Mt. Whitney Portal Store & Hostel Forums General Mt. Whitney Portal Store Message Board Trail Report 5/30-5/31 with some Complications

Thanks for all the advice that the members of this board gave me before our climb last weekend. I thought I should deliver a trip report, although the conditions are changing rapidly as the temperatures fluctuate so your conditions may vary if you hike soon.

We left Sunday morning in a party of 4 around 10 AM and had a nice pleasant hike up through the Mt. Whitney boundary. Shortly after that we encountered our first patches of snow on the trail, although I didn't even bother putting gaiters on until just shy of Bighorn Park. Around there, we encountered a lot of mixed, slippery, slushy snow conditions depending on the amount of sun any given spot had received. The wayfinding was generally good, but there were a good number of spurious boot tracks and some sections of the trail were completely covered.

At mirror lake we stopped for a nice lunch, and found it a good place to filter water and refill our bottles. There wasn't any good running water above mirror lake, so fill up here. Like JDinSD's experience we found it quite a bit of work to get up to trail camp with our full packs. We had camped the night before at the Whitney Portal, but definitely found it more work to go from 10,500 to 12,000'. I'm not sure crampons were absolutely essential, but they made they made the going for the last mile or two to Trail Camp much safer and easier.

Contrary to some info we had received, Trail Camp is not 100% snow covered. We found a nice flat rocky area to pitch our tents. It took a good hour and change though to melt snow and make dinner. We went to bed early and all the group while tired was still pretty strong.

After a cold night, we woke up around 3 AM to get ready for our summit attempt. I was the only one in the group with previous snow climbing experience and the going up to Trail crest was slow. The chute is in fact quite physically demanding and a good fraction of people we ran into were turned around by the snow on the chute. The final part of the climb is a good 45 degrees. We were fairly slow going up to trail crest, but all felt well. The trail after trail crest was a good boot and a half wide of frozen snow interspersed with rock and dirt. It was a hard decision on whether to use crampons or not, as the stability was enhanced on the snow and diminished on rock with them. Some of the very exposed places would certainly be your last slip if it happened...this was soon to be a major worry for us.

Upon reaching the needle, 3 of us felt good and decided to go for the summit, while one decided to wait. We had to put our crampons back on for a painful climb up the south side of the summit and then take them off again for rocks. We had a beautiful sunny day on the summit all to ourselves.

As we started to leave the summit that's where things got complicated. I noticed that one of the guys with me was having a hard time getting his crampons back on, becoming very uncoordinated. As we descended the summit he showed sudden signs of severe altitude sickness, potentially even HACE, as he stumbled and tripped on flat easy terrain. We rejoined the climber who had remained behind and was happy and rested. By the time we made it back to the notch, the sick climber was too uncoordinated to walk a straight line, barely coherent, complaining of a headache and nausea. The obvious cure is to descend, but unfortunately, the perilous section of narrow trail with a sharp drop-off was in between us and trail crest.

We had a good cell signal, so I called the sheriff's department seeking advice and rescue options. We didn't have nearly enough gear to set up safe belays and move him along the ridge. They advised that our only option was to somehow get him down to Trail Camp where they could land a helicopter. Luckily, a passing hiker had a medication with them (I believe it was dexamethasone) that significantly improved his symptoms and allowed us to safely move him. The SAR coordinator had advised it would take at least 4 hours to get a helicopter, but as we were walking a fire helicopter circled us. We believed we could get him down safely so we waved off a later rescue. Luckily the snow conditions at Trail crest were soft snow which allowed for a safe glissade to trail camp. His condition improved markedly at 12,000' and we decided to strike camp and attempt to hike all the way out to the portal to get down to low altitude.

The snow was soft but with the delay it was almost 6 PM when we headed out, so we donned headlamps. The hike to mirror lake was without incident and we refilled water. At outpost camp, the conditions had changed significantly in just one day, and we had to navigate around some snow on top of deep water where we had come in yesterday. After leaving bighorn park darkness had arrived and we began to have significant wayfinding difficulties. There were a lot of boot tracks and the trail had changed significantly in just a day in terms of snow coverage. Instead of a risky hike down in the dark, we found a rocky spot east of bighorn park to camp for the night. Monday night was quite windy down low...I imagine it was far worse up at trail camp. In the morning, we could easily compare landmarks to the map and quickly found the trail, hiking out without incident. Due to the rapidly changing conditions we really did have to pay attention to wayfinding, and there were some really unpleasant soft snow conditions on the way down.

So, in summary, we had a really nice time but we learned that altitude sickness can strike anyone at any time. The victim was a 27 year old who had just spent 6 years on active duty in the military in very fit condition & who felt fine prior to summiting. I'm actually wondering if I should carry altitude sickness medication in my first aid kit from now on, as I'm not sure what we would have done otherwise.

In terms of equipment for those of you planning on hiking in the near future: ice axe, crampons, and a good set of boots/gaiters are pretty essential. I was glad I brought along a water filter for the lower elevations and wish I had brought along a wide-brimmed hat to keep the sun out when it was hot. I found myself adding and subtracting layers a lot as the temperature and wind fluctuated. Sadly as we had a full mine the stars were not great (the astro in my handle is because I'm an astronomer) While, we did meet some people who did it, I personally think it's still a bit insane to do this hike as a dayhike in these conditions.

Thanks again for all your advice prior to our outing.

Sounds like you did all the right things with your climber. Good on you!

After the Shasta incident this winter, I think it's a good call to carry dexamethasone whenever there is the possibility that someone along your hike might come down with HACE. There was a SP thread about this recently. Just be prudent about its use; respect the need to acclimatize despite having dex as insurance and administer only under unequivocal symptoms, since side effects can be pretty bad (snapping tendons).

But seriously, good, clear-headed thinking about this rescue.

here is some medical clarification for those interested in AMS/HAPE/HACE. Maybe Ken or others will add comments on this important topic.

snapping tendons is a side-effect of longer term steroid usage, and usually a result of intra-tendon injection rather than oral. or intramuscular. And none of this matters in this case because:
(A) HACE can be rapidly fatal and use of dex for HACE far outweighs any side-effect risk.
(B) while dex can work in a few hours (if that actually what was given versus Diamox), descent probably had far more and rapid effect anyway.

This was a very informative trip report and happily a safe outcome.

For more reading on altitude illness, please see a tutorial that I have posted here frequently. Harvey

High Altitude Tutorial

If you don't have the time to acclimatize properly, Diamox is an acceptable alternative that may make you trip up a little better...

Interesting TR. Thanks for posting.

Are a lot of you guys taking Diamox? We are day hiking MMWT on June 24th and I am teetering back and forth whether or not I should seek a prescription. In the past, I have felt minor bouts of nausea at heights greater than 10,000 ft. After eating and drinking, I feel better. I attribute this minor nausea to exhaustion and dehydration more than anything. My dad is a family doc.....wouldnt be hard to get a script....

Any thoughts or suggestions??

I am in agreement with my fellow physician and published altitude-illness author, Harvey.

The potential side effects of a few doses of Dex in oral form are trivial, at worst. Probably the most common practical problem would be sending a diabetics sugar numbers up. However, I generally don't think of it as a first line drug, except in these circumstances.

For prevention, in particular, I'm much more inclined towards Diamox. Most people who get it, use too high a dose, and may get side effects that are unpleasant. I currently advise 1/2 of a 250-mg tab, taken as a single bedtime dose, starting three days before the climb, works well for most people. It does NOT cover up symptoms, it accelerates acclimatization.

Dex, by the way, DOES cover up symptoms, and is one reason that I don't like it for prevention. In the setting mentioned above, however, it can be life-saving.

One thing that I might disagree slightly with, is the onset of action. While the HACE literature is not clear, in the pediatric asthma literature, it is suggestive that we see responses in less than an hour. Of course, different clinical situation, so may be different.

You were lucky to get your buddy down. This happened in exactly the worst place, where you could NOT descend rapidly for a couple of hours. Very bad. Had he been only a little worse, you'd have been stuck. There were other alternatives (dropping straight west off the mountain, towards Guitar, to drop altitude), but I'd think of that as dire.

i do not take Diamox. i used it on Kilimanjaro above 13k when i had weird symptoms like stuffy nose and later GI problems. so i chose to take it in case those symptoms set off AMS.

i am fortunate that altitude pretty much never bothers me, though i will take two Excedrin if i feel the slighest headache coming on. aspirin rather than ibuprofen is my drug of choice for headaches in altitude. my advice is to get as much altitude training as possible before heading above 10k, plus get a good night's rest in the days preceeding and/or during a high altitude camp/hike. i will take Rx sleeping pills when sleeping at altitude (though i never need them at home) to make sure i sleep well. and finally drink water! hydration is necessary, please make sure you stay hydrated. i had a hiker drop with a seizure in front of me on White Mtn at 13.5k as his wife cried that he hadn't been drinking water all day. once he stopped seizing we administered water and Gu for sugar until he could sit-up. he eventually walked with help until a Jeep came for him, but it was very terrifying to see what dehydration can do to someone at altitude.

this thread makes me wonder if i should put two Diamox in my emergency kit?

Yeah, we got lucky on this one. Had his condition not improved, I'm really not entirely sure what we would have done. I think we got almost as much acclimation in as is practical with time contraints. We spent an entire day at Whitney portal prior to the hike with a good acclimation hike most of the way to Meysan Lakes. Then the first night we went no higher than Trail Camp.

As to diamox, I tried taking it once before when I was climbing a volcano (Laskar) in Chile from 14,500' to 18,500' or so. I started 2 days before the trip, but I found the side effects very unpleasant. I had strong tingling/numbness sensations in my hands and feet. I also had to urinate very often which made me feel dehydrated and interrupted my sleep. I discontinued it prior to ascending the mountain. Luckily for this trip, I got to go to 4,000 meters on daytrips for 2 days before the hike and was sleeping at 3,000 meters. That made the altitude mostly just headache-inducing.

astroclimber wrote:
> As to diamox, I tried taking it once before when I was climbing a volcano (Laskar) in Chile from 14,500' to 18,500' or so. I started 2 days before the trip, but I found the side effects very unpleasant.

How much and how often were you taking it?

Good to have a doctor to clear up the side effects issue... the labels on bottles always have such unnerving warnings! I will be less hesitant to administer if I suspect HACE, then. Thanks!

I'm glad you and your friends got down ok.

In my honest opinion, diamox or any other type of medication should be discouraged from being used as standard practice for acclimatization. I think acclimatization and mountaineering go together like peanut butter and jelly sandwich.

Agree, but the fact of the matter is we live in a world where instant gratification is a way of life. Look at how many people attempt Whitney, Shasta, Hood, Rainier, Denali. Everest, etc without ever putting in the real work required to get it done safely.

I'd rather see people use Diamox then end up in a situation like the one talked about here. (Two days is not proper acclimatization! Three, or four weekends at altitude prior to those two days might start to get you there.)

This may be good advice. In the past I typically have not had a hard time acclimatizing to the elevations normally encountered in the Sierras so I would probably never use Diamox to adjust to altitude faster, but after hearing about some of the recent incidents involving HACE maybe it IS a good idea to have some dexamethasone in the first aid kit just in case someone you come across may need it. Acclimating to altitude is something that can be foreseen and planned for and would not be an emergency whereas the rapid onset of HACE would definitely be considered an emergency and need to be treated immediately.

RichardP: Actually, much of the literature I've read says that you lose your acclimatization in just a few days back at sea level, so it's not clear to me if this strategy of going high for a few weekends prior helps. Despite reading this, I spent the weekend before doing Shasta at elevation near Tahoe. I'd be curious for some of the medically-trained folks to weigh in on this point.

I've been waiting for some of the researchers to study me and other people like Bob R, etc who basically are weekend warriors... After a few weekends at altitude in late-winter / early spring, I never have an issue, so obviously, it does seem to carry over.

Richard, some might say you need your head examined!
I disagree.

you are correct about some individual's carryover effect (key word is some). Anecdotally there seem to be people who are different. After all, we are not all the same, whether we are measuring height, IQ, blood sugar, or acclimatization. You can imagine that guides like Kurt Wedburg on this board would have been weeded out if they were not better than average at acclimatizing and holding it.

Acclimatization is clearly not just one factor and they have different onsets of action and disappearance (ranging from seconds to months). Here are some factors;

Respiratory drive (response to O2 and CO2 levels), pulmonary artery pressure response, ph and temperature and 2,3 DPG levels to beneficially shift the oxyhemoglobin dissociation curve to help capture O2 in the lungs and a separate function to release it from hemoglobin once it is transported to the cells.

Then there are longer-term changes like making more blood, metabolic changes at the cellular level, changes in cell membranes, migration of mitochondria closer to cell membranes, prior multiple and prolonged exposures to altitude, inborn genetic differences, etc. These take weeks to months to lifetime.

There is great difficulty in translating these medical parameters (and adding in physical stamina, size, sex, age, mental drive, experience, weather, work load and so forth) to a prediction of ones ability to tolerate altitude. Tests have been performed in the lab to try to predict, without much success. Assuming one has all the proper and healthy body parts first, the best test is to 'just do it.'

You know I like mountaineering quotations, so set down the medical textbook (even if it is Charlie Houston's) and listen to these favorites of mine. Harvey


Acclimatization theory and practice differs widely between climbers.
Alex MacIntyre, The Shishapangma Expedition page 105

One man acclimatises quickly, another slowly…The whole process appears to be analogous to sea-sickness about which predictions are impossible.
Eric Shipton, Upon That Mountain page 376

here we go...the magic meter (not). Same now as in 1924.

This matter of acclimatization…is so very real…yet it is so indefinite, so immeasurable. That is it – we want somebody to devise a simple meter.

Bentley Beetham, Chapter VIII in
EF Norton, The Fight for Everest 1924, page 177

That situation on Shasta has much more information which everyone needs to read in detail before using it in this context.

Why do people climb the mountain anyway?

The message I'm trying to put out there is that people new to the sport of mountaineering shouldn't think that it is standard practice to use Diamox in place of proper acclimatization. Don't threat this sport like a race. It isn't. It's not just getting to the top but also how you got there. The journey is just as good as the destination. Don't take shortcuts, that's how you end up in trouble. Ed Viesturs knows a thing or two about mountains and he would tell you to not take shortcuts to the top.

Thank you very much astroclimber for sharing your story and h_lankford for posting the link to the exceptional High Altitude Tutorial. I'm headed up Whitney at the end of June with my teenage son for the first time. Your story about AMS is a great lesson for the both of us and, after studying the tutorial and hearing your story, I'm headed to my doctor to discuss bringing emergency medicine with us. I've always known that descent was the best remedy, but your story was the first time I realized the kinds of situation that medicine may be needed in order to descend safely.

I'm having my son study the High Altitude Tutorial and am going to be quizzing him on it too since my life could be in his hands if I'm stricken and he's the one who needs to make the decisions.

We'll be acclimatizing for three days beforehand (Yosemite, Mammoth and the trailhead) and we have a three night trail permit so hopefully we have enough time to acclimatize and then ascend slowly if needed.

--John

Quite a story - thanks for sharing. I'm headed up next week with my son on our first trip. Seeing what happened to the one member of your group, I thought I'd ask my doctor for an emergency prescription of dexamethasone that we could have in our first aid kit. He refused to give it to me - citing that it has some pretty serious side effects. He said that if you get in that kind of situation, you need to call for rescue immediately rather than take dexamethasone.

I tried to explain the type of situation you were in that rescue required a couple thousand feet of descent with tricky terrain and the dexamethasone made it possible for that descent to happen. He wouldn't budge. No dexamethasone in our first aid kit.

He did prescribe Diamox and thinks we should take that to help prevent AMS. I took the prescription to preserve that option, but I'll have to read more about Diamox and decide if we want to take it or not.