Hi Alpine-quester,

My understanding and experience is that one can recover from HAPE and return to altitude in a very short time-frame. Whereas with HACE and AMS, if you get that your expedition/climb is done. The key is you have to be able to descend low and get the lungs clear.

Here is my personal experience: In 2009 I came down with HAPE during a solo attempt on the west face of Makalu at 6800m when stuck in a tent in a storm for a couple days. It took me 1 very long day to get to BC (very tough day, one of my hardest experiences in the mountains). But BC was still 4800 m. I spent the night in the Gamov bag, then walked down as low as I could get, to 11,000’/3300m (approx). I spent 4 nights there, my lungs cleared completely. I did a couple phone consults with Dr. Peter Hackett and he said as long as I felt fine I could try again. I went up one more time on that trip but got turned around at 7,000 meters but never felt HAPE symptoms again on that trip (or ever since). I did take Niphedipine and Cialis during the incident but discontinued when I returned to BC after the rest low in the Barun valley.

I wrote an essay about that experience in Training for the New Alpinism which you can find on page 363.

One of the things we don’t understand well about HAPE is what the trigger is. I’ve been above 7,000m many many times (50+?) and used basically the same acclimatization time-frame every time, and I got HAPE once, doing nothing different. If you talk to other experienced high-altitude climbers you’ll hear similar stories.