The JMT Diaries: Part H.A.P.E.

jmt1It was a strange sound.

I’m sure when you were a kid, at some point, you lifted your head just above water enough that your nose was almost completely out of the water and then took some breaths. You were trying to be sneaking so you lifted your nose just high enough that it bubbled and made a gurgling sound as you breathed. Then you brought yourself back under water to swim toward your target. The bubbles pop and then rush through as the air moves away from your nose. You think this is a great tactic to staying hidden until the third or fourth time, you realize you aren’t getting quite as much air as you need and you can’t stay under water for nearly as long as you would like. And then you have to bring your head all the way out of the water and take some deep breaths.

That’s the sound that I could hear and to make it that much stranger, it was coming from my chest. At first it was only when I would cough, but after our dinner at Perry’s Italian food in Mammoth Lakes, it started to build until it was every breath. I would inhale, dragging air through the moisture and then release a gasping exhale that just bubbled and gurgled as it went back out. Despite the fact that I was sitting still and hadn’t moved in 10-15 minutes, my breath was heavy and I just couldn’t seem to get enough oxygen. We had been to the hospital just a few hours earlier and they had sent me home with some antibiotics and a respirator. I assumed that I was fine.

jmt2

Saturday night I went to sleep with a bit of an altitude head ache. Nothing special, I’ve experienced hundreds of these. They start light and then grow. Often times, I can feel my heart beating in my brain. Most of the time I can sleep them off and in rare cases, I’ve had to take a few Ibuprofen to get rid of the pain. This time, it was the latter and when I awoke on Sunday, I popped a couple pills and within about 15 minutes the pain was completely gone and I felt great. We had been sleeping at about 8500 feet. We climbed 1200 more feet as we made our way over Sunrise Pass and then dropped into Long Meadow making our way to Cathedral Lakes. This consisted of us climbing over Cathedral Pass before dropping down to our campsite around 9200 feet.

I spent the afternoon sitting around in the sun, washing my clothes and generally enjoying my surroundings. By mid-afternoon, I was short of breath. I didn’t think much of it as I usually lose my breath easily at higher altitude and it’s something that I have learned to just ignore until it goes away after a day or two. By early evening I couldn’t walk more than 50 yards without stopping to catch my breath.

We went to bed early. After a bit, the fever set in again and I tossed and turned whilst shivering. Then the cough came. I didn’t sleep much at all that night.

The next morning we packed things up. I took some more Ibuprofen and we headed down to Tuolumne Meadows to our resupply. Our packs were light and as we descended I began to feel better, again. We got our buckets and jammed as much food as possible into our bear canisters, we weren’t going to be resupplying again for about six days. My pack was heavy but the last 10 miles of that day were relatively flat as we walked through Lyle Canyon to the base of Donahue Pass. We had planned on making our way a bit up the pass to cut down on the long climb the next day.

By the time we had made it to the end of the canyon, I was exhausted. We stopped and I said that I could probably make it if we took a little time, ate some food and rested. It was agreed that we would rest for about an hour and then continue another mile or so to the bridge. I immediately got the chills once we stopped. I cooked some Ramen and drank some water. I didn’t feel much better but was committed to continuing.

We began walking again. After climbing maybe 100 feet there was a camp site on our right. I could barely breath or stand up straight. We stopped and made camp. We set up our tent and I laid down. The gurgling in my throat when I coughed had gotten a lot worst and I immediately had the chills. I took some more Ibuprofen and read. KB came and found me and read to me the symptoms for HAPE. It sounded about right but I was feeling better again and got up to sit around the fire.

Kathleen went and found a guy with some “medical training.” He came over and took my pulse. It was high, over 100 beats per minute. He recommended we get lower and discouraged me from continuing up Donahue Pass that would put me around 12,000 feet. He also told me to drink lots of water mixed with Gatorade. I did the latter drinking two liters in about 30 minutes. The fire felt good and we laughed and chatted until we went to bed.

I slept great until the Ibuprofen wore off. I awoke shaking and sweating. All my clothes were drenched. I stripped off my base layers and removed my beanie. That wasn’t quite enough so I pushed my head up and out of my sleeping bag. Then I started to cough. Every few minutes I felt like I needed to clear my throat. This worsened all night long to the morning around 5. The cough was to the point that it was uncontrollable and when it hit I would go into dry heaves.

Somehow I got out of bed, drank the peppermint tea that Benjamin made for me and the oatmeal that KB shoved into my hands. After 30 minutes or so I felt better. As long as I was standing, I wasn’t coughing very much and thanks to some more Ibuprofen the fever was gone. We packed everything up.

jmt4There were three decisions made that probably saved my life.

1. As we sat around the camp fire that morning, I did not want to head off the mountain. Our plan was to go over Donahue Pass and camp at Thousand Island Lakes. From there, it’s actually a shorter distance to drop elevation. I wanted to get there and then see how I felt. KB thought about it, but she’s smarter than I and wouldn’t have anything to do with it.

2. Once we started down the trail, KB started to cry. Things were a bit emotional at that point and leaving Benjamin and Brother Meinkey wasn’t easy. There was also an air of disaster floating around us and the idea that we might not be able to finish our trip was definitely on everyone’s minds. I once again suggested that we could go over the pass and see how things went. She thought about it.

After we had hiked over ten miles back to Tuolumne Meadows we went directly, after eating lunch of course, to the ranger station. Our plan was to find a doctor, see what was going on and then hit the trail again at Red Meadows to finish out the JMT as planned. There was no doc in the Meadows, but there was a first responder ranger who they called and came and talked to us. He wouldn’t examine me unless we got in the ambulance. We didn’t. Instead we decided to hitch hike down to Lee Vining and over and up to Mammoth Lakes where the closest hospital was.

We walked up to the road, slowly. KB held up the sign. A few cars drove by but soon one pulled over and in broken English asked where we were headed. They looked at their map a bit confused and we pointed to Lee Vining and it was set. The French couple was here on vacation and didn’t mind our big bags or our stinky asses. They dropped us on the highway toward Mammoth and headed toward Vegas. We held up our sign again and cars just wizzed on by. After about a half hour, we were getting discouraged and started to walk back toward Lee Vining. Another ten minutes or so another car pulled over and in broken English asked where we were headed, Mammoth Lakes. They moved all their shit and let us into the car. They were from Argentina.

We made it to the hospital and got checked in at the clinic. After waiting for about an hour, I was finally seen. They took my temperature, weight, all the normal stuff and stuck me in a room. The doc, or who I assume was a doctor, came in to see me. We walked through my symptoms and concerns. I specifically mentioned HAPE. She listened to my breath, prescribed me some antibiotics and told me to wait a day or so and be careful when we hit the trail again. Ecstatic we headed to the Motel 6 up the road.

We showered and put back on our dirty clothes. And then walked across the street for some grub. It was cold and I got the chills and had to stop a few times to catch my breath. We were in good spirits as we expected to start the trail again in a couple of days. We ate and headed back to the motel. As soon as we were back in the room, we laid down and started to rest. Immediately, the gurgling in my throat started. I searched for gurgling noises in my throat and found something about not being able to burp after eating veggies. I thought whatever.

After about an hour, I couldn’t lay down or the gurgling was so bad I could barely breath. I started to get a bit concerned. My faith in the “doctor” I had seen was certainly being questioned, but I knew she had listened to my chest and had heard nothing out of the ordinary.

I sat up and continued to watch TV.

Around 9, I was tired and wanted to go to sleep. I tried to lay down, but as soon as I did I started to really hack. I sat back up and searched again, but this time for HAPE symptoms. Gurgling in the throat was right there with a warning to call 911 immediately if this symptom developed. I trusted the earlier diagnosis, finished reading the symptoms and tried to go to sleep. Once I laid down the same thing happened. This time I couldn’t stop coughing and ended up in the bathroom where I hacked up what was the nasty shit I had ever seen come out of my body.

I found the “doctor’s” card on the table. It said Physician’s Assistant. Hmm. I called the number. There was no answer. I started to cough again and returned to the bathroom as a huge amount of fluid came up. I could barely breath and felt like I was drowning.

3. I told Kathleen to call 911 if I collapsed. We walked back out into the cold air and began the half mile trip back to the hospital. About half way there, I couldn’t walk unless KB helped me. She offered to call 911, but we were so close. By the time we finally stumbled into the Emergency Room, I wasn’t getting hardly any oxygen and the memories of that moment are pretty blurry.

JMT5They quickly put me on oxygen and took my blood pressure and oxygen saturation. I was below 80. X Rays were ordered. As the technician rolled me back to the ER room, he said we would probably have to plan our trip for some other time as it looked like a classic case of HAPE. The ER doc came in and said the same thing giving me two options. I either got to Bishop that night or I stayed in the hospital on oxygen. We had a car somewhere in Bishop, but had no idea where it was or how we would get to it. So I spent the next 19 hours in the hospital. The next morning they took some more X Rays hoping to see some improvement but my lungs looked basically the same.

Shelby and Ben got off the mountain and brought the car down. We made plans to get down to Bishop. The doc didn’t want me to go without oxygen as there had been little improvement in my condition. The Respiratory Bitch Therapist was under the impression that I was going to Southern California despite the fact that everyone I had talked to had full conversations about where I was from and that they had spent time in or around St. George. Apparently the oxygen company wouldn’t allow their tanks to go over state borders. This turned into a big deal. Around three it was obvious that we weren’t going to make it home any way. So we told them to send us to Bishop where we would check in with the oxygen place and have my oxygen saturation checked. If it was above 92, I wouldn’t need the tank, but would stay in Bishop overnight and if anything happened the same nurse that had been attending to my needs all day would be in Bishop at their hospital.

We made it to Bishop. My oxygen was fine but only because my heart rate was elevated. The nurse felt I would be fine but sent me off with the tank any way for the night. We camped just outside of town. We did some fishing and sat around a camp fire. And then I slept all night for the first time in days. We returned the tank the next morning where they check my saturation levels again. They had improved and other than some shortness of breath I was feeling normal.

I don’t think I will ever forget that gurgling sound as my chest forced my breath through my body’s fluids that were trying to drown me.

P. L. and R.

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