This report is about an amazing hike to the summit of Mt Whitney and a subsequent case of HAPE. For all of us who spend countless hours researching every possible thing that can go wrong on the mountain and preparing for it all, most do not even think about the possibility of HAPE as it is considerably rare.
Little history on myself. I'm in my early 40's and in excellent physical shape. I'm very active in pretty much every type of sport and have been an avid hiker for many years. Our decision to hike Whitney was made in January of this year, so I increased the intensity and frequency of my gym visits and put together a consistent regimen of weekly hikes and runs. I was already in physical shape for the one-day hike of Whitney, but mentally I wanted to ensure the trip was easy so I could truly enjoy the vas beauty of the mountain during the ascent.
Although I lived most of my life in the Pacific NW, I currently live close to sea level in Southern Cal (OC), so I included the typical training regimen of high altitude hikes. The only time I had any sign of any mountain sickness was Baldy, where I experienced very mild nausea on the summit, which went away after 10 minutes of rest. Although it seemed like we hiked very slowly as I'm not use to frequent rests during hikes, we reached the summit in just over 2 hours, which included a 20 minute rest at the ski hut.
I'm somewhat of a health/nutrition buff, so my preparation included a strict regimen of pre-hydration (4-6 liters water every day the two weeks prior to trip, more on work-out days), additional electrolytes to balance water intake (love NUUN tablets - also use in our hydration packs while hiking), liquid chlorophyll (although I slacked off the last week prior to hike), ginkgo biloba (don't know if it works for AMS, I take for other reasons), heavy diet of fish and green food, very limited alcohol, Glucosamine/Condroitin, Chia Seeds (they are part of my regular diet - I either soak them in water and then add to my juice, or I sprinkle them in my smoothies or other food items), and a high antioxidant beverage to help with recovery (athletes need much more antioxidants than non-active persons). Outside of the increase in water intake, I pretty much always follow a healthy diet (I need every edge I can get to make sure I can still out-hike my husband who is younger ).
I also had a prescription for Diamox, which I have never used before.
We arrived in Lone Pine early Saturday morning (13th) and headed for Horseshoe Meadows (10,000') for a short hike to Cottonwood Pass (~11,200 according to my GPS). I had taken just under 100mg of extended release Diamox the night before. I suffered the normal side effects of Diamox - frequent urination and taste sensitivity). Our hike was very easy, mostly shaded and just under 8 miles RT. I completely emptied my 3l Camelback during the hike, but didn't realize until later that my liquid intake did not off-set the side-effect of frequent urination. My ER doctor was negative toward the use of Diamox, as it can cause dehydration and you don't know it until it's too late.
On Sunday, we hung out at Whitney Portal, hiked the trail as far as you could without a permit, and spent the latter part of the day prepping our stuff for the next day's hike and very early morning. We stayed at a one of the Motel's in Lone Pine.
The next day we began our hike at 3am. Scouting the trail the day before made the trek in the dark much more enjoyable. We also had the help of headlamps and a beautiful moon.
We made pretty good time, even with our frequent stops to take pictures or take in the sights. We had planned to enjoy ourselves during the hike and not make it a race to the top - which was initially tough for me as I'm more of a power hiker.
We reached the summit just before noon, which included a 30 minute stop in the meadows and 30 minutes at Trail Camp. It was such a beautiful day, it was challenging to not stop and enjoy it.
The switchbacks were easier than I expected, conquering them in an hour and 30 minutes. We also hung out at Trail Creast for a while - so many amazing views from this location.
We probably spent too much time on the summit - an hour and 30 minutes, but we weren't in a hurry. I felt no symptoms of AMS outside of tightness in my head every once in a while. I also developed a slight cough, which I contributed to the increase of my breathing rate. My appetite was questionable, but not totally off. Some things - like my Twix candy bar, were awesome, and other things, like my tuna salad pita, I couldn't bring within a foot of my mouth.
My water intake on my ascent wasn't to par with my regular hiking. I only went through 3L on my ascent and another 1L from the summit to the first water source on our decent down the switchbacks. I used another 3L from the switchbacks to the Portal.
I felt great from the summit to Trail Camp, which we covered very quickly. At that point, my coughing was a little worse - but again, I didn't suspect anything but dry throat due to rapid breathing. My pace also started to slow and I started to feel very fatigued, which was completely out of norm for me. When I hike or run trails, I typically get a second wind and run a significant portion of my miles.
When we reached the meadows, I stopped to double up my socks. The fatigue was also causing pains in areas of my body that I had never had before, which was both confusing and frustrating. I had already taken 600mg of IB on the summit, so I knew some pain was already being masked.
By the time we reached Outpost Camp, I wasn't sure how I was going to make it down, at least in a decent time. I could hike very slowly, but covering 3.8 miles at a slow pace didn't seem like a good option. Outside of pain, fatigue, and coughing, I didn't have any other symptoms that you would associate with mountain sicknesses. I took another 600mg of IB to help with the last leg of the descent and I gave my backpack to my husband, which was only 12 pounds, but it helped.
Not knowing what I was doing was wrong, I covered the last 3.8 miles without stopping and at the fastest pace my body could handle, and mostly in the dark. All I could think of was getting off the mountain. We reached the Portal at 7:30pm. Our descent took us 6 hours, which was pretty good considering my struggles.
Made it back to our Motel in Lone Pine, picked up dinner along the way, which I couldn't bring myself to eat. A hot shower never sounded so good, yet felt so bad. The hot water was actually cold when it hit my back. For the first time I noticed I still had a shortness of breath. My resting heart rate was at 113, a far cry from my normal rate of 55, and I was running a fever. It was 90 degrees outside and all I wanted to do was cover up with 10 blankets while my husband was shedding clothes. I did a little research and decided I should go to the hospital since my symptoms were getting worse.
To my surprise, Lone Pine has an ER and hospital. Actually they have 4 acute patient rooms and 33 rooms for elderly nursing care. I was thankful for this as the next hospital of choice is in Mammoth, and we didn't have a positive experience with their ER a couple years ago (my husband broke his back snowboarding).
The ER/hospital doctor and nurses were great. Along with every other person I came in contact with. I was diagnosed with moderate HAPE and AMS. Although I didn't have the usual outward symptoms of AMS, my labs showed different. I can't begin to describe how off my blood work was - they couldn't believe I had made it off the mountain on my own. The first 24 hours my conditions worsened to severe HAPE. I gained 20 pounds of fluids during the same time. At first I questioned the accuracy of their scales, but one look in the mirror and truth be told. One positive thing - my face was filled out and I had lost most of my wrinkles - at least temporarily.
I spent three days in the Lone Pine hospital. My x-rays didn't show improvement, but my labs did. I was also diagnosed with Pleural Effusions, which were a complication of the HAPE, and significantly slowing my recovery. It took almost 10 days to get my breathing and constant coughing under control.
In regards to myself, I learned a lot from this trip:
- Excellent physical fitness and acclimatization training does not make you exempt from getting sick on the mountain.
- Diamox is good for mountain sickness, but also bad. The side effect of increased urine output can cause dehydration. Water intake must be increased significantly to offset fluid loss.
- Focus on deeper breathing while at high altitude. Short breaths help contribute to fluid build-up in the lower portion of your lungs.
- If your pace slows up more than normal, stop and monitor your recovery - not just in time, but more importantly, count your heart rate. If after a short rest, your heart rate does not go down, there can be reason for concern.
- Coughing is not a good sign, especially if there are crackles.
- Make sure your hiking partner is well versed on all mountain sicknesses - not just headache/nausea. They are your eyes and ears when your brain and body is not functioning normally.
- You should be hungry after 22 miles and 17 hours on a mountain. When the thought of those yummy Whitney Portal french fries I had eyed they day before (and promised myself after my day on the mountain) didn't even sound appetizing, then I should have known something was wrong.
- I'm not sure hiking Whitney in one day is the right thing for everybody, even with proper acclimatization at 9-10,000' feet. Climbing over 6,000 feet in one day to a high altitude is stressful on the body - and I don't mean in the physical way. Us "sea-level sissies" need to take even more precautions.
- Limit time on the summit, where you're most exposed to lower oxygen levels. Eat, drink, take pictures, and short rest. If needed, I would spend more time resting at lower altitudes such as Trail Camp.
- If you are experiencing signs of HAPE (coughing with crackles, shortness of breath at rest and not recovering easily, fatigue out of normal), do not push yourself hard on descent, it could place even further stress on your body and worsen your conditions. My rapid descent caused my conditions to worsen.
- During busy months, the Lone Pine hospital might have a couple HAPE cases a week. They have also had a few deaths over this summer.
- It is very important to monitor your conditions and your hiking partner's conditions at all times - if something is wrong, don't let it get worse.
- This message board is the best - I have consistently read for almost a year. Really helped me prepare.
I'm recovering nicely, although still coughing when my heart rate increases or I take a deep breath. Much better than not being able to sit up on my own or lay flat while enduring really bad chest pains (couldn't take good pain meds as it slows your breathing and worsens HAPE).
Mentally, I'm ready to head back up the mountain to conquer it versus it conquering me. Next time I'm taking the Mountaineer's route and spending a few nights on the mountain and enjoying my french fries at the Whitney store.