High Sierra Topix

I was leading a May ascent of Mount Shasta on the normal route. We got to 10,000 feet to camp overnight, and several tents were placed within 10-20 feet of one another. We all crawled in for sleep around 9 p.m. since we planned on moving out toward the summit at 5 a.m. Around 1 a.m., a guy from the next tent woke me up. It seems as though his tent mate was having some kind of trouble, and it was reported as a racing heart and disturbed breathing. I went to check on the guy, and I couldn't detect any obvious reason for symptoms. His breathing was rapid, but deep. Since I couldn't do much for him there in the middle of the night, I gave him one pill and instructed him that he should probably not go to the summit unless it all cleared. We slept, and that guy did not go to the summit in the morning.

What was the pill? A salt tablet, as a placebo. It seemed like the guy was suffering from anxiety more than anything else. If his breathing had been rapid and shallow, I might have had to do something else.

As an overall practice, I think I wouldn't be giving anything to someone unless you completely understand the underlying problem Here, it could well have been a panic attack but I'd sure want to eliminate HAPE, Cheynes-Stokes, CHF etc. etc.. Salt isn't a benign placebo type choice since there are weird relationships between blood pressure, electrolytes and breathing (I say weird 'cause I don't understand them). I don't know the state of research now, but at one time there was a thought that high salt intake contributed to HAPE. The advice not to go higher was, of course, right on but just want to point out that a salt pill might not act as a placebo in the sense that it might have real physiological effects. If it is a panic attack, just talking to the person for 10 - 30 minutes or so should see a resolution of symptoms (rapid breathing, high heart rate, sometimes tingling around mouth and tongue, feeling like you can't get a full breath). If that doesn't happen, there could well be something else going on.

I've been around enough climbers that were having real symptoms of AMS and HAPE and HACE.

That article was good reading. Thanks.