H.A.P.E almost got me

“Was skiing at Vail for a few days. Had the classic altitude sickness symptoms. Crushing headache, nausea etc.

After the third day of skiing I went to bed, as soon as I laid down, my lungs filled up with fluid. Was drowning all nihgt. Went tothe emergency room the next morning. Had a blood/oxygen level of 56 (normal is 95-100); x-ray showed lungs full of fluid. High Altitude Pulmonary Edema [HAPE].

Lots of fun.

Was on oxygen in the E-room for 6 hours, then headed back to denver with an oxygen supply to last me until I got on the plane.

Still tired, although am feeling better each day (this was one week ago this morning).”

“Wow, lee, that sounds horrible!

Glad you are feeling better, take care of yourself!”

“Wow; I've had the minor symptoms, but never anything like that.

lee, how high were you?”

“Thanks Fritz --

I was staying at 8500 feet (Vail Village) and skiing at between 10500 and 11,500. The day I got nailed we spent quite awhile sitting in the sun at 11,500 feet. Between that, and having had a few margueritas the night before, some sort of line was crossed between normal altitude sickness . . .and HAPE. HAPE is not necessarily a progressive reaction to altitude. They are not sure exactly what triggers one person to walk away with a headache, and the next to have their lungs fill up.”

“SnowDude is susceptible to HAPE. After reading about it and talking to the ranger, we figured alcohol is a contributor. SD had drinks the night before each incident. Since he quit drinking before hiking, (and acclimatizing a few days) it hasn't happened.

Our friend got it after snowboarding at Mammoth too. She had to be driven to Bishop, 4,000' for the night before going home. (pink foam at the mouth?) She also quit drinking while up there.

Glad you're ok.”

“On all the week long hikes I have been on, they have all been above 9000' for 90% or more of the time.

We always bring bourbon, vodka, or eveclear. Not one of us has ever experienced altitude sickness like that.

Must have been the smoke, mushrooms and peyote that kept us 'normal'.”

“S.Nymph --

Yup. I figure next time. 1) diamox, 2) more time in Denver, 3) no alcohol.

I didn't drink (no appetite for it) except one night. I had 3 margaritas and a beer (not even that much!) . . .but I got HAPE after skiing the next day. I can't rule out the connection.

I never turned on my light the night i was coughing. I would lie in one postion . . .cough for 10-20 minutes to clear my lungs, and then sleep. Coughing produced a tremendous amount of fluid, most of which I swallowed. Some I coughed into a kleenx, and the kleenx was pink/orange the next morning . . .so I assume that their was some frothy blood involved.”

“yikes!! what a nightmare!”

“SnowDude was backpacking all the time when this was happening, and he works out a lot, so he's in good shape. Most of the time he was fine with the altitude. We were a little concerned when he got it twice in one year. He also takes Diamox at the beginning of the season now, along with no alcohol & going up a few days early. Good luck!”

“Thats got to suck!

In july it will be my first time at 8000 to 10000 I just hope I don't get it!

I am glad you are ok.

Get well soon!

8|”

“Glad your fine now. That's gotta suck!! Since I don't drink maybe I'll never get to enjoy that feeling.”

“lee, I didn't catch what altitude you live at (hanging prep noted). I never here of people who live around here getting it (5000+ ft) who ski regularly at 9-10,000. I've never had a problem.”

“Dehydration contributes to altitude sicknesses.”

“Who would've thought this happens at a ski resort. You would think this happens to people who go way up in the backcountry. Get well soon Lee.”

“And alcohol contributes to dehydration”

“We go to happy hour on Saturday night after snowboarding, but he's never had a problem on the slopes. I've had a slight hangover from drinking too much. We carry Cytomax with us on the slopes to rehydrate. Good stuff!”

“Lee, I'm so sorry. That sounds perfectly horrible! I hope you get better very quickly and wish you all the luck in the world avoiding it in the future.”

“Dehydration shouldn't have been an issue. I was chugging water constantly. While skiing I was carrry a bottle that I refilled several times.

Pathman -- I live at 500 feet above sea level.”

“Sounds like all the classic donts being done.
Alchhol.
Dehydration.
Too high, too fast.

Diamox is good, but.
It disguises symptoms.
It only works if you take it a couple of days before you go high.
It makes you pee, so you have to drink even more fluids.

You were lucky 1st Aid was so close, you could have been in all sorts of problems.

Climb High, Sleep Low.”

“Lee -

I had a similar situation a couple of years ago in the Rockies. I went unconscious after coming down from 10,000-12,000 feet. The NPS guys called EMS. After hours in the hospital, when I could sit up without my blood pressure crashing, I was discharged. Quite an experience to live through. For me, it really made me examine my priorities.


For those wishing to read details, I have them posted at:

Scrapbook Adventures ”

“Sorry to hear about that, Lee. I must be one of the lucky ones, because I haven't been affected yet. Hope you are back in good shape, soon.”

“Bunyip --

I wish that the causal connections and answers were as easy. HAPE is NOT as simple to undertand as acute mountain sickness

1) I spent 24 hours in Parker, CO (6000 feet) and an additional 72 hours at 8500 before HAPE got me.

Although I am sure acclimitization WAS a factor, I did have a fair amount before going to altitude.

2) Hydration was NOT an issue. I regularly have 124 oz of water a day or more. In Vail I was drinking MORE than that. I was skiing with a liter sized bottle of water that I refilled several times. I embarrassed my friends on more than one occasion by peeing in the middle of the back bowls at Vail.

3) Alcohol. I didn't drink for the first 3 nights I was in Colorado. The third night I had 3-4 drinks. I think that alcohol was contributory, but not in a simplistic fashion.


I don't mean to be defensive. It is just that I DID follow what were prescribed to be the "best" practices for avoiding altitude problem. I did NOT get off the plane, go to altitude, ski, not hydrate and drink alcolhol and caffiene.

I assidiously avoided making these mistakes.

It is apparent, however, that I was not extreme enough. I should have taken LONGER to get acclimitized, and I should have had NO alcohol on night three.

HOWEVER, as a said before . . .there is NOT a bright line progression from altitude sickness to HAPE. HAPE is something else.

One can get acute mountain sickness, vomit and pass out, without having the lungs fill up with frothy bloody liquid.

HAPE is the result of pressure from the pulmonary arteries pumping blood into the aveolli (sp??!)[the cappillaries in the lungs], the pressure overwhelms the cappallaries causing them to leak into the lung. The lungs fill with fluid, essentially drowning the afflicted person. Very similiar to the effects of pnemonia (present similarly on an xray). Difference is the frothy blood in HAPE and the lack of fever/infection/heavy mucus associated with pnemonia.

Anyone can get HAPE, but it seems most closely associated with people who have different stresses/pressures/tensions in the lungs. e.g. a weak spot on the wall of a balloon. When you blow it up, the weak spot distorts and stretches more.

Because of complications at birth (a diaphramatic hernia), my right lung is weaker than my left. The pulmonary artery is smaller and less developed.

My left lung filled up more than my right. My pulomary Doctor's conjecture is that the left lung was working harder, applying more pressure to its capallaries, and as a result the edema started and my lungs filled up.

Thanks for all the notes of concern.


I am encouraged by Snow Dudes persistence. I was/am somewhat grumpy that the holy grail of hiking and skiing (the big mountains of the west) may have been put out of my reach by something like this (now if I can just convince my wife that I will befine).”

“Lee, it sounds like you should continue to visit the mountains for high altitude activities only as long as you are close to medical facilities and always with a companion who can get you to those medical facilities at a moment's notice. I am glad that you survived, are doing better now, and learned that this is something you personally need to watch out for. It is good that you took the precautions that you did, because now you know that for you, it wasn't enough.”

“Lee, don't stop going. Pay attention to the signs. You know the symptoms.

SnowDude was hospitalized (and helicoptered out) the first time, late 80s. The next 3 times (98, and twice in 2000) we aborted our trip ASAP. He also drinks more water than anyone I know. It just happens.”

“HAPE (high altitude pulmonary edema) and HACE (high altitude cerebral edema) are, as far as I'm aware, forms of AMS (acute mountain sickness) which can occur from altitudes of 5580ft and over.

Didnt your mates at any stage during the 3 days suggest that you should descend? It sounds like you had all the classic symptoms.

You found out you have a preconditon for it and are aware of the symptoms so that evil bugger wont get you again.

I congratulate you on being ballsy enough to tell others of what you went through.”

“Bunyip, where'd you get the 5580' figure you cited? I thought it actually had no set altitude, but was at least a couple thousand feet higher.

I got what I'm sure was AMS while climbing Mt. Baker (10,775') but didn't feel the effects until I was probably above 9200' or so.

After that, I had my doctor prescribe Diamox before my Mt. Rainier trip and it made a huge difference.”

“Nah, that's the insidious nature of AMS. It can affect anybody at almost any height over 1850m.

My source is from a Lonely Planet Guide, "Trekking In The Nepal Himalaya", the health section was written by David R. Shlim MD, Medical Director Himalayan Rescue Association.
I was using that as an extreme example, most other guide books state that AMS can occur over 2000m but has been known to occur much lower.
If Lee was able to spend a week at 1900m, maybe he wouldn't have had such a quick onset of HAPE.
In these days of 1 week or if your lucky 2 week vacations, Diamox seems like a wonderful solution. I've never taken it as I've always allowed time to acclimatise.In 5 trips over 5000m I haven't suffered anything more serious than a throbbing headache. Who knows it might get me on the next trip.

In reading I've also found another altitude related problem. HAFE, high altitude flatulence emission. And here I was blaming those lentil curries!”

“How's about a couple-a plates of beans then some SCUBA down to about 120 feet?

Glad you're doing better, Lee. I had a little run-in with the garden variety headache and nausea at about 10K once... no fun! Now that was a case of classic screw-ups, LOL... Caffeine, alcohol, dehydration, no acclimation... Ah, to be young and stupid again!”

“I have never been over 5000 ft so should I worry about it?

I am in very good shape and I go backpacking every weekend?

I am showing great worry about this now????

The trip is 8000 to 10000 down to 6000 for the Montana trip.

Do you guys think I am going to be ok.

Also I am driveing to Montana so when I get out of the car what alt will I be at?And will that help?”

“Lee - Interesting info about weak spots in the lungs being a possible contributor to HAPE. I was in a car accident in college and suffered a punctured lung. May explain why I've had problems with HAPE.

BTW, SnowNymph gets HAFE all the time.”

“Crazy,
I'd read up on it as much as possible. I would think at least you can expect a ripper headache, possibly for a couple of days. Thats the cute thing about AMS, you could fit young and healthy and cop it big time.

I certainly would not let this stop me from going! If you are really worried, get some Diamox, just remember that it's a diuretic and you'll want to know where the nearest tree/toilet is.”

“Crazy Mike I really don't think you'll have any problems. Last July in Montana a friend and I varied between 5500 and 10000 and really didn’t notice anything, no head aches nothing. Both of us are from areas that have an average elevation around 700 ft. Yes there were times when were sluggish but in order to see as much big sky as possible we averaged covering 20 miles per day. Of course I hear it all depends on the individual.”

“All right I will stop worring about it and pick up the pills from my doctor just in case!

Thank you guys!

8)”