gdurkee wrote:Whoa!! These are all classic.
Night 2: they're having trouble sleeping. They may (?!?!) find it more comfortable to sleep sitting or propped up. Very bad sign. Fluid is significantly accumulating in the lungs. But don't depend on this as a sign.
The big sign is day 3. The person is very slow. They walk maybe 200 feet, stop, bend over and breathe; another 200 feet (or less). Stop and breathe. They are hurting. All of you are in trouble at this point. .
Yes, he couldn't breathe laying down, and sat up a lot. At the time this was new to me. If it happens again, I'll know it by day 2, its the way his head hangs down, how he moves, etc. On the 3rd morning, tieing his shoe or coming his hair was a big ordeal. He was totally helpless. One foot in front of the other was hard for him to do. He had to be talked to constantly.
gdurkee wrote: If at any point someone is slow to respond to answering questions, making decisions, hallucinating, stumbling -- ANY mental impairment, YOU NEED TO DESCEND IMMEDIATELY! Whatever time it is, you need to get down about 2,000 feet if possible. Even 1,000 feet is helpful. Someone's also got to go for help; whatever time it is. It's a difficult decision to make, but if you can't move the person down, you may have to leave them alone to get help. There's nothing else you can do for them if you can't get them down. Oxygen will help, but the only thing that will cure them is low altitude.
I got him to Rock Creek, then ran to the ranger station. I had to run to keep up with the ranger on the way back to Rock Creek, he moved FAST. SnowDude drinks a lot so he wasn't dehydrated. The morning we descended to Rock Creek, he drank 100 oz just that morning. On the trip where he was helo'd out, he said he had to pee, but when he crawled out of his tent, he couldn't. He crawled a lot the night before someone got help.
gdurkee wrote:By the time you can hear fluid in the lungs (and in the 70+ cases I've seen, I've only heard rales with a stethoscope maybe 5 times) they could be less than a day from dying. When they're actually gurgling, you don't have much time. Hours, maybe.
"Rales" (and there's some disagreement about the term) describes the crackling you hear, like hair being rubbed together when you listen to the lungs closely. On the off-chance you have a stethoscope, try the right upper lung close to the armpit. But don't get hung up on this as a symptom.
The first two times (3rd morning), he breathed out so I could hear the gurgling. The last time (3rd morning again) it woke me up. It was dead quiet in the morning, and I'm a light sleeper. The gurgling woke me up! We didn't need a stethescope to hear it.
gdurkee wrote:The main symptoms of HACE are a severe headache, unrelieved by aspirin etc., sleepiness/groggyness or altered mental state (hallucinations, slow to answer, can't make decisions etc.). This is obviously another medical emergency. Only descent will help them and you've got to do it while they're competent enough to walk.
The first time (I didn't know him then) he said his symptoms were more like HACE. He couldn't pee, sleep, eat, or talk. He was out of it. Symptoms started on the 3rd day. He was helo'd out from Guitar Lake on the 5th day.
Hopefully, with all the precautions we won't see it again.