Mt Hood Cough? or HAPE?

[dmuja]

 

 

Anyone else get a cough after going up Hood?

 

I was half joking about the "HAPE" but its happened like 4 out of 6 times and lasts (but improves) a few days after the climb. Feels painfully dry but it produces phlegm and crackling wheezing chest congestion. Its never happened to me on other Volcanoes.

 

So is it the noxious volcanic fumerols on Hood or should I not make plans for any high altitude?

[Jens]

Pressure breathing will do that to some folks even if the altitude isn't affecting them at all.

 

I had an old climbing partner that had pretty much the same thing that you describe but he was pretty strong up high.

 

I'm pretty clueless but would guess it isn't HAPE.

[KaskadskyjKozak]

 

Anyone else get a cough after going up Hood?

 

I was half joking about the "HAPE" but its happened like 4 out of 6 times and lasts (but improves) a few days after the climb. Feels painfully dry but it produces phlegm and crackling wheezing chest congestion. Its never happened to me on other Volcanoes.

 

So is it the noxious volcanic fumerols on Hood or should I not make plans for any high altitude?

 

I believe with HAPE you actually cough up pink, foamy shit.

 

I've only been up Hood once, and must say the fumes are pretty strong up there on the S. side. Every whiff of that sulfur made my stomach turn . I can't think of any of the other volcanoes that are that bad

[catbirdseat]

You guys are whips. We chemists just love it. Reminds me of the good old days in the lab doing heavy metals analysis using saturated hydrogen sulfide solution.

[KaskadskyjKozak]

You guys are whips. We chemists just love it. Reminds me of the good old days in the lab doing heavy metals analysis using saturated hydrogen sulfide solution.

 

Yeah, there's nothing like the smell of H2S in the morning!

[nkane]

I actually felt like crap the day after my Hood climb. Something with the sulfur, lack of sleep and altitude made me feel hung over for the next day, and then I picked up a nasty flu.

 

Not that it made me want to stop climbing mountains...

[iluka]

The fact that it last several days after coming down argues against this being due to HAPE. Improvement occurs with descent and, while the symptoms can last days in very severe cases, it should resolve faster, particularly if you go down to sea-level.

 

Someone else in the thread mentioned that in HAPE people cough up pink sputum. That is typically a very late finding in severe HAPE. Early on, before it gets really severe, many people have a dry cough.

 

Exposure to the H2S could create the symptoms you describe. A useful bit of info to helping figure out what this is would be how high in altitude you've been on other volcanoes. If you've been to similar elevations as Hood on other peaks but no symptoms, that would argue against HAPE

[catbirdseat]

In all seriousness, I don't ever remembering the H2S fumes being all that bad. As long as you don't stop and take a break near one of the vents, your exposure should be minimal.

[ivan]

it's just all the 'boarders n' dirt-bag oregon climbers polluting the air w/ their excessive byproducts

[scott_harpell]

It certainly seems possible. It is hard to say now that you are on terrra firma. Some other signs too look out for are low grade fevers and tachycardia and tachypnea at rest, ataxia or any mental changes. blood tinged sputum (as someone noted earlier) is a really late sign.

 

The only real way to find out for sure is usually ABG, pulse oximetry or seeing if going down helps.

[ivan]

It certainly seems possible. It is hard to say now that you are on terrra firma. Some other signs too look out for are low grade fevers and tachycardia and tachypnea at rest, ataxia or any mental changes. blood tinged sputum (as someone noted earlier) is a really late sign.

 

The only real way to find out for sure is usually ABG, pulse oximetry or seeing if going down helps.

nonsense - you don't develop HAPE days AFTER coming back down to sea-level, whihc is what he's talking about in the original post

[scott_harpell]

I think he was stating that his symptoms persisted for that duration rather than that being their onset.

[iluka]

Some other signs too look out for are low grade fevers and tachycardia and tachypnea at rest, ataxia or any mental changes.

 

While low grade fevers, fast heart rate and fast respiratory rate are features of HAPE, mental status changes and ataxia (clumsiness) are not...

 

Altered mental status and ataxia are feature of high altitude CEREBRAL edema (HACE). Some people get both HAPE and HACE together but many get HAPE alone and would not have altered mental status etc. It's an important distinction because if you see altered mental status and ataxia going on as well, your choice of medications to treat the problem would change a bit... you'd add Dexamethasone for the HACE symptoms. Descent remains the best treatment for both but if that isn't feasible... meds are necessary.

[scott_harpell]

Some other signs too look out for are low grade fevers and tachycardia and tachypnea at rest, ataxia or any mental changes.

 

While low grade fevers, fast heart rate and fast respiratory rate are features of HAPE, mental status changes and ataxia (clumsiness) are not...

 

Altered mental status and ataxia are feature of high altitude CEREBRAL edema (HACE). Some people get both HAPE and HACE together but many get HAPE alone and would not have altered mental status etc. It's an important distinction because if you see altered mental status and ataxia going on as well, your choice of medications to treat the problem would change a bit... you'd add Dexamethasone for the HACE symptoms. Descent remains the best treatment for both but if that isn't feasible... meds are necessary.

 

I am staring at my PA reference right now. It says "mental changes, ataxia, decreased LOC, coma" for HAPE.

[scott_harpell]

There is also something called High-Altitude Pharyngitis and Bronchitis. It is pretty similar to what you described:

 

1) Sorethroat

2) Chronic cough (dry or productive)

3) Dry or cracking nasal passages/ rhinorheah

 

Most of the suggestions are prety intuitive:

 

1) hydration

2) Losenges/ hard candies

3) codeine or another anti-tussive agent

4) nasal bacitracin (anti-biotic ointment) or vaseline

 

[iluka]

Most of the suggestions are prety intuitive:

 

1) hydration

2) Losenges/ hard candies

3) codeine or another anti-tussive agent

4) nasal bacitracin (anti-biotic ointment) or vaseline

 

None of which have ever been shown to work for dealing with the dry hacking cough that is common at high altitude.

[scott_harpell]

uhm... ok.

 

anti-tussive means cough supressant. There is no physiological reason that an anti-tussive would not work simply because of altitude.

 

Same goes for hydration/ hard candies. Keeping the mucous membranes moist will prevent the aforementioned "dry cough."

 

the bacitracin will just keep the dried out mucous membranes of the nares from drying out and becomming infected.

 

[iluka]

Just because there are good physiologic reasons for something to work doesn't 'mean it is actually effective in practice or that there are research data proving clinical effectiveness. Anti-tussive medications are notoriously ineffective for cough, whether it be here at sea-level or at high altitude. Also, the cough often derives from irritation down in the lower airways, well lower than anything a throat lozenge will access or a little bacitracin in the nostrils will affect.

 

The dry, hacking cough at high altitude typically does not respond well to any of these standard approaches and often just resolves once someone gets down to lower elevations. No harm in trying any of the things you mention... just don't be surprised when they don't work.

 

 

Edited June 12, 2008 by iluka

[Gary_Yngve]

I am staring at my PA reference right now. It says "mental changes, ataxia, decreased LOC, coma" for HAPE.

 

Sounds like your reference is wrong.

 

(edit: though certainly HAPE and HACE could be co-occuring)

Edited June 12, 2008 by Gary_Yngve

[Gary_Yngve]

nonsense - you don't develop HAPE days AFTER coming back down to sea-level, whihc is what he's talking about in the original post

 

yeah, my understanding is, for the vast majority of the population, it takes at least 24 hours at moderate altitude before HAPE may onset.

 

it makes sense to me... partial pressures/chemistry change, allowing fluid to seep into the alveoli over time.

 

it sounds to me like the original poster has "track hack"

[Gary_Yngve]

nonsense - you don't develop HAPE days AFTER coming back down to sea-level, whihc is what he's talking about in the original post

 

yeah, my understanding is, for the vast majority of the population, it takes at least 24 hours at moderate altitude before HAPE may onset.

 

it makes sense to me... partial pressures/chemistry change, allowing fluid to seep into the alveoli over time.

 

it sounds to me like the original poster has "track hack"

[pindude]

 

Anyone else get a cough after going up Hood?

 

I was half joking about the "HAPE" but its happened like 4 out of 6 times and lasts (but improves) a few days after the climb. Feels painfully dry but it produces phlegm and crackling wheezing chest congestion. Its never happened to me on other Volcanoes.

 

So is it the noxious volcanic fumerols on Hood or should I not make plans for any high altitude?

 

I, too, doubt it's the fumaroles, and if I were you I'd pay attention to potential HAPE and other high altitude problems next time you go high.

 

HAPE diagnoses are not uncommon at elevations of Hood or lower. Part of it is the elevation you originally were acclimated to, and have traveled from, to do your volcanoes. I'll describe a situation I went through in the chance it'll give you some info to go by.

 

A couple years ago I met my brother, who lives and works in the Bay area, on a Friday evening at Tuolumne. He had driven straight from work to get to us. We left early the next morning and climbed Cathedral, which is just shy of 11,000. He showed signs of AMS (Acute Mtn Sickness) near the summit: lethargy, short of breath, not 100% there cognitively--but improved dramatically on the descent and seemed to be his old self. We camped again at Tuolumne that night, which is at 7500 ft. He awoke in the morning after a really bad sleep, and described rales in one of his lungs: a clicking, rattling, or bubbling sound, caused by fluid. He felt it in one lung only, and tried to compensate for it by sleeping on the other side. We knew his vacation at Tuolumne was over, and the best thing was for him was to head back down to sea level, where his HAPE cleared up after a couple days.

 

Personally I do very well at altitude most of the time, but I've also had a few times when I got AMS and had my ass handed to me. My response to altitude, and others I've noticed, is not consistent--and even with good conditioning--seems to vary widely.

[dinomyte]

I know pretty much jack and shit on this subject, but can certainly share my experience...

 

Never felt anything on Hood, though the fumeroles are ass!

 

Have felt a little light-headed at about 12K on Adams.

 

But then again nothing on Shasta.

 

I think I have read that this shit is pretty damn inconsistent, and I have ran around 25-30 miles per week for the last 10 years or so, in addition to weights and hiking/climbing, and I know people say that conditioning has little to do with it.

 

I just try to listen closely to what my body is telling me. I mean, I hope everyone is a little beat at elevation, but if shit starts getting wierd, I take my ass back to the truck!

[dmuja]

 

Thanks people

 

Just to follow up..

 

Yeah, the cough starts while on the climb, and then it continues for a few days afterwards as well (dry up high, then produces phlem beginning on the drive home usually). I don't keep records of it (maybe I should) but it seems to be confined to Mt Hood climbs only which I tend to do in one day - departing from sea level. All other volcano climbs are multi day trips for me (felt fine on Rainier, Adams, Baker) - which perhaps is allowing my body to acclimatize somewhat Im guessing.

 

It usually hits me around the fumerals on Hood which might be the (or part of the problem) OR it may just be that they (fumerals) are at the right altitude for problems to start rather than the fumes themselves. [bTW, The fumes vary depending on the wind direction etc,. Ive been up there when you could not smell them and also when they nearly cause you to pass out.]

 

Also want to particularly thank iluka for responding as he is a Doc who has spent quite a bit of time studying in the Himalaya and lecturing about Altitude related illness. Check out one of his talks when they come around if you can.