Tuesday 23 August 2011

Day 3: Of Lunch Boxes and Altitude Sickness

Awaken by our alarms at 5.00a.m., we took a rejuvenating shower just because we knew we weren't going to have the chance to up at Laban Rata Resthouse (3,270 metres). Our wonderful tour organisers, HK Lee and Adeline from One Tour and Adventure (1tourandadventure@gmail.com) picked us up from Kinabalu Daya Hotel itself and departed for Kinabalu National Park to get us registered before trekking. During the journey, HK tested my history knowledge on the derivation of the name Kinabalu. All I remembered from Malaysian History classes was that the name was extracted from the Kadazan Dusun word, Aki Nabalu, which when translated means 'the place of the dead'. The indigenous people of the Kadazan Dusun mostly practised animism, before they embraced Catholicism, and thus believed that non-human, non-living entities embodied spirit and life-principles. As such, words were passed on from one generation to the next that spirits of the dead would leave for Mount Kinabalu hence making it a revered place of the deceased.

We had wonderful sceneries along the way, with the route dotted with numerous small local churches - two viewpoints deserving mention are
(i) Poropok Viewpoint
(ii) Pekan Nabalu
If you're planning on renting a car and driving along this route, make full use of the liberty you've paid for and stop, not just to enjoy the view but also the lifestyle of small mountain village dwellers, what with their morning markets and small-scale sundry shops!

Despite stopping for between 15 and 20 minutes at Pekan Nabalu, it still only took us 2 hours to arrive in Mesilau Nature Resort to embark on the Summit Trail. We were told by our tour organiser that the Mesilau trail offers better sights and easier routes, despite being about 1-1.5 km longer than that of the train from the Timpohon Gate. To be honest, I didn't think the trail was any easier but the Mesilau trail unequivocally was more pleasing to the eye. The Timpohon trail officially starts at 1866m, from where it's an 8.72 km walk to the summit. Being the cheaters we are, the Mesilau Nature Resort is at a slightly higher altitude of 2000ish metres, but were no closer as the route was still about 9km long. 

You will be advised to leave no later than 9 a.m. from the Mesilau Nature Resort as it takes an average of 6-7 hours to arrive at the Laban Rata Resthouse which is about 6 km away. We left slightly later than 9 a.m. due to some miscommunication between HK and the Park authority and strolled along with our lovely and wonderfully helpful guide, Lerry. As Lerry enlightened us with the Latin names of Malaysia's extensive flora and fauna, we encountered an injured snake, which according to Lerry, is poisonous. My friend and I obviously did what any ordinary person in their right mind would do - pace away as discreetly as possible. Unfortunately, Lerry didn't see eye to eye with us on that and decided to meddle around with the snake, not with the intention to hurt it of course, but rather to probe it to find shelter.

I must admit that this ascend of approximately 1300m in 6 km was one that left me gasping for air (despite believing and being convinced by my friend that I was relatively fit, physically). Unlike my friend who managed to overcome his slight altitude sickness in the 1st kilometre, I struggled with the lightheadedness and fatigue up to the extent of losing my balance, which has never happened in any hiking excursion I've participated in, nor in my week-long trip to Tibet last year. 

The selective onset of acute mountain sickness in different individuals independent of physical fitness does urge me to ponder on the factors predisposing one to its signs and symptoms. As most diseases and illnesses with individual susceptibility, altitude sickness is also believed to depend on genetics, although specific genes are yet to be identified. This may be preliminary evidence for a major gene involved in enhancing oxygen transport at higher-than-usual altitudes, further supporting a statistical study conducted on native Tibet population demonstrating a key gene in influencing %O2 of arterial haemoglobin. In addition, this is a mark of ongoing human evolution and adaptation, which a researcher further extrapolated about a possible maternal KIR and fetal HLA haplotype combination favoured by adapting to a high-altitude environment. 

Nevertheless, we persevered, motivated by the thought of buffet dinner at the resthouse to compensate for the almost miserable, though diet-fulfilling lunchbox provided by the Kinabalu National Park which included two bananas, two hard-boiled eggs and numerous sandwiches (cheese and tomato as well as tuna/lettuce) and a bottle of water. We immediately went to bed after finishing dinner after being instructed by Lerry to be ready by 2 a.m. for the 2.7km hike to Low's Peak, the summit. 

A few points before closing this entry. I deem it useful to have known what to bring along for our hike hence shall include a list of items that have been categorised into essential and non-essential but useful for those interested in climbing the mountain in the near future.

Essential:
(i) Hiking (DUH, or running shoes if you don't have proper hiking shoes)
(ii) Headlamp (Chargeable, if not, with spare batteries)
(iii) Gloves (as they would be useful not just in keeping you warm but also to prevent the consequences of grabbing the ropes too tightly whilst hiking to the summit)
(iv) Wool or Fleece Hat
(v) I would personally recommend thermal tops, but if not, just bring a jumper and accompany it with an external layer of waterproof/rain jacket
(vi) Wool Socks, perhaps? (my friend found it very useful bringing his football socks)
-Also include mosquito repellent for the first half of your hike, unless you're in long sleeves and trousers (which I strongly recommend). As tempting as it is, shorts is a bad idea especially at the summit when windchills could bring the temperature close to zero. 

Useful
(i) Extra food/snacks such as energy/protein bars and a bottle of water (however, do not fret if you don't wish to carry the weight. You can refill your bottles at the resthouse, and if necessary, your guides will be more than willing to assist you with your backpack)
(ii) Pack cover (for temperamental weather)
(iii) Earplugs for dorms (though it won't be too noisy since everyone would be exhausted and asleep very promptly)
(iv) Medication (refer to next section)

Medication
The usual paracetamol and anti-diarrhoea will not suffice. In case of acute mountain sickness, equip yourselves with acetazolamide (diamox) which can come in handy when breathlessness kicks in and also to ease the lightheadedness. For it to take effect, you should begin consuming acetazolamide two days before you are subjected to high altitude. Ask the pharmacist for the appropriate dosage. For those interested: 
Acetazolamide is a carbonic anhydrase inhibitor and interferes with the reabsorption of bicarbonate in the kidney, hence acidifying blood. This will help overcome respiratory alkalosis as a result of hyperventilation in areas of low partial pressure of oxygen. This will subsequently stimulate increased breathing rate, which really is what you need.

Also bring along with you some NSAIDs such as ibuprofen which can help relieve the peripheral oedema but not solve the cause. If necessary, also have steroids (dexamethasone) and nifedipine (calcium channel blocker, thus a blood vessel dilator) to ease the oedema/pulmonary oedema. Diuretics such as frusemide would also help with possible pulmonary oedema.

Despite having these medication with you, bear in mind that the best management for altitude sickness is to descend. So, take note of the following symptoms of onset of altitude sickness and don't insist on hiking to higher altitudes. The symptoms include:
(extracted from Wikipaedia)

So that marks the end of our first day up Mount Kinabalu!





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