“I have about a three and a half-litre lung capacity,” Lisa rasps at me as we plod up the rutted road toward Tanglangla, the ‘World’s Second Highest Motorable Pass’ at 5380m. “My Dad, who’s a lifelong smoker, and most other normal people have a lung capacity of five or more. I shouldn’t be here.”

Rasp, rasp, rasp.

None of us should be here. Not the seven runners who have signed on to tackle the 222km La Ultra The High, nor the 2-5 crew per runner.

But Lisa especially.

If you look past her asthma, her lead-in to this run isn’t exactly mountain goat material. She’s a desert runner specialist. Low and hot is how she likes it.

Here in the Ladakhi township of Leh, we sit out our ten-day acclimatization period at 3500m. Every day or so we trip up to the race route passes which top out at 5600m.

Expected altitudes were at the core of Lisa’s problem’s months earlier, too. Using an altitude acclimatization device back home, she suffered hypoxic concussion, tooth abyss, kidney problems and, bluntly, a fair swing at a trip to the Big Trail in the Sky when she dialed the thing up to 6500m “because she wasn’t feeling any different.”

She soon did and not to good effect.

Lisa Tamati takes in the view over Leh, where she has been acclimatising for two weeks readying for La Ultra

Then, after a good trot in The North Face 100 in the Blue Mountains, she twisted an ankle badly, pulling ligaments on a post event photo shoot.

But blown ankles wouldn’t keep Lisa from La Ultra.

Yesterday, with a 12km training walk/run to the top of Tanglangla, the second pass of the race, we had to stop for Lisa to say goodbye to some local pizza she had tried to refuel with.

Today she’s in bed with stomach cramps and zapped energy levels.

Not an ideal lead in, but she’s not alone.

Everyone here complains of the dry, oppressive heat during the day, the air clogged with fumes that make each breath an exercise in choking on a pair of dirty socks soaked in diesel. It’s enough for Dubai-based Australian racer Catherine Todd to call it a day and go home, exiting the race before starting it.

“I just can’t breath. I wake up nauseous, then an arm goes numb, it’s one thing after another. I’m  flying back to Dubai and then may head to Europe to do a 100 miler there, where at least I’ll feel healthy going in to it. Here I just don’t feel healthy.”

That’s what the atmosphere does to you here: it clogs your immune system. Enough for a tough nut like Cath – as well regarded adventure racer and ultra runner used to extreme conditions, decide it’s just not worth the pain.

Then there’s the waiting. Lisa has been here over two weeks now. There’s still another seven days until race start. That’s a long time for runners to be thinking about the dangers, to be bored, to be filling the mind with what ifs, to be analyzing the topography profiles, to be revising crew strategies, to be worrying about how the hell they’ll pull off a finish. No-one is really thinking about winning. It’s all about just surviving.

The waiting. The waiting. Things roll over in minds. Everything starts to annoy the runners who are fuelling up on tension. The slow service. The overbearing hotel manager. The spicy food. The routine imposed by race organisers. Everyone’s losing weight. Everyone’s wanting to do their own thing. Everyone’s second guessing what everyone else is doing.

You went up KardungLa? How’d you go? Feel sick? Headache?

Everyone wants to hear a yes, to know that others are weak, too.

But few admit to it.

“Fine, feeling fine, you?”

Lisa, who tends to externalise her negativity, lets it out. She’s scared. She feels like shit. She doesn’t know if she can do this. She can’t believe others aren’t as on edge. Why is Sharon Gayter (UK entrant) bouncing off walls after doing a marathon training run the other day? Nuts.

And back to the waiting. This, remember, is a place where two minute noodles take 45 minutes. The only thing that is fast is your taxi driver who just missed a donkey, an old lady carrying grass on her back, a monk, a stoned hippie tourist and a truck, all by an inch while tooting madly as though it was their fault your driver was on the wrong side of the road.

You’d tell everyone to take a deep breath and relax…if only there was enough air.

Postscript: race day is Aug 11. Competitors have 60 hours to complete the 222km course. After heading up to the second pass today with a few runners, the legendary Ray Sanchez, Aussie rocket Sam Gash, Sharon Gayter and Jason Rita, I tried to do the maths on them finishing it on the loooong, rough ride back to Leh. Our journey took 6 hours in a 4WD. We covered less than half the course. I have no idea how the six remaining runners will complete this course in 60 hours, if they can complete it at all. But it’s going to be an adventure for all finding out.