Mt. Whitney Portal Store & Hostel Forums General Mt. Whitney Portal Store Message Board Trying to understand what happened to me

Please forgive the extremely long post, but I had a frightening experience this past Monday, and trying to understand what happened. Any insight is greatly appreciated.

My original plan, was to sleep at the Portal on Sunday night, and take it very slowly, sleeping at Outpost Camp on Monday, Trail Camp on Tuesday, and then hopefully summit on Wednesday.

I had a permit for 2 people, and I think the first mistake was not canceling my trip when my partner bailed at the last minute. I have hiked by myself quite a bit, so I wasn't concerned, but I should have been. I got to the Portal as planned on Sunday. Had a great time just soaking up the atmosphere, eating, hydrating etc. and attempted to go to sleep around 9pm. Problem was, I couldn't sleep at all. Not a wink. I normally have problems sleeping before a big hike, so this didn't bother me. I continued to try to sleep until 4am, at which time a good many day hikers were heading up, and even with ear plugs I could hear them, so I then gave up and made myself some coffee. After picking up my permit and having an awesome breakfast at the Portal, (and I ate almost all of it), I started on the trail.

I have had issues with dehydration and loss of appetite in the past, so I paid special attention to these. I was eating snacks every hour, and drinking large amounts of fluid, (I had 3 liters of water and 1 liter of cytomax by the time I reached Outpost Camp). I don't feel I was dehydrated, because I drank all my water and Cytomax, and my urine was clear.

Despite not a wink of sleep, I felt surprisingly fantastic. Great appetite and energy level. I took things slow, as I have a chronic knee issue, but still did well. When I got to Outpost Camp, I remember feeling wonderful, and because I arrived earlier than expected, I wanted to take some photos of the meadow. I set up camp, filtered and drank more water, ate a full meal, (I was ravenous) and did my dishes. Out of the clear blue sky, I was suddenly overwhelmed by a fatigued feeling that I've never experienced before. The exhaustion hit me like a brick wall, but I chalked it up to not sleeping the night before. Luckily, everything was prepped for the morning, so even tho it was before 5pm, I decided to go to sleep.

I only slept for 1/2 hour, when I was awoken by a severe headache, the likes of which I have never experienced. I have migraines sometimes, and this was worse. I got out of the sleeping bag to get some Ibuprofen from the bear canister, and when I got back to my camp, there was a woman sitting there in shorts and a tank top, with no daypack visible. I thought it was kinda strange since I had all my clothes and a jacket on, and I was a bit chilled. The woman looked at me and said, "You're not feeling well…you better head back down. Don't worry, I'll walk with you". For some reason, (which is very unlike me) I just said, OK, and started packing up. I didn't even fold anything neatly, I just shoved stuff into my pack and started walking down ahead of her, without even thinking that it was starting to get late. I could hear her walking behind me, but because of the headache, I wasn't talking.

Less than a quarter mile down, I started to throw up. I turned around to talk to the lady who was walking with me to apologize for holding her up, but she wasn't there. At first, I was upset that she said she was going to walk with me, and then left me. It was further down the trail that I came to the frightening realization that she never existed in the first place.

My head was getting much worse, and with a kind of weird detachment, I noticed that I was unsteady, dizzy and stumbling around quite a bit. I remember being puzzled and thinking that since the elevation was decreasing, that I should start to feel better. Unfortunately, I started to feel much worse. When I reached Lone Pine Lake, I stopped to try to drink something, and when I looked up at the ridge, I had the most terrifying experience of my life. I saw corpses hanging from ropes attached to the mountain. There were tons of them, all in orange sleeping bags, with nooses around their necks, hanging from the mountain. It was at this point, that I knew I was in serious trouble, and am not ashamed to say I started to cry. It was now starting to get dark, and I knew I had to get down, so I got my headlamp out, and continued down.

The log crossing was incredibly difficult, as I was so unsteady and dizzy, and I thought I was going to fall. Shortly after that, I did fall several times, (and have the bruised knees to remind me) but I knew I was in big trouble, and just kept telling myself, "get down - keep going - keep going". I was becoming more disoriented and started seeing weird lights and animals crossing the trail, (animals that didn't make sense, like buffalo). All this time walking down, I was completely alone, and didn't see anyone, and I was terrified, particularly when I started having visual disturbances. I am quite sure this is just in my mind, but it looked like there was a dense fog, which made seeing the trail very difficult.

About halfway down, I had an overwhelming feeling to just lay down in the middle of the trail. It was very dark by now, and I was looking for headlamps of other people, but couldn't see any, and never did run into anyone. I didn't know how I was making it in the dark, stumbling around, but I would have these strange amounts of time that I didn't remember at all...coupled with certain times where I seemed to be a bit more lucid and aware. I decided to start counting steps out loud to try and keep focus. This caused me to realize that I wasn't speaking properly. so I knew I had to get down fast. I made it out to the Portal, still disoriented, nauseous and with an excruciating headache, and had trouble finding my car, even though it was close to the trailhead. When I finally found my car, I looked back up on the mountain and saw about 30 sets of headlamps, so I have no idea why I never ran across anyone else. I immediately started driving down, desperate to get off the mountain, completely forgetting that I had additional supplies in a bear box at the campground (I'm so sorry I forgot those).

When I got to Lone Pine, I stopped at a gas station to get something to drink and gas up the car. I was shocked that I wasn't doing any better, and I should have been, since I was no longer at altitude. My head was still feeling like it was going to explode, and although I took 8 more Ibuprofen in addition to the 8 I took up high, they did nothing. I was still disoriented, but at least I wasn't hallucinating anymore. I tried to call my husband, but got voicemail, and left him a crazy, sobbing, incoherent message. Clearly, I should not have been driving, but I wasn't in my right state of mind. About 30 miles outside of Lone Pine, I stopped at a truck stop to try and get some sleep. I could only sleep for about 30 minutes, and the headache was not getting better, so I kept driving. I was just desperate to get home.

I finally arrived home 4 hours after I left the Portal, and my husband was shocked at how bad I looked. He said I was stumbling like I was drunk, and couldn't stand up straight. He also told me that the voicemail I left him didn't even sound like me, and I was babbling and he actually thought it was a crank call at first. He also said he tried to call me back multiple times, but I don't remember the phone ringing once. I have no idea how I drove. I immediately went to sleep, but only slept about 5 hours, still with a headache which persisted into the next day. I couldn't do much of anything yesterday, and the headache, coordination problems and nausea persisted till evening, when I all of a sudden started feeling better.

I was absolutely amazed at how quickly I deteriorated, and the fact that I didn't get better even at sea level. The scariest part by far, were the hallucinations. That was horrifying. Although I feel really tired, all the symptoms are gone now, and I'm just trying to understand what happened. I am familiar with altitude symptoms, but don't understand how I went from perfectly fine, to exhausted, then headache, and a progression of symptoms that sound too severe for the altitude I was at, (and I've been over 10,000 feet many times, including frequent visits to the summit of Mt. Baldy) and the short time period that they occurred. It just seems that the symptoms were so severe, that altitude alone doesn't make sense to me. I am also puzzled as to why I didn't get better after descending, even once home at sea level, until late the next day. Does this make sense to anyone else?

I know that not sleeping the night before was probably an issue, and I should have tried to get a permit for the next day, but I am really trying to figure out what else I did wrong, so I never have to experience that frightening night again. Any input is appreciated, (feel free to be brutally honest) and I do appreciate your taking the time to read this.

holy smoke. Glad you are alive. no kidding.

although the usual rule is "illness at altitude is high altitude illness until proven otherwise" I agree with you that this was severe for Whitney, but it does happen.

It could have been bad AMS with rapid onset and complication of HACE (headache, disorientation, unstable gait is typical). The hallucinations are not typical, but possible. This rapid HACE scenario does happen, even at moderate altitudes.

What else could it be? This story reminds me of the pattywatty case a year or two ago. The discussion then was whether it was HACE or something else.

You drank a ton of fluids. I cannot personally imagine drinking those 4 liters between WP and OC. How much do you weigh? That much lasts me all day round trip. There is the possibility of water intoxication (too much water so that bloodstream sodium gets diluted, ie electrolyte disturbance.)

Lastly, there is the possibility of undiagnosed non-altitude medical illness. If it were me personally, I would want to know. As a precaution, a brain CT scan would be on my wish list.

Trust me, I am glad to be alive too. At one point on the way down, the thought did occur to me that I wouldn't make it.

Yes, the symptoms seem really severe, and I have been trying to deconstruct everything. There are some things that indicate that although I felt really great, I actually wasn't. Although I didn't have a headache or any other symptoms except fatigue, prior to going to sleep, I have a vivid memory of taking movies of the waterfall at Outpost Camp. Looking at my camera, I have a video of the ground and my feet. Clearly, there was something going on even though I felt like I was fine. Interestingly, I had lengthy conversations with several people at Outpost Camp, and none of them indicated that they saw anything wrong with me, so who knows?

I have an appointment with a doctor in the morning, so we'll see about the brain scan.

With regards to the fluid - I should point out that I am a middle-aged woman who has hot flashes. I overheat and sweat a lot, and when I don't drink a lot of fluids, I get dehydrated, which has been a problem in the past that I was determined would not repeat. I know it sounds like a lot of fluid, but that is the same that I would drink going up the ski hut route on Mt. Baldy. I was also snacking every hour, and 1 liter of the fluid was Cytomax, so while I guess it's possible that I had too much water, that too seems unlikely. By the way, to answer your question about weight, I am 5'9" and not proud of the fact that I weigh 155lbs....LOL

Funny that you mention HACE. It didn't even occur to me, but it does mention hallucinations as a symptom on Wikipedia, but still....seems like it hit too fast and at too low an elevation. Will definitely ask my doctor about it though.

Harvey, I understand that you are suggesting the CT scan to identify/rule out other possible causes, but I am curious: if someone has experienced HACE, would there be changes visible on a CT scan? And if so, for how long after the symptoms resolve?

Karin, I'll ask Peter Hackett when I see this weekend at the Exped Med conference. In the 1980s, he studied Denali HACE and HAPE victims and reported brain changes. Imaging (both CT and MRI) has improved dramatically since then. The extent and duration of brain imaging changes can vary from zero to mush, and one day to a lifetime. As for "usual" victims, many of them have symptoms even after descent for days or weeks before resolution. There has been this debate about whether there is long term damage, but if you look at what we now respect about football concussions or other brain injuries, then you'd think a HACE might be problematic , too.


There are some pretty scary stories in Charlie Houston's book, you can read it online
Going Higher

My rationale (in the case here) about wanting a CT (or better, MRI) is not to prove HACE (because it likely may not, then or now late) but to exclude other possibilities. Better safe than sorry.

Really good point about excluding other possibilities. At this point, I really just want to understand what happened, because it was so terrifying that I don't want to become one of those people who never goes into the mountains again, out of fear. Really appreciate the information. Are you a doctor?

Ken and I on this forum are. We try to help out from time to time.
Best wishes.

Fascinating and thanks again.

Coincidentally (and please excuse the digression), I have been consuming mountaineering literature these last few months, and just last evening finished reading Forever on the Mountain (about the summer 1967 Denali disaster), in which Peter Hackett, his research, and his Everest expedition, are mentioned several times. I realize that the mountaineering community is small (and the community of MDs who specialize in mountaineering medicine even smaller) but still mildly surreal to move so smoothly in one day from book to real-time reality.

(Further digression, just before reading Forever on the Mountain, I read Minus 48 Degrees (about the 1967 Denali winter expedition), which I have to say was the most absorbing mountaineering book I have read yet. Great story and great writing.)

Anyway, thanks, Harvey, for sharing your expertise and literature recommendations, and best wishes to the original poster for a fast and full recovery.

No wonder you sounded so knowledgeable! Thanks for taking time out of your busy schedule to respond. I will let you know what the doctor says tomorrow, and thanks again for taking the time to read and respond.

First, the disclaimer: I don't have access to your records, nor to you personally for examination, and am really only commenting on the story.

What you describe is a constellation of symptoms that can have a number of causes, and like Harvey, I would want to have things excluded. Your doctor will know how to do that.

While it is true that symptoms involving headaches are Altitude related until proven otherwise, such proof is not always easy to obtain.

What jumped out at me in your narrative, was history of migraine.
In my experience, most people who say that they have migraine mean "a real bad headache". But what severe migraines involve is considerably worse. It often involves neurological abnormalities. You had several triggers going on: lack of sleep, menopausal state, exertion. Visual hallucinations in the setting of migraine are rare, but described. The fact that you were not in possession of one of the modern migraine treatment meds suggests to me that your episodes have been of relatively mild duration in the past (although they might not work for you, also)

However, visual hallucinations can also be present in a sleep deprived state.



It goes on to describe migraine as one of those pathological states.

Wikipedia notes:



So, my thought is migraine, particularly the altitude, the duration, persistance with descent. the hallucinations may have been from a combination of things.

But there are a lot of other possibilities, and you should certainly be checked out. And I suppose that altitude is still probably the most likely culprit.

Ken, at the expense of dharma ( sorry) we have a very interesting medical story.

Karin - this is for you. Highly recommend it.
Frank Smythe

Frank Smythe was a British mountaineer and writer. In the 1930s he was famous for his imaginary companion/Kendal Mint Cake story on Everest. At Camp Six, he was a lot higher than Whitney, and hallucinations are much more common there, due to hypoxia, or HACE, or both. Here is Frank describing the most famous hallucination in all of the world's mountaineering literature :

This “presence” was strong and friendly. In its company I could not feel lonely, neither could I come to any harm. It was always there to sustain me on my solitary climb up the snow-covered slabs. Now, as I halted and extracted some mint cake from my pocket, it was so near and strong that instinctively I divided the mint into two halves and turned round with one half in my hand to offer it to my “companion.”
Frank Smythe, Camp Six page 633

Don't forget to thank your Angel in the shorts and tank top.
Just a thought.

Ken - thank you so much for the information. I don't know why I never even considered migraine, although I was completely unaware that there could be hallucinations, especially the vivid weird ones that I experienced. That actually makes more sense to me somehow, although I will definitely ask the doctor about it. I didn't have migraine medication with me, because I never really responded to them, and they caused horrible side effects, and frankly, I haven't had one in over 6 months. They started 10 years ago (at the onset of menopause) and have been decreasing steadily over the years to the point where I only had 2 within the last year. All the information is really helpful, and I am going to print this out to take with me to the doctor.

A harrowing story, indeed. I'm really glad, and impressed, at how you were able to will yourself down and get yourself to safety.

Now, you weren't in your right mind during any of your driving, and you may not have known, but there is a small hospital in Lone Pine. Southern Inyo hospital is located at the northeastern end of town.

Good luck with all your testing and MD appointments, hope all turns out clear.

-L

Hi dharma,

Glad to see your mental status normalized in well under 48 hours. Your trip report is lucid, concise, and interesting.

Hopefully the workup by your physician is negative. If it is, you might consider the possibility of hyponatremic encephalopathy. Timothy Noakes has recently published some of his research in book form: WATERLOGGED, The Serious Problem of Overhydration in Endurance Sports. I have not yet read this book, but my impression is that those possibly predisposed to this sometimes fatal condition seem to be younger females taking NSAIDs.

Some of us Whitney enthusiasts appear to manage without drinking at every chance on the Mountain. For example, I did a dayhike on September 22 (two days before you) and drank nothing during the last eight hours of the hike. I was fine when I got back to Whitney Portal (where I enjoyed two cups of coffee at excellent prime rib dinner at the 25th annual potluck...thanks Doug, Doug, and Earlene.)

My note here is simply to stimulate thought. Of course, we are all experiments in one and must discover what works for us individually.

Again, glad to see you are feeling better. Please follow up if you get a handle on what happened to you.

Jim F

Thanks again, Harvey! You are making my reading list longer, and that is not a bad thing!!!

Waterlogged is a very interesting read for the scientifically minded among us. The book goes on for some 448 pages in his quest prove to the reader that over drinking is not necessary and outright dangerous. His premise is that endurance athletes were taught to drink very little until the invention of Gatorade and the founding of the Gatorade Sports Foundation. Then despite evidence to the contrary athletes were told to drink as much as possible. This is not easy reading as the book was edited down from something like 1500 pages to its current form. He is determined that the reader understand his well proven point of view. Purchase it in paperback as the Kindle edition is not formatted properly.

Sorry for the highjack of the main topic.

To everyone -

I can't begin to tell you how much your comments have helped put my mind at ease.

For what it is worth - I neglected to mention one other thing. Shortly before Outpost Camp, I ran into a very friendly and helpful ranger (sorry, but don't know his name) that I had a 10 minute conversation with. He was walking ahead of the mule team, and mentioned that it looked like the mule team was stopped, and drinking water out of the creek. He instructed me to move to the side when the mule team came past, and also told me where the tent sites at Outpost Camp were, (I specifically asked him that). I would think that if I was having problems at this point, that he would have noticed and said something, so am pretty sure I was fine then.

Ken - after reading what you posted, and after some time on Google, I think migraine combined with lack of sleep might just be the culprit, which makes me feel significantly better. The migraines I had in the past were always accompanied by visual disturbances (doctor called it aura?), and wonder if the dense fog that I saw could be attributed to that. My migraines also caused some ringing in the ears, which I neglected to mention that I also experienced. It might be interesting to note that I also occasionally suffer from insomnia, and like this trip on Whitney, once I get past a certain point with no sleep, I just don't feel tired any more. I wonder if the intense tiredness that came on suddenly was actually the start of a migraine?

Joe - You bet that I'm thanking that angel in the shorts and tank top. The current joke amongst my friends, is that I must have been really, really sick, because I would never just say "ok" and listen when someone told me to go down (Not that I'm known to be a bit stubborn or anything - LOL). Don't know what to make of that woman in the tank top and shorts, but as opposed to some of the other hallucinations, she was quite pleasant.

Harvey - The story of Frank Smythe is fascinating, and I must admit, hearing the footsteps behind me was comforting.

Moosetracks - I was aware that there was a hospital in Lone Pine, but I was so out of it at the time, that I wasn't thinking well. Clearly, that would have been the wise decision, and I can't help but feel that if I didn't hike alone, that a partner with a clear head could have realized that I needed medical attention. Once again, I know I probably made a big mistake by going alone.

Jim F - I am hoping that the doctor appointment goes well. I will definitely mention the whole issue of hyponatremia, and bless you, for thinking I am a young female...LOL

I will keep you all posted as to what the doctor says tomorrow. Thanks again!

Steve C - Will definitely ask the doctor about that. But with that said, it's not out of the norm for me to drink that much. I was going very slowly, deliberately, because I was very careful about my footing due to some nagging knee issues. I was really slow going up the steps and anywhere there was rocks, because I didn't want to hurt my knees any more than they were already hurting, so it took me longer than a couple of hours.

Not wanting to make any of the men uncomfortable, but I am post-menopausal and have major problems with hot flashes and heat. Twice, on routine hikes in hot weather, I overheated to the point of needing medical attention. By the time I got to Outpost, my shirt was completely soaked, so I was deliberately drinking a lot to try and compensate for that, particularly because on previous hikes on Mt. Baldy, I became severely dehydrated. I guess it's a very good possibility that I overdid it on the fluids. Not to give too much information, but I remember urinating twice on the way up, once at Outpost, and twice on the way down. Don't know if that is normal or not. I will definitely ask the doctor about it.

I had very similar symptoms and timeline (much less severe and without the hallucinations) on a hike to Chicken Spring Lake. Slept ok the night before, hiked up, slept a couple of hours and then headed down with very similar but less severe symptoms. Never had hallucinations but was completely out if it, vomited, unbelievable headache. By the time I got back to Horseshoe Meadow Trailhead I was feeling a little better and was able to rest. Drove down to Lone Pine and felt OK. But had an overwhelming desire to drive home. I've always had trouble with altitude sickness (starting at around 10k ft), I'm sure that was the problem for me.