Sunday, September 25, 2011

Arrival at Kilimanjaro Airport

We left Ethiopia at 10:00 a.m. arriving in Tanzania's JRO - Kilimanjaro airport at 12:40 p.m. Our plane was the only aircraft at the airport. I only remember one runway, but there could have been others out of my line of sight. As we landed, my eyes searched for the mountain we would soon meet. I have never seen a mountain as high as Mt. Kilimanjaro and could only imagine how high 19,340 feet would appear from her south facing flank. I wondered about the approach, would we see snow, would it rain, are there really glaciers on the summit? My only reference to a big mountain is Mt. Rainier whose massive glaciated summit does give you pause at the enormity and expanse of a free standing mountain. The Mountain, as we fondly call Rainier, is only visible during clear skies, othewise hidden behind the mountains own generated cloud layers. When the Mountain is 'Out', traffic around Seattle slows considerably as it is hard to take your eyes off such a beautiful part of nature. I wondered how often Kilimanjaro is 'Out' to mesmerize the people. Unfortunately, her mystery prevails for yet another day as she is hidden within the thick cloud layers that consume all in the distance.  
I was feeling strong as I lifted my backpack out of the overhead luggage stow. It was full of the absolute necessary gear for the trek that I knew I couldn't replace if my boundary bag got lost. I wore my comfortably worn mountaineering boots, carried my medications, cameras, favorite mountain snacks, technical layers and my alpine down coat. I had taken 2 liters of water on board in Washington DC and had managed to drink almost all the water I had carried onboard plus the drinks served every few hours by the airline attendants. Dehydration will greatly limit performance on the mountain and lead to problems with altitude including fatigue, headache and muscle cramps, none of which can be tolerated on the mountain and can mimick acute mountain sickness. I had closely monitored my water intake for a month before the climb drinking more than thirst called for. Once arriving in country for the climb, it would be even more important to make sure enough water is consumed. It would be impossible to get fully hydrated if you start a climb dehydrated since the body needs time to distribute and equilibrate the body's water over several days. 

The workouts had continued up to the day before leaving for Africa yet I wondered if I had trained hard enough. But it was too late now to worry about whether I was fit enough. I thought of the team whom I would meet in a couple more days. I wasn't sure about a lot of things, all I knew once stepping onto the Kilimanjaro tarmack is that Monique and I were there for a bigger purpose than pursuing our own climbing aspirations.

We made it through customs with no problems. We exited the terminal to find our guide and porters waiting for us with a Bushbuck Safari jeep. As the porter and guide loaded the jeep with our boundary bags, we headed back to the washroom. We had to remember, no tap water can be consumed or even splashed into the eyes. This is challenging coming from the States where tap water is never given a second thought. I tipped the porter at JRO and our driver both $5 usa. I later learn this would be a tip for a whole day of service. All six of us piled into the jeep. The interior of the jeep was comfortable, seating enough for 10. We were off and moving closer to our objective. 

The road to Arusha has two lanes. Cars, trucks, motorcycles and bicycles used whatever lane was open. Oncoming traffic was nerve racking. In Kentucky we call this form of driving playing 'chicken'. It was Sunday and many people were out at church gatherings and walking alongside the road in their Sunday attire. I was amazed at the colorful fabrics of red, purple and blue. The women dressed in beautiful layers of flowing color. The color was strikingly beautiful. In the States, clothing styles are driven by the best marketing companies where in Tanzania, the clothing is beautiful and practical. I find most American clothing monochromatic in nature where everyone looks the same. Women were carrying objects on their heads leaving their hands to carry even more. Children were also carried, bundled on the front or back. I could imagine these women could easily climb a mountain. I also thought they could easily outwork any man I know in the States. 

There were many more people walking along the road than driving. The road was lined by small herds of cattle and goats and a few herdsman. We passed small diners along the way with dirt parking lots full of motorcycles. Coca Cola was the predominant advertisement with several red and white awnings and chairs displaying the familiar logo.

It was almost an hour to get to the Arusha Hotel. We were greeted by Ben Johnson, our Alpine Ascents guide. What a nice looking guy and very soft spoken. Ben made sure the check in process went well and told us we would meet tomorrow morning at 9:30am with Eric Murphy, our lead guide for a short meeting before we headed into town for sightseeing. So far, the trip coordination was just as promised by Alpine Ascents.

Our room was very adequate and clean. The hot water pot was a nice addition since it could boil water. Our room overlooked the inner lawn and dinning room. The inner lawn was full of palm trees, flowers, and a manicured lawn with a central walkway leading to the pool. It looked like it would rain at any moment and the air was a cool 65 degrees. Arusha is at just over 4,000 feet elevation. Of course the temperature would be cooler, even though we were close to the equator. I had looked at the projected weather for Kilimanjaro before leaving Seattle. I was surprised to see the weather was very much like Seattle weather and we should have clear skies and a full moon for our climb.
I was anxious to open up the bags to make sure all the gear made it seeing as you can't lock the Sealine Boundary bags. We opened our boundary bags to find they had been searched. Some of my gear was in Monique's bag and some of hers in mine. It's a wonder nothing was taken or lost and thankfully we were traveling together. We unpacked and separated our climbing items from the safari items and repacked the boundary bag for the climb only. The safari bag would remain at the hotel while we were on the mountain. Gear is all there, now time to eat.

Ben asked us not to sleep until the evening to help with jet lag. Stay up and go to sleep at your normal bedtime. That would be very difficult considering the 10 hour difference. I was tired but also ready to go downstairs for lunch. We met John in the dining room and had a quick lunch. Martha, Nan and Doug had already eaten and retired to their rooms. The buffet lunch had really good Indian food, one of my favorites. We had pumpkin soup, pasta primavera, rice, potatoes and steamed vegetables. The coffee is the best I have had, ever. I live in the world of Starbucks but have never liked their coffee. People I meet are so surprised that I am not a Starbuck's fan and then they usually admit to disliking the bitterness of Starbucks as well. The coffee in Tanzania is very smooth while maintaining a rich flavor. We were just getting to know John, he is a really funny guy. My persistent yawning was telling me it was time to rest. We bought two three liter bottles of water from the waiter who added 5,000 shillings to our lunch tab. We were very focused on avoiding diarrhea while trying to still drink several liters of water a day. I picked up our bottled water and we were off to the room for a quick nap.

Sierra and John

Porters, John and Martha

John our Bushbuck driver

Monique leaving for Tanzania from Ethiopia

Monique ready to leave for Arusha

Homestead on the way to Arusha

Goat herd and homestead

Small town on the way to Arusha
Children at play on the way to Arusha

Wednesday, September 7, 2011

Heading to Africa

July 8, 2011. 
Monique checking in for
Seattle to Washington D.C.

After almost 10 months since my initial contact with Lori and 6 months of focused training, departure day had finally arrived. I had also just finished my comprehensive board exams as a final step to complete a degree in Philosophy. I wouldn't know if I passed my exams for several weeks but what a relief to now just focus on one thing, climbing. The flight from Seattle was delayed a few hours but we did finally leave Seattle at 1:00 a.m. The late departure was fine since Charles Mulvehill, the travel agent that Alpine Ascents recommended had made sure he allowed for delayed flights. I remember asking him back in December why there was so much layover time between flights. He said with confidence, "the time will fly and you will need the extra buffer in case of flight disruptions". Charles was right, why would anyone expect to fly 10,000 miles and not experience a delay some where along the way.

We arrived at 8:30 a.m. I managed to sleep most of the 4.5 hours to Washington Dulles International. I don't take sleep medication due to the hangover, so whether I sleep or not depends on the passengers near my seat. Monique said she didn't get much sleep. We made our way to the Ethiopian air gate for our boarding passes. We confirmed our climbing bag from Seattle was checked to Kilimanjaro airport. What a relief we didn't have to retrieve the 115 liter boundary bags and recheck them to Africa. Our boarding pass had a blue sticker and I wondered if Ethiopian air boards by colored dots. Monique saw another person in line with a red dot so she said they most likely will board by color. I wasn't sure when blue boarded so we would need to stay close to the gate. We ran into Nan and Doug at the gate. I was finishing up some last minute emails and noticed a text message from an unknown number. I texted back, "who is this?" Reply, "John". Oh, John and Martha. I dialed John to see where they were then noticed John walking toward the gate. We were meeting Martha for the first time.

Martha was very friendly and as jovial and engaging as is John. What a great couple. John is one of the PD climbers and Martha is climbing as his support companion. I think he said they had been married for twelve years. I hoped to get to get to know Martha better, she was confident, funny but also serious. I noted a familiar ascent as Martha was talking and learned that she was born in Kentucky. I am also from Kentucky and lived there until I left for New York for physician assistant studies. I left my teaching position at the University of Louisville's laboratory sciences department and was also about half way through an immunology graduate program. At the time, I couldn't have imaged how Parkinson's would be come a big part of my life and focus of my medical career.      

Martha and John had a lot of experience trekking the Rockies and John had experience with search and rescue. I knew I could count on Martha and John during the climb. The climb was unique in that most of our team were not very experienced in climbing at altitude but were very experienced at living life with the daily challenges and struggles of living with MS or PD. These challenges will usually make a person stronger and more resilient, that is when there is adequate support and caring. I tell my patients that climbing a mountain is very much like living with PD or MS. Climbing requires targeted fitness, planning, self-care and generally support from at least one other person, all ingredients to living well with PD and MS. 
Sierra, Martha, John,
Doug, Nan

We ate a quick breakfast in order to take our first dose of Malarone malaria prophylaxis tablets. My nervous energy was subsiding and I hoped I wouldn't have Nan's reaction to Malarone in flight - GI motility! After breakfast, we had some time to talk about the adventure before boarding. Boarding by color was nicely done and orderly. What a treat without the mad rush to the boarding area. Monique and I lucked out that someone wanted to trade seats so we managed to sit together on the long flight to Ethiopia. It's nice to fly with someone who will ask for a water or soda when the attendants come by while you sleep.

Monique, Nan and Doug
Waiting at Washington Dulles
There is no turning back now. Leaving for the climb was exciting and beyond my childhood dreams. I couldn't stop thinking about the MS and PD climbers. Most people I talked to about the climb were shocked at first that anyone with PD or MS would try to climb a mountain and then shocked even more that I would go along. More about this later. It was true, climbing is hard enough without having to contend with a neurological condition. Then I think about Lori, a living example that we should not define a person by their disease. I always encourage my patients and expect a lot for them and from them, but I have no idea what to expect on such a long trek at altitude. The climb will be an adventure in combating fears and working very hard to reach a goal. Ultimately, my thoughts settle that no matter what happens, no one should be denied the chance to try.
Once buckled in, I notice the amenities on the plane. Foot rests, toothpaste, eye shields, head phones, free movies, big cushy seats with lots of leg room. Very comfortable. It's still hard to believe I am going to Africa. As the plane lifts off, I feel a sudden sense of freedom; now time to relax

Wednesday, August 31, 2011

Ready to Climb

Obtaining the VISA from the Republic of Tanzania was rather simple. Fill out a form and mail my passport with a check to their embassy in Washington DC. Alpine Ascents recommends also sending a self addressed paid FEDEX envelope for next day return with tracking. I chose the two day return since it was half the price. My passport was processed quickly and returned within two weeks. No problem. So far, there had been no problems with preparations, training, or logistics for Kilimanjaro. Six of us would be flying Ethiopian Air and due to the itinerary, we would be arriving in Africa a day early and staying a day later than the rest of the team. Ethiopian had the best price and the fully refundable or changeable ticket was a nice bonus.

May and June were the final months to really crank up the training intensity. Long hikes at higher altitudes, trail running, long cycling bouts and lifting weights focusing on the muscles that especially need to be strong on the mountain. Backpack weight was also increased to 40-45 pounds for long carries and a few more nights stay at Camp Muir may help a little with acclimatization. Toward the end of June, I developed a much dreaded plantar fascitis from most likely running hills, sprints and most likely wearing sandals. I was worried the foot pain would be a problem on the mountain so I backed off the intense training and decided to wear my Sportiva mountaineering boots on Kilimanjaro. They are way too much boot for Kilimanjaro, but well worn and less likely to aggravate a sore plantar fascia.

The last chores to complete was left to the few weeks before leaving for Africa and included buying the recommended food items for the mountain as well as sorting and packing gear. If you look at the food, you would think I was headed out for a month in the backcountry or maybe opening up a snack stand. Food at altitude just doesn't appeal to most people, so you need a steady flow of calories from snacks you know you will eat. The brain and muscles must have some form of calories to keep the body moving and thinking. Chocolate, raisins, ginger, fruit wraps, peanut butter, caffeine injected jelly beans, powdered drink mix, hot chocolate, snickers and dried fruit was all neatly packed into a stuff sack. I figured if I didn't eat all the snacks, I would share with my teammates, guides or porters.

I think packing for a big adventure is more stressful than actually climbing the mountain. Training is focused and usually spent outdoors; a nice relief to organizing gear into little piles all over the house. However, a person can't train all the time so all free time was filled with 'To Do' lists that seemed endless requiring frequent trips to REI. Each new piece of gear was tested out in the elements, usually on my favorite training trek to Camp Muir on Mt. Rainier's south flank.

The last few days before leaving for Africa involved a daily procedure of reviewing the gear list, making more little piles, assessing what was needed, what could be left behind. We had a weight limit of 50 pounds. I managed to come in at 34 pounds that included 8 pounds of t-shirts that were donated by REI for the team. The day before departure, all items were strategically placed into the boundary bag. All electronic gear would go on as a carryon in my backpack and I planned to wear my boots to avoid any unforseen problems. Replacing such well worn boots in Africa would be impossible.

Psychologically I am ready to go. Really nine months of training and planning are done. I sent the family a copy of all my documents and intinerary. I am in the best shape ever. I know Kilimanjaro is a mile higher than Rainier but what does that really mean. Lots of thoughts swirling around. What if the boundary bag is lost? What did I forget? Can I do this? The flight leaves in a few hours, time to take a break and relax.

Tuesday, August 23, 2011

Training Outings with PD Teammates

Doug and Nan at foot
of Mt. Si Haystack
Nan and John were the first with PD to join the team. Doug and Martha, their spouses would also join the team as companion climbers. The whole idea about having a companion for each person with either MS or PD on the climb was a big advantage over how most climbs are organized. The benefit of having companions will become more obvious when we actually start walking on the mountain.
Monique and Sierra at foot
of  Mt. Si Haystack

Nan and Doug also live in the Seattle area so we planned on getting in some hiking. The weather in the Northwest was cooperating in January, so we headed out to North Bend Washington to hike Mt. Si, a favored training site for climbers getting ready for Mt. Rainier. We started out early enough to give us time to get down before dark which is around 5pm in the winter when in the thick wooded trails of Washington. The hike starts at 750 feet and over the next 4 miles we traveled through a couple ecosystems of old growth forest and the beginning of subalpine terrain before the rocky summit. We didn't have any views that day due to the low hanging clouds. We had lunch at the Haystack Basin which sits at 3900 feet. Mt. Si tops out at 4167 feet, beyond the basin is a rock scramble of class 2 or 3. With the snow, wind and likely ice we decided to descend. We spent a good five hours hiking that day and a great way to gauge fitness.   
Glenn joined the team in February. He has a lot of mountaineering experience and a good amount of experience living with Parkinson's. He is a patient from our clinic. Glenn had to drive a long way to have access to expert care. Washington has a surplus of doctors that specialize in Parkinson's however, most of them work in or around the Seattle area. We lived too far away to get in any training hikes with Glenn. Glenn would be teamed up with Sean, also a very experienced hiker and athlete from Oregon. 
Sierra, Monique and Nan
Snoqualmie Pass

John Snoqualmie Pass

We planned another training outing while John was in town in March. We headed out to Alpental ski slopes at Snoqualmie Pass to get in a little fitness training. We had a fun day of laughs and snowshoeing is great for fitness training. This is the first time meeting John. He is a lot of fun to be around and very experienced in the backcountry. A good guy to have around on a big mountain climb.

Nan, Doug, John, Monique and Sierra
snowshoeing at Snoqualmie Pass

Martha, John's wife and companion climber wasn't in town for the snowshoe outing. I had looked at her profile on Lori's website for the climb and was hoping to meet Martha before going to Kilimanjaro, possibly on one of our trips to Denver. We planned to climb Pike's Peak for some time at elevation and hoped that John and Martha could join us. We had climbed Pike's Peak and Mt. Adams the month before our successful climb of Mt. Rainier in 2010 so we thought we would use the same schedule for Kilimanjaro training. Unfortunately, we didn't get the chance to trek up Pike's Peak due to weather when we were in Boulder nor did we have time to meet up with Martha and John.  

Monique, Nathan and Sierra
returning from Camp Muir,
Mt. Rainier
Nathan joined the team in March. Really the last month anyone could be added to the team unless the person was already fit to climb Kilimanjaro. We had only 3 more months to train. Nathan has a lot of experience hiking around Washington and also has PD. I had known Nathan for a short time from our clinic. I have never seen a person with PD train so hard and accomplish so much in such a short time. Monique and I climbed to Camp Muir in May with Nathan. Camp Muir is not an easy nor moderate climb, it is a challenging climb physically and mentally as it just keeps going up. The climb to Camp Muir from Paradise lodge parking lot is 4.5 miles and 4700 foot elevation gain over snow and at times steep terrain. We had a beautiful sunny day above the clouds with full views of Mt. Adams and Mt. St. Helens. The day was long and hard work but definitely worth it seeing Nathan standing atop Camp Muir. 

We had a chance to add one more person with PD at the end of March. He had just returned from trekking in northern Eurasia and was hoping to join the team. He was found to have a medical issue that would take some time to sort out so he decided to take a pass on the climb. As of April, Lori has accepted 4 people with PD, two of them will be bringing their spouse and along with Monique and I, brings the total to eight PD related climbers that will join the Kilimanjaro team. In all, there are now 28 confirmed climbers for Lori's Leap of Faith adventure.

Monique running the Howe stairs.
We continue to train on the trails of the Cascade mountains of western Washington. There is no better training for a big mountain than getting out on the trails with a backpack. Additionally, many teammates were cycling and running and working out in a gym setting. We added in stair climbing and hill running for more intensive cardio. Seattle's East Howe Street stairs are a favorite stair climb with 282 steps with elevation gain of 153 feet. Nan and Doug were also climbing these stairs with backpacks of increasing weight and improving their stamina with every step.

John and Martha were training on the peaks of Colorado and both John and Nan are getting good results from cycling for their PD symptoms. Their good base of cycling endurance can only help with the upcoming climb of Kilimanjaro as the legs and cardio will be an asset when trekking for 7 days.

John has lived with PD a long time and over the years has found ways to negate the symptoms of PD. Martha's supportive attitude and investigation into alternative therapies has helped John find beneficial complementary therapeutics to manage the PD. I haven't seen anyone doing as well as John considering the number of years he had been diagnosed. I think John's positive attitude is a big contributing factor for his very slow progression with PD.Monique and I have seen over a thousand people with PD in our clinic from all walks of life. From couch potatoes to serious athletes, the key to doing well seems to hinge on the mindset and how stress is managed. Poor handling of stress can take a big toll in both the physical and mental changes from the PD. Of course the fitter the person is with PD the better all aspects of life will be from getting out of a chair to coping with setbacks from illnesses.

With just a few more months to train, the team is carrying more weight in the backpack and training for longer periods of time. The anticipation continues to increase as we make final preparations to leave home for the two week adventure, select last minute gear items and focus on good nutrition.

Thursday, August 18, 2011

Odds and Ends January 2011

January was a decisive month for work. I decided to resign from my job and look for a position that had a comprehensive approach that included surgical options for patients. My expertise is in the surgical management of Parkinson's, tremor and dystonia. Now I have some time on my hands so I decided to take a wilderness first aid class to make sure I am up to date for the climb. Remote Medical International provided the course with very professional and very knowledgeable instructors. I had been trained in emergency medicine in the past so most of the course was a review of stopping exsanguation, finding occult injury and things I should have in the back country in case of an accident. The attendees did mock injuries and role play to address accidents, assessment and treatment. It was a fun day patching up bleeding limbs and broken bones. We had a large class with several medical professionals. One of the physicians talked to me about Kilimanjaro and passed along the recent altitude illness prevention paper that specifically addressed Kilimanjaro.

Kilimanjaro is known to be associated with acute mountain sickness (AMS) due to the altitude gain and rate of ascent. After reviewing Alpine Ascents itinerary, I felt we would have plenty of time to acclimatize to the high altitude where it takes more work in breathing to get in enough oxygen. The extra day built in for acclimatization should prevent problems noted with the more common five day ascent where summit success is low due to AMS. The five day ascent is cheaper so it is popular.

Diamox is used for prevention of AMS but slow ascent is as good or better. Ibuprofen has also been studied and is also a good medication used for prevention of AMS. I have used both and prefer ibuprofen as long as headache does not escalate. Diamox can cause dehydration for which you can't monitor without a way to measure urine output or blood pressure. Heart rate could be helpful at sea level to monitor for dehydration, but not at altitude. If a person is concerned about AMS, the recommended dose to prevent Diamox varies widely so it is difficult to provide guidance so it is best to decide individually what is the best strategy for prevention. Treatment of AMS is different than prevention and I find most people get these two scenarios confused.

 My travel doctor prescribed 250mg of diamox. When I got home I realized it was slow release capsules which can't be cut. For me, 250mg would be too much. There are wide opinions about the right dose of diamox, but there are research papers that include doses that are known to prevent and or treat AMS. I prefer to use a very low dose of diamox if I get a headache that doesn't respond to ibuprofen or tylenol. My plan on Kilimanjaro was to use diamox 62.5mg once a day and increase to twice a day if a headache came on and persisted above 10,000 feet. I think most people use too much too fast and get dehydrated which leads to more risk of AMS. AMS is an elusive problem on high mountains as no one knows if AMS will be a problem. AMS generally is more common in young men and most think it is because they go too fast. AMS can strike at any time in any one, no matter how many mountains climbed. All we can do is train, eat, drink, go slow and hope it doesn't strike on summit day. As anyone that has had AMS knows, if it comes, you just have to go down, you really don't have a choice as the body is in charge.

January 2011 Kilimanjaro Kick Off Event Big Success

Lori's inspirational presentation was awesome. The Mountaineers conference center was a perfect venue to have the event. One quarter of the room has a floor to ceiling climbing wall as well as climbing anchors around the perimeter of the large conference room.  After introductions, Lori entered the room from the back to the sounds of the high winds of Mt. Everest blowing as she slowly walked into the room. Lori was dressed in her full summit gear as pictured. The high winds could not muffle the sound of Lori's breathing. One deep breath...another deep breath...another step. It was like being there beside Lori as she climbed toward Mt. Everest's summit. You could almost feel the effort that it took to walk each step to the top of the world. Lori clipped into a rope from her climbing harness to make the traverse around the room. She made the traverse safely and when she reached the front of the room, the wind died down and Lori removed her Everest gear to reveal a tiny mountain climber dressed  in a formal business suit. 

Lori's presentation was very inspirational and empathic for anyone with a neurological condition wanting to explore the world. I highly recommend Lori as a motivational speaker to any organization wanting to inspire their employees to believe in themselves to reach beyond their perceived limits.

The kickoff for virtual Team PD Kilimanjaro was off to a good start. Monique's grant submission was accepted and provided funding for the virtual team and the kick off event. We partnered with the Northwest Parkinson's Foundation and the virtual team would become an extension to the already well established Team Parkinson's. The Northwest Parkinson's Foundation has a long history with cyclists to both raise awareness about PD and also organizing a team to ride in the Seattle to Portland bike ride. The Northwest Parkinson's Foundation has served the PD community of the northwest for over a decade and are unique in their focus on care instead of cure to help people with the day to day challenges of living with PD. (

The virtual team would include the PD and MS community offering monthly meetings to provide support and encouragement for the members to train as we train for Kilimanjaro. We set up and online tracking group through the President's Challenge physical activity website. We helped some attendees set up their log in and passwords. We didn't know how the virtual team would work out. It was the first community based exercise program for PD of it's kind, at least in Seattle. We would lead the charge to increase the physical activity levels of our community living with PD. We encouraged families and friends to join in and support those living with PD. Our goal was merely to increase awareness about the benefits of exercise for PD and MS and to provide training information through a supportive meeting format.

The Northwest Parkinson's Foundation staff  (Colleen, Alecha, Elizabeth, Joe, Monique and volunteers) organized all aspects of the logistics of the kick off event making the afternoon a very big success with over 160 in attendance. Two of Lori's friends surprised Lori and attended the event. What a nice surprise. We hosted a dinner after the program with the foundation and friends. We had a great evening with stories of high adventure.

Sunday, August 14, 2011

No Vacancy December 2010

The Leap of Faith team is full by December. Thirty climbers were now committed to an adventure to climb Kilimanjaro including people with MS, PD and several companion climbers. Lori had added six people including two with PD, their spouses and Monique and I. I was so very happy to be part of something so different and something that would certainly change my life. I wasn't sure how well I would acclimatize but I would train harder than ever.

All climbers completed a bio for Lori to both send to the group and post on her website. Empowerment Through Adventure Lori emailed us qualities that she had gleaned from our bios. No one has ever read my bio and then taken the time to return such insightful and encouraging words. Lori is a true leader.

We learned about each other through the bios and photos. Lori's climb was very unique in that she combined a companion climber with a climber that had either MS or PD. The companion climber was a source of support before the climb and also while we were on the mountain. I have never heard of a expedition leader setting up a climb this way but it was a great idea. Climbers would get to know each other before arriving in Africa and have someone to hang out with, tent with and talk to. This is very important for internal communication within the team as a lot of symptoms of MS and PD are not always obvious. Having a companion that you can talk with while in a foreign country and climbing a mountain was a comfort not usually experienced on big climbs. Guided climbs are usually filled with strangers with one goal in mind - the summit. This climb would be different in so many ways. We would benefit from Lori's insight into both having a neurological condition, climbing, and this new approach to expeditions.

We also secured a date for Lori's speaking event that would be held at the Mountaineer's conference center in Seattle on January 22, 2011. This was very exciting to bring someone to Seattle that had accomplished so much in her own life and who also had a gift to share her inspiration with others. We planned to launch the Virtual Team community exercise program after Lori's motivational presentation. We partnered with the  Northwest Parkinson's Foundation to make the Virtual Team a reality. Monique is their medical director and she maintains their online wellness website. NWPF Wellness Center

The days start to fly by with July fast approaching. We increase our training intensity and plan some training outings with John and Nan for January. We are learning more about the team which is humbling as we start to read about the amazing men and women. I still haven't heard back from the sponsor proposals so I send off emails to see where we stand with sponsorship. Then we start to hear rumblings about a potential political snag with one of my biggest hopefuls for funds. Humph! More about this later.

Lori Schneider's Leap of Faith Team Expands

After a few more weeks, Lori emails the great news. She can expand her team of MS and companion climbers to include people with Parkinson's. Lori said it is all about “helping others step beyond their diagnosis”. This would bring Lori’s team to more than thirty and Lori wanted to get everyone acquainted quickly. Lori as team leader had a lot to organize and disseminate due to the size of the expedition. Lori was very organized. We received her past monthly update that included how we should begin preparing to climb a big mountain. I felt we were in good hands with Lori’s experience of climbing the seven summits and I was excited to climb with such an accomplished mountaineer. We could anticipate monthly updates to keep us on track with training, nutrition, and gear recommendations as well as inspiration each step of the way.

There was a lot happening behind the scenes. Lori was in discussions with a documentary film company and making connections with potential sponsors. We still hadn’t heard back from our sponsorship proposals but it was still early. We put in a grant for the virtual team meetings. Things were moving along.

We had also heard back from Nan and her husband Doug that they would like to join the team. Since Lori's team was almost full, we only had a few lucky spots for PD. Nan was very excited about the climb and it felt good to bring a new opportunity to the PD community. Nan recommended John Carlin and his wife Martha. John and Martha are from Colorado and had also cycled across Iowa. I hadn’t met them but Nan confirmed with Jay Alberts that they could manage the climb based on his experience with them on the long ride across Iowa. I passed this information along to Lori. Lori's team now included six more climbers. We paid the deposit to Alpine Ascents and plotted out our next nine months of training.  

Kilimanjaro Opens a Door November 2010

Monique and I talked about Kilimanjaro to a few of our patients who always asked about our climbing. We had just climbed Mt. Rainier and some of our patients wondered about the next mountain. A few expressed worry that we were taking on a risky hobby, but overall, the topic of climbing another mountain brought an unexpected uplift to our patient visits. Climbing for us was a way to stay in shape and find balance between our dedication to the Parkinson's community and our personal lives.

Looking back, talking about Kilimanjaro had opened a door. Medical appointments are usually focused on symptoms, medications or the many worries that come with living with PD, but now for some, we focus on activities that they refused to give up or the dreams that remained. I enjoyed learning more about our patient's interests and travels before the PD.  Many of our patients had climbed Mt Rainier and other peaks around Washington. It was a nice way to connect with our patients and I learned that many continue to hike and backpack despite living many years with PD. Some patients talked about running marathons, cycling and swimming. I'm not sure if it was our openness to talk about our physical activities that led to our patients sharing more, but we noticed a big change. And it was a nice change in focus from disability to ability. 

One of my patients liked to talk mountaineering during his appointments while I fine-tuned his deep brain stimulator. These visits take up to an hour so there is a lot of time to talk about things other than PD. He loved to talk about and I enjoyed listening as he reminisced about his years climbing with a few famous mountaineers from the Northwest including Himalayan legendary climber Pete Schoening. One day he brought his personal copy of Schoening's self-published book about his expedition in the Himalayan mountains. I was honored to read the book written from a viewpoint of the man that made history on K2. At his next appointment, he tells me about his return to one of the mountains he once trekked. These are the stories that bring significant enjoyment to our work.   

We noticed we were seeing an energy we had not seen before from our patients. Medical appointments do generally focus on the negatives out of necessity but patients were now sharing more about their own lives or past dreams about world travel. Several commented that given the chance, they too would like to climb Kilimanjaro. This left us wondering what could we do for the many people with PD that can't go to Kilimanjaro but have an interest in working toward a lofty goal. We start to ask patients to also train with the same intensity as if they too were going to climb a mountain. This led to the formation of the Virtual Team PD Kilimanjaro.   

The Virtual Team turned out to be a great idea but we needed structure to keep track of things. We would like to have monthly meetings to discuss how to track progress, advance training programs safely, and provide nutritional information and most importantly, motivation. The Virtual Team evolved from a clinic idea to a community wide program. We asked Lori if she would give her motivational presentation as a kick off for the Virtual Team. Her message to people living with MS was perfect for people living with PD. Once again, we start working on another grant proposal.

Friday, August 12, 2011

Next Steps October 2010

A lot happens quickly over the next couple weeks with a lot of emails and conference calls with Lori. Even though we haven't met, the conversation flows easily and I get the sense that Lori is the real deal. Lori is a living example of the life we want for our patients with Parkinson's. I know I am asking a lot to add more people to Lori's team since most climbing expeditions are generally much smaller. But what an opportunity it would be for people with Parkinson's to join a team destined to empower and enrich the lives of other people living with MS and PD.

Combining an event for MS and PD has not been done to my knowledge, at least in our area. Even though I work in a clinic that offers care to people with MS and PD, we never had shared events bringing the groups together. MS and PD actually share a lot of problems common to both conditions. Once we were told that people with MS and PD don't want to mingle, going so far to say the waiting room should be separate. Worse though was when an older man on the program planning committee commented that no one would want to see a person with PD shaking and they should be rushed into a private room. What an idiotic comment. A few, including me, were quick to respond we would not have an isolation room. I wondered why someone would say such a terrible thing and thought maybe he was afraid of getting tremor and he would want to hide himself from the public. Who knows why people have these mindless biases, but Lori's climb is sure to change the way people think about MS and PD.

Lori is in conversations with Alpine Ascents International about expanding the team. We work with Lori to prepare proposals seeking pharma sponsorship from our region. Everyone I talk to about the climb is very enthusiastic about sponsorship since the climb is so unique. The climb would include a large group of people with two neurological conditions and led by the only woman with MS that has climbed the seven summits. What a promotional opportunity for the lucky company that steps up to sponsor a great idea.

I also start working to find people with PD that have or had Kilimanjaro on their bucket list. A lot of people with PD have dreams and goals that are long forgotten or dismissed after the diagnosis. I wasn't sure if I would find anyone that would want to climb a mountain as high as Kilimanjaro. I started my search by asking people that were physically active and connected to the PD community as well as getting the word out in our clinic.

I had recently been introduced to Nan Little from Seattle by Bill Bell. Bill thought I might be the person who could help Nan find space at our hospital for some tandem bikes to start a cycling program for PD. Nan has PD and was using cycling to keep her PD symptoms under control. Nan learned about the positive impact of cycling for PD  thanks to a research study performed by Jay Alberts. Jay is a colleague that we worked with at the Cleveland Clinic. We left Cleveland before Jay had finished his inital exercise research study. I remember seeing a few of our patients in clinic who participated in Jay's study. I was told by my patients that the rapid pedaling was a lot of hard work but worth it since symptoms seemed better for hours after the pedaling. One patient was having more muscle cramps so we worked on a plan to help reduce cramps so he could continue pedaling. Another patient thought he needed less medicine. No matter what the mechanism, we always believed exercise was good for both the body and brain and had always recommended exercise to our patients, even when our colleagues discouraged exercise. Jay's study would hopefully strengthen this message for people with PD to exercise.

As I learned more about Nan and her cycling connections to PD, I contacted Nan to see if she knew anyone with PD that would be interested in climbing Kilimanjaro, put the word out to other groups and informed our administration.

Thursday, August 11, 2011

Lets Talk

Lori responds. It’s not like Lori didn’t have things to do while I paced around the clinic wondering. Why was I in such a big hurry anyway? The climb was next year and there was plenty of time to prepare. It was the excitement about climbing to bring hope, awareness and empowerment that deeply appealed to me.  It was the same message we delivered to our patients every day in our clinic. And Lori's climb was different in so many ways, the leader had a neurological condition who worked tirelessly to bring her message to others. Not for some big payoff, but to help others. And, the climb was not the usual event where you sign up or donate to something that may make an impact sometime in your lifetime. This climb would make a difference now for people living with MS and just maybe, PD.  
Lori writes me that the delay in getting back to me was due to driving ten hours to speak for an MS event, even though it has been only one day since I sent the email. Did Lori somehow know how much the climb had consumed my thoughts. She tells me she had been traveling the USA and Europe spreading the “message of hope…not to give up, even when faced with a potentially devastating diagnosis. It is all about believing in yourself and not being afraid to try.”
Lori fills me in on some details about her message, the climb, the climbers and the companions. How many people would I like to add to her team and the final words “Lets talk!”
Now I can’t sleep.  

Cautious Optimism September 2010

Time seemed to crawl waiting for Lori to respond. I realize it had only been 24 hours, but I was beside myself in excitement. I hoped Lori would respond that the team wasn't full. Monique and I really wanted to go and were ready to sign up if Lori had any spots open on her team.
After emailing Lori, I immediately contacted a pharmaceutical company that makes medication for both PD and MS to see if they were sponsoring Lori’s climb. I had heard about a pharma sponsored climber/motivational speaker that also had MS so it seemed logical that Lori's climb would also be sponsored. No one knew if another regional office was in discussion with Lori but locally, there was some interest in hearing more. I thought for sure, Lori’s climb would be a shoe-in for sponsorship.
I emailed three other companies that Monique and I have worked with in the past. We knew a few people higher up the chain that could reach the people necessary to gain some attention. I wasn’t sure who was on what drug or whether there would be anyone with deep brain stimulation going on the climb but the special focus on MS and possibly PD seemed like a great way for one of these companies to show support for the medical conditions from which they produce medication. Even if Lori didn’t have spots for us or people with PD, I was still invested in trying to help bring attention to the climb with hopes I could spread the word, at least in our area, about Lori’s cause and the climb.
One of my contacts responded positively and asked for more information. This leads to more excitement, and patience did not come easy.   

September 13, 2010 The Journey Begins

Monday night was like any other, staying up too late on the computer. I should be reading my philosophy homework; instead I am on youtube again watching climbing videos. Occasionally, I will come across useful new climbing techniques or new ways to tie knots. The Scotts have a practical way of roping up for glacier travel but being a woman, I can't imagine undoing all those perfectly tied practical knots to pee. My team would leave me behind for sure if I show up wrapped in a climbing rope full of knots. Canadian climber Mike Barter has the funniest videos on basic mountaineering, always very non-PC typical of British humor. I get bored quickly of watching Mike and just before I close my laptop I spot a video about mountain climber Lori Schneider.

I had never heard of Lori Schneider in all my reading about mountaineers. The stack of mountaineering books is now competing with the number of medical books I have on the shelves. I especially enjoy reading mountaineering tragedy books since you can learn so much from reading about past mishaps. I have several high altitude medical books as well since I have had personal experience with altitude sickness a couple times in the past. This eventually led to learning that I have a heart defect or hole that allows some blood to bypass my lungs but also bypassing much needed oxygen at high altitudes. I wanted to learn as much as possible how to compensate when the air becomes thinner since I was not going to give up climbing. I just have to breathe more deeply and more often than most and focus my training on anaerobic exercises.

Lori's 2009 video is still my favorite. The video is about her journey to climb the seven summits and was filmed before she climbed Denali or Everest. I was moved to tears listening to Lori's story about her MS diagnosis and her focus on not letting the diagnosis define her, the photos in her video of her climbs and especially her story about her mom and Mt. Elbrus was very moving. I found her website and spent hours reading about her seven summits, places I frequently read and dreamed about. I was hooked on climbing and had just finished reading about Dick Bass and Frank Wells and their climb of the seven summits. I thought I too wanted to climb all those summits, except for Everest of course. I was inspired by Lori to really consider climbing those summits in more than just my mind. I was also impressed at how down to earth Lori was in her message about her personal journey with MS, her belief in other people and her courage to never give up. I thought, this is a woman I would like to climb with someday.

While reading about Lori's summits, I noticed she was forming a team of people with MS to climb Kilimanjaro. I wondered if maybe Lori would let Monique and I join her team since we would be an asset as medical professionals and possibly helpful to her team. We had tried the year before to form a team to climb Kilimanjaro to support awareness for Parkinson's wellness but our friends would say yes to going but then quickly lose interest when we were ready to sign on with a guide company. Thinking it would be too risky, we never considered asking anyone with PD to climb Kilimanjaro but hoped we could inspire people with PD to train as we trained and then follow us up the mountain from their computers.

The next day I couldn't stop talking about Lori, Kilimanjaro, climbing and Monique finally insisted I get back to work. Between patient appointments, I found the courage to write Lori an email hoping she wouldn’t say no. I mentioned to a few patients that day what I was up to and was surprised at the response "I want to go too!" I talked to Monique about my thoughts and whether I should ask Lori if people with PD could also join her team. Monique and I talked for a few days about the pros and cons of asking people with PD to join us in climbing a mountain. First we weren't sure Lori would want to do it. We had never climbed with anyone with PD. What would our hospital say about it? Could we raise money to help pay for the climb? Were we expecting too much from our patients with Parkinson's? What if someone fell or was injured? What if the PD symptoms become uncontrollable on the mountain? What if the medications get wet or get lost? Was the climb too expensive or too risky? How would we answer to our medical peers if something went really wrong on the mountain? How could we face the families if we failed? Should I risk going to high altitude with my heart problem?

I couldn't stop thinking about the excitement, the smiles and the change in the faces of the patient's in clinic when I mentioned Kilimanjaro. We both decided if we are going to preach to our patients about living life to the fullest, we should also walk the walk and take that leap of faith that Lori embodies for those with MS. I wasn't sure Lori would say yes or if her team was full, but we both decided we were ready to step outside our clinical roles into an unknown founded on a hope that anything is possible, that there is a life to be lived, even after a diagnosis of PD. If we set an example for our medical peers, maybe they too will expect more for their patients with PD. More importantly, if we were successful, it might empower all of our patients to at least try to do things they feel are impossible because of the PD.