Mt. Whitney Portal Store & Hostel Forums General Mt. Whitney Portal Store Message Board Caring for Someone w/ Alt Sickness

Four or six of us are starting our first assent to Mt. Whitney. We hiked Mt San Gorgonio last week, and one of us got hit with headache and exhaustion at about 10,500 feet. When we substantially lightened his pack, he charged up the rest of the mountain. In the event that someone gets Altitude sickness, how do we judge the responsibility of the rest of the group to care for that person if it manifests itself as:

Headache and exhaustion?
Nausea?
HACE or HAPE?

Thanks

In my humble opinion,

In a summit attempt, any adult willing to put themselves in that position, and is in an able condition to care for themselves should do just that and take appropriate measures. Of course this is subjective to the situation (health, abilities, relationships, weather, etc). If it is a guided group (this is also subjective) a guide should descend with the affected person.

If there is concern from the group or the affected person, or there is an obvious reason that they will not be able to care fore themselves then someone must be chosen to assist the individual.

Again, this is only my opinion.

Avraham,

My two cents worth...

If you leave as a party you should return as a party. That is why it is so important to know the strengths and weaknesses of each individual in your party.

First of all I think the extent of the persons illness needs judged. If the person is in a low level of AMS then it's probably safe to send them back down or leave them be while you finish.

That being said... If you know that this individual has issues above a certain altitude then you, as a group, need to figure out a way to make it better for this guy. If it can't be worked around or dealt with then you need to find a place where he will be safe (medically and otherwise) to leave him and then you and the rest of the party can summit. If this means leaving him at Trail Camp (or lower) to hold down the tent while you and the rest go... then maybe thats what it needs to be. However... if you get to 13600 at teh top of the switchbacks and realize that he's having issues.. you can't tell him to stay there or try to send him back on his own. There are to many risks inherent with sending a sick man back on his own or leaving him by the side of the trail to wait for you and the rest of the party to come back down.

SoCalGirl has the right idea.

Several years ago we came across an evacuation of a wife of a very determined and goal oriented man. It was near 13,000'. She had been ill for over 48 hours and had been prodded by her husband to continue. He obviously was bringing his college football coach's experience to bear, "You can do it. Come on a little more. Don't be a wimp - push it. No pain to gain. DO IT WOMAN!" types of encouragements.

She had HACE onset symptoms, eyes dialated, unresponsive to commands and not able to stand or sit up with out assistance, not communicative. She was definitely in the wrong place with the wrong family member.

EVERY non-acclimated person has altitude induced symptoms above 10,000'. For most they are minor. For many they are slowed down sometimes A LOT. For a few, they become severe enough that they are very noticeable by the recipient. They will usually complain or if they try to tough it out, it will become apparent to others. If the symptoms are similar to flu with nausea or vomiting, headache and listlessness, for the weekend warrior, it is really not worth the aggravation to continue on. It would be best to escort that one down lower by at least one responsible person. They will feel better shortly and only a part of the vacation will be redirected. No need to stay sick if you can fix it quickly.

If it is enough to be very noticeably uncomfortable, it will not get any better staying high. It will not only ruin his but your trip as well. Might as well get them down and let the rest of the party continue on - or re-plan the trip to take into account an acclimatization issue.

If there are rales (noises in the chest), coughing and gurgling (HAPE); or vision, staggering or communication problems (HACE), that person should be transported quickly to the nearest care facility for observation. Your chances of experiencing this are pretty slim in the lower 48.

Assuming we're not talking about children, there's no reason for everyone in the group to exit if one person is starting to exhibit symptons of altitude sickness. If they are minor symptons (headaches), that person should be responsible and turn arround to start heading down, preferably with an escort... if it is truly altitude sickness, this is the only option.

I disagree with "staying at trail camp and holding down the fort"... who's to say that the syptoms will not continue to get worse, and if the person is alone, this could develop into a much worse situation.

Obviously if the person is starting to exhibit any type of disorientation or more severe symptons, then at least one person MUST accompany them down to lower elevations... preferably two in case one must be dispatched for help, but there's still no reason why everyone in the group should turn arround, unless they choose to.

But I have to wonder if your partner actually was experiencing altitude sickness when, after "substantially lightening his load" was able to "charge" up the mountain. San Gorgonio can be a pretty intense hike... it sounds more that he wasn't as conditioned as the rest of you for a hike like this.

Ultimately, It is the individual's responsibility to take care of himself. His party is does not know how his body is reacting to elevation. Do not take a headache higher and know the symptoms of AMS, headache, nausea, malaise, loss of appetite and vomiting. Most can be dealt with by the individual...if they don't let the symptoms spin out of control.

The problem with Mt. Whitney is Mt. Whitney. That is, everyone has invested in a lot of time and money in this trip...this year it includes ~$120 in gasoline from SoCal. So, to ask all to give up a dream for an individual with a big headache is too much to ask. Especially, all that is required for this person to get better is to descend...possibly as little as 500' to 1,000'.

Neither HACE nor HAPE will likely be the problem, I seen one person in the Sierra with HAPE in a dozen years or so. Therefore, you will most likely be dealing with AMS.

A headache at 10,500', should be a trigger for your partner to have a conversation with doctor about Diamox and what it can do to help. BTW, don't expect the doctor to be conversant on the subject; therefore, go prepared to make your case for a prescription.

Please, don't just bail out on a sick person! Take care of each other out there.

I spoke with the victim who was evacuated by helicopter from Iceberg Lake, so I will try my best to be accurate.

This last Spring, a group of hikers flew into Las Vegas from the Great Lakes area, got into a rental car, drove to the Portal and got out and started hiking in the middle of the night. Off to a bad start!

Heading up the MR, when one of the group began feeling ill, the group, who consider themselves experienced mountaineers, did not stop or turn around to take care of him because he was "outnumbered". His health deteriorated as they continued.

The helicopter in Independence was busy, so a CHP helicopter was brought in from the Fresno area, at a very expensive rate, and leaving it's base area without a helicopter. Weather didn't allow an immediate landing, so it flew back and forth a couple times...$$$$ big time! Inyo Co. tax payer $$.

The next morning I spoke with the victim who was concerned about his group that continued on saying "we might need to get another helicopter up there, my group hasn't come down yet".

Rather than come down immediately after their "friend" was helicoptered down and check on him at the hospital, they continued their hike as planned. It was reported that they should have been down to the Portal by midnight (meaning they were hiking at night in winter conditions). They came out later that day.

This was preventable!
This case of HAPE was only a symptom of a series of very poor decisions. The actions the group took after the helicopter rescue was a testament to this, as the bad decision making continued!

So, I pose this question:
Was this truly HAPE, or was it one of or a combination of, exhaustion, conditioning/acclimation, dehydration, hypothermia, nutrient deficiency, stress/mental fatigue...?

Plan ahead, be prepared, don't be this guy!

Have Fun!
~DougC

Thanks RangerDoug for the information. Are you an Inyo National Forest ranger? If so, thanks again, and we will look forward to hearing more from you in the future.

Speed of ascent? Indeed...

When I can take time to acclimate, altitude isn't much of a problem for me...but a fast ascent will bring on symptoms quickly, to wit:

A couple of years ago, my son and I were out in Hawaii to "climb" (read, "drive up") Mauna Kea, 13,796', the HI highpoint. Basically, you're staying at sea level in Hilo. You hop in the car, drive up to the Onizuka Visitor Center at 9,000' and stay there an hour or so to "acclimate." (yeah, right)

You then hop back in the car and drive up to one of the observatory parking lots at about 13,600' and walk 1/4 mile and the last 200' up to the cinder cone that is the actual summit.

From there, we spent an hour or so wandering around the summit area and looking at quite a few $billion in various taxpayer (US and elsewhere) dollars in the telescope "farm" on top of Mauna Kea.

By the time we were ready to head down, I was coughing and feeling like I had a significant chest cold...incipient HAPE, I strongly suspect. Having gone from sea level to almost 14,000' in the period of 2 hours or less, I wasn't surprised.

Once we drove back to sea level, the symptoms subsided quickly and I was fine. I would not have wanted to spend all day at the summit...

Yeh, I work for Inyo NF, mostly on the main trail.

I think a lot of high elevation sickness in the Sierras is preventable. If you want to climb Mt. Whitney and not get a headache, have tingling and swelling extremities, vomit, and experience an altered state of consciousness, plan ahead and be prepared!

Plan to: Get plenty of rest, get in shape, acclimate to high elevations, hydrate before and during the hike, eat nutritious meals, don't rush or race, have attainable goals, keep an eye on each other.

Be prepared to: Stop and turn around and try again some other time!

The advice doesn't get any better than that RangerDoug.Of course that is the advice repeated over and over. Hopefully coming from someone in your position it will carry an extra weight of authority. Thanks

Identifying AMS can be tricky. I live at sea level and regularly hike above 10,000'. The best defenses for AMS are: 1) slow ascent, 2) hydrate (consistently several days before the hike and while heading up), 3) aspirin or advil as a prophylactic works for some, 4) prescription Diamox, and 5) REPEAT: ascend slowly. Most people from sea level will get a bit light headed, headachy, and/or interrupted sleep above 10,000'.

When I've hiked with others they are not always aware of their own symptoms of AMS--hiking partners, I now realize, may have to override what the ill person says. Hikers must also take responsibility for themselves and listen to their bodies. The mountain will be there another day, no need to risk major illness or worse. People who get headaches and feel lousy at 8,000' aren't going to feel better at 10,000' or higher. AMS doesn't resolve as you climb; it gets worse.

Here's an example: I hiked Mt. Whitney last summer for the first time, used Diamox, took two nights on the trail to aclimatize (Outpost and Trail, plus the first nite at the Portal) and had no problems at all. I was hungry, slept like a baby, and drank 4+ liters of water a day. For the record I'm 47, 125 lbs (carried a 40 lb pack), and I'm in good shape, but by no means a mega athlete.

I now know that my hiking buddy was having AMS (not just feeling bad). She's an RN and didn't recognize her own symptoms and just thought she felt lousy & tired, and I accepted her assessment. She opted to stay at Trail Camp--felt too worn out--and I went for the summit. On my way down at 12:30 I ran into her, she'd come to just beyond Trail Crest. She said she felt fine and would turn back within the hour. Long story short, word starting coming down to me from hikers that she was unwell (vomiting, headache, shaky)--at the top of Trail Crest. By 6 PM I started back up the switchbacks and found her about half way up being assisted down by a fellow hiker. I was scared that she wouldn't make it down. I wanted to take her down to Outpost Camp, but she was too pooped to hike down. She was better in a few hours (hydration, good calories--not just GU & Shock Blocs--and got through the night).

BIGGER QUESTION: Why do people want to go up Mt. Whitney so fast? Is it just to prove some kind of physical prowess? I don't get it. A one day trip starts in the dark with Mr. Bear chugging around at the Portal, on an unfamiliar trail. But more importantly, you are missing the beauty of the place if you charge up and down. I've read on this board that 67% of ascents are abandoned due to AMS. Why risk it? I took over 200 pictures last summer and still think I didn't take enough.

Slow down, take time to look around, rest, hydrate, spend the night (yes, you have to carry a heavier pack, but so what?), and enjoy. It is too beautiful and too much of an epic experience to not try to minimize your chance of illness and having to turn back too soon.

I'm heading back at the end of July for the same 4 day total "middle aged woman's" hike--I wouldn't do it any other way. I plan to take my time, rest every hour, and take even more pictures this time. See you on the trail!

Ranger Doug! WELCOME! I've often thought that it would be good to have perspective from those who work for the agency.

I've done trail projects for Jeff Novack, and know Calder. I've been a volunteer wilderness ranger on the Sierra NF.

I hope to meet you on a trip sometime!

Your advice is sage, and agrees with what many veterans post. It seems that every time I've been on the mountain, I've been involved with sick folks <sigh>

Thanks for the work you do!

Hi Karen,
Out of curiosity, now that you have hiked Whitney, do you have friends coming out of the woodwork saying that they "have always wanted to hike Whitney?" That happened to me on my first three day hikes when people in your category joined our group and had varying degrees of problems coming down (see Previous hikes). On my first hike the rest of the group split when I accompanied a person with leg cramps all the way down from Trail Crest. While I like to do day hikes on the main trail, I have enough personal experiences to recommend that people consider day hiking to Trail Camp for their first trip if they do not have the time/resources to do an overnight trip. I did a day hike to Trail Camp last October and got to see the fall colors in daylight.

Hi There Versatile Fred,
Yes, many people "talk" about wanting to hike Mt. Whitney. But, when I tell them what they have to do (training wise), only a select few remain interested. The stories of day hikers puking up their boots on the summit usually convinces them. I think many people underestimate what they're up against--primarily the altitude. A fall hike to Trail Camp sounds beautiful...I might give that a try.

Hopefully people planning the hike will find this board, as I did, and heed the advice of all the experienced folk. Everything from what to expect, a detailed map of the switchbacks, gear, conditions--it's all here. The hiking community is extremely generous with their knowledge for which I am very grateful. Another great resource is Paul Richins book: Mount Whitney--the complete trailhead to summit hiking guide. Helped me a lot.

Happy Hiking!

Thanks. Those are my sentiments as well. This message board was not around when I did my first three hikes.