Myths about AMS
Acute Mountain Sickness (AMS) is a curse to hiking in high altitudes. I like to say it as the celebrity of trekking in the Himalayas. Well, everybody is talking about it. Even though everybody is scared of it. It is a superstar that people do not want in their lives.
As you know with popularity follows rumors. People are talking so much that it is difficult to distinguish between what is true and what is wrong. With AMS the same has happened. While interacting with trekkers we get to hear about these misconceptions. Some of the myths they believe so strongly that it is difficult to convince them what is right. We, therefore, think the best way to convince them, is to let them learn themselves through some real stories. For each of the myth of AMS, we have narrated some unfortunate incidents. Look at them as stories with a takeaway message that will put light upon a myth of AMS.
Please note: The aim of this initiative is not to demotivate or spread negativity or blame anyone. Our motive is to spread awareness about AMS so that trekkers can be prepared. We want all to know that if it comes to AMS, trekkers should work for its prevention themselves and not depend totally on the trekking company.
This story dates long back when Stok Kangri was not that popular. People knew it as a difficult and the ultimate trekking peak. All the trekkers would come prepared hard for the summit. Sometimes, so over-prepared, forgetting the thin line between being positive and overconfident. Rakesh Pant himself was Trek Leading the trek so he remembers it all.
"The group was good. All were sincere, attentive and strong. Amongst them was a man who was the strongest. On treks, we never differentiate between the trekkers, but he was really strong. Sadly, for him, he was aware of the fact.
As the days passed and we gained height, his confidence was also gaining height. He would always reach the camp first, never wait for rests despite various warnings. Until the summit day, it was manageable so we also kept tolerating. On the summit day, he demanded to go alone at the front and not wait for the group. He kept saying I want to complete as early as possible and come back fast. He was not willing to slow down for the rest of the group, he didn't have that much patience. I requested him saying that summit day is not like previous days. It is serious height gain and steep, we should go slow. We should rest and breathe. We should not exhaust our body. And he kept saying I will not get exhausted, I am strong, I can do it...without stopping. After a few arguments and his stubbornness, I gave up. I knew he was wrong and he should learn that, if not by me, then by nature.
I told my team that I will accompany him and the rest of the team can come slowly with another Trek Leader. We started at his pace, we did not stop. Honestly, I was shocked to looking at his speed and strength. We had reached the shoulder nonstop walking. Although I was happy that he was still doing fine, I was worried that we need to stop for a while. He was still reluctant to wait when I told him that if he does not want to stop he can carry on I will catch him, but I need to rest for now. While resting the winds starting blowing so I zipped up myself, covered my head and fingers to avoid wind chill. Despite a word of precaution, he was standing there without covering himself. Again trying to prove he was strong. Within a few minutes windchill hit him and he began shivering. The next moment he started feeling the exhaustion of his body. He was ready to drop and puffing. He gave up, he said he was feeling fatigued and have no strength to continue. We immediately descended and took him to the base camp where he could rest.
Sometimes I think of this incident and wonder what if he was willing to walk slow, he would have summited Stok Kangri. He had learned the lesson the hard way."
I should say, not only the trekker we all learned a lesson. AMS is a critical condition, there are many factors that trigger it. It is common sense if supply is less its demand must be reduced. Remember by working hard we should magnify the need for oxygen which cannot be met by drinking water also. Because it is slow. That is the reason why mountaineers follow a slow and steady pace. They never let their body starve of breathing. You might have heard Everest climbers say, for each step, it takes 10-20 minutes. Yes, it is that slow. Yeah of course on 8000 meters, but for 6000 meters it should be at least 5-10 seconds slow, don't you think? In conclusion, be strong, be confident but be patient first.
Because...you might be fit enough yet AMS might happen to you!
It is said that practice makes a man perfect. The more we work on something the more we gain knowledge. Eventually, we become an expert. When it comes to high altitude trekking, veterans become more aware of his/her own body responses. With time one knows to what extent mountains can strain and how their body would react. Yet, there are some golden rules that always apply, no matter how experienced one is.
Dilip Singh is one of our senior Trek Leaders, he has an unbelievable event to share,
"It was not that I was going to Stok Kangri for the first time. I have guided many times now it was time for me to be as a Technical Team member. I was super excited. It was our first batch of the season, I geared up for route opening. Going up and down, we did it all as planned. Back to back each day we were loading up and performing our best. I was getting tired, but I am experienced I thought. I have done this before. All is well!
The summit route opening was exhausting yet we managed to clear the path. I was for about 45 minutes on the summit, hardly rejoicing. While descending when I reached the shoulder, I threw out blood. I knew AMS hit me at 19000 feet. Our Trek Leader checked my Oximeter reading, it was 65. I was shocked, I couldn't believe this is happening to me. I am experienced, my body is experienced, my body has gone through worst before. I was a Safety Expert for years. How can this happen? I kept wondering. Then I was brought down immediately. I rested for 2-3 days. That is when I got to thinking.
However experienced I am, my body demands rest. I had been so harsh on my body blind under the impression that it understands. But it does not. It needed rest. I am experienced, I should remember this, I thought."
We should also remember this. Whenever a human body comes in the high altitude it is always a fresh start. It has nothing to do with past experiences. Your mind remembers it but not your dumb body. It forgets everything it has learned the moment it goes at sea level. Because it is busy adjusting to another set of climate and environment. Again.
As much as we are aware of this fact, we refrain from accepting it once we are diagnosed with AMS. It is hard to digest that experience only is not the right immunity. With all the excitement we wish to push a little harder not wanting to go back. We should rather make peace with it and promise to be more cautious the next time. That is what experienced do!
One may be a doctor, a mountaineering course certified individual, a frequent trekker or a Trek Leader, mountains treat all equally. If rules are not followed, AMS may happen to an experienced also!
And you know what else experienced people do? They pass on their unfortunate stories so that others can learn from them.
Cheating or lying is what we all are always taught is bad. However, in desperate situations, we always end up lying and pretending to be what we are not. Cheating at sea level might be tolerable, but in the mountains, it can be dangerous!
We are not sure if you heard of this terrifying incident of two brothers being rescued in a helicopter to Dehradun from Roopkund trek. It was all unanticipated and happened so fast. "We just got an emergency call for arranging an air rescue for two brothers from Pattarnachnai camp," recalls Sandeep Rawat.
"There were these 2 boys who seemed normal throughout. They were good physically. Never did they report about being weak or anything. They both suddenly collapsed on day 5 at Bhogwassa campsite. We know Roopkund is a critical trek where AMS cases occur frequently. But we usually find symptoms quite in advance. Such sudden disrupture of trekkers was shocking.
The boys were then immediately taken down to Pattarnachnai camp from where we had planned a Heli rescue. When they were flown to Dehradun hospital, the doctor asked them to vomit. And there the mystery of their degradation was solved. Doctors found Brufin tablet undigested in their puke. Both of them. It was then discovered that they were having these tablets, right before giving Oximeter reading. Point to be noted, without any recommendations or informing the Trek Leader. Brufin is a blood-thinning medicine, it messed up the oxygen level reading. Hence, the Oximeter could not catch their low oxygen levels. The boys didn't know that as the height increases, medicines do not digest fast and they don't function properly. All the while, the,y just kept faking, ina stead of actually facing the issue. They forgot that cheating Oximeter might work but not cheating on their own body." continues Sandeep.
Yes, in desperate situations we always end up cheating. Be it cheating the life-saving device or lying to a responsible Trek Leader. All the while knowing that cheating is bad and eventually, the truth will be revealed. Yet we forget, even if we cheat the world around us, we can never cheat on our body. Because in the mountains, the consequences of cheating are deadly.
There is a fine line between being tolerant and being ignorant. While tolerance helps us to keep trying, ignorance, on the other hand, forces us to tolerate something that will cause harm. Amongst the vibe of India becoming less tolerant and people criticizing it, we think being tolerant is good...at least when it comes to AMS.
Our Trek Leader Pawan Kumar recalls this incident when he had a hard time guiding a college group. "I understand how friends want to be supportive when one is sick. But this group was difficult. First, their female friend was sick with vomiting and a headache at Pattarnachnai. We took her Oximeter readings it was normal. We went for acclimation walk and again her reading was normal. We found out it was a false AMS call. It was the only acidity. She turned out radiant the next morning.
While everybody was busy observing her condition their another friend was hiding something behind that. I noticed he was not able to walk properly. I immediately checked his Oxygen level, it was near 60. It was time to send him back. But, that is when true friendship aroused. He along with his friends wanted to continue.
They then revealed that he was not well from the previous night they were hiding it and how nothing happened till now. They thought his condition would improve, just like their friend's did. I tried to explain to them how those two cases were different and any more tolerance would be stupidity.
Failing to listen, I told them I will only take him ahead if he passes my test. And all agreed. I just asked him to complete a circle around the campsite. Obviously, he failed badly. He was dizzy and puffing, he could barely walk. He was rescued instantly. His Oxygen level improved once he reached Lohajung."
Yes, being tolerant can be stupidity in the mountains where every second is important for recovery. Being unable to accept that we are sick when rest all are fit, we try a little harder. We just want to give our best. Remember, when we are doing our best our body has already crossed the limit of doing its best. So, if we try to tolerate a little more, AMS won't go!
We all hate that recovery period of injuries. Recovering from an injury is hard but what is even harder? Despite being healed, not able to achieve the goal. When the target is right in front of you and you are helpless. We think we fell, we rose, and we became stronger. But are we strong enough to fight that urge?
Stok Kangri being the toughest and highest trekking peak is the true assessment of everything. One gets to analyze all kinds of human behavior here. Amongst these is an incident where Sandeep Rawat was leading a batch. "To our relief this trekker was obedient. Once we noticed AMS had hit him at Base Camp we decided to lower him. I sent a helper along with him to escort him safely to Mankorma. I was happy he went down early before his condition could worsen.
To my utter dismay and surprise late evening I saw him again at the Base Camp. I was in complete shock as to how this happened. When inquired he told me that when he reached Mankorma he started feeling better. He had some tea and snacks. He fatigue and nauseousness vanished. He was feeling better so he thought of going back again. The helper was not willing to come back, but he had to. The trekker seemed really happy and excited for the summit.
I wish I was as happy as him. I told him this was wrong. Once we lose height we start feeling better, but our body needs time for recovery. He should have rested and not gained height. He hardly bothered about what I said. He thought he fought against AMS. Any argument was not going to work.
Not to my surprise and yet another dismay his situation has degraded till morning. It was HAPE. He was facing problems while breathing. He could barely walk now. He was sent down on a stretcher this time."
We think we have recovered. We think we fell we rose and we became stronger. In reality, we are still recovering. We are strong only if we fight the urge to go back. Everything else may run at a normal pace but our body is functioning at a slow pace. Mountains are a slow world. So even if you have descended and feel good, don't dare to go back, take a proper rest at lower altitude and once body is recovered then only try for it.
Money cannot buy happiness. But we can invest in things that make us happy. Sometimes we forget that happiness was the sole reason why we put so much money on it. When it comes to high altitude trekking there is no certainty of anything. The journey gives immense pleasure unless reaching the top is the main aim. If for once we try to separate summit from completeness we realize any trek will always be worth it.
We dwell onto the completeness of the trek more than safety, many times. Our Sales Coordinator Pooja Semwal, in her 5 years of experience had encountered enough instances of trekkers arguing for refund in case of the incomplete trek due to AMS. "This is a common reaction when trekkers are asked to return back when AMS has hit them. Specifically for difficult treks like Goechala, Stok Kangri, Chadar, etc. Firstly, trekkers do not believe they are not well, secondly, they think of wastage of money. Then they act stubbornly.
We had this incident in 2018 Chadar trek. The man was not able to acclimate right from day 1. So on the second day, he was sent back. Though he unwillingly agreed to go back, his fellow trekkers were sad. Once they all reached back to the base village they started arguing with the Trek Leader. Their major concern was the man was poor, he worked hard to earn money for his dream trek and we sent him back. We should have rather given him a chance.
Those who have done Chadar can understand our misery. It is really difficult to rescue anyone. Early precautions are the best. We tried to explain those trekkers a lot. Of course, if he earned now he can earn again in future, only if he returns alive now. Just for a weak emotional money moment, we can not risk a life.
I wonder why money becomes an issue here. Going back home safely is the true summit of the trek. Like they always say, mountains will be there, we can go visit them again. For now, returning is important."
Well, money might buy a little happiness but it cannot buy your life. If not now you always get it the next time. Of course, money is valuable but it has no value in front of your life. So, money is not wasted if you do not reach the summit. It is wasted if you reach the summit and do not return!
PS: By returning we mean going down by walking and not on the stretcher.
Nature has its own way of teaching us lessons. It is hard but enjoyable. Over the years of failure and discovery, we finally evolved some concepts of surviving in the cold and oxygen deficit high altitudes. They are pretty easy and simple. Just keep drinking water and take it slow, if that does not work, immediately lose height. We as humans try to make things even easy by manifesting our intelligence. Trekking and mountaineering fields too fall in the same veins. Apart from high-class equipment, medications also keep developing. Well, equipment may fail at times and so does medicines.
We have always been preaching acclimatization by only natural means. We never suggest Diamox or any other medicines in the mountains. But if any trekker wants to depend on them, we never even force them to stop. We agree natural remedies don't give a 100% result. We can surely say, neither these medicines do. Pawan Kumar has one such incident which will make you deduce the same.
"It was Goechala trek this year. When it's Goechala there are cases of AMS frequently, despite precautions. This girl was doing perfectly well until Dzongri. She had good physical strength, no nausea, headache, oxygen reading normal. After reaching Dzongri campsite, she was feeling weak.
She then insisted on having Diamox. She had been following the course before the trek. We were not sure at first, but we thought to let her at least complete the course. Despite that no improvement. She had a strong feeling that something was bad with her. And she herself readily suggested going back. We immediately arranged help and sent her back.
After 2 km descend, her situation worsened and she couldn't even walk. Her oxygen had suddenly dropped. She was brought down on a stretcher. At 10 pm our team reached with her at the road ahead. It is raining heavily and yet we managed to bring her down till midnight.
Of course, 2-3 days later she recovered fine. Sometimes it happens right when everything seems normal."
Yes, AMS is a mystery. Anything can happen anytime. Diamox may not be able to help every time. So next time before you take medicines for acclimatization ask yourself, will it really save me??
Motivation is something that forces us to never give up. Motivation helps us moving forward. In trekking, moving forward means reaching the top and returning SAFELY. Safely in capital letters yet is always silently ignored. This one mistake confuses us with the wrong meaning of motivation.
We figured out that this confusion about motivation is due to a few other misconceptions like,
Sub-Myth 1: For the easy trek, the team went out of the way to support and for difficult trek nothing
This one wrong misunderstanding leads to sudden disbelief in the team. Well, let's just compare an easy trek and a difficult trek. The major difference is the height gain and number of days. As the height gain increases the grade of difficulty increases(it not because the route is tedious). The height is the villain why?
- After 10,000 feet, AMS rules. As height increases, it leads to HAPE/HACE. On a difficult trek, mere exhaustion also causes AMS.
- If this was not enough, the weather becomes unpredictable. After 12 pm the weather rules. Anything can happen. So, wherever one is, after 12 moving towards tents is a wise option.
- Let's say if one gets caught by AMS and bad weather, there is no easy or early going back. With height, you have gotten really far from the villages or help. Reaching a safe place is long and risky.
- To make it worse, help cannot be called easily due to lack of /break in communication. Of course, there is walkie talkie, but weather and winds blow it off. If luckily there is a connection and help is answered. It will be reaching slowly to that height. In serious situations, instant response or rescue is not possible. And life is ticking on seconds.
In all, on easy treks, it is possible to respond quickly and efficiently in critical situations. Not to forget, chances of critical situations are itself less. A slight delay in reaching the summit when one is slow or slight tolerance in case of headache is manageable. On the contrary, on difficult treks, there is no scope of 'slightest'. Slight means serious. So, if the timeline is getting disturbed even in minutes or minor headache means returning back. No words of 'You can do it' or '10 minutes more'. Because motivating means if you are not getting back safe, do not reach the top!
Sub-Myth 2: Trek Leader scared us telling how hard it would be in the briefing sessions
If something is difficult it will be difficult. If ignorance is dangerous, it needs attention. Being honest about it and not sugar coating the challenges is really the key. As you can see, despite stating the harsh consequence, we see cases of no physical preparation, smoking, drinking, disobeying and what not. The way we see it is if someone is getting intimidated by the unfavorable it seems he/she is not confident enough. They doubt their strengths. They fear they cannot live up to that mark. They get demotivated easily. When the true intention was...motivating by being harshly honest and not lying!
Sub-Myth 3: I didn't want to go down, Trek leader was rude and forced me to
Sadly, Trek Leaders are towards the receiving end of all the criticism. Even when they are not wrong. After all, they are just trying to save a life!
Mahavir, our Trek Leader, unfortunately, had to face something. "When we arrived at Bhogwassa, she was feeling awful. Sudden headache and vomiting. I immediately decided to take her down. Roopkund is a trek where such incidents always occur. At 6:30 pm we reached Pattarnachnai camp, her oxygen reading was 62 now. So, after some rest, I told her we need to go down now. It had started raining by the time.
She denied straightaway. She was not willing to come. She kept saying that we were trying to kill her by taking her down in such worst conditions. She wanted to stay there until she feels better. I tried convincing her that immediate descend is the only solution for AMS and losing height will make her instantly better. Yet, no change of mind.
I was really worried. We arranged a horse and then asked her to sit on that it if she does not want to walk down. She didn't want to come but got on after a lot of convincing. It took us 5 hours to Bedni Bugyal. Throughout the path, she was crying and saying we were trying to kill her. It was raining, dark and she kept crying and shouting we were trying to kill her. I know hard it was to keep calm and not shout at her.
After reaching Bedni she started acting stubbornly. She was not ready to move further. I had 2 more helpers with me. We all were pacifying her doubts. Consoling her. She just didn't believe in us. She didn't move at all. I knew it was all because of critical AMS. Forcefully, we decided to spend the night in a tent. We all were extremely worried now. All 3 of us would take our turns to keep a check on her condition. While breathing we could hear noises from her lungs. It was clearly HAPE. But our hands we tied.
Early morning we immediately took her down to a local hospital in Deval. She recovered fine after 2-3 days of treatment. Even the doctors at the hospital mentioned that it was HAPE and any delay in reaching down would have meant losing her life. Despite that, she didn't even bother to say goodbye or even a thank you. She did not acknowledge our efforts at all.
Yet, I am always proudly satisfied that I saved her life!"
Yes, trek leader is not always motivating. Being a Trek Leader or any staff member is tough. They are rarely acknowledged for the mountainous efforts. For the slightest mistake in the management, they are loaded with bad comments. For the biggest favor of saving lives, they get a few words of appreciation. For a change, don't they deserve some motivation?
Mountains are unpredictable. There are some rules that must be followed, yet there is always some uncertainty. Despite reaching the summit before 12, clouds may block the views. Despite going during the best season, flowers may not have blossomed. Despite the hot sun on a clear day, it may rain. Despite the perfect weather forecasting, there may be heavy snowfall. Sometimes, after having a perfect trek, flights to back home may get canceled.
It is because life is unpredictable.
Virendra Negi (Billu) is our senior-most member and Base Camp Manager. In his vast experience, he has witnessed a wide range of AMS situations. Sometimes obvious cases and sometimes shocking. "This was on Bagini Glacier trek. All of our trekkers were going well. Bagini Glacier trek has maximum height gain of 14,000 feet so it is not that risky. Until base camp, all were having a great time. Early morning we were informed that one of the trekkers' condition has suddenly been serious. His breathing was noisy. We assumed it was HAPE. We immediately rescued him to the base village.
After the situation was under control and everything was taken care of, other trekkers were worried. They wanted to know what went wrong. For the first time, I and my team were blank. That trekker was fit, well-hydrated, his face reading and oxygen level were also normal. Not even a pinch of error. We were awestruck how could AMS even hit him. He himself didn't complain even a slight bit of discomfort after he recovered.
The only explanation was despite all the precautions his body was not getting acclimatized. Why? Well, no one can tell that. Every human body behaves in a different way. A body may take around 24-40 hours for acclimatization. We have seen cases wherein less hydration or extreme exhaustion also trekkers turn out well. I myself have experienced that. Sometimes my body is at its best, where it tackles worst situations. And at times even minor discomfort is unbearable."
We have this tendency of finding excuses when we fail or something goes wrong. Basically, it is the reasoning capacity of humans to justify any phenomenon. When AMS strikes, we try to find the answer 'why did it happen to me?' Every why does not have an answer. All we can do is accept it open-heartedly and keep our confidence up. Not blaming yourself or anyone, instead being satisfied that we have got yet another interesting background story to tell when we succeed.
Right, AMS is also unpredictable. So, next time try your best, follow all the principles to avoid AMS. Despite that, if AMS gets struck, don't ask, 'why me' just say 'it is fine, I will fight it now and come again!'
It is silly how we always say, 'I know myself better'. When we clearly don't. All our assumptions are based on the comfort life we have been living since birth. If we never really got out of comfort zone, how can we be sure, we know ourselves? Or how our body would react? It is easy to envisage that dreamy picture but hard to implement. Trekking seems an exceptional life on Instagram. Only those who have been on treks can tell the reality. Even the easiest treks make you sweat and go out of breath. Imagine the exhaustion on difficult treks. Being oblivious, does it help there?
If Stok Kangri has seen the exuberance, the joy of victory, tears of satisfaction and burst of confidence. It has also seen the awful, the despair of loss, tears of pain and loss of confidence. To reduce the chances of later, knowing own body helps a lot. Pawan Kumar, our Senior Trek Leader has led many trekkers to Stok top. Well, in this incident emotion at Stok top was really of happiness. "After crossing the glacier itself he suddenly slowed down. He was walking really slow compared to his early pace. So I asked him to return back. I knew he was near exhaustion. Again going to the summit then the whole descent, he will be dead tired. But as usual, this trekker too was not ready to give up. So, I checked his oxygen reading it was 90. I had no other point to argue with him.
I walked with him the whole time. Somehow he managed to reach the top. But he was really tired, I don't think he even enjoyed being there. Anyway, we then started climbing down. It is like my worst dream come true, he gave up after the shoulder. I hurriedly checked his Oxygen, it was 60 this time. Sudden drop! I put him on artificial oxygen and we continued. He was talking rubbish, walking weirdly. I put his hand around my shoulder and made him descend properly. Once we crossed the glacier, he came to senses. And in the next 4 hours to Base Camp, he was fine. After resting for 2-3 days, he realized what had happened. He then apologized and thanked us!"
Yes, knowing your body really helps. Because only then you know, when to stop ✋Again, easier said than done! Those last few meters seem so irresistible, that it eats our intelligence and triggers us to do the forbidden ie. to stop when the body is exhausted.
This incident is analogous to the dreadful news we hear about Everest. That how climbers are so tired they sleep after the summit while walking, that they are so busted they sit and sit for forever, that climbers lose their way due to tiredness, that they run out of oxygen slowing down, that they just don't care anymore, all because of exhaustion. Presumably, because climbing up took every ounce of their energy, leaving nothing for climbing down.
What causes situations like this? Whether it was AMS or not able to decide when to stop, it is for you to ponder. All we can say is, climbing down is easy only if we have the strength to complete it.
We have come towards the end of this AMS awareness drive. The last myth that we would share will definitely force you to be more responsible and sensitive towards your own safety. We have talked about various concerns and it all sums to being self-careful, self-responsible. Only if you help yourself, we can help you!
Let's read a fortunate incident last incident. Chadar trek as you know is the star winter trek. Although it is in -30 degrees cold, everybody wants to walk on the frozen river. Chadar trek does not have that much height gain, but the extreme cold and slight negligence make it prone to AMS. Harinder Chauhan aka Bunty, our Base Camp Manager is known for saving lives. Not only of TTH trekkers but other companies too. He narrates one such event. "I was coming along with my group. We had just finished our Chadar trek successfully. While walking towards the road head I could see many people encircling someone. I knew that somebody is being rescued and others are helping. When I reached there, I found a Malaysian trekker of another company sitting in awful condition. She was on artificial oxygen. She looked tired. I checked and found her oxygen cylinder was about to empty. I immediately gave our rescue Oxygen cylinder. We attached it to her.
She was suggested with a thick jacket and head cap. I then removed her cap and loosened the jacket. I also suggested to not surround her and let fresh air reach her. She then started feeling a little better.
The real situation was her team had efficiently and timely rescued her to the road head. But to their dismay, the road was flown away by a sudden rise in river levels. Hence, no transport vehicle was able to reach her. It took hours for the vehicle to reach her and she had to wait. There was no other option. She was fortunate enough that I came there with my team and I had oxygen. So at least we could extend the time. Had I not been there...!"
Well, mountains are unpredictable, nature also is. Despite blood and sweat, sometimes things are just not the right way. Therefore, being careful right from the start is the only option. How much ever money you pay, however, experienced the company staff is, whatever you do once the rescue has started, you really can't do anything if nature is not in your favor.
It is wise to avoid such acts that lead to emergency evacuation. Better safe than sorry. Take all the necessary measurements quite in advance, follow all the rules, do not be overconfident, don't cheat or lie about your discomfort, don't try to push yourself if your body is not ready, listen to your Trek leaders, and moreover just look after yourself. But never remain under impression that, I will be rescued safely!
Feel free to share your experiences too. Let us all contribute to eradicating this evil celebrity by enlightening everyone else.