,000 feet
[610-1,220 meters]).
There are two other severe forms of altitude illness, High Altitude Cerebral
Edema (HACE) and High Altitude Pulmonary Edema (HAPE). Both of these happen less
frequently, especially to those who are properly acclimatized. When they do
occur, it is usually with people going too high too fast or going very high and
staying there. The lack of oxygen results in leakage of fluid through the
capillary walls into either the lungs or the brain.
High Altitude Pulmonary Edema (HAPE)
HAPE results from fluid buildup in the lungs. The fluid in the lungs prevents
effective oxygen exchange. As the condition becomes more severe, the level of
oxygen in the bloodstream decreases, and this can lead to cyanosis, impaired
cerebral function, and death. Symptoms include shortness of breath even at rest,
"tightness in the chest," marked fatigue, a feeling of impending
suffocation at night, weakness, and a persistent productive cough bringing up
white, watery, or frothy fluid. Confusion, and irrational behavior are signs
that insufficient oxygen is reaching the brain. One of the methods for testing
yourself for HAPE is to check your recovery time after exertion. If your heart
and breathing rates normally slow down in X seconds after exercise, but at
altitude your recovery time is much greater, it may mean fluid is building up in
the lungs. In cases of HAPE, immediate descent is a necessary
life-saving measure (2,000 - 4,000 feet [610-1,220 meters]). Anyone suffering
from HAPE must be evacuated to a medical facility for proper
follow-up treatment.
High Altitude Cerebral Edema (HACE)
HACE is the result of swelling of brain tissue from fluid leakage. Symptoms
can include headache, loss of coordination (ataxia), weakness, and decreasing
levels of consciousness including, disorientation, loss of memory,
hallucinations, psychotic behavior, and coma. It generally occurs after a week
or more at high altitude. Severe instances can lead to death if not treated
quickly. Immediate descent is a necessary life-saving measure
(2,000 - 4,000 feet [610-1,220 meters]). There are some medications that may be
prescribed for treatment in the field, but these require that you have proper
training in their use. Anyone suffering from HACE must be
evacuated to a medical facility for proper follow-up treatment.
Other Medications for Altitude Illnesses
-
Ibuprofen is
effective at relieving altitude headache.
-
Nifedipine rapidly
decreases pulmonary artery pressure and relieves HAPE.
-
Breathing oxygen reduces the
effects of altitude illnesses.
Gamow Bag (pronounced ga´ mäf)
This clever invention has revolutionized field treatment of high altitude
illnesses. The bag is basically a sealed chamber with a pump. The person is
placed inside the bag and it is inflated. Pumping the bag full of air
effectively increases the concentration of oxygen molecules and therefore
simulates a descent to lower altitude. In as little as 10 minutes the bag can
create an "atmosphere" that corresponds to that at 3,000 - 5,000 feet
(915 - 1,525 meters) lower. After a 1-2 hours in the bag, the person's body
chemistry will have "reset" to the lower altitude. This lasts for up
to 12 hours outside of the bag which should be enough time to walk them down to
a lower altitude and allow for further acclimatization. The bag and pump weigh
about 14 pounds (6.3 kilos) and are now carried on most major high altitude
expeditions. Bags can be rented for short term trips such as treks or
expeditions.
Cheyne-Stokes Respirations
Above 10,000 feet (3,000 meters) most people experience a periodic breathing
during sleep known as Cheyne-Stokes Respirations. The pattern begins with a few
shallow breaths and increases to deep sighing respirations then falls off
rapidly. Respirations may cease entirely for a few seconds and then the shallow
breaths begin again. During the period when breathing stops the person often
becomes restless and may wake with a sudden feeling of suffocation. This can
disturb sleeping patterns, exhausting the climber. Acetazolamide is helpful in
relieving the periodic breathing. This type of breathing is not
considered abnormal at high altitudes. However, if it occurs first during an
illness (other than altitude illnesses) or after an injury (particularly a head
injury) it may be a sign of a serious disorder.
Sources:
-
Mountain Sickness, Peter
Hackett, The Mountaineers, Seattle, 1980.
-
High Altitude Illness, Frank
Hubble, Wilderness Medicine Newsletter, March/April 1995.
-
The Use of Diamox in the
Prevention of Acute Mountain Sickness, Frank Hubble, Wilderness Medicine
Newsletter, March/April 1995.
-
The Outward Bound Wilderness
First Aid Handbook, J. Isaac and P. Goth, Lyons & Burford, New York,
1991.
-
Medicine for Mountaineering,
Fourth Edition, James Wilkerson, Editor, The Mountaineers, Seattle, 1992.
-
Gamow Bags - can be rented
from Chinook Medical Gear, 34500 Hwy 6, Edwards, Colorado 81632,
970-926-9277. http://www.chinookmed.com
Additional Reading:
-
Altitude Illness Prevention
& Treatment, Steven Bezruchka, The Mountaineers, Seattle, 1994.
-
Going Higher, Charles
Houston, Little Brown, 1987.
-
High Altitude Sickness and
Wellness, Charles Houston, ICS Books, 1995.
-
High Altitude Medicine and
Physiology, Ward Milledge, West, Chapman and Hall, New York, 1995.
This article is written by
Rick Curtis, Director, Outdoor Action Program. This material may be freely
distributed for nonprofit educational use. However, if included in publications,
written or electronic, attributions must be made to the author. Commercial use
of this material is prohibited without express written permission from the
author. Copyright © 1998 Rick Curtis, Outdoor Action Program, Princeton
University.
Photo Gallery
of Mt Kinbalu: External Sites
1) http://bobday.best.vwh.net/kinabalu/index.html
2) http://fototrek-travel-photography.com/sabah.htm
More
information to travel to Kinabalu
http://www.sabahtravelguide.com/MAPGUIDE/default.asp?page=kinabalupark
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