By Julian Rickard, Medical Officer

Overall the expedition was fairly healthy.

On arrival in Kathmandu, and also when passing through on the way back, there were some incidences of traveller's diarrhoea, but these cleared up fairly quickly, although Loperomide (Immodium) was sometimes used to make travelling easier.

Dr Julian patching up a porter's foot Photo © Tom Padgham 1998

The first to go down with anything more serious was of course the medical officer, who developed prolonged diarrhoea which after a week hadn't gone away. Then appetite was lost as well, so I took a course of Ciprofloxacin, which started to clear things up after about a day, and by the time the coarse was finished all symptoms had gone.

Another member had similar symptoms a bit later, but things started after a fever. Again he took a course of Ciprofloxacin and things cleared up fairly quickly.

At altitude most people treated headaches with Paracetamol. (N.B. Onset of anything other than slight headaches means it's time for immidiate descent, we weren't using Paracetamol to overcome altitude sickness, just dehydration and too much sun). In a couple of cases this was supplemented with Codeine. As a side benefit these people found they slept better having taken the Codeine, while the rest of us found that even when reasonably acclimatised sleep above about 5000m was fairly broken.

Diplofenac, Paracetamol and bandages were given to one of our head porters after a stumble left he knee swollen and very painful. He also used his own cure - rubbing vigorously with butter and walking on it again as soon as he could bear it. One or both of these lead to a very fast recovery.

The only other use of the first aid kit was to patch up a porter who had cut his foot. Some members used the Eurax anti-itch cream on insect bites.

A week before returning home, one member developed a deep-vein Thrombosis in his leg. We did not diagnose this at the time, because of the 'strange' symptom of the pain migrating in a distall direction (towwards the foot). This didn't seem to be consistent with a thrombosis, and it didn't occur to us that it was not moving, but growing larger very rapidly.

On return to the UK, this was treated with a long-term course of Warfarin accompanied by an unpleasant week's hospitalisation.

If you experience any unexplained pain in the limbs after climbing at altitude, don't ignore it, as thromboses are most dangerous when small and mobile. Get help as soon as you can.

A big thank-you to Dr Alan Swann at the Imperial College Heath Centre for suppling us with the first aid kit, and to those companies that contributed drugs to it.