Saturday, August 4, 2007

Tibet - Rooftop of the World, I think...

Kathmandu, Nepal - So I am in Kathmandu enjoying myself in a new country, interacting with very friendly people, and eating great food while awaiting Karl who is traveling overland from Lhasa as I write. What? Karl's not with you? Why? What happened? Did you guys get sick of each other...24x7x4 months and counting? Well, maybe a little...we have both never spent so much time with just one other person ever...but the real reason is that I got a little case of AMS. More on that later...

So after working out how much time we had left and figuring out the most flexible and least expensive place for me to fly back home from, we realized we had to cut out Yunnan and head straight to Lhasa after Chengdu. I was sad...Yunnan had been at the top of my list at the beginning of the trip. But on the other hand, we were ready for a change of weather to anything besides hot and humid. Also we had read about severe flooding in Yunnan and the Tiger Leaping Gorge trek was considered dangerous due to landslides. So it was off to Lhasa! We wanted to take the train or go overland but all the train tickets were sold out (you had buy them on the black market) and overland was long and expensive. Flying was the cheapest option by far.

We took off from Chengdu early in Wednesday (Jul 25) morning...8am. I got the window seat facing south and after just 10 minutes in the air the view was incredible.

The ride was only suppose to take an hour and a half but it was about 2 and a half hours when we started descending. We dropped out of the clouds for a few moments and I could see Lhasa below me before we went into another bank of clouds. And then we started ascending and sharply. About an hour later, Karl woke me up from a nap and said that we were headed back to Chengdu. "No way! Funny!", I said. He said they just announced it, "No kidding" -- the landing had been aborted due to bad weather. Hmmm...a few clouds and some light drizzle, but we heard from other passengers that this was common. Well about another hour went by and we landed back in Chengdu. I got a kick out of the young Japanese couple behind us who remarked as the plane came to a stop how Lhasa looked very much like Chengdu. Guess they had slept through the announcement too. We informed them that it looked like Chengdu because it was Chengdu.

Anyways, Karl and I wondered what we were suppose to do next. There was no announcement like we have rescheduled the flight or go to counter X to get help. The plane just sat on the tarmac for about 20 minutes with no one getting on or off. Finally they announced something in Chinese and the Chinese passengers clapped and shouted joyously...hmmmm, I wonder what's going on. Then it was translated in English...we were going to take off once refueled and head to Lhasa, again.

This time I gave Karl the window seat but I think it was cloudier then before and he ended up just reading his book most of the way. However, when we got closer to Lhasa we could see that it was clearer then before and not raining. We passed the airport sitting in a valley to our left, descended a little, flew alongside a range of mountains with the range between us and the airport valley (at the same altitude as the peaks...almost felt you could stick your hand out the plane window and touch them), turned 360 degrees at the end of the range, and came back down the valley. Now I understood why the pilot did not want to land it on the first trip. Making that 360 degree turn without hitting the mountains required visibility. I was happy when we landed safely...albeit 6.5 hours after initial takeoff.

Just getting off the plane onto the departure tunnel, I could feel the difference in temperature...felt like 60 degrees Fahrenheit. We got a bus and then a bicycle rickshaw to our hostel, chilled out and took some pics.

So the next day we spent just getting to know Lhasa a little. We had heard that to get a ticket to see Potala Palace you had to wait in a line starting at 5am in the morning the day before. Well, it was Thursday and we thought seeing the palace on Friday was a good idea but that it was ridiculous to start waiting at 5am especially since they didn't start selling tickets until noon. We figured we would get in line at around 11am or later. So we went to the front (south) gate of the palace and a sign there said to buy the ticket for the next day at the west gate. Off we went to the west gate. We stopped at a few building on the west side wondering if this was the gate and ticket office...nope, not that one, nor this one. Then on the way back to the south side after wandering in circles, Karl realized he still had the key to our dorm room in his pocket. This single key is shared by all in the room (4 people in our case) and you are suppose to leave the key at the hostel desk. Yesterday we had not known this and when we went out to dinner we had effectively locked out our 2 other dorm mates for a couple of hours. So Karl ran back to the hostel and said that I should check out one other building off in the distance for tickets and then meet him at the hostel.

I looked at the building from afar and did not think it was likely to be selling anything. I never ended up checking it out. Instead I turned back west and found the gate and ticket office. However, now I knew the reason folks got there at 5am. The ticket office only sold whatever tickets were left over after the tour operators got through buying tickets. In addition, they stopped people from even waiting in line for those leftover tickets around 8 or 9am. It was 10:30am when I arrived and they had blocked the whole waiting area off. I went up to one of the official-looking gentleman at the blockade and asked if this is where I wait in line for tomorrow's tickets. He said yes but that it was closed, no more tickets. I said that I only wanted one ticket and smiled as sweetly as I could. He looked around to see if any of his other official-looking buddies were within earshot and said, "Passport?". I said yes and showed him the corner of my passport. He said hurry and let me pass through the 1 foot gap in the barrier. I was last in line and waited two and a half hours but Victory! -- I got a ticket voucher for both Karl and I for tomorrow (you need a passport to get a voucher and I had Karl's passport).

The most interesting part of this experience was the queuing. Just a little China, there are no queues, just a mad crush of people with sharp elbows and if there is something resembling a queue, the Chinese try to cut the line all the time. When trying to buy a train ticket, many will just walk right up to the front of 50 person queue, elbow the guy in front, and shove his money under the window. In Taiyuan, when Karl and I were trying to buy a train ticket to Dunhuang about 2 weeks ago, one elderly Chinese fellow just cut right in front of me, oh-so-nonchalantly. In English, I managed to let him know that I was not a happy camper and then used by big Osprey pack with all my worldly possessions to nudge him oh-so-non-gently out of the way. He then stood behind me oh-so-nonchalantly again. The Chinese lady behind me told him that the end of the line was way back there and shoved him out of the way. He ended up waiting behind her and the rest of the line of at least 50 people did not protest.

Anyways, I back to my point...folks had been waiting for hours and of course, there was no maintaining a single-file line for hours (especially with so many different cultures and philosophies on queuing represented here in this waiting area) so people in the enduring hours had sat down over here, over there, or under a tree or stood at various corners of the small courtyard to have a smoke. Around 11:30am, a official-looking gentlemen shouted something and all the Chinese got up and rushed into line. Then a kafuffle took place. One Chinese boy was shouting at a western girl and one of the official-looking men joined. Basically the Eastern boy was saying that the Western girl had arrived after he did and that she should be in line after him. She was standing in line after her friend and a few places in front of the angry boy and she said that her friend had been holding her place for both of them. That didn't fly with the Chinese in line and they yelled at her until she moved back in line after the boy. It was oh-so-hypocritically Chinese! Normally most Chinese cut in line, save places in line or at a table for family and friends (for hours, I've seen!), and elbow and push folks, but now these Chinese insisted that this was not allowed here in this line (to see Potala Palace in Tibet of all places!) and that the westerners (they also split another group of Germans and made half the group move back a few spots) were rude and unfair, etc, etc, etc. I stayed calm in my last place in line but the little devil on my left shoulder was tempting me to jump in the fray and express my opinion. (Almost like those five Americans in April of this year, who went to EBC on the China side and protested with "One World. One Dream. Free Tibet 2008.") In the end we all got tickets when the dust settled, the different queuing philosophies made no difference...just like all the times at the train station.

Friday morning I woke up early and noticed I had a mild case of HAPE. I could hear fluids gurgling when breathing out after a deep intake. Ughhhh...this was what Karl and I had discussed briefly and hoped would not happen because the treatment for HAPE was to descend but descending in Tibet required a flight out of Lhasa. I always thought that I got HAPE because of a combination of factors: rapid ascent, high cardiovascular activity and lack of water. There was nothing I could do about the rapid ascent: we went from just about sea level in Chengdu to 3700m (12,210ft) in Lhasa in a 2.5hr flight, but I tried to avoid the other two, though just walking up the flights of stairs to our dorm room or to the roof top sitting area of the hostel constituted high cardio for me. We both felt a little dizzy and winded walking around town the previous day but it was just walking. Folks at the hostel did suggest drinking at least 2 liters of water a day and I did that easily. The only thing that I should have done in hindsight was take Diamox to help with the acclimatization, after all that's what it was prescribed for...but one the other hand, I had never gotten HAPE without some form of high cardio activity. Anyways, we went to Potala Palace at our appointed time of 15:40...very slowly since it was a uphill. Looking back, I didn't feel that bad because all the Chinese tourist were just as slow and Karl was happy because he had time to take pictures. The palace was amazing. It is amazing not so much because it's really ornate or large (which it is), but that it's unique...not commercialized in that Chinese-sort-of-way that makes Karl and I cringe. the word that comes to mind when I remember Potala Palace. (No pictures were allowed inside!)

So back to HAPE. After Potala, we went to the hospital. They took my blood pressure, listen to my chest with a stethoscope and lastly, did a chest x-ray to confirm I had what they could translate into English: lung edema. Yup. So what next? In the meantime, none of the doctors could speak English but there was a group of 4 guys from Beijing presently at the hospital who could speak English fairly well. They were there as volunteers for the Beijing 2008 Olympic to spread the word about the games to the locals in Lhasa. They had taken the train from Beijing and one of the guys had gotten sick and was lying in the emergency room. Also, one of them was a doctor himself (and luckily for me not the one that was sick). Jingang is his name (he just sent me an email today) and he really helped out translating and bringing us to the right places for the diagnosis.

So they basically wanted to get me on oxygen and give me some medication. Karl was hesitant because we could not get an answer on what medication they wanted to administer. Jingang could not translate the medication name and regardless this was not his field of expertise. Karl went off to contact our travel health insurance company because they could provide a doctor who spoke both English and Mandarin and could help us understand what the hell was going on. In the meantime I went ahead and took the oxygen...figured that wasn't going to kill me!

What I had was a mild case of HAPE, even the doctor confirmed that...said that he saw cases like this all the time and that mine in particular was not bad. But that I should start treatment sooner rather than later so that it did not get worse. To make a long story even longer, that night I admitted myself into the hospital after Karl spoke to our health insurance company and their doctors in Shanghai spoke with the doctors in Lhasa. However, we didn't get an explanation from the Shanghai doctors...they just said to the Lhasa doctors that I should be treated.

Later on I found out they give me oxygen and 3 types of medication: diamox, nifedipine (googled this and found out it's normally used for high blood pressure and effective in treatment of HAPE) and antibiotics in case of infection (from what I don't know). Anyways, on Saturday, the next day I was probably better but all the medication had me a bit out of my head. I took the last of the medication on Saturday and by Sunday when the drugs wore off I was much better. However, in the intervening time, the doctors in Shanghai (1 French doctor and 2 Chinese doctors) had decided that the medical facilities and personnel in Lhasa were inadequate and wanted to evacuate me to a hospital in Chengdu. In fact one of the doctors had already left Shanghai on Saturday and was due in to Lhasa from Chengdu on Sunday morning to evacuate me. I spoke with the Shanghai doctors and asked if this was really necessary. The doctors here in Lhasa dealt with these cases all the time. However, they stuck to their guns and insisted that I go to Chengdu.

Dr. William arrived on Sunday late morning despite the rain and clouds, checked me out and said that I was doing well...except for one oxygen saturation was 87% when it should be 96%. "Hmmmm...what is yours?", I asked. He tested himself and he as at 83% at which point he took my oxygen mask and put it on brought a slight smile to my face. He tested Karl...96%...this put me frustratingly in my place. So Dr. William re-iterated that I should go down to Chengdu...a first class seat for me and a coach class seat for Karl had already been purchased leaving in just a few hours. The doctors in Shanghai also called and insisted we go to Chengdu though in the end they said it was my decision. With all these expert opinions, I decided, fine, let's go.

During all the back and forth communication between the doctors in Lhasa, the doctors in Shanghai and our health insurance company, I asked Dr. William (it should have been Dr. Huang or something like that but he insisted we call him Dr. William...even the French doctor in Shanghai would ask to speak with Dr. William) if he had ever been to Lhasa. He said yes many fact, just last week. Really? Why? He had evacuated a Dutch couple last week for AMS to Chengdu. Karl asked if this was his specialty, helping foreigners, because he could speak English. Yup.

Ironically, after all this, we didn't end up going to Chengdu. The weather got worse and all flights were canceled for that day in and out of Lhasa. Hah! I would have another day to get better. Dr. William on the other hand was a little worried about 2am he couldn't sleep because of a major headache and put himself on oxygen (he told us the next day). By the next morning my oxygen saturation level was 98%, my blood test came out normal, and the chest x-ray confirmed my lungs were clear. So I said that I was not going to go to Chengdu. Dr. William agreed with this decision as long as I stayed in the hospital one more day. He left and caught the noon flight home. (I do have to write that I do really appreciate the efforts of the travel health insurance and the doctors in Shanghai...their reaction to the situation is exactly what I would want from a health insurance company and doctors. Rather this reaction than one where they just say you are fine and do nothing! They just wanted to give me the best care they could offer. So I would definitely recommend and use this travel health insurance again and if you are interested in knowing the name of the company just email me.)

(Karl thought the name of the hospital was the funniest thing about the whole experience...couldn't say it with a straight face.) In the end I checked myself out of the hospital that same day Dr. William left. Couldn't stand another day in the hospital (the Shanghai doctors were right about one thing...the medical facilities were less then adequate...the hospital was dirty and I was afraid of catching something worse). Plus I needed a shower and was tired of ramen noodles.

Karl found me a ticket to Kathmandu for a great price and we decided that I would fly out and he would go overland to Kathmandu. We did the Barkor circuit around Jokhang Temple in old town Lhasa and little souvenir shopping before I headed out. Still wish I had spent more time at the Rooftop of the World, though.

Maybe Karl will blog when he gets here to Kathmandu and write about his extra days in Lhasa and his overland trip. For now that's all from me. As usual, more pics below.

07-30-2007 Lhasa

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