[alpine.quester]

Hi – I was recently diagnosed with HAPE (high altitude pulmonary oedema) following an attempt on a 7000m peak in Nepal. It is now confirmed has having cleared. I think I have a good understanding of why it happened and what I can do differently next time to minimize the risk of reoccurrence. What I would like to canvas though is what approach people have taken to returning to altitude following HAPE and how long you suffered continued impact to performance/lung function following diagnosis?

I know some people have been told “not to return to altitude for 6 months minimum” or even 12 months – but what does altitude mean and what has worked for people in the past? Has anyone found that the healing process has gone on for a long period or become an ongoing limitation?

I am not looking to substitute this for my own medical advice (my doctor has advised that the longer I give my lungs to recover the better chance they have of regaining pre-incident function and I don’t have any immediate plans), but I would be interested to hear what experiences others have had.

Topic

[Reed]

Reed on March 22, 2019 at 2:30 pm #18946

If you haven’t already, you might consider reading Charles Houston’s Going Higher: Oxygen, Man, and Mountains. Others may have additional resources to point you towards that might help you assess your risks and next steps.

[Steve House]

Steve House on March 25, 2019 at 9:32 am #19054

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.