When I signed up to climb Kilimanjaro, I simply took it for granted that I would summit it. And why not? I have always loved nature, and it has always been kind to me in return. I have hiked up almost all of the high points in Yosemite, and though they were not nearly as high as Kilimanjaro, they were steep and somewhat technically challenging hikes. And on top of that, I had to carry 30lb packs while climbing them.

Kilimanjaro on the other hand, though almost twice as high as Yosemite’s highest point (19,341′ vs. Clouds Rest at 9,990′), was just one long arduous climb up a steady incline. And we had guides and porters with us to help carry our gear (more on that whole colonial era concept in a follow-up post). And if not for anything else, all my long distance training for marathons had prepared me well for winning the mind over matter game needed to endure such long treks.

Of course, there were many times on this trail when my mind had to do just that, and remind my body what it’s really capable of. The route we took was the newly opened Northern-Circuit, which closely follows the well known Lemosho route and takes 8 days to summit and descend, giving us an extra day to acclimatize to the high altitude over the already long 7-day Lemosho route.

Northern Circuit

The first two days of hike getting through Forest Camp up to Shira 1 Camp were a breeze. But on the critical third day, when we were expected to actually start feeling the effects of altitude, I got hit with a contagious stomach bug that was making its round around our camp. I wasn’t the only one to get sick. In fact there were five of us in our climbing group, and all but one got sick on the mountain. I just happened to be the one with the unfortunate timing of getting hit on acclimatization day when we camped above 4000m for the first time.

So, I had to visit the “toilet tent” a few more times than the others… So what? Big deal! Even after hitting the loo twice before 8am, I brushed it off as just a case of indigestion and went onwards with our 5-hour hike to the next camp at Moir Hut. This camp was at an elevation of around 4200m, the highest I had ever been up until that point. Once there, I was still feeling okay, and even decided to do the optional acclimation hike that evening up to a towering rock formation around 4670m (approx. 15,200ft), the highest elevation I have ever climbed to.

In hindsight, this was probably a mistake and I should’ve probably rested at camp like my campmate who was recovering from her sickness from day 1. But, I had a huge case of FOMO, and I had no idea how much worse it could get. It was daunting, but I just kept saying to myself “sip by sip, step by step!” and made sure I stayed hydrated. And it was totally worth the hurt. I got to see one of the most beautiful sunsets ever.

Sadly, it will also be the highest I will ever get to on this trip. When we returned to camp that night, we had to go through our routine checks for our pulse and blood oxygen saturation levels. Everyone else registered a healthy reading in the range of 89%-92%, slightly lower than the 95%-100% readings we got the day before. But that drop was expected due to the decrease in atmospheric oxygen at high altitudes. I registered a mere 73% – way below the 80% threshold the guides were comfortable with on the mountain.

Before I proceed any further, let me explain a little bit about blood oxygen saturation. It’s basically the percentage of red blood cells that are oxygenated in your body. Usually, 95 - 100% of your RBCs are oxygenated. And as you go higher up in elevation, the lack of atmospheric oxygen causes a lesser amount of blood passing by your lungs to get oxygenated, thus causing your saturation level to drop. Below 80%, the main organs like your brain and heart begin to get affected. And to compensate, your heart starts to beat faster to push more oxygenated blood to your organs, resulting in higher blood pressure, a higher pulse, and a throbbing headache.

Here’s a little video that explains a bit more about the effects of Hypoxia.

The video focuses on the drastic effects above 25,000ft and how it affects your mind in a matter of minutes. We obviously weren’t that high, but we had to deal with it for days, not minutes. And symptoms aren’t the same for everyone affected by hypoxia. For some, it’s diminished cognitive skills. Others start to slur while they speak. For me, it was fatigue and headache. Both of which could be attributed to just dehydration.

The only sure way to keep track of the effects of hypoxia was to measure your blood oxygen saturation. On the mountain, the guides recorded our pulse and saturation levels twice daily – once after breakfast, and once before bedtime. Your saturation level is expected to drop to 80 - 90% on the third day until your body acclimatizes, at which point it creeps back up to settle around 85 - 95%. My 73% reading that night was definitely a cause for concern.

We attributed my low reading to the stomach bug, and decided to check again the next morning, thinking may be my body had to prioritize my sickness over altitude. That night I had to use the toilet tent four additional times, and when morning came, my reading hadn’t changed by much. In fact, I woke up with an even lower reading of 69%. The highest reading I could get even with my sleeping bag acting as a temporary hyperbaric chamber was 77%. We did register a reading of 86% at some point in the morning, and the guides decided to officially record me at that. They didn’t want me to take further readings that day.

They wanted me to continue on the mountain and successfully summit just as much as I did. We decided to give it another day, and headed off to the next camp, Pofu Camp, which is at a slightly lower elevation of around 3850m. I thought I was feeling better that morning, but I couldn’t have been more wrong. This hike was brutal. I was still sick, and I had to hike 12km in 6 hours over rolling hills through a burning fever. Mind over matter right? Well, somehow I made it through that day.

That second night at altitude, my oxygen saturation was still stuck at 77%. My fever had begun to subside, and I was starting to feel a lot better. The guides though were weary with doubtful faces, but still tried to be optimistic about it. And I was too. Maybe things will get better once we get to the next camp at Third Cave, which is at around the same elevation as Pofu camp. “Don’t worry, tomorrow is gonna be an easy hike. It’s only 3 to 4km, and after about 20 minutes of uphill, it’s all downhill. We will take a reading once we get to Third Cave and then decide if you should continue or not. But I think you will be fine!”

The Northern Circuit is pretty much designed to give the body as much time as necessary to acclimatize. After the third day at 4200m, it’s basically two days of camping at lower elevations to let the body acclimatize before getting up to base camp on the 6th day around 4600m at School Hut, all ready for the summit and descent on the 7th day.

On the morning of the fifth day, my fever was gone, and I was upbeat about my health. The pulse oximeter still showed a reading of 77%. “It’s fine, we’ll check along the way to the next camp, and hopefully it will go up as the day progresses.” We checked along the way, and it didn’t waver much. It still showed 77% wherever we stopped to take water breaks. By the time we made it to camp, I was exhausted. It was only 3km, and it was all downhill, but I was done. I was ready to quit.

It was no longer a matter of mind vs. body. The night prior, I slept in the cold for a good half of it because I woke up to go take a leak, then decided not to, but then, forgot to zip up my sleeping bag. I kept waking up cold after that, and noticed every single time that my sleeping bag was open. But I kept forgetting to zip up. This happened not just once or twice, but three times! And earlier in the night, I was shivering for a bit in my fully zipped up warm sleeping bag. I was not thinking straight. I had already been feeling fatigue and constant headache for the past two days. And now, add reduced cognitive skills to my list of symptoms.

My body was telling me to GTFO, and this time, my mind was in agreement.

When we arrived at Third Cave, everyone went to take pictures with the camp signs. I went straight to a tent to rest. The lead guide came and checked my levels, and looked at me with a serious face. “You need to descend immediately! One of the guides and a porter will accompany you, but you should eat your lunch, or pack a boxed lunch, and descend right away. You can come back and climb again another day, but not today. Next year, next month, may be even next week if you want. This mountain will still be here. You’re still too young. You still have a lot of life left in you. Don’t die on this mountain today! Go!”

Words can’t express my gratitude towards Msafiri and Twalib, the guide and porter who left the mountain with me and helped carry my stuff. It took us 5 hours to descend via the scenic Rongai Route, and I already started feeling better half-way down the trail. I still had some symptoms of altitude sickness begin to show up even after I got back to the hotel that night, like a little bit of fluid in my lungs. But, they would have been worse had I decided to stay up on the mountain another night. I had had enough with altitude sickness after the throbbing headaches and shivers. I didn’t need to cough up blood to realize how bad it could get.

I have always loved nature, but now I have a new found respect for it.

I will be back to climb the mountain again, and the next time I will be better prepared for it. I will go climb other high elevation peaks to train for it, and not just rely on running with my scorpion-looking altitude training mask. I will put in the work the mountain demands, and give it the respect the mountain deserves. I only ask that the mountain returns the favor and respects my effort.

In the video about hypoxia, they mention that death can occur at any instant when your blood oxygen level drops below 60%. My reading that afternoon was 63%. I have no regrets descending that day.