Mt Shasta Self-Rescue Question from trip this Week

[Dhamma]

I had to self-rescue my buddy from Shasta today. Thankfully I was successful in getting him and his gear down the mountain without requiring any rescue assistance. Being new to the sport/hobby/diversion I have a few questions on the decisions I made, and am asking for some feedback and constructive criticism from the experts.

 

We were planning a 2 day Ascent up avalanche gulch to the summit after camping in the parking lot at Bunny Flat (With a high camp at Helen lake), but barely made it to Helen lake today-and wouldn't have even gotten that far if I hadn't taken on more then my share of the work.

 

My partner had been fighting a mild headache all the way up to 9500 feet (right before Helen Lake) when he started sitting down and saying he couldn't go on. He was complaining of knee pain, and I assumed it was some kind of strain instead of AMS (which he was reporting mild symptoms of earlier) so I encouraged him to suck it up till we got to camp. After trying to get him going about 3 times, I climbed up to camp, dropped my 60lb pack, grabbed my Ice axe, glissaded down to him, shouldered his 60 lb pack up to the top so he could try to climb with no pack- which he did-- very slowly.

 

We didn't get to camp till almost dark and I had to do everything myself- pitch the tent, go find snow to boil for water, and make food. I had him go inside the tent and get warm in his sleeping bag. Mind you, I was tired after the climb, so doing all this was pretty draining.

 

I sat up alone on a rock after dark boiling snow so we could both stay hydrated, made him food, and got him in his bag. We were the last team into camp and our alpine start (which he decided to pass on) was supposed to be at 2 or 3am. I boiled 10 liters and then went to bed.

 

We both stayed wide awake the entire night. Winds kicked up on the exposed camp-- blowing 40mph consistently with gusts up to 60. Windchill outside was probably around zero. He was still not doing too well. I have never seen weather like this in my life it was truly awe inspiring and quite fearsome. When the sun eventually came up I awoke to him rolling on the ground, clutching his head, saying he couldn't' take it anymore, and begging me to help him. I raced him up and dressed, and sent him on his way down with a super light pack--leaving a TON of shit at camp that I had to pack up first. After packing the heaviest load I've ever carried in the Bora, we eventually made our way down and he started feeling better.

 

Facts:

He had summitted before, I have not.

He has suffered severe AMS before, I have not.

We were both SUPER hydrated

We were both munching gu/sport beans/etc

We were taking a slow and steady pace

We were layering appropriately

We both live at sea level

 

I know the best cure for AMS is descending, but my rationale was, if i could get him up to camp and put some fluids in him and let him get warm and sleep, he might acclimatize and feel better. I know a conflicting school of thought is to descend when symptoms start and bivy at lower altitude.

 

I'm wondering if I shouldn't have carried his pack for him the final several hundred feet up to camp, and instead made him turn around under his own power to lower altitude.

 

Interested in hearing opinions. Thanks.

 

FYI, this has nothing to do with my other post on PLB's. I would clearly not think of activating one on a non-seriously life-threatening situation such as this.

Edited July 13, 2009 by Dhamma

[Doug]

 

I'm wondering if I shouldn't have carried his pack for him the final several hundred feet up to camp, and instead made him turn around under his own power to lower altitude.

 

Interested in hearing opinions. Thanks.

 

If this included both of you descending at that point, then yes that was a good plan. Not sure sending him down alone while you packed up camp was a good idea.

[Dhamma]

If this included both of you descending at that point, then yes that was a good plan.

 

Yes, that's what I meant.

 

Not sure sending him down alone while you packed up camp was a good idea.

 

I didn't want to separate, but he was on the verge of panic and I was worried he'd do something stupid like wander off if I didn't start him going.

[catbirdseat]

Next time try spend a night at ca 5000 feet if you can and bring Diamox (acetazolamide). Even if you don't start taking it before the climb, it can help in cases of AMS.

[Lafayette]

On the Diamox topic. My understanding is that this just hides the symptoms of AMS.

[rocky_joe]

When did your friend start complaining of the headache?

[Jeff W]

Well, this sounds like quite a story. With that said, and assuming your partner has been afflicted with "severe AMS" in the past, then it probably would have been prudent to retreat to a lower elevation and set up camp rather than continue up the mountain.

[iluka]

A few thoughts:

 

- His history of AMS in the past means he is susceptible to the problem and likely but not guaranteed to get it on other trips to high altitude. He would be a person, as CBS suggests, that would benefit from using acetazolamide (diamox) on future trips for prevention and he should definitely have it along for treatment.

 

- With his history of AMS, ascending to the summit of Shasta in only two days is likely too fast and another night or two at lower elevation would be of benefit

 

- Being hydrated doesn't prevent AMS. All it does is prevent dehydration which is easy to develop at high altitude and feels and looks a lot like AMS

 

- Avoiding overexertion is thought to be important in preventing altitude illness. Going slow and steady as you did helps... 60 pounds for that trip sounds like a lot of gear, however.

 

- Continuing to move higher when he had a headache on the first day was probably not the best idea. Would have been best to stay put if the terrain allowed it, treat and acclimatize there

 

- Getting him down rather than going higher on Day 2 was a good idea but I probably would not have sent him down alone. Had he been showing signs of HACE, rather than just AMS, he could get into some real difficulty

 

- In regard to whoiswillhockett's comment: diamox does not "hide" the symptoms of AMS. It actually helps the body acclimatize to high altitude so if you're feeling good on the medication, your body is doing well.

[Dhamma]

When did your friend start complaining of the headache?

He had what he described as a mild headache when we first arrived at the parking lot at around 7000 feet.

[Dhamma]

A few thoughts:

 

- His history of AMS in the past means he is susceptible to the problem and likely but not guaranteed to get it on other trips to high altitude. He would be a person, as CBS suggests, that would benefit from using acetazolamide (diamox) on future trips for prevention and he should definitely have it along for treatment.

 

- With his history of AMS, ascending to the summit of Shasta in only two days is likely too fast and another night or two at lower elevation would be of benefit

 

- Being hydrated doesn't prevent AMS. All it does is prevent dehydration which is easy to develop at high altitude and feels and looks a lot like AMS

 

- Avoiding overexertion is thought to be important in preventing altitude illness. Going slow and steady as you did helps... 60 pounds for that trip sounds like a lot of gear, however.

 

- Continuing to move higher when he had a headache on the first day was probably not the best idea. Would have been best to stay put if the terrain allowed it, treat and acclimatize there

 

- Getting him down rather than going higher on Day 2 was a good idea but I probably would not have sent him down alone. Had he been showing signs of HACE, rather than just AMS, he could get into some real difficulty

 

- In regard to whoiswillhockett's comment: diamox does not "hide" the symptoms of AMS. It actually helps the body acclimatize to high altitude so if you're feeling good on the medication, your body is doing well.

 

I think we did bring too much gear, and we were talking about ways to reduce weight on the drive home. I told him about diamox, and I told him to go to the doc before we went out again together. I think you guys are right, and I feel the same way, I think we should have descended when he couldn't climb and more, and camped at lower elevation, and then re-evaluated in the morning. Thanks for the advice.

 

me looking like a skeleton after doing all this shit at night

 

Edited July 13, 2009 by Dhamma

[rocky_joe]

since the headache started before the 8000' mark, it might be possible that your partner wasn't experiencing just AMS. Usually, and someone correct me if I'm wrong, AMS doesn't occur on its own until one is over 8k. The early headache may have just been made worse by the elevation gains.

And what were you carrying that weighed 60lbs?

[Dhamma]

i think i may have overestimated the weight of the pack. it was probably more like 45-50. for sure when i loaded up his shit to it was 60

[LostCamKenny]

since the headache started before the 8000' mark, it might be possible that your partner wasn't experiencing just AMS. Usually, and someone correct me if I'm wrong, AMS doesn't occur on its own until one is over 8k. The early headache may have just been made worse by the elevation gains.

 

This is accurate according to Medicine For Mountaineering. My copy says, "Only a few persons have AMS at 8000 feet (2400m), but after going rapidly from near sea level to 14000 feet (4200m) more than half have symptoms."

 

Also, "None of the symptoms of AMS is diagnostic of the condition. Similar symptoms may occur in people who are exhausted, dehydrated, hypoglycemic, suffering from carbon monoxide poisoning, taking prescription or recreational drugs, or developing an infection..."

 

It is possible that your friend was not experiencing AMS, but just feeling drained after a long week at work or even just being tired from the slog up to high camp. In the case of recreational or prescription drugs (meaning, were you toking before you left the trailhead?) that last hit, pull, or drag could have manifested itself on the ascent - I have seen that happen before.

 

The main idea is that it is a good idea to be watching your partner because when AMS appears (or its more serious cousins HACE and HAPE) you will not know it and if you are feeling symptoms your judgement will be hindered by your desire to want to push on. Being able to recognize the symptoms is just the beginning - you have to talk to your partner, too, and ask them what they are feeling. And to go along with what was said earlier on this thread, descent is never a bad decision if AMS is suspected. Live to climb another day...

 

Cheers, and safe climbing in the future!

[iluka]

 

This is accurate according to Medicine For Mountaineering. My copy says, "Only a few persons have AMS at 8000 feet (2400m), but after going rapidly from near sea level to 14000 feet (4200m) more than half have symptoms."

 

 

Most text books will quote the 8,000 foot figure as the lowest altitude at which you will see AMS but very susceptible people can get sick at lower elevations that this. There are also studies in the literature documenting its occurrence at elevations much lower than this, such as this one looking at the incidence of AMS in a general tourist population in Colorado:

 

http://www.ncbi.nlm.nih.gov/pubmed/8452324?ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

 

That being said, the symptoms of AMS are, as noted above, very non-specific. If someone was dehydrated from carrying too much gear on a hot day at altitude, they could have a bad headache. The fact that the headache persisted after rehydration in camp, however, would argue against his problems being solely due to dehydration.