Mongolia trek al­most turns tragic

Marlborough Midweek - - YOUR LOCAL NEWS - BRENDA WEBB

Four days into a two-week horse trek in the iso­lated Mon­go­lian Al­tai Moun­tains, Del Bis­sell re­alised she was in se­ri­ous trou­ble.

The 65-year-old Marl­bor­ough woman – no stranger to far flung lo­ca­tions and high al­ti­tudes – had de­vel­oped three dif­fer­ent lifethreat­en­ing blood clots.

An ex­pe­ri­enced nurse, she knew her con­di­tion was grave and, de­spite the re­mote­ness, a full-scale med­i­cal evac­u­a­tion was needed.

‘‘It was about the worst pos­si­ble place to be – I’vMon­go­liae been told I’m lucky to be alive,’’ Del said, back in the com­fort of her Wai­hopai Val­ley farm.

Del was first driven over rough tacks to a lo­cal hospi­tal be­fore be­ing air­lifted to the Mon­go­lian city of Ulaan­baatar for surgery.

‘‘The very ef­fi­cient ED doc­tor there went into over­drive at the se­ri­ous­ness of my con­di­tion,’’ she said.

‘‘They thought I wasn’t go­ing to make it. I did ex­actly as I was told - they didn’t want this for­eigner dy­ing in their hospi­tal, and nei­ther did I.’’

An em­boli fil­ter was placed in her vein to trap any throm­bus de­bris and al­low her to fly home to New Zealand ac­com­pa­nied by a doc­tor who ad­min­is­tered an­ti­co­ag­u­lants and oxy­gen the en­tire trip.

Back home and em­bark­ing on a six-month re­cov­ery process, Del has had time to re­flect on the se­ri­ous­ness of her con­di­tion and just how lucky she was to sur­vive.

‘‘One clot is nor­mally enough to be a prob­lem – I man­aged to have three,’’ she said.

‘‘Ba­si­cally I sur­vived the non­sur­viv­able.’’

The trou­ble be­gan when Del

‘‘One clot is nor­mally enough to be a prob­lem – I man­aged to have three.’’

no­ticed she was short of breath.

Phys­i­cally fit from bik­ing, horse rid­ing and tramp­ing, she had pre­pared thor­oughly for the trek so the breath­less­ness trig­gered alarm bells.

She had suf­fered al­ti­tude sick­ness while in the Al­ba­nian moun­tains last year which was short lived and her first thoughts were this was the same.

But symp­toms per­sisted. Us­ing her med­i­cal back­ground, and chat­ting with fel­low rider, Peter Louden, an Aus­tralian doc­tor, the pair de­duced she had a clot.

The New Zealand com­pany she was with, Zavkhan Trekking, stressed the re­mote­ness of the coun­try on their web­site and warned of dif­fi­cul­ties in the case of emer­gen­cies.

‘‘Zavkhan have an amaz­ing exit plan and they were on the satel­lite phone to the medics and to my in­surance com­pany who mas­ter-minded the whole evac­u­a­tion,’’ Del said.

‘‘We piled into a trusty old blue Rus­sian Landie [4WD] and set off for Ul­gii, stop­ping ev­ery few me­tres in al­ti­tude and dis­tance to top ev­ery­thing up with wa­ter.’’

Med­i­cal fa­cil­i­ties in the first hospi­tal in Ul­gii were scant and de­spite Del’s crit­i­cal con­di­tion, med­i­cal staff told her it was al­ti­tude sick­ness and to go away.

But she re­fused, and even­tu­ally paid for an ECG, ba­sic blood tests and a chest X-ray. The clots were con­firmed via phone calls with a doc­tor in Ulaan­baatar.

Anti-co­ag­u­lants were top of the list but none were avail­able at the hospi­tal but amaz­ingly, Dr Louden, who ac­com­pa­nied Del, found some in a nearby store.

Af­ter two wor­ry­ing nights in Ul­gii, the med­i­cal team ar­rived and ad­min­is­tered se­ri­ous an­ti­co­ag­u­la­tion ther­apy be­fore air­lift­ing Del to Ulaan­baatar for full clin­i­cal eval­u­a­tion and surgery.

Back on the farm she is slowly re­cov­er­ing but ac­cepts it will take some time be­fore she is back to nor­mal.

She had no pre­vi­ous his­tory of clots.

‘‘I was told it was due to age and bad luck – nei­ther of which can be treated,’’ she said.

But, gut­ted at hav­ing to aban­don the trek and the sub­se­quent train ride across the Siberian Plains to St Peters­burg in Rus­sia, Del is al­ready eye­ing up an­other trip.

SUP­PLIED

Wai­hopai Val­ley woman Del Bis­sell, right, fell ill while trekking in the Mon­go­lian moun­tains.

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