Kilimanjaro - 1 year on

27.10.2010 -  8am. I Summited Kilimanjaro. 5895 m / 19341 ft above sea level.

After 7 days treking the Lemosho route in Tanzania, Kilimanjo peak came into view. 12 of us had gathered on the 19th October 2010 at Heathrow to fly out to Tanzania. Landing 8 or so hours later after a few small delays,  and then a half day rest and briefing we had spent a comfortable first night in the Arusha lodge hotel, a small oasis of calm overlooked by mount Meru, a sister mountain to Kili.

Days 1-3 (21 - 23 October)

Over the first few days we ascended the mountain taking in and treking through jungle, moon scapes, rocky outcrops, an area that seemed like the lost world, full of hanging creepers and strange shaped trees, monkeys and ghoulish sounds. A bit of rain didnt slow us down and generally we kept up quite a pace. The whole group were fit, kitted out and we had around 50 or so porters including 7 guides. Everything is carried up the mountain, the portapotty included! Breakfasts were porridge, jam, bread, and scrambled egg and bacon!!

The scenery was as you might expect with the base surrounds of a mountain in Africa. WE started by taking 4WD vehicles out to Londorossi  and thats where we began walking at around 2250m, so had a good 3000m to. The days were laid out with  a good easy going pace, but slower than you would expect as the whole point of the first, and longer route of the Lemosho is to gain acclimatisation more slowly, thus decreasing the risks of atlitude sickness, which can strike in any number of ways, but most commonly headaches, nausea, diarohhea, vomiting, and then only if its really bad do you get the more nasty pulmonary edoema........we discovered in fact whilst climbing that ginger tea is in fact one of the best things for all of these symptoms, and nearly everyone on the trip felt some effect of altitude at one point or another. The ginger tea was something we noticed all the porters and guides were drinking and found it also something of a relief. I personally failed to sleep over about 3000m and so found that a combingation of the ginger tea and a few tylenol were the only answer to actually getting a few winks each night. i did generally fail to sleep on the mountain, so that became one of my personal battles to cope with. After about a 3-4 hour walk the first day we camped at the Lemosho forest camp (2650m).

The group was excited and there was a lot of banter and messing about. it was only day one! After a decent night sleep and good breakfast we continued on at around 7 or so in the morning.

couming out of the jungly forest we started to ascend to Shira Plateau.The trail starts out in the lush rich montane forest before ascending into the moorland zone of giant heather. The trail climbs steadily

with views across the plains opening out as we reach the rim of the Shira Plateau. There is a tangible sense of wilderness especially if the afternoon mists come in. We camp in the centre of the plateau at “Shira One” (3550 m). Approx 6-7 hours walking in total and we started to notice that the air was getting a bit thinner (you can often ski up to this height) It was also a bit cooler and the 3 girls definitely started to apply the next layer of clothing. Another camp at shira one, at least the porters that tend to motor past you on the mountain despite carrying 3 or 4 times what we were, set up the tents in advance and even boil water for us to have a wash and clean our selves up. "Washy washy" every afternoon and evening before we sat down and had tea in the mess tent, ususally with popcorn and hot choc, coffee etc. After this we did an aclimitisation walk for another hour or so, up to 4000 m and back down. Its important to try and do these extra walks as it allows you to go higher but then camp lower at night. the rule is generally to sleep 500m below the highest point reached during the day.

We'd sort our kit for the next day, have a briefing and then sit and chat waiting for dinner to be brought. WIth only torches and the odd lantern, the aim was to do as much in daylight hours as possible. your body clock moved to day light hours pretty fast. rising early and going to bed by about 9! games of cards and sitting drinking ginger tea in the tent was popular, but we were turning into our tents relatively early so as to try and kip for the next days treking.

Day 3 was continuning on the Shira Plateau with an easy day to help acclimatisation and to explore the grassy

moorland and the volcanic rock formations of the plateau. We walked to the summit of Shira Cathedral, a huge buttress of rock surrounded by steep spires and pinnacles. There is a tangible sense of wilderness here (especially when the afternoon mists come in!) and the views from our camp near Shira Hut (3840m) of Mt. Meru floating on the clouds are simply unforgettable. 

latest status

So, another month or so on and where do I find myself this week? its about 4 or 5 weeks since I was in hospital and yet again Im not really at all clear where all that time has gone. Im timesliding.

After I left hospital my bro got me up to my parents place in Suffolk where I lounged in the garden in those 10 days of glorious indian summer that we got in September. Back to london for more appointments and tests and living quietly since. (see previous blogs for those updates)

Im still on whacker killers, but I decided that I was going to give myself a bit of a push and go back to work earlier than last time. Pain levels are still high, but I was getting to the point of just drifting from one day to the next in an endless stream of nothingness. Yes I sorted out some cupboards, paperwork, made a tray, did some filing, applied for a mortgage and had a daily wander in the lovely local parks and shops (not a great state of play for my current account  - I can say that is one major advantage of being at work, not to mention that there isnt a spare inch in my wardrobe now either, note to self......monitor major shopping habit!!) but all in all i didnt feel like I was really making progress. This is not really the case in reality. I was resting a lot, eating good diet and not drinking, and making small steps daily in what I could manage to do for myself, so as a girlfriend of mine said.......small achievements and goals to check off........like a gold star sheet when your 5! I must have a full sheet by now, maybe I'll put one up in the kitchen! an achievements chart!hmmm.

SO, I went back to work on Monday. HUGE tick. I was high as a kite. Loved seeing everyone, arranged my return to work schedule, spoke to doctors, made lots of decisions, status reports from my team and even met with my boss. It was a busy day and I barely stopped. I had to go back up on the painkillers to get through it all and by the time I flopped on the sofa around 7 in the evening, I knew I wouldnt be doing a lot for a while.

Tuesday and WEdnesday I barely left the house, did work calls, read some reports, emails, and generally caught up with work stuff, but I was utterly floored! my body was simply not responding to my mental instructions to carry out basic tasks. ITs rather like having ME I suspect. I was utterly knackered and body and brain simply not working together! and then also not sleeping just to add insult to injury!

Work again on Thursday, again productive and I have a list an arm long of todos! now I can get stressed about too much to do and how to fit it all into 2 days a week! but a good problem to have. Nice also to be needed, I was starting to feel that I might not be a necessary cog in the wheel! My team reassures me otherwise. thanks peeps! But I will say that Im tired. par for the course and like anyone whos had a holiday for a few weeks, those first days and week back at work are always a bit overwhelming and knackering even if you are fit, which of course Im not!

My fridge had got to a rather sorry state this week, so a rather emergency shop was done today on the way home slowly following a chat with a journo about this whole saga. She seems to think that its a good message and story to get out there, so I'll keep you posted on what happens there! Maybe I have a voice and a cause here and this is my time to charge like the lightbrigade in the cause for osteoporosis in younger people (there is so little research on this currently!)

A couple of other things have occured over the past few weeks too though. My phone deal with 02 is definitely working out more cost effective and I think I might finally be using some of those 1000 mins I get in my package. Im going all old fashioned again, Im actually calling girlfriends/ friends and chatting a lot, texting is suffering a harsh demise in some regards in my life,(that could also be because Ive developed lazy finger syndrome and cant be bothered to type!) and facetime is getting a great reception too. love it! although I do have  a slight panic about bad hairdays and smudgy lippy or eyeliner when Im actually "facing"!! I feel like one of those teenagers that had their own line in their room and used to constantly hog the phone (Im aware they still do this, but just on a pay as you go mobile phone now!)........and people also love actually chatting too......really! how and when did we all allow ourselves to get so impersonal and stop talking to each other?

Ive also been using the postal system a lot more, messages and cards to friends, little things to send in the post, its given me a lot of satisfaction, and be honest, we all love getting a letter or package in the post!
so Im also going to champion us all chatting and swapping addresses again, like we once did about 10 years ago in the heyday of the filofax and brick mobile phone! the funny thing is that getting a note or gift in the post can go a huge way to brightening someones day, and those little things have made such a huge difference in my rather bubbletastic world of late!

And lastly, I have discovered that covering myself in black charcoal and thinking that Im giving life drawing a go is a wonderful way to switch off! It remains to be seen that i can actually make anyone look like an actual human being through the medium of carbon on paper, but it was fun and messy and for 2 hours a week I was managing not to think of anything in reality in my life and just switch off to focus on naked body parts and whether the knee was in line with the nose and the right hand! Oh well, all quite good for a bit of positive thinking and well, any excuse.......

It has been a tough week too though. Ive done a lot of research this week on both depo and on osteoporosis and the more I read the more frightening it gets. Ive joined discussion forums for fellow sufferers and I cant begin to say how many people seem to feel as isolated by this illness, as I have. Doctors just dont have the info and the knowledge and no-one seems to know how to treat this condition in people under 50! the drugs and medication is so limited if not agressive in so many of us with horrid side effects. many are dealing with alternative solutions, diet and general support. But it is scary actually how many people are affected and not just getting the odd broken bone, these people are housebound, in constant pain, many have walkers or wheelchairs.......its a slow and silently progressive disease,  and Im finding its very hard to take that all in still. I dont know if Im still in some place of denial and not wanting to face up to all this, but equally I dont want this to beat me. I will keep researching and messaging and finding out all I can. I feel its a responsibility to myself as well as others. If Im honest I do find it a bit depressing, but the only way to deal with this is to confront it and just find out more. 

preventing osteoporosis - a stitch in time......

Over the past number of months whilst Ive bee largely incapacitated, Ive spent a lot of time wondering if I could have avoided this. The simple answer for me is probably a combination of yes and no. Ive always had a healthy diet, in fact grew up with a hippy vitamin, bran eating mother who fed us nuts and raisins and not sweets and crisps! so in general, that and the sporty outdoorsy lifestyle I have always lived, there isnt a whole lot I could have done to avoid this had I been more aware that this is NOT just an old persons disease. I did smoke for a few years, and did my fair share of partying hard at uni, and in the early years in London, but didnt everybody!? I wasnt any different to my friends, and certainly no alcoholic. I also never did drugs or pills or any of that stuff, just wasnt my scene, and can happily say that Ive NEVER done a line of coke, (I must be in the minority on that one!). so when you look at general lifestyle, diet and fitness, Im in good shape. HOWEVER, and this is where there is the BUT......you can never tell what your genetics are programmed to do. I had no idea Ive probably had a vitamin D deficiency for years, leading to lack of K and C and calcium being absorbed into my bones......I cant help wondering if all the bruises Ive always had have been some sort of indicator of this as they are certainly linked!? anyway, I digress. I chose to take a contraceptive that when looking at the paerwork in the packet, made no indication of this disease, only in women still maturing was there a warning (18 -  26 years old), so taking this at 32 was not deemed a risk.

I can say though that the more I research and read discussion posts by other sufferers of this disease, it does seem to be linked with a number of other conditions........coelic, chrones, gluten intollerances, hyperpararthyroidism, vit d deficiency, the list actually goes on and on.........diet is a big factor......cut out the dairy (its a myth that drinking a lot of milk actually helps significantly -  if you dont have the vit d, its actually bad for you it seems ) cut out gluten, eat only fresh fruit and veg, nothing prepackaged, dont drink, dont smoke, dont eat too much red meat..........etc. etc

I have copied a section here from one of my blog/ discussion sites for reference to anyone interested in keeing their bones fit and strong, so that you are preventing this at the very least in later years, or losing 5 inches in height, breaking bones just by brushing your hair or bending over, having hip operations, constant pain and tiredness, not being able to pick your kids up, worrying about falling, dropping out of various activities because you are terrified to break, stress and anxiety, fertility problems, incapacity, being in a wheelchair because you simply cant walk,  ......these are all very real issues on a daily basis for the large percentage of sufferers!!!!

"Because it is hard to replace bone that is lost, prevention is key. Beginning a lifelong commitment to exercise and healthy nutrition while you are still young reduces your risk of developing this condition later in life. Remember, you are never too young to think about preventing osteoporosis.

Exercise increases bone mass before menopause and helps to reduce bone loss after menopause. Bone strength increases with regular exercise -- to help prevent bone loss weight-bearing exercise such as walking, low-impact aerobics, or tennis work best.

An adequate calcium intake is essential in the prevention of osteoporosis. Good sources of calcium include dairy products, leafy green vegetables, nuts, and seafood. Most women get only about half of the calcium they need everyday so taking a calcium supplement is often advisable. The best form of calcium for preventing bone loss is calcium carbonate. If you choose to use calcium supplements, it's important that you understand that the body can only absorb up to 500 mg of calcium at one time, so you will need to divide your dose if the amount of calcium supplement you take exceeds that amount.

Vitamin D is necessary for the body to absorb calcium Milk that is fortified with vitamin D is one of the best sources. Sunlight also is an excellent source of vitamin D. In fact, being in the sun for just 15 minutes a day helps the body produce and activate vitamin D.

Calcium is important throughout a woman's life, although the amount necessary varies with age.

·         Children from ages 1 to 10 require 800 mg of calcium daily.

·         Teenagers need 1200 to 1500 mg of calcium per day.

·         Women between 25 and 50 need 1000 mg of daily calcium before menopause and 1500 mg after surgical or premature menopause.

·         Women over 50 require 1500 mg of calcium if they are not taking estrogen and 1000 mg if taking estrogen.

·         Pregnant or nursing women need an additional 400 mg of calcium daily.

Younger women who experience the symptoms of premenstrual syndrome (PMS) may be pleasantly surprised to find their symptoms are reduced by employing these osteoporosis prevention techniques. Studies show that calcium supplements may reduce or prevent up to 50% of all PMS symptoms, and exercise is often effective for reducing PMS symptoms.

Bruising is an indication of lack of vitamins D, K and C. These are all linked to uptake of calcium in the bones, so all are impacted when one is depleted!

so what can you do in your diet to affect all this?

There are foods that rob your bones of calcium, such as,
Foods to consider avoiding
 -1%, 2% and whole milk and products
 - Meats with 96% or less fat
 - Red meats (Increases calcium loss)
 - Hydrogenated oils such as stick margarine, and when listed as an ingredient in foods
 - Food with high butter fat and other animal fats
 - Hot dogs, hamburgers
 - Salt (a major bone robber) or foods prepared with salt
 - More than one cup of coffee or other caffeine beverages a day
 - Sugar (a major bone robber)
 - Chocolate
 - Soft drinks due to high phosphorus content
 - Alcohol (it inhibits calcium absorption)
 - Carbonated Beverages
 - Caffeine (increases rate of calcium loss through the urine)
 - Smoking

Also keep animal protein consumption down, it increases calcium loss.
Some foods to consider eating more often : (1-5 servings per week recommended) - Salmon and other fish, including the skin and fat (Research suggests this fat (EPA fat) has the ability to raise HDLs. (good cholestrol)
- Fresh fruits (good source of boron to aid in calcium absorption)
- Sesame seeds, Dried fruits, unsweetened, especially apricots, dates, prunes
- Low fat tomato sauces and pasta
- Peanuts, walnuts, almonds, peanut butter
- Grape juice, Grapes, especially red grapes, Grapefruit, especially pink, oranges, raisins
- Bean and, chickpea dishes and dips (great source of boron to help increase calcium absorption)
- Tomato salsas, Mineral water, Non fat yogurt, Skim Milk
- Sardines (Atlantic with bones), Pink Salmon (canned with bones or fresh), 
- Bok Choy, Turnip Greens, Brocoli, Non fat Baked Beans, Kidney Beans, Okra, Squash, Spinach, Carrots, lightly cooked, Pumpkin, canned or cooked, Sweet potatoes

 

a serious warning

I have refered to this in the previous posts but this is a quick update and a pertinent but sharp warning to anyone on depo provera as I was.

Now this drug is still prescribed as a viable contraceptive, and whilst it works brilliantly in preventing pregnancy, and in my case also controlling my hormone levels (eostrogen) which were increasing the number of severe migraines I was getting a month (about 8 a month), this injection, carried out quarterly, does in fact have a black box warning........NOT something I was aware of when i was prescribed it by my doctor 3 years ago!

...the black box warning states (ref wikipaedia)

Black box warning

While it has long been known that Depo-Provera causes bone loss, it has recently been discovered that the osteoporotic effects of the injection grow worse the longer Depo-Provera is administered, may remain long after the injections are stopped, and may be irreversible. For these reasons, on November 17, 2004 the United States Food and Drug Administration and Pfizer agreed to put a black box warning on Depo-Provera's label.^[34] However, the World Health Organization (WHO) advises that the use of Depo-Provera should not be restricted.^[35][36]

It is unclear whether the bone density loss associated with Depo-Provera use is reversible, and if so, how completely. Three studies have suggested that bone loss is reversible after the discontinuation of Depo-Provera.^[37][38][39] Other studies have suggested that the effect of Depo-Provera use on post-menopausal bone density is minimal,^[40] perhaps because Depo users experience less bone loss at menopause.^[41] Use after peak bone mass is associated with increased bone turnover but no decrease in bone mineral density.^[42] However, as of 2006, no study has directly examined fracture risk in post-menopausal women who have used Depo-Provera; therefore, the risk is unknown.

humpty dumpty sat on a wall.....

and as you all know from the nursery rhyme, he had a big fall and none of the kings horses nor the kings men could put humpty together again. Well  -  that sort of sums up how I have generally been feeling until the last week or so.

I left you all last on my way for an ultrasound. 3 new fractures were discovered but there was one key difference this time -  they were stress fractures and not traumatic ones (traumatic are incurred by sharp/ heavy impact such as a car accident/ severe fall etc). Now I say not traumatic -  the pain is still the same and the incapacitation, however this is a slightly positive if somewhat depressing situation! Through the course of repeated actions, such as various people hugging me goodbye -  the depressing bit that I can break so easily   (and not bear hugs I hasten to add!)  - it seems that this is enough to create stress on my ribs that are already, as humpty knew so well,  weak, and once cracked, somewhat impossible to prevent from crisis and further breakage!  It does mean apparently though that they might not take as long to heal. good news. 

So the grand count to date this year on broken ribs( or should I say the last 18 months) has been a record total now of 21 broken/ fractured ribs. Some rebroken, from previous incidents but overall a whopping 21! can I have an entry form for the guiness book of records please?

Following my ultrasound and a small incident involving Helen one of my girlfriends feinting in the ultrasound room whilst she escorted me, and then borrowing my bed for 5 mins to recover, I was back to recovery mode and pampering by all the nurses and my lovely visitors.

Following day I was carted off to Princess Grace Hospital (where the bone density scanner or dexa scanner is) and they zapped me again to see if things were worse, the same or not. I was told in no uncertain terms there was no point in this scan as there would be no improvement, and they wouldnt normally do this before 12 months after the previous. I had had to point out to my consutant that a) Im not a normal case ie 75 and b) I wanted to check that I was on the right track and that things werent still getting worse! He agreed and so off I went. Now, Im no pro but I had the print outs with me from my previous readings, and I managed to decifer from the new set that there had in fact been the smallest of improvements in my bone density. Frankly something of a miracle -  must be wangerama's gunge that Im taking of course!  This was later validated by Dr B! Anyway, it seems that my arms are fine a bit low but not bad and not likely to break if I fall. My hip is still pretty dreadful and the femeral head and neck which are the top of the thigh bones where it connects to the hip socket is pretty dire, but the rest of the pelvis and femor are very slightly better than 3 months ago -  yeay! Then on the spine they take 4 readings. basically from top of spine in 4 chunks down to where it meets the pelvis. L1 is at the top and L4 bottom. L1 and 2 have improved a bit -  yeay! L3 not great and L4 utterly horrendous readings.
SO what does this all mean? basically if I fall over I could easily break my hip like an old granny or my spine and be left in any number of unthinkable states, really doesnt bear thinking about. But it is slightly better and the baynon was gobsmacked. He thinks the chinese medicine will poison me and is a bunch of tripe.....but he would.......and hes now utterly convinced that, sadly for me, it is predominantly down to the rather ghastly contraceptive that I was on. (It turns out the world health org wanted to ban depo provera but realised that it was a great way of preventing too many births in 3rd world countries, so didnt and despite all the risks they continue to prescribe it. Frankly Im utterly shocked and will be considering some sort of national/ political rant to that effect when Im stronger! anyone want to join me, please do!???) I seem to be one of the incrediblly rare cases in the world that this can happen to and the numbers and probability is low, but still! they know the risks and still do nothing to stop it!

So, to continue. I left hospital on the Saturday morning and my dear brother managed to get me and my rather upset felix cat, still intact both, to my parents place in Suffolk for further Tlc. Louie (the cat) had a cat holiday chasing mice and hiding in bushes and shubbery for 10 days and didnt want to come back to london -  frankly I dont blame him, and I was tucked up in bed for r and r. I was also very lucky to get the indian summer weather, so I was also set up on the sun lounger in the garden for maximum vitamin d absortion! (and a nice autumn tan to go with)

Blood tests came back on Wednesday and were all pretty positive too. My horribly low Vit D deficiency it seems has been stabilised now to more normal levels, but I have to continue taking 20000 units a week for the forseeable future. (most daily vit pills have about 400/d just to put that in perspective!). the big news on all that though was that in fact my hormones are relatively normal, which is great news. there were a few anomalies, but apparently thats sort of normal!

All in all the tests have been a step in the right direction and I have to say that when I spoke to Dr B this Tuesday again in London, and he compared me to a cracked egg (hence the humpty reference) it seemed like a good way of explaining. Basically you lot are like a nice happy solid egg with no cracks -  the type we all check for in the egg carton, and Im one of the cracked ones that if you end up with one, you escort it home very carefully and then chuck it in a pan asap.........poor humpty! however it does seem that the kings horses and men seem to be making some progress in medical science since the rhyme was written and I actually, albeight VERY VERY slowly, might actually be able to glue my cracks back together again and be almost the same as the rest of the egg fraternity! funny how only a couple of months back I was banging on about having a double yolker! hmmmmm definite egg theme emerging here!

The tens machine has been my saviour and the endorphin rush you get from it is wonderful. that and the extra pain relief it gives. I was using on my ribs and my back and I tell you, for anyone who suffers nasty back pain or problems GO AND GET ONE. they are fabulous for back spasm, pain relieve, migraine, all sorts......

Im still on mega 'killers' but have reduced the tramadol a bit. Im moving about better, can carry a few things, can make myself food and stuff a bit better now, but I still get my good days and bad days and the one ever consistent thing that really hasnt changed is my insomnia......its currently 3am and Im wideawake club! ho hum.....had  yummy dinner cooked for me by nins and candi tonight though, and some green soup with every vit d vegie on the planet in it -  thanks Nina......Im gonna be popeye soon!

but the key thing is that my state of mind is more positive- these test results have given me a degree of hope that I can make good progress now and over time live a more normal life - whatever that may be, certainly not one involving extreme sports anymore, dancing on table tops in my ski boots or even going crazy on the dancefloor! Art, culture and golf seem to be the way forward! and you never heard that in the nurery rhyme did you.........POOOOOR HUMPTY.