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I was airlifted from trail camp
#7802 09/26/10 04:31 PM
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I started the Mt whitney trail at 0530 on 8/24/10 alone. I was planning on just doing part of the trail anyway. I had done trail camp 3 yrs ago.
I had just been to high elevation with a group 2-3 days prior.
we hiked to 12000 and 11000 feet near Bishop.
I remember going to Lone Pine lake and took a picture at 0700.
I dont remember anything past the lake but I must have hiked to trail camp because my last picture on my camera says 1205.
I stumbled into some doctors camp and was confused and had a seizure. (My first seizure in my life)
They saw me at 4:00 pm
They called search and rescue or 911. All I remember is waking up 4 days later in ICU in the hospital in Reno,NV.
They said that I almost died because I had electrolyte imbalance.

I had cerebral edema, pulmonary edema, hypothermia. I ended up being in the hospital 3 wks 2 days total in Reno.
This was a scary experience.
I had stayed in a campsite the night before a few miles down the road from the portal and slept in my car, but that morning did not go to my bear box to get food or my usual bottle of sunscreen.
I thought maybe I was already getting hypoxic but just did not know it yet. I had my backpak in the hospital with me and no indication of any food was in the backpak.
I did have my camel pak of water and a water bottle holder but no bottle and tablets to treat water.
It is all a mystery to me. I have no memory of this incident at all. I have been to high elevation many times and nothing like this ever happened.
So I guess the lesson learned is expect the unexpected.

Re: I was airlifted from trail camp
pattywatty #7809 09/26/10 06:34 PM
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I excerpted a few salient points:
Originally Posted By: pattywatty

I dont remember anything past the lake but I must have hiked to trail camp because my last picture on my camera says 1205.
I stumbled into some doctors camp and was confused and had a seizure. (My first seizure in my life)
They said that I almost died because I had electrolyte imbalance.
I had cerebral edema, pulmonary edema, hypothermia.

I had stayed in a campsite the night before a few miles down the road from the portal and slept in my car, but that morning did not go to my bear box to get food or my usual bottle of sunscreen.
I thought maybe I was already getting hypoxic but just did not know it yet.


You were indeed very lucky to survive. As a physician with high altitude experience, I can only give you some very unofficial words because I was not there, and did not care for you. By posting here, I know that you are searching to understand what happened. See if this helps:

Your description of unawareness beforehand does suggest that you already had AMS rapidly progressing to HACE and HAPE. HACE, in particular, has reputation for going from good to bad in a hurry. Your seizure sounds related to the degree of hypoxia. The electrolyte disturbance and hypothermia was likely not a cause of all of this, but a result of your entire system crashing. (You mentioned not having seizure disorder before, and I assume you do not have Type 1 diabetes or some other metabolic disorder). So AMS progressing to HACE/HAPE seems to explain it all, even on a mountain with just moderate altitude like Whitney. Everyone has their own sensitivity threshold.

The only way I can guess any other diagnosis is that you just coincidentally had your first seizure for non-altitude reasons. Severe hypoxia from a seizure can cause all sorts of problems, incl brain edema and a type of pulmonary edema called ARDS that looks a lot like HAPE. It can also cause electrolyte imbalance and post-ictal (after the seizure) hyperthermia or hypothermia. But this whole scenario is less likely than obeying the rule,
"Illness at altitude is high altitude illness until proven otherwise."

For more information , please see
AMS Guide
there are links to several levels of discussions. I hope this helps.


Last edited by Harvey Lankford; 09/26/10 07:00 PM.
Re: I was airlifted from trail camp
Harvey Lankford #7810 09/26/10 07:06 PM
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Thanks Harvey for replying.
Yes I keep analyzing this whole incident. I only wish I was aware of symptoms early on so that I could have turned back.

I have seen a neurologist recently. I have been taking dilantin 300 mg. He said I now have to be on meds for 2-3 yrs.
I was shocked I have to be on for so long for just 1 seizure and with no history of seizures.
Patty

Re: I was airlifted from trail camp
pattywatty #7817 09/26/10 08:47 PM
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Patty,

Thanks for sharing your story. It's a good reminder to me as a solo hiker to really be aware of my suroundings and my body. I hope you didn't pass other hikers that didn't notice you may be in some type of distress. You were very fortunate to have encoutered medical personal on the mountain.

When I'm hiking by myself, I know it is my responsibility to have the right gear and make the correct decisions to stay alive, but sometimes 'stuff' happens and we need assistance. I hope other hikers would lend me a hand as I have offered assistance to others when they need it.

I really hope you fully recover and get back to enjoying hiking and the great outdoors.

Re: I was airlifted from trail camp
pattywatty #7818 09/26/10 08:58 PM
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I would suggest a second opinion. If Harvey is correct that the seizure was possibly secondary to HACE then I would want someone elses opinion about having to take ant-seizure meds for 2-3 years. Especially if they haven't diagnosed the cause.It sure sounds to reason Harveys expert opinion that this was AMS with HAPE/HACE. With no prior history of seizures then being at altitude AMS sure sounds like a reasonable cause of your seizure as well as all your other signs and symptoms.Second even third opinions are always good ideas IMO.

Re: I was airlifted from trail camp
Rod #7831 09/27/10 12:04 AM
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First, I hope you are feeling much better and have a full recovery. Regarding some of the comments, and some other thoughts.

She has already had a second opinion. There is no doubt that she was seen by a neurologist in the ICU. no doubt. There would have been an exhaustive search for the cause. When no cause can be found, it is termed "idiopathic" (unknown cause) seizure disorder. The most common type is epilepsy. I would be suspicious of the electrolyte disorder, but know nothing about the specifics in this case. Some are associated with seizures. By the way, there may have been another, unwitness seizure accounting for the memory loss earlier. Hard to know.

Once a person has had a seizure, a whole series of things happens. You are required by law to lose your driver's license in Ca. Generally, if you have no seizure in a year ON MEDICATION, a physician may certify that, and the DMV MAY give the license back. If, during that year, you have a blood level of anti-seizure medication that is subtheraputic (which usually means you are not taking the drug), the DMV will usually NOT return the license.

Once a person has a seizure for any reason, they are FAR more likely to have another. Each time it becomes easier. The current state of thinking is to protect a person for 2-3 years against that possibility, before withdrawing the protection, and seeing what happens. ( a nervous time for all. ) If a test of electrical activity of the brain demonstrates abnormal electrical activity, a drug would not be withdrawn, as a person is VERY likely to experience another seizure.

Of course, like Harvey, I've not been involved in this particular case, and my comments are only general.

Re: I was airlifted from trail camp
Ken #7833 09/27/10 06:03 AM
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Ken, I agree with you.

Rod, you may be thinking that without a "structural" problem the seizure might not return. Not so. Once the wires are crossed, so to speak, there is risk.

If it were me, I would want to use an anticonvulsant. The risk to not do that is significant, as Ken has pointed out. Rod, you seem to be anti-medication on various posts, but it might save a life, eh?

The same seizure rule with DMV applies here in VA. Relies on voluntary reporting so many are not.

Re: I was airlifted from trail camp
Harvey Lankford #7835 09/27/10 08:08 AM
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We went through the seizure med "Russian Roulette" in my family, when my sister had an idiopathic seizure some years back. It took her two more seizures(luckily, they were at night in bed) before she got her act together and took the meds (habitual meds at a young age take some adjustment)Over a period of two or three years, with diligent monitoring, the docs were able to lower and lower the dosage, so that it is now very much a maintenance level (they determined that she needed to stay on the meds)


The body betrays and the weather conspires, hopefully, not on the same day.
Re: I was airlifted from trail camp
CaT #7868 09/27/10 11:18 PM
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If the convulsions where just that convulsions due to AMS most likely HACE and a lack of food and water leading to low blood sugar and an an electrolyte imbalance maybe a seizure never really happened. It is possible a seizure was improperly diagnosed while on the mountain. Depends what the work-ups show and what the EEG and subsequent EEG reveal. Hate to be saddled with a seizure diagnosis is it never really happened especially if it was really HACE/HAPE and hypoxia causing seizure like symptoms. Do we really know from the information given that a true seizure occurred?

Re: I was airlifted from trail camp
Rod #7869 09/27/10 11:44 PM
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Originally Posted By: Rod
maybe a seizure never really happened.


I dunno. Generally, an "episode" witnessed by a lay person is usually enough. According to the OP, it was witnessed by a physician.

Re: I was airlifted from trail camp
Ken #9043 11/07/10 11:52 PM
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Following up on this thread, I contacted Patty to see how she was doing, and to maybe find out more about her experience. She gave me the ok to write about her situation.

She still has no memory of her hike beyond Lone Pine Lake, but from her camera, it showed she hiked and took pictures all the way up to Trail Camp, at 12,000' elevation.

The unusual thing is that she slept low, at Lone Pine campground, elev. 5900', got up in the morning, and did not think to get her food for a day hike out of the bear box. It is sure odd, because she had been hiking for five days before with a Sierra Club group up to 11,000 and 12,000'. Two years before, she even hiked the Inca Trail (13,600') in Peru with no trouble.

Patty wrote:
Quote:
I suppose the lesson I learned is not to hike by myself because I was not aware of any of these symptoms. If I had someone with me hopefully they would have recognized the symptoms and would have sent me back down. And I suppose being acclimated for a few days before your hike doesn't mean you wont get high altitude sickness or HACE or HAPE.

I never had anything like this happen before and I have been at high elevation before at 14000-15000 feet.
I suppose this was a wake call for me because the doctors said that I almost died, because of electrolyte imbalance and respiratory arrest.


Her picture at Trail Camp was taken at 12:05, but she had the seizure there around 4 PM. Helicopter took her out at 1830.

So I am wondering what she did for those 4 hours, wandering around, unaware of her condition. Luckily she wandered into the right people at Trail Camp when she had the seizure. As she writes, "I wish I knew who the doctors were that were camping at trail camp and found me. They are the ones that saved my life."

Incidentally, her helicopter evacuation cost was paid by her insurance: $1700 to Lone Pine, then $18000 to Reno.

Patty has not been able to return to her full-time job as a flight attendant, since she is taking seizure medicine. But she is also a nurse and is able to do that.

Re: I was airlifted from trail camp
Steve C #9065 11/09/10 09:17 PM
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Patty, first I wish you a full recovery and I want to thank you for sharing it with us. For me this was an eye opening and made me realize how important it is to have a 'buddy system' on my hikes.

All the best,

Nei


Always happy to meet new hiking friends.

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