16 x 4,000m summits in 5 days

Judith Safford leading descent from Lyskamm
Leading the descent from Lyskamm

Only 18 months after requiring a wheelchair at the airport, I have accomplished my dream of climbing several of Switzerland’s highest peaks – 16 in all – in only five days.

I was diagnosed with Ankylosing Spondylitis (AS) two years ago, and wrote about coming to terms with the diagnosis in a first post, and in a second, the treatment that allowed me to resume my passion for mountains. Now, I will describe my five days on top of Europe in the Alps of Monte Rosa.

I looked around me. Dazed and disbelieving I saw a sea of fluffy clouds over the Po plain of Italy to the south. It was like being in a plane, except that the landscape stayed still and the cold wind stung my face.

Mont Blanc and Matterhorn from Dufourspitze
View of Matterhorn and Montblanc seen from the Monte Rosa

In all other directions, occasional clouds were scattered amid the peaks below me. Between them I could just see down to green valleys, far below. To the north and east huge glaciers wound magnificently down towards the lone summit of Matterhorn, which seem to stretch elegantly but somehow coquettish to the sky. That icon of the Alps was below where I was standing now. Left of the Matterhorn in the distance stood the great massif of Mont Blanc, the only point in western Europe higher than where I was now.

I was standing on the Dufourspitze, also known as Monte Rosa, 4,634m above sea level. It was the 16th 4,000m peak that I had climbed in five days. I had achieved everything that I had wanted to do. The toil of the last months of preparation had paid off. The fear and doubts, the sleepless nights listening to my heart thumping, all disappeared in the sublime beauty of that moment. I turned to my rope partners and we hugged and congratulated each other, I sobbed tears of gratitude and relief.

Mountain summit
It’s too cold to wait long on the summits

We took in the scenery for a few more minutes, took some photos, drank a sip of hot tea from our thermos flasks, forced down some dried fruits or chocolate and then our guide, Roman, said, “Let’s go. Concentrate.” Indeed, we had several hours to go before the tour was safely completed. As everyone who has climbed trees as a child knows, going down is usually more difficult than climbing up.

Nothing but a step

On the summit of Monte Rosa there is plaque commemorating the first ascent in 1855 with a quote by Seneca, “What you think to be the peak is nothing but a step.” Taking ‘nothing but a step’ had been my driving force during the last days. The tours had been long – up to 12 hours – and if a particular slope had seemed endless and I had felt that there was no way that I could muster the strength to continue, I just concentrated on taking a step. Eventually one of those steps was indeed the summit. Indeed, this idea of taking one step at a time has been an important element of managing my life generally since the diagnosis of Ankylosing Spondylitis.

Roman’s frequent reminder to concentrate was also about taking steps. Many of the peaks we had ascended were along thin ridges, where steep slopes fall away for perhaps 1,000m on both sides. A fall would mean almost certain death. So, the only safe way to proceed is to walk exactly on the top of the ridge, so that if someone did stumble and fall on one side, another rope partner can jump in the other direction down the other and thus break the fall. Naturally, this is only a measure of last resort.

Steep ridge in the Swiss Alps
Treading carefully on a steep ridge

The best way forward is to concentrate all your senses on every single step, take even, perfectly placed paces, feel how your rope partners are moving and coordinate your movements with them.

On day two we crossed the Lyskamm, one of the classical traverses in the Alps. The West peak is 4491m ascending slightly to the East peak at 4527m. It is an exposed ridge stretching for about 2km with stunning views, as if suspended in space over its north face. I love the awareness that such situations create. I feel alive and confident in my abilities, knowing that I am no more likely to stumble as I would when going downstairs at home.

Only on the last day, very early in the morning on an icy traverse between Zumsteinspitze (4452m, 14th peak) and Dunantspitze (4632m, 15th peak) did I become fearful and start thinking about my family. I immediately had to remind myself, that this did not serve my purpose, and I must focus entirely on the task at hand – making a safe step.

Why I love mountaineering

These mental demands are part of the fascination of mountaineering for me. Climbers require very balanced skills. They need finely honed techniques, physical strength and endurance and a strong mental focus. The importance of the overall mental challenge should not be underestimated.

Our group of four was led by two mountain guides, so that the crucial elements of risk management, planning and decision making were delegated to experienced professionals. Nevertheless, even with this support the ability to overcome fear, to concentrate completely on the task at hand and master the challenges presented is essential to success.

During the tour, I experienced many moments of doubt. I was surprised and worried about how tired I was already after day two. I was very nervous of the technical challenges of the Lyskamm on day three, and the long fourth day which included no fewer than seven 4,000m peaks. On that morning, I felt too tired to eat much and my legs were like lead after only an hour or two of walking. Luckily with the guides’ support, some rye bread, dried meat and cheese topped up with tea helped stabilise my condition. I felt much better after a couple of hours. But my doubts about whether I could complete the tour continued even into day five.

The mountain hut experience

We spent the night of day four on the Signalkuppe at 4554m. The Italian Alpine Club (CAI) has built a mountain hut right on top of the summit, called La Capanna Regina Margherita. Even if you are well acclimatised, that is a very high place to sleep. At this altitude, the oxygen content of the air is almost half what it is a sea level. The body cannot recuperate as it would be able to at lower altitude.

DSC00910 (2)
Capanna Regina Margherita: the highest mountain lodge in the Alps

Needless to say, mountain huts are not typically very comfortable places. Beds are in tightly packed dormitories. You can purchase a limited selection of food and drinks. Accommodation includes a set evening meal and breakfast offered between about 4 and 8am, depending on when your planned tour starts.  Water is usually only available for washing in cold and limited quantities.

The Capanna Regina Margherita has no water supply at all.  If you think about it, it’s not surprising, because where would you get water on a mountain summit? The toilet is a small tin clad room with a hole in the floor. There is hospital antiseptic concentrate to clean your hands.

All in all, I didn’t feel much like eating, but we sat down to the most stunning meal that I’ve eaten for a long time: a carrot and ginger soup garnished with a deep fried, crispy topping, then a salad of different tomatoes and burrata, then two sorts of pasta with aubergines and sweet red pepper. The main dish was roast lamb infused with garlic and copious quantities of rosemary on a bed of crisp, but perfectly cooked cabbage, accompanied by Italian fried potatoes. Oh, and I almost forgot the beetroot salad! For dessert there were shortcake biscuits, little black and white chocolate coins and water melon. It was probably one of the most wonderful and surreal experiences of my life. I believe that it helped me to manage the final day!

As I write this, I am still somehow in a trance. I haven’t really understood what happened. I can’t really believe that I managed to climb 16 4,000m peaks in five days, when a little over 18 months ago, I could barely walk.

What does this success mean to me?

People have always suffered from rheumatic diseases. My mountaineering success is mainly due to an effective combination of medications to treat my AS. I am incredibly grateful for this treatment. Through my contacts both through the Swiss AS Association and my family, I know that many sufferers do not find a way to handle the disease, which makes a normal life possible. I am very lucky and privileged. However, I live on a knife’s edge, always attentive to aches and pains, knowing that there is not yet a cure for AS and therefore my situation could change. For many people for whom effective treatment has not yet been found, life is just about carrying on and making the best of it. I know this myself and often reflect on the years before diagnosis, where I spent so much energy just trying to get through the day.

What does my climbing achievement mean to me? It closes the dark times of unrelenting pain and exhaustion as AS was active. The memories were still very present, but now I feel that I can move on. It has shown that with this treatment I can do things that I could not do for a least the last 20 years. It shows that some effective medical treatments are now available.

I’m still very tired, but already reflecting on what mountaineering projects I could do next year. I’ve also noticed that in the last couple of weeks I’ve been free of back pain. Exercise seems to really be important for me. Ideally, I would do hours of sport every day instead of sitting (or standing) at a desk, and then I might not have backache any more. Finally, I now have a job at the Institute of Arthritis Research where I am responsible for fundraising for more research. This climb gives me a strong sense of purpose to support efforts to find better treatments and cures for many more people. That is my next dream. It’s a much bigger project than climbing mountains, but from AS and this climbing trip I’ve learnt to take life one step at a time.

A plea for more Arthritis research

The combination of two substances that make up my treatment is not yet recommended by ASAS (Assessment of SpondyloArthritis International Society) or EULAR (European League Against Rheumatism), because there has not been sufficient evidence presented to show that the treatment works.

Secondly, the high costs and unknown long-term risks of treatment means that the treatment is not freely prescribed. Finally, only a small proportion of all arthritis patients are helped by the medication I receive – for most others there are only symptomatic therapies, such as anti-inflammatories and other painkillers or joint replacement. Musculoskeletal disorders is the disease group responsible for the highest combined direct and indirect health costs (more than CHF 20 bn per year) of all non-communicable diseases in Switzerland. I wonder why arthritis research receives so little attention?

My climbing achievement despite AS shows that medical treatments are now available to help people affected by arthritis to live full lives. But at present only a privileged few are benefiting. More research is needed to relieve suffering, to prevent and ultimately to cure.

The final tour

Day 1.   Roccia Nera 4075m

Day 2.   Pollux 4092m and Castor 4223m

Day 3.   Felikhorn 4087m, Lyskamm traverse over the Westgipfel 4479m and Ostgipfel 4527m

Day 4.   Punta Giordani 4046m, Piramide Vincent 4215m, Balmenhorn 4167m, Corno Nero 4321m, Ludwigshöhe 4341m, Parrotspitze 4432m, Signalkuppe 4554m

Day 5.   Zumsteinspitze 4563 m, Dunantspitze 4632m, Dufourspitze 4634m

Thanks

Mountain climbing team Monte Rosa tour
From top left: David, Judith, Rick, Christian, Roman and Oliver

I couldn’t have done this alone.  My gratitude goes out to all the staff at the huts, including, of course, the chef of the Cabanna Regina Margherita.  Our guides, Roman and Christian, from Bergpunkt AG, gave us a perfect combination of professionality, care and friendship. My rope partners, Rick, David and Oliver were the best companions I could imagine on this journey. Lukas and Melina supported and believed in me, as did many friends and my family both in Switzerland and the UK.

The photos are by Roman Hinder, Bergpunkt AG (1,3), David Isliker (4,5,6), and myself (2)

Journey is destination

What’s next

With the help of a new medical treatment, my health had improved beyond recognition.  However, I did feel that this drug regime was not the whole solution, because I still had aches in my back and other joints sometimes, which showed that AS hadn’t been stopped entirely.  When I took up sport again, it realised that the more I could exercise my body, the less pain I had.  I want so much to live again without pain.  I learnt of patients for whom the medication stopped working after a while.  Maybe the long-term outlook would be better, if I took lots of exercise.

At the same time, being too preoccupied with keeping healthy might let the disease determine too much in my life.  I still find it difficult to find the balance between ignoring the diagnosis and just enjoying life, and respecting it as a part of me and giving it space.  I’d had back pain and other health problems for such a long time, but no diagnosis. It takes a while to realise that I’m not just neurotic and imagining it.  I would plan carefully with respect towards my body.

Mountaineering preparations

Young ibex at a salt lick in Swiss Alps
Young ibex get attracted to a salt lick near the mountain hut

In late mountain Springtime (June), the climbing and hiking season had begun, so out I went. That helped me to develop basic fitness. I saw beautiful landscapes, birds and animals.  With friends from the Swiss Alpine Club (SAC) we walked in the Bächlital in the Grimsel area, or to the Grand Muveran on the border between Vaud and the Valais.

View of Grand Combin
View across the Valais in Switzerland to the Grand Combin

In addition, my physiotherapist recommended some specific training the gym and I enrolled for a 3-month course at a local fitness centre.  So now I am lifting weights and doing some funny exercises on very strange looking machines.  It is surprising how much difference those rather comical exercises make.  If they didn’t make a difference, I probably would stop, because I find them rather monotonous and it needs discipline to do them regularly.  I really admire the people who go regularly to Fitness centres!

Matterhorn
The imposing form of the Matterhorn

But what is the point of all this? What mountain tour am I going to attempt? The first mountain that I thought of was the Matterhorn.  Isn’t it the icon of Switzerland, if not of mountains worldwide? That would be cool! I’ve never climbed the Matterhorn.  But I go to the mountains is to be in wild nature and to find quietness and solitude.  That’s not so easy on the Matterhorn in August.  Every fine day there will be about 120 people queuing up to go up the popular Hornli ridge to the summit.

Finally, I decided on a 5-day tour in the Monte Rosa, a mountain massif located between Valais and the Piedmont and Aosta Valley.  It includes some the wildest glaciers in Europe, the highest mountain in Switzerland (Dufourspitze) and the twin mountains Castor and Pollux, which I always wanted to climb because my zodiac sign is Gemini.

A local mountaineering tour company offer a very challenging 5-day program staying in mountain huts in Switzerland and Italy and including 15 4’000m peaks.

Day 1.  Roccia Nera 4057m

Day 2.  Pollux 4092m and Castor 4223m

Day 3.  Lyskamm traverse over the the Westgipfel 4479m and Ostgipfel 4527m

Day 4.  Punta Giordani 4046m, Piramide Vincent 4215m, Balmenhorn 4167m, Corno Nero 4321m, Ludwigshöhe 4341m, Parrotspitze 4432m, Signalkuppe 4554m

Day 5.  Zumsteinspitze 4563 m, Dufourspitze 4634m and Nordend 4609m

That is quite a daunting project.

But I keep reminding myself: “the journey is the destination”.

How it all started

There are big unforeseen events in our lives that we never forget. Do you remember what you were doing when you heard about 9/11, when John Lennon or Ueli Steck died? In the same way, I bet everyone with Spondyloarthritis or other nasty diseases remembers when they got the diagnosis, and learnt that the cause of their symptoms has a name.

I can also remember my first attack of strange low backache very clearly. I was 24 years old. At the time, I couldn’t have known that this backache would become important, and yet intuitively I sensed its significance. I was a student and had just got a fantastic Summer Job looking after 3 race horses.  I remember taking a hot bath and willing with all my strength that the pain should go away.  It did – for a while.

Equestrian riding contest in Southern Germany Judith Safford
Equestrian contest in Southern Germany

However, from that point on the pain kept coming back. My whole adult life was plagued by phases of severe back- and neckache and stiffness. I often felt totally exhausted and was frequently ill. Sometimes doctors found something wrong with me. Mostly the symptoms went away for a bit by themselves, and I got on with life. The good times often lasted a year or two.

Diagnosis

Now fast forward 31 years to the day I got the diagnosis at the age of 55 that I had axial Spondyloarthritis (AS), an incurable rheumatic disease. Of course, it was a life-changing event; finally, I had an explanation. Answering the questionnaire at the Rheumatologists was almost surreal. The questions exactly fitted me! I felt enormous relief that my suffering had a name.  I felt amazement at how I had managed so long.  I felt bitterness at doctors who over the years had told me that I had a curved spine, too heavy periods or psychosomatic problems. I felt shame that I hadn’t thought of it myself. My grandfather had AS, as does my brother, but I’d been told many years ago that women don’t get AS, and had never questioned that information.  Finally, I felt sadness and fear. AS is an autoimmune rheumatic disease, which means that my own immune system attacks me and makes me ill.  Therefore, a cure is very difficult, if not impossible. I read horror stories about it on the internet, and dry medical summaries about the difficulties of treatment and possible development.  My grandfather died young, and I’d seen my brother’s years of suffering.  How was I going to manage?

I asked my Rheumatologist if he could be mistaken.  He said there was no other disease that caused the changes to my spine that he could see on the MRI.  So, Spondyloarthritis was a part of me.  A part that I really thought I didn’t want.  I couldn’t see any good in having AS at all.

The big flare-up

The diagnosis coincided with a big flare up.  I was in unrelenting pain, could hardly walk when I got up in the morning, and spent nearly an hour doing exercises to reduce the stiffness.  The rest of the day it felt like walking through deep mud.  The exhaustion – “fatigue” as it’s called – of an autoimmune disorder is hard to describe. I often had this overwhelming desire just to lie down exactly where I was, close my eyes and switch off. I wonder if people noticed.  I think they did.  Sometimes I still want to contact such people, and explain. “Sorry that I acted so uninterested in you that day, sorry that I didn’t really engage with you, please don’t take it personally!”

The big flare up was probably partly caused by stress.  Life had been horrible in the year preceding diagnosis, both professionally and personally. The pain and exhaustion were never ending and instead of going away again, as my symptoms always had in the past, they just got worse and worse.  I lost my job and felt as if I was fading out of life.

Like most rheumatic diseases Spondyloarthritis is not fully understood and there is certainly no cure at present. But there are now some treatments that improve life for many people.  My rheumatologist suggested that I try one: a medication called a TNF inhibitor.  It helps the majority of patients.  Given regularly by infusion or injection it would suppress my immune system, thus stopping my body from attacking itself and making me ill.  But, doesn’t the immune system have a rather important function, which I need?  This treatment would be backed up by a weekly injection of a medication mainly known for its use in Chemotherapy.  Won’t my hair fall out?

I looked on the internet again and scrolled through pages of side effects and warnings. Long term effects? Unknown. I was already taking 12 different sorts of pills, mainly painkillers, but also treatment for loss of bone density, a fungal infection, some alternative medication and some pills to reduce the side effects of other medication. These new drugs didn’t seem appealing at all.  So, I said no to more medication.  I had been doing yoga in the morning for 30 years already, because it loosened me up.  I had practised a lot of sport.  I meditated to reduce stress.  I ate very healthily.  Now I would be even more disciplined about sport and eating and sleeping and stress reduction.  I would get back control of my body without putting more poison into it.

That’s what I thought.  But this time, it just didn’t work.  It didn’t matter what I did, I just got thinner, and weaker. The only real pain relief was opiates, which made me feel blurrily nice, but like a zombie.  I took them in the evening, lay down on the sofa in despair in front of the TV.

The turning point

As winter came, weighing 49 kg and totally consumed by never-ending pain, I gave in. OK, let’s give the immunosuppressant a try.  I wanted to go to London and visit my family at Christmas and hoped that I could start treatment before the trip.  I was very disappointed that this didn’t look possible.  A range of check-ups were needed before treatment could begin.  Firstly, there were some inoculations to do.  Then there were checks that I didn’t have a form of hidden TB.  I had travelled to East Africa the year before.  So, the doctor made sure that I wasn’t carrying some nasty disease from there. My dentist decided to take two teeth out that might go bad and get infected.  The whole procedure took several weeks and I was very tense during this period, but thanks to the doctors’ effort, it was just possible to fit in my first treatment before Christmas, on the 23rd December. Phew!

It went fine.  The staff at the hospital looked after me wonderfully.  They even gave me tea with real milk. A rare treat in Switzerland, where tea is generally served with cream. You probably think I’m nuts, but details mattered. I really liked that.

I didn’t feel any different immediately, but that’s normal. Everybody reacts differently to the treatment. Some people take up to 6 weeks to feel the effects. And sadly, for quite a few people it doesn’t work at all.

Happy Christmas!

London with Melina smallThe next day was Christmas Eve and I was flying to London with my two teenage kids.  I was happy to be seeing my family.  I was happy that the infusion had been without problems.  And having initially resisted treatment, I was now very positive about it. I was pretty sure that it would work. Although I could no longer walk more than a few yards, I didn’t mind on that day. A neighbour drove us to the station.  At the airport, I had ordered wheel-chair.  We got on the plane first all by ourselves.  Even the passengers with Speedy Boarding had to wait.  My kids were quite embarrassed.

But at my mum’s house in London I slept very badly.  The mattress was old and lumpy. In England, we celebrate Christmas on the 25th but I woke that day feeling like I’d spent the night in a tumble dryer.

Judith Safford in London park
First days after treatment

My mum loves to go to the Church service on Christmas Day. We walked together very slowly and stiffly to the Church. And that was the amazing thing: I was stiff, but the pain had receded and I could walk those 300 meters! The congregation sang the old Christmas Carols from my childhood and I cried my eyes out through the whole service.  I felt properly alive for the first time in months.  My own personal miracle had happened.

The next day we walked to the park.  Every day on that London trip I could walk a bit further.  I started doing some simple yoga exercises in the morning.  For months, I been telling myself that I was not my body, because my body gave me nothing but pain and misery.  Now within days of the infusion, I was walking with a level of discomfort which painkillers could now control.  I was starting to enjoy life again.

Where do I go from here?

In the months that followed, I slowly weaned myself from NSAIDs (Nonsteroidal anti-inflammatory drugs) and other painkillers. But I still had a lot to do to pick up my life again.  And new things to think about.  If Spondyloarthritis is incurable, what does that mean?  It is a part of me that is here to stay, whether I want it or not.  How will I manage?  Am I frightened?  Is there any good in having AS?  How does it limit me?  Or can I maybe do new things that I couldn’t do before the diagnosis?  Do I want to change my life, or can I carry on as before?

Since my student days, I’d always loved mountains and am an enthusiastic climber. In summer I go on hikes, alpine or rock climbs. In winter, I love to walk up on skis and then ski down again.  After my miraculous health improvement, I wanted most of all to spend time again in the Alps. For many months, I’d barely been able to walk. Now with the support of my physiotherapist, I made rapid progress. Soon I cautiously tried skiing and by Spring I’d made my first ski mountaineering tour. I noticed that I had more endurance and flexibility than I had for many years.  Slowly the idea formed itself that I could test my limits and try to do things that hadn’t been possible for many years. Maybe I wanted to show my AS who was in charge of my life now. But above all I noticed that the more I moved my stiff joints, the better I felt.

The call of the hills

OLYMPUS DIGITAL CAMERA

That’s how I got the idea to train and attempt a big mountain tour in the summer. I want to experience myself in the high Alps again, test my limits and find out what is possible for me with AS. In the next blogs I will tell the story of this project. It’s an exciting prospect for me, although it’s strange to feel that whether I reach those summits is no longer the most important thing. “Der Weg ist das Ziel” as they say here. The journey is the destination. Is that something that Spondyloarthritis has taught me?