The
E3 Expedition Team presented this morning's rounds to the Yale-based
Medical Team from the relative comfort of the Italian High Research
Center in Lobuche. Dr. Christian Macedonia, E3's Director of Medical
research, expressed his gratitude to the Center for allowing the
E3 team to make use of the renowned facility. Of special note,
Dr. James "Butch" Rosser, Director of the Yale Endo-Laparoscopic
Center and staff member of the Yale/NASA Commercial Space Center,
participated in the live teleconference from his home.
Dr. Ken Kamler opened
the session by presenting the case of a Sherpa yak driver who
complained of significant tenderness in his shoulder. Physical
examination by Dr. Kamler led to a preliminary diagnosis of a
torn rotator cuff. Ultrasound imaging of the affected joint by
Dr. Macedonia revealed impingement of the supraspinatus as well
as the presence of bone fragments that had avulsed with the muscle.
Yale radiologist Dr. James Brink complimented the high quality
of the transmitted images that permitted identification of hemorrhage
in the sub-deltoid bursa in addition to the bone fragments. Dr.
Rosser made some suggestions for the care of this patient and
discussion centered around the different priorities of life in
Nepal when compared to North America.
Dr. Kamler stated
that the recommended treatment for such an injury typically involves
2 to 3 weeks of immobilization followed by 6 months of rehabilitation.
Unfortunately, after Dr. Kamler administered an anti-inflammatory
and anesthetic, the patient declined immobilization, citing his
need to continue working in order to support his family. The episode
portrayed the gap that can exist between our approach to practicing
medicine and the practical realities of life in Nepal.
Dr. Macedonia also
told us that the E3 team was privileged to have met Junko Tabei,
who in 1973 became the first woman to reach the top of Mt. Everest.
The Japanese climber is with a group of researchers headed to
Base Camp to study mammalian life at high altitude. She received
a personal tour of E3's medical research and clinical activities
while at the Italian Center.
Dr. Javier Davila,
E3's Chief Medical Researcher, reported that cardiovascular, blood
chemistry, and vision data has been collected on 12 team members
to-date. We look forward to receiving the results of their work
when they return and, immediately, beginning the process of review
and analysis. Medical data and images will continue to be posted
on the E3 web site for those interested in the physiological affects
of high altitude.
Today's session was
the last live teleconference between the E3 Expedition team and
us at Yale. They will resume their descent tomorrow, stopping
in Pheriche and Namche Bazzar to perform the final phases of medical
research before arriving in Kathmandu one week from today.
In wrapping up today's
session, all agreed that the project has been successful in terms
of high-altitude research conducted and high-tech devices demonstrated.
Dr. Macedonia concluded that the proudest moment of all was the
"real-time" integration between the E3 medical teams at Base Camp
and Yale during the evaluation, diagnosis, and treatment of the
3 climbers who presented to the clinic in acute respiratory distress.
The outcome was that they were all able to walk out of Base Camp.
Today's participants:
Dr. Peter Angood (moderating), Dr. Butch Rosser, Dr. James Brink,
Dr. Leslie Scout, Brett Harnett, Doris Farquhar, Gary Stilwell,
Dmitry Albert, and Norman Stewart.
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