There's more to climbing big mountains than climbing, or how to stay healthy on expeditions

The first time I tried a really big mountain was in 2006. In the summer of that year Ben Firth, Eamonn Walsh, Ian Welsted and I traveled to Pakistan to attempt the then-unclimbed Kunyang Chhish East (ca. 7400 m). We felt strong and fit. In the weeks before our departure I went on an alpine climbing binge on Mt. Andromeda. It culminated with the first ascent, together with Scott Semple, of DTCB, an unlikely line left of the Andromeda Strain. Onsighting virgin Rockies’ choss, I felt on top of my game. As we made our way to Kunyang by plane, jeep and foot, I was optimistic about our chances.

The 2500-metre tall southwest face of Kunyanf Chhish East, Pakistan.

It was not to be: our highest attempt ground to a halt nearly a vertical kilometre below the virgin summit. It happens; after all, success on an expedition to Pakistan is never a given. But it wasn’t overhanging rock or thin ice that stopped us. In fact, our climbing skills were never put to a real test. No, what made us turn tail and start descending under cloudless skies were churning guts. They started churning in Islamabad the day after we arrived in Pakistan, and the churning never truly stopped. By the end of the trip, we’d lost count of the number of nights one or another of us had spent on all fours or squatted over a disgusting hole in the ground.

Sometime after returning home, I was talking with a friend, a seasoned Karakoram veteran. 

“So many stars have to line up to get up something big in Pakistan”, I complained. 

“You’ll figure it out”, he assured me. 

A dozen years and several expeditions later, I like to think I know better what it takes to succeed in those mountains. Sure, skill and fitness matter; but you’re going nowhere fast if you don’t stay healthy and and don't acclimatize properly. High mountains halfway around the world are a great equalizer. Below are a few of the often-painful lessons I learned there: trying, failing, trying again, and sometimes succeeding. As the saying goes, good judgement comes from experience, and experience comes from bad judgment.

Going nowhere fast.

• Water. It sucks to generate heaps of plastic waste but I use only bottled water only while traveling through a third-world country – both for drinking and brushing my teeth. I make sure the seal on the bottle is intact, and that it wasn’t just filled up from the tap. I go as far as to avoid swallowing any water while taking a shower.
• Fruits and veggies. As tempting as fresh mangoes and tomatoes might be, I try to stay away, at least while travelling to the mountains. There’s just too much risk they were washed in tap water. In basecamp it’s a different story, provided you have a good supply of clean water (more on that below).
• Food. While traveling to the mountains I try to eat only cooked food from decent-looking kitchens. Having said that, I’ve been sick after eating at a good restaurant in Islamabad. This part is somewhat out of your hands but do your best to be careful and disciplined – avoid tasty-looking street food until you’re on the way out.
• More on water. On the trek in, filter and treat drinking water, as chances are you’ll be hiking through animal pastures. Once in basecamp, make sure your water comes out of a moraine or some other pristine source, and not from a stream that yaks drink from. Make sure your cook gets water from a clean source. too.
• Cook. In the Himalaya and Karakoram, it’s customary to hire a local cook (and often also an assistant cook) for basecamp. It sounds decadent, but you’re also giving someone a chance to earn a decent wage. Your cook can make or break the trip. He (it’s always a he) should have good hygiene. Ideally, it’s someone who’s been on other expeditions, and knows what the western gut needs to stay healthy.

Temptation on the way in.

Partaking of fresh apricots on the way out.

Don't get water where the yaks go!

A good cook can make or break your trip, says Ali.

In 2006, our last acclimatization outing before attempting Kunyang Chhish East was the deliciously-named Ice Cake (ca. 6400 m). Originally, we’d planned to spend a night camped on the summit, based on the rule of thumb that we should try to sleep at an altitude a thousand metres below the peak we hoped to climb. However, after only a few hours, splitting headaches droves us down. A mistake: the headaches were a good indication we still needed to acclimatize better. The process of acclimatization is boring and painful, but unless you’re a genetic phenomenon, there are no shortcuts. 

• Take your time to acclimatize. At least at the start, I like to day hike to an altitude before I sleep there. Few things are as unpleasant as trying to sleep at an altitude you’re not used to.
• Don’t try to do interesting climbing while acclimatizing. Your body has enough to deal with without throwing in hard climbing. Ideally, you'll be able to basically walk up really high.
• Listen to your body. Don’t push yourself if you’re not feeling well. On a few occasions I tried to push through a cold, kept going hard, and ended up with a sinus infection. Your body doesn’t heal as well in a 4000 or 5000-metre basecamp as it does at a lower altitude, so you’ve got to give it time to recover. In the end it delayed me more when I ended up having to take a course of antibiotics than if I’d rested for a couple of days.
• Digestion. Most people don’t digest well at altitude. I found out the hard way – we’re talking about spending half the night with my head out of the tent, throwing up dinner - that I can’t digest heavy foods above 5500 metres or so. I have since adjusted my diet accordingly, pretty much only eating carbs while venturing higher.

Acclimatizing is boring and painful, but there's no way around it.

Headaches all around on the summit of Ice Cake.

So that's my hard-earned, if perhaps obvious wisdom: be paranoid about water and food hygiene while traveling, make sure you have a good setup in basecamp with your cook and water supply, and respect the altitude. And lastly, even if things aren't always going your way, remember that you're on holidays in an incredible place.

PS: I’m writing this post on a hot, muggy evening in Islamabad, starting yet another Karakoram expedition. We'll see if I can walk my own talk.