Sherpa Ice Doctor Tragedy, Everest ER and Mountain Medicine
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Dr Rachel Anderson from EverestER joins the EWM family…
EWM is honoured to welcome Dr Rachel Anderson of EverestER and Antarctic Expedition & Logistics fame to the EWM family as the course director of the 2014 Nepal Mountain Medicine Course…
Mountain Medicine Nepal Course Director
Rachel is an Emergency Medicine registrar in the UK who has worked in the expedition environment in Nepal and Antarctica.
She has worked for Everest ER for two seasons as a base camp medic as well as at Union Glacier and the South Pole for Antarctic Logistics and Expeditions. She has recently completed the Diploma in Mountain Medicine (DIMM) and was lead lecturer on a wilderness medical expedition to Aconcagua in 2013.
She is a keen mountaineer and spends time in Scotland, the Alps and at high altitude venues such as the Himalaya. She also has an interest in humanitarian work and has the Diploma in Tropical Medicine and Hygiene and has worked in South Africa. Her next planned trip is to work as part of the mountain rescue team on Denali this summer.
Of Interest
Remote medicine news, Extreme Medicine Conference updates and more!
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Updates from Mountain Medicine course in Nepal led by Dr Luanne Freer
Our Mountain Medicine course heads for Nepal led by Everest ER founder Dr Luanne Freer, head medic for Antarctic Logistics and Expeditions Dr Martin Rhodes and world authority of frostbite and cold weather injuries vascular surgeon Prof Chris Imray.
Progress updates here and on the Expedition & Wilderness Facebook group
Updates; most recent on top
- We only got one Heli out -1/2 in lukla 1/2 back on ktm. Will try again tomorrow morning. Damn cyclone!
- Cyclone playing havoc with flights and all flights to lukla cancelled but not deterred EWM has hired all the available helicopters !!!
- The 2013 mountain medicine course is headed to lukla this morning! We’ve amassed our considerable pile of gear and are negotiating the chaos of the ktm domestic terminal. Lots of anxiety about the cyclone in Bay of Bengal (prayers to the people who are in the path of that storm) and it’s almost certain effects on the weather about to hit here – hope we all get landed at the trail head before rain rolls in!
- Just had group intros – everyone is here – we have 16 countries represented by our 30 participants! Wow! Well have some fun!
Join us next year in Nepal on the next Mountain Medicine course
Oprah features Extreme Medicine Conference speaker
Photo: Luanne Freer
In 1999, emergency room doctor Luanne Freer was invited on a volunteer medical mission to a remote Himalayan village in Nepal. Upon her group’s arrival, Freer was greeted by 600 villagers, many of whom had walked for days just to be seen at the clinic.
“They were lacking basic healthcare,” Freer says. “I felt like I could offer something meaningful.”
Back in her home base of Montana, Freer found herself eager to return to Nepal.Three years later, while volunteering at a clinic in Pheriche, Nepal, Freer hiked to Everest Base Camp. She discovered that only a few of the climbing expedition teams there included doctors with high-altitude training. Freer, who had the requisite knowledge from her years working in the Northern Rockies, was even more dismayed to learn that the area’s native Sherpa and Rai populations were sometimes turned away by the foreign expeditions’ doctors. She was determined to find a way to provide better medical care to both climbers and the hundreds of Nepalese working on Everest.In the spring of 2003, Freer founded Everest E.R.—a small clinic at Base Camp that operates during the two-and-a-half-month climbing season. The clinic supplies free and heavily subsidized medical care to locals by charging climbing teams a nominal fee. During its first year, Freer dealt with malfunctioning equipment and flooding (in addition to freezing temperatures and no electricity). But the memory of the first life she saved—a Nepali porter dying of cerebral edema—brought her back the following year. Since then the clinic has continued to grow: In 2003 it treated 84 patients; in 2012 it saw 570. Today nearly every expedition relies on Everest E.R. for medical care. But Freer, 55, says her connections with the local people are the greatest reward of all.
“I have tangible evidence that I’ve made a difference in someone’s life,” she says. “If I never picked up another stethoscope, I would still feel complete.”
From the April 2013 issue of O, The Oprah Magazine
Read more: http://www.oprah.com/spirit/Luanne-Freer-Everest-Doctor#ixzz2aQSmSNZS
Expedition & Wilderness Medicine courses of interest…
Meet Luanne at this years Extreme Medicine Conference hosted by the Harvard-Affiliated Fellowship in Disaster Medicine and Emergency Management
Oprah features EverestER Legend Dr Luanne Freer
EWM Facualty Dr Luanne Freer, leader of EWM’s Mountain Medicine Course and speaker at Extreme Medicine 2013 Conference…
Meet the Doctor Whose Office is Mount EverestIn the extreme conditions of Everest’s Base Camp, Luanne Freer, MD, cares for a neglected population.
By Molly Loomis
In 1999, emergency room doctor Luanne Freer was invited on a volunteer medical mission to a remote Himalayan village in Nepal. Upon her group’s arrival, Freer was greeted by 600 villagers, many of whom had walked for days just to be seen at the clinic. “They were lacking basic healthcare,” Freer says. “I felt like I could offer something meaningful.” Back in her home base of Montana, Freer found herself eager to return to Nepal.Three years later, while volunteering at a clinic in Pheriche, Nepal, Freer hiked to Everest Base Camp. She discovered that only a few of the climbing expedition teams there included doctors with high-altitude training. Freer, who had the requisite knowledge from her years working in the Northern Rockies, was even more dismayed to learn that the area’s native Sherpa and Rai populations were sometimes turned away by the foreign expeditions’ doctors. She was determined to find a way to provide better medical care to both climbers and the hundreds of Nepalese working on Everest.In the spring of 2003, Freer founded Everest E.R.—a small clinic at Base Camp that operates during the two-and-a-half-month climbing season. The clinic supplies free and heavily subsidized medical care to locals by charging climbing teams a nominal fee. During its first year, Freer dealt with malfunctioning equipment and flooding (in addition to freezing temperatures and no electricity). But the memory of the first life she saved—a Nepali porter dying of cerebral edema—brought her back the following year. Since then the clinic has continued to grow: In 2003 it treated 84 patients; in 2012 it saw 570. Today nearly every expedition relies on Everest E.R. for medical care. But Freer, 55, says her connections with the local people are the greatest reward of all. “I have tangible evidence that I’ve made a difference in someone’s life,” she says. “If I never picked up another stethoscope, I would still feel complete.”
From the April 2013 issue of O, The Oprah Magazine
Read more: http://www.oprah.com/spirit/Luanne-Freer-Everest-Doctor
Where to meet Luanne?
Extreme Medicine Conference at Harvard Medical School
Mountain Medicine CME & FAWM Course in Nepal
Mountain Medicine course in Nepal reaches Everest ER and Base Camp
The third annual Mountain Medicine course in Nepal under the leadership of Everest ER founder Dr Luanne Freer and Antarctic Logistics lead medic Dr Martin Rhodes has successfully reached Everest Base Camp and spend time visiting 
the highest clinic in the world, established by Dr Freer, Everest ER.
The CME accredited course not only provides a didactic medical learning experience but also raises significant monies to support the work of Everest ER in not only providing life sustaining support for Everest trekkers and climbers but also for the local Nepalese community.
Join Expedition & Wilderness Medicine on next years Mountain Medicine course – time not only well spent in learning but also in one of the worlds most amazing outdoor classrooms.
Of interest
- Everest ER
- Extreme Medicine Conference at Harvard Medical School
- Remote and Wilderness Medical Courses
‘The ultimate mountain medicine course, the path of which follows the Everest Base Camp Trail up the Khumbu valley to base camp itself, situated in the shadow of the world’s most iconic peak.
Many of you know Dr Luanne Freer as the founder and director of Everest ER, and a volunteer physician for the non profit Himalayan Rescue Association (HRA) in Nepal. Founded in 2003 EverestER is the world highest clinic a seasonal tent-based medical facility at the Everest Base Camp (17,600 ft/5350m). Dr Freer will be joined by Dr Martin Rhodes DiMM lead medic for Antarctic Logistics and Expedition and runs their medical backup each polar season in Antarctica. This duo will be joined by additional guest medic to add variety and provide an eclectic teaching pool.
‘The Mountain Medicine course was one of the most amazing experiences of my life lead by a world class exped team. Really grateful for the opportunity to attend the course’Spaces are strictly limited
*A significant proportion of the profits from this expedition go towards supporting the work of Everest ER.’
Nepal Mountain Medicine with Dr Luanne Feer
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Mountain Medicine in Nepal with Everest ER founder Dr Luanne Freer
We have a couple of last minute discounted places on our upcoming Mountain Medicine Course in Nepal headed up by Dr Luanne Freer of Everest ER and Dr Martin Rhodes. Contact admin@expeditionmedicine.co.uk if you are interested and have the time free!!
Some of the detail…
The ultimate mountain medicine course, the path of which follows the Everest Base Camp Trail up the Khumbu valley to base camp itself, situated in the shadow of the worlds most iconic peak.
Many of you know Dr Luanne Freer as the founder and director of EverestER, and a volunteer physician for the non profit Himalayan Rescue Association (HRA) in Nepal. Founded in 2003 EverestER is the world highest clinic a seasonal tent-based medical facility at the Everest Base Camp (17,600 ft/5350m).
Luanne, who is also a past president of the Wilderness Medical Society and Medical Director for Yellowstone National Park, aims to pass on the learning’s from her years of providing medical cover at this altitude through this mountain medicine course, and also hopes to transfer her passion for the Khumbu valley and Nepal in general
‘The Mountain Medicine course was one of the most amazing experiences of my life lead by a world class exped team. Really grateful for the opportunity to attend the course’
Everest ER founder heads up Mountain Medicine Course in Nepal
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Nepal Mountain Medicine with Dr Luanne Freer
Details on next year’s Mountain Medicine course trekking to Everest Base Camp with the founder of EverestER, Dr Luanne Freer.
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Nepal Mountain Medicine leader featured in Smithsonian article
Dr Luanne Freer, leader of this years Nepal CME accredited Wilderness Mountain Medicine course in Nepal, has been written up in a brillant article on the illustrouis Smithsonian website in an article entitled ‘Inside the ER at Mt. Everest’ by Molly Loomis.
A middle-aged woman squats motionless on the side of the trail, sheltering her head from the falling snow with a tattered grain sack.
Find out more about Mountain Medicine in Nepal
Luanne Freer, an emergency room doctor from Bozeman, Montana, whose athletic build and energetic demeanor belie her 53 years, sets down her backpack and places her hand on the woman’s shoulder. “Sanche cha?” she asks. Are you OK?
The woman motions to her head, then her belly and points up-valley. Ashish Lohani, a Nepali doctor studying high-altitude medicine, translates.
“She has a terrible headache and is feeling nauseous,” he says. The woman, from the Rai lowlands south of the Khumbu Valley, was herding her yaks on the popular Island Peak (20,305 feet), and had been running ragged for days. Her headache and nausea indicate the onset of Acute Mountain Sickness, a mild form of altitude illness that can progress to High Altitude Cerebral Edema (HACE), a swelling of the brain that can turn deadly if left untreated. After assessing her for HACE by having her walk in a straight line and testing her oxygen saturation levels, the doctors instruct her to continue descending to the nearest town, Namche Bazaar, less than two miles away.
Freer, Lohani and I are trekking through Nepal’s Khumbu Valley, home to several of the world’s highest peaks, including Mount Everest. We are still days from our destination of Mount Everest Base Camp and Everest ER, the medical clinic that Freer established nine years ago, but already Freer’s work has begun. More than once as she has hiked up to the base camp, Freer has encountered a lowland Nepali, such as the Rai woman, on the side of the trail ill from altitude. Thankfully, this yak herder is in better condition than most. A few weeks earlier, just before any of the clinics had opened for the spring season, two porters had succumbed to altitude-related illnesses.
Each year over 30,000 people visit the Khumbu to gaze upon the icy slopes of its famed peaks, traverse its magical rhododendron forests and experience Sherpa hospitality by the warmth of a yak dung stove. Some visitors trek between teahouses, traveling with just a light backpack while a porter carries their overnight belongings. Others are climbers, traveling with a support staff that will aid them as they attempt famous peaks such as Everest (29,029 feet), Lhotse (27,940 feet) and Nuptse (25,790 feet). Many of these climbers, trekkers and even their support staff will fall ill to altitude-induced ailments, such as the famed Khumbu cough, or gastro-intestinal bugs that are compounded by altitude.
A short trip with a group of fellow doctors to the Khumbu in 1999 left Freer desperate for the chance to return to the area and learn more from the local people she had met. So in 2002 Freer volunteered for the Himalayan Rescue Association’s Periche clinic—a remote stone outpost accessed by a five-day hike up to 14,600 feet. Established in 1973, Periche is located at an elevation where, historically, altitude-related problems begin to manifest in travelers who have come up too far too fast.
For three months, Freer worked in Periche treating foreigners, locals and even animals in cases ranging from the simple—blisters and warts—to the serious, instructing another doctor in Kunde, a remote village a day’s walk away, via radio how to perform spinal anesthesia on a woman in labor. Both the woman and the baby survived.
Find out more about the Nepal CME accredited Wilderness Mountain Medicine course in Nepal attendance of this course will count toward a FAWN degree.
Acute mountain sickness – a review by Dr Sean Hudson
Management of AMS
Prospective, Double-Blind, Randomized, Placebo-Controlled Comparison of Acetazolamide Versus Ibuprofen for Prophylaxis Against High Altitude Headache: The Headache Evaluation at Altitude Trial (HEAT)
High altitude headache (HAH) is the most common neurological complaint at altitude and the defining component of acute mountain sickness (AMS). However, there is a paucity of literature concerning its prevention. The researchers sought to compare the effectiveness of ibuprofen and acetazolamide for the prevention of HAH.
Three hundred forty-three healthy western trekkers were recruited at altitudes of 4280 m and 4358 m and assigned to receive ibuprofen 600 mg, acetazolamide 85 mg, or placebo 3 times daily before continued ascent to 4928 m. Outcome measures included headache incidence and severity, AMS incidence and severity on the Lake Louise AMS Questionnaire (LLQ), and visual analog scale (VAS).
Two hundred sixty-five of 343 subjects completed the trial. HAH incidence was similar when treated with acetazolamide (27.1%) or ibuprofen (27.5%; P = .95), and both agents were significantly more effective than placebo (45.3%; P = .01). AMS incidence was similar when treated with acetazolamide (18.8%) or ibuprofen (13.7%; P = .34), and both agents were significantly more effective than placebo (28.6%; P = .03). In fully compliant participants, moderate or severe headache incidence was similar when treated with acetazolamide (3.8%) or ibuprofen (4.7%; P = .79), and both agents were significantly more effective than placebo (13.5%; P = .03).
Fascinatingly the authors demonstrated that Ibuprofen and acetazolamide are similarly effective in preventing HAH. This adds another medication to the useful arsenal to use in the treatment of AMS and in particular is especially useful when you have a patient who can’t take acetazolamide (diabetics or sulphur allergies) .
Learn more about Altitude Medicine by joining Expedition and Wilderness Medicine’s CME accredited Mountain Medicine course in Nepal headed up by Everest ER founder Dr Luanne Freer
Expedition Medicine lecturer and wilderness medic par excellence Dr Luanne Freer organiser of ‘Everest ER’ writes about her plans for 2010
The Everest base camp medical clinic “Everest ER” will be on the mountain in April 2010 for our 8th season (!) As always, we offer services to base camp climbers, support staff and trekkers-through in support of our mission to prevent and treat illness at high altitude and to use proceeds for care from non-Nepalis to subsidize free or low cost health care for our Nepali friends. The 2010 staff will be comprised of myself, Lakpa Norbu Sherpa (our faithful logistics coordinator,) Dr Steve Halvorson, and Dr. Peter Hackett, longtime HRA volunteer and world renowned altitude expert (and Everest summitteer!) will join us for the month of May. We plan to carry out a research project aimed at answering a plaguing question a high altitudes everywhere – what’s the best treatment for high altitude “Khumbu” cough?
Expedition Medicine lecturer and wilderness medic par excellence Dr Luanne Freer organiser of 'Everest ER' writes about her plans for 2010
The Everest base camp medical clinic “Everest ER” will be on the mountain in April 2010 for our 8th season (!) As always, we offer services to base camp climbers, support staff and trekkers-through in support of our mission to prevent and treat illness at high altitude and to use proceeds for care from non-Nepalis to subsidize free or low cost health care for our Nepali friends. The 2010 staff will be comprised of myself, Lakpa Norbu Sherpa (our faithful logistics coordinator,) Dr Steve Halvorson, and Dr. Peter Hackett, longtime HRA volunteer and world renowned altitude expert (and Everest summitteer!) will join us for the month of May. We plan to carry out a research project aimed at answering a plaguing question a high altitudes everywhere – what’s the best treatment for high altitude “Khumbu” cough?