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View Full Version : Returning to Colorado Early, HAPE


AxleIke
05-19-2014, 05:37 PM
Hello all,

As I posted in another thread, I was set to go up to Summit Station Greenland to assist in a drilling project through some collaborators in Rochester, NY.

I left on May 10th, and arrived on station May 14th.

Being at an actual altitude of 10,600 or so, and a pressure altitude of 11,300 to 11,700 depending on the day, I was obviously not worried at all about any altitude issues nor having any problems acclimating. And, for the first 2 days I had none. The only real difference in this ascent vs any in CO is doing a sea level to 11k + jump in an hour.

The first day, I was out and about checking cargo, and getting the usual safety briefings for snow mobiles and small tracked vehicles called Tuckers. Second day, I took a snow mobile journey out to our actual camp, which, despite being wicked cold (wind chill ~ -70C, actual ambient temp ~-32 C), was good. Set up some tents out there for sleeping, as well as unloaded some drill cargo, and began a few other small projects. Left there and headed back to the main station for dinner and bed.

That night (2nd night at altitude sleeping) it was pretty cold (-36 to -38C) and I awoke at about 1:30 am with a cough. I could not stop, and it rapidly progressed to a wet cough, and eventually I could not catch my breath and it felt and sounded like I was breathing out through a straw blowing bubbles through liquid. I assumed it was the cold, so at 4am, I headed into the station.

On the way in, I was a tad dizzy and a bit disoriented, but only after hacking for a bit and spitting out some bloody liquid did I realize I should be headed for the medic station. Got there, O2 was at about 72, pulse pretty elevated, and I was a bit out of it. Got put in a Gamow bag (a portable pressure chamber) for an hour, but only had enough to get down to around 5k feet, which is obviously my normal elevation. This, along with some O2 from the tank got my stats up into the 90s.

The medic suggested a flight out to get checked out, but I refused, and he agreed to monitor me for the day. I spend a couple hours in the station, and then went back to my tent to sleep it off. This didn't work because laying down made it worse. I listened to my Ipod for a while, and finally got out of my bag and organized my gear. I was convinced I was feeling better, despite still coughing up blood.

The medic came to my tent, asked me how I was doing. I replied, "Great! I'm good to go. Give me a snow mobile, and I'll head out to our camp and get to work". He asked, "you still spitting up blood?" "Yeah, but I'm sure that is just for a bit longer, it'll get better", I said.

So, he hooks up the O2 monitor and my pulse was up, O2 at 75. He says to me, "I'm going to be totally straight with you. You are NOT going to camp. There is a bird on the ground fueling right now that brought some people in earlier today. It leaves in 30-45 minutes. You are getting on it, so pack your bags. End of discussion."

So I did, and was pretty clumsy walking back to the station to await further orders. I further insisted that I was fine, I didn't need to go out, and I was ready to get to work. I was also over reacting to everything. The low O2 really makes an impact on your judgement, and your ability to think rationally. I could only focus on getting out to camp, and was totally ambivalent to anything else.

The plane we took out was a small ski plane, unpressurized, which made things worse. I lost the ability to remember how long I was at station, how long my wife and I had been together, what day it was. After a bit, the realization that I was unable to think straight sunk in, and I panicked. Luckily, the RN from the station was brilliant and was able to calm me down quickly, and get me to relax, and take in what little of the oxygen tank I could. My nose was clogged up from the O2 drying it out, and the cold and everything, and every breath hurt pretty bad. Deep breaths set off fits of coughing that were even more painful.

I arrived at Ilulissat, Greenland to a hospital where they xrayed and confirmed Pulmonary Edema. They gave me lots of things, but, because of the language barrier, i was only able to figure out a few of them. A major difference in hospital procedure from the US: no gloves for the nurses administering IV and shots. But, I was too out of it to do much. The floors were also quite dirty (lots of silt from the mud and glacial silt outside). I mean I get that, but it just struck me as odd for a hospital.

The next day there was lots of bed rest, constant oxygen, and nothing to do but sit in bed. Luckily the hospital was on the edge of the Fjord, and it was beautiful to look out the window and watch ice burgs and fishing boats go by at any time of day because it doesn't get dark.

Yesterday I was able to get off oxygen after an xray showing the edema gone, and only mild inflammation/irritation. I was able to go outside, which was a godsend. I walked around and took pictures, and hiked over to an outflow glacier and took pictures of the huge ice burgs just flowing out to sea.

Today I have made it back to Kangerlussaq and am flying out on 109th ANG flight to NY Tomorrow, and will be back in CO on Wednesday morning.

After reading much, and the doctor getting advice from doctors in Denmark, it seems that I need 3-6 weeks of recovery time before attempting to return up to the station due to the rapid ascent requirements. Generally after a few days, a slow ascent can be tried (according to mountaineering websites) but because that is impossible, I need a full recovery before giving it ago again. Which means this season is out.

At the time I didn't realize how serious this condition was, and that you can actually die from it. So, I am VERY glad and thankful that the medical crew on station knew what they were doing, and insisted upon a medivac. I was not thinking clearly, and had it not been for the others, I would not have made the right choice.

Thanks for reading the saga, I'm bummed to be back so soon, but happy to be be on the mend and actually able to come back walking rather than anything worse.

Peace,

Isaac

DaveInDenver
05-19-2014, 05:54 PM
Glad you finally relented and let them treat you. Pulmonary and cerebral edema takes the lives of more climbers than technical accidents by far. Pulmonary is as you've found pretty uncomfortable but the cerebral swelling (which you probably had, too) leads people to make very bad decisions. So medics familiar know that the person will think everything's fine. You should read the stories of Everest and other trips, people think they are in Hawaii and start stripping layers, get confused and walk off the mountain and other really weird stuff.

Acclimation is the key, even a good diet & hydration, being fit and careful you can get altitude sickness, just the roll of the dice sometimes. I doubt they'll let you go again soon, you do need to recover since you stressed your body, but maybe see if your doctor will prescribe Diamox if you try again. It's kind of a band-aid but some climbers take it as a prophylactic during ascents.

Good to hear you're on the mend, definitely.

MountainGoat
05-19-2014, 05:58 PM
Damn Isaac, that is a scary story. :eek: Glad you got back in decent shape man! :)

rover67
05-19-2014, 06:11 PM
holy **** dude, I'm glad you're ok! thanks for telling the story!!

holy smokes..

MDH33
05-19-2014, 06:22 PM
Glad you're ok! :thumb:

Sounds like you have a cool job, what do you do? Just back from New Zealand and off to Greenland?

Hulk
05-19-2014, 06:47 PM
At the time I didn't realize how serious this condition was, and that you can actually die from it. So, I am VERY glad and thankful that the medical crew on station knew what they were doing, and insisted upon a medivac. I was not thinking clearly, and had it not been for the others, I would not have made the right choice.


Glad you are OK. Is there any chance you already had something -- the flu or a virus -- that might have contributed to the Pulmonary Edema? Maybe you won't have to deal with this when you go back.

A major difference in hospital procedure from the US: no gloves for the nurses administering IV and shots.

Gloves are for their protection, not yours. It's a common misperception. When I worked at the blood bank, we had a number of phlebotomists who wouldn't use gloves because the material of the gloves interfered with their ability to feel and hit the vein with the needle. It was their choice, although they would always put them on when asked.

LARGEONE
05-19-2014, 07:16 PM
Man, Isaac...so glad to hear you're alive to tell about it.

Dave is right...more people die on high mountains for this reason than any other. This is why climbers spend so much time at each camp to acclimate.

ttubb
05-19-2014, 07:43 PM
We have had some hunters die of PE in the high country before. Nothing to mess with. Glad you are OK.

AxleIke
05-19-2014, 07:49 PM
Thanks all.

Yeah, they gave me some stuff for cerebral edema, but I don't know what it was as the nurse only knew the Danish word.

Dave, relented isn't the right word. They just told me what i was doing. The camp is remote, evacuation is touchy at best (weather changes rapidly), and if there is a plane that can go, and they want you on it, you are going on it. They don't have the resources to treat for long up there, and they won't waste them unless you are stuck. I wasn't, so I wasn't staying.

I've been on Diamox and steroids according to the ANG medic who looked at my paperwork and is helping with my transport. The climbing sites list some other, strong meds, which I will talk to the doc about when I get back.

Matt, I was healthy as a horse before I left, and when I was up there. I literally had no symptoms until the onset. Interesting that gloves are a choice. I never knew. Makes me feel better though.

Acclimation will be a big help. I haven't been to that elevation really since last summer. Even hunting this year was only at 10300 or so, just where we found the animals. Online research (I know, not the best) says HAPE is not well understood and can hit anyone at anytime, so being prepared to deal with it (mostly having the whole group prepared in case anyone gets it, they can be brought down safely and carefully.

Given the situation I think this year is out. Next year I will be sure to try and ski and get up to the mountains a bunch before going. Can't hurt. Still will bring the meds. Of course, assuming I get invited back :D

Martin, I'm in Grad school doing climate science. My collaborators are studying C14 production in the snow layers on top of the ice sheets (Greenland and Antarctica) which interferes with past atmospheric signals/reconstructions. They needed a guy good with the technical and okay with the cold, so they asked me to go. The New Zealand trip was for my own project as one of my advisors is down there, and invited me to come down to work with her.

60wag
05-19-2014, 09:43 PM
Wow, interesting story. Living in Colorado tends to make you think you are immune to altitude related problems. Thanks for sharing the details.

Jenny Cruiser
05-19-2014, 09:49 PM
Props to that medic! :thumb:

subzali
05-19-2014, 11:00 PM
Glad to hear you've gotten good care Isaac, that's scary. Does anybody know if one is more or less susceptible to contracting HAPE or HACE again once it has been contracted once?

wesintl
05-19-2014, 11:21 PM
now you realize how people on Everest die pretty easily. Pulmonary Edema is interesting how it effects different people and rise of ascent. I normally don't have any issues with alt either but i could feel it when at the aguille du midi The 9000ft + cable car rise in a short amount of time .

Glad they have people to spot this and get you to safety.

Fishy
05-19-2014, 11:29 PM
Glad to hear you're ok. I too think it's fascinating how some people are more susceptible than others, regardless of the level of fitness. The stuff that happens above 8000M is amazing to me.

I'll PM you in a few days when you're rested up. I'd like to share your story on a few things.

Jenny Cruiser
05-19-2014, 11:32 PM
Glad to hear you've gotten good care Isaac, that's scary. Does anybody know if one is more or less susceptible to contracting HAPE or HACE again once it has been contracted once?

Having it once does put you at higher risk, but doesn't guarantee that you'll get it again. He prolly just went up way too fast. If he consumed alcohol at all while there that could also be a factor.

Inukshuk
05-19-2014, 11:34 PM
Glad you are going to recover.

AxleIke
05-20-2014, 03:56 AM
No booze at all even in the days leading up to the ascent.

Matt, I've now been told both things. I'm obviously going to a doctor upon return to CO, and I'll see what they say. I plan to have meds on hand to help in the future, just in case.

Thanks all. And Fishy, I should be all good by Thursday (getting settled in and all), so feel free to PM any time, and I'll get back to you as soon as I can.

Cheers!

nattybumppo
05-20-2014, 09:58 AM
I had that once. In December 1981 I drove non-stop from Hanover New Hampshire to Breckenridge, then the next day went skiing hard at Vail. Sure enough, symptoms similar to what you described put me down and out. I was staying with my cousin, a doctor, who guessed correctly it was HAPE (didn't make sense to me since Summit County/Vail is not that high). He drove me down to Boulder to see the HAPE specialist there who confirmed his diagnosis. One ski vacation ruined. I chalked it up to the "nothing can hurt me" attitude I carried around with me those days, and learned that I possessed the same human frailties everybody else did. Right there on the spot I gave up any hope of climbing Everest!

I'm glad everything worked out so well for you, Issac, and sorry you missed your adventure this time, but I'm sure there will be more!

Jacket
05-22-2014, 01:14 PM
Holy cow dude. That's crazy. Coughing up blood is serious ****. Glad you bailed out in time. Maybe the opportunity will come up again and you can try a different approach to acclimatizing.

Romer
05-22-2014, 01:31 PM
Glad your OK man. At least you have been on an adventure and have a story to tell about it

AxleIke
05-22-2014, 06:04 PM
Thank guys. Unfortunately Matt, there is only one approach. I will try to acclimatize better before the next go around. Probably spending a month in NZ at sea level before heading out didn't help, but many folks there came from sea level. Its just too uncertain at this point.

Story for sure. Not that excited about it yet. The loss of rationality is something I'm still struggling with to be sure. Actually more so than the actual illness.

Rezarf
05-25-2014, 03:03 PM
Wow man, glad. You are on the mend, that's some spooky stuff.