HAPE

Wyoming, Wind River Range

(On August 20,1986, Dennis Fenstermacker [33] had to retreat from the Cirque of the Towers because of an attack of High Altitude Pulmonary Edema. Here is his account).

We left Seattle on a Friday morning to drive to Wyoming. We arrived at the Big Sandy trailhead on Saturday night and hiked into Big Sandy Lake. Sunday was an easy hike into the Cirque and that evening I hiked up a sub-peak to get a good view of the range. At this point I felt great although during the day I probably should have drunk more fluids than I did. On Monday I climbed nine short pitches on Pingora up to the 5.8 level and still felt very well with no loss of energy.

Tuesday morning I started to hike up to the South Watchtower. Barely 90 meters out of camp I was unusually tired and developing a headache. I was slowly able to get up the hill to the start of the climb and I did the first pitch, but by this time my headache was so severe that I decided it was best to descend. I rappelled down and spent the rest of the day watching other climbers in the Cirque. I was taking Empirin with codeine for my headache, but it didn’t go away.

Tuesday night I went to sleep with a headache. I awoke once to relieve myself and became completely winded walking only 20 meters. My breathing was labored and it took me an hour to recover and get back to sleep.

At midnight shortness of breath awoke me. I had extremely labored breathing, rales in my chest, and a splitting headache. People in the next tent said my breathing had awakened them also. I had to sit up to breathe or else the fluids in my lungs caused me to cough uncontrollably with great pain. At this point, it was obvious that I had high altitude pulmonary edema.

We elected to wait until morning to hike out. With the help of eight people, I was assisted over the pass and able to slowly hike out. The loss of altitude brought immediate relief. By the time I got to Big Sandy Lake, I felt pretty good but it still took eight hours to get to the trail head.

A checkup and X-ray in Jackson indicated severe fluid buildup in both lungs and some heart enlargement. The doctor felt that a six to 12 hour delay in reaching a lower altitude could have been fatal. This came as quite a shock since I had climbed above 6000 meters before and the Cirque of the Towers is generally under 3400 meters. (Source: Dennis Fenstermacker)

Analysis

Unusual fatigue and headache should be recognized as early HAPE indicators. It may be a good idea to rest a day or descend even at low altitude. Getting proper fluids even several days prior to a long driving trip and hot approach hike is recommended.

Climbing with a strong group who were ready to leave the Cirque after only two days of climbing and after a two day drive may have saved my life. They unselfishly gave up their climbing holiday to get me to medical attention. (Source: Dennis Fenstermacker)