Casey, thanks for sharing your great trip. I am glad to see somebody knows how to catch those fish!
It is pretty clear to me that you had a classic case of AMS. There are several things you can do next time.
1. Since you are so susceptible, get a prescription for Diamox (Acetazolamide), and start taking it (in small doses 62.5 or 125 mg) twice a day, a day before you start at altitude. It doesn't prevent AMS, but it helps. Try it for a day at home to see if you have any bad side effects (Do NOT take larger doses!)
2. Carry a lighter pack. You should be able to get it down to 30 lbs. The exhaustion makes the AMS worse!
3. Make SURE you drink lots of water -- at least a pint an hour. At altitude, most people don't feel thirsty and don't drink enough. If you aren't peeing every few hours, or if it is extra yellow, you aren't drinking enough. (By the way, I don't filter the water -- most of it is just fine to drink.)
4. Acclimate way more. One night at Lone Pine lake just gets the AMS started. That is not acclimating. You should spend two nights at Horseshoe Meadows. Or since you are a good fisherman, drive up to the end of the road at Rock Creek (near Crowley Lake, hike in several miles (easy hiking) and fish during the day. Head back to the car and sleep overnight. Here's a map of the area:
Ruby Lake
