A Funny Little Thing Called H.A.P.E

Posted: June 3, 2011 in Uncategorized

Altitude has a number of remarkable effects on the body, most of which are poorly understood.  The high altitude environment is so foreign from the one for which our bodies were designed that we have an extremely difficult time coping and/or compensating even for just a short period of time. The process of oxygenating the blood becomes exceedingly difficult. Basic motor functions are compromised and eventually the lack of perfusion of oxygen to the body’s cells makes maintaining healthy tissue impossible.  Those looking to sensationalize love to refer to the “Death Zone,” the altitude above which the human body can no longer acclimatize and thus begins to starve itself of oxygen and tissue death occurs.  Generally this elevation is agreed to be 8,000 meters, but there is no magical threshold and this process begins at different elevations for each of us.

Despite popular belief, lack of oxygen is not the culprit of these debilitating symptoms.  As high as 70,000’ the amount of oxygen in the air remains constant at 21%.  Rather, a decrease in atmospheric pressure is the real villain.  Less densely packed molecules reduce the available oxygen as well as impair respiration efficiency.

Under ideal conditions (sea level: 1013 millibars) the diaphragm and intercostals muscles contract, opening up the chest cavity and creating a low pressure in the lungs.  Surrounding air rushes in trough the mouth and nose to equalize the pressure differential.  This process is known as Negative Pressure Breathing.  Once filled, air in the lungs travels through progressively narrowing passages called bronchioles until it reaches the alveoli.  This system is often referred to as the “respiratory tree”, and like the leaves of a tree, the alveoli is where the exchange of oxygen and carbon dioxide takes place.

At 8,000 meters, however, the average atmospheric pressure is 350 millibars, roughly 1/3 of that at sea level.  When the diaphragm contracts creating a negative pressure, the gradient with the ambient air pressure is much less pronounced resulting in far less air rushing into the lungs.  Moreover, the air molecules are less densely packed so the available oxygen is further reduced.  The physics around which our bodies were designed are altered at altitude, and as a result our ability to nurture our cells with oxygen through the process of respiration suffers.

Though one could not live at these elevations, climbers have long been darting in and out of these inhospitable high altitude environments in search of the summit.  The idea is to enter and exit upper elevations before the negative effects of altitude are able to take hold of the body.  Beyond minimizing ones exposure with light and fast assaults on high peaks, bottled oxygen is often used to increase the length of time the body can spend at these elevations as well as increase respiration efficiency.

Our intention was always to climb and ski with oxygen.  Climbing an 8,000 meter peak is difficult, skiing an 8,000 meter peak is extremely difficult, while skiing and documenting the descent of an 8,000 meter peak is an exceptional pain in the ass.  This is especially so on a mountain like Lhotse that has never been skied and extends well into the so-called “Death Zone” at 8,516 meters.  Kris and I agreed to do everything in our power to increase our chances of success as the odds were stacked heavily against us.  We would carry all of our own loads, which would include the precious gas that would hopefully help us reach the summit.

The days leading to our summit push were extremely difficult.  Our rest day at Camp II was spent on a rescue of some climbers who did not know when to say when.  The rescue extended late into the night with Kris and I suiting up in our down suits and heading onto the mountain twice that night.  At 1:00 am we crawled into our tent exhausted.  Miraculously all parties were still alive.

The next day we woke and continued to Camp III.  We were cooked from the night before and the loads were heavy, but we still managed good time.  The views were spectacular that evening with clouds dancing around Pumo Ri and Cho Oyo in the setting sun.  We were tired but felt good.

The trip to Camp IV was brutal.  We added two bottles of oxygen, a stove and fuel to our already heavy loads.  Our bodies strained under the additional weight as we slowly continued up the Lhotse Face.  Progress was slow.  I felt almost lethargic as I forced myself to ascend the fixed lines.  My coughing fits were becoming more pronounced and frequent.  At around 7,300 meters I decided I had enough.  If I were going to have enough energy for a summit push and ski descent I was going to have to ease the pain a bit.  I broke out the oxygen and turned it to a low flow, just enough to get me to Camp IV.  The effects were immediately noticeable and Kris soon joined in.  The loads remained heavy but now felt manageable and our pace quickened.

Camp IV sits high atop the Lhotse Face just a couple hundred meters below the mouth of the couloir, which carves a direct path to the summit.  Kris and I gladly shed our packs and began settling in.  We chopped ice for brewing water and took our positions in the cramped tent.  We hoped a few hours rest would give us the energy needed for the remaining 800 meters to the summit.

Resting at 7,700 meters (25,250’) is a bit of a misnomer.  The body expends and immense amount of energy just to maintain itself.  Every breath taxes the body.   Despite this, excitement in the tent was high.  Months of preparation and weeks of climbing, carrying loads and acclimatizing were about to be put to the test.  We joked about my increasing coughing fits and bouts of dry heaving and vomiting.  After a few hundred more meters of climbing it would all be down hill.  The thought was almost incomprehensible to me.  Once again I was so close to reaching of one of my greatest dreams.

We were to start climbing at 1:00 am.  Sharing a sleeping bag, we tried to sleep.  I couldn’t.  More than excitement kept me from nodding off, however.  Every time I lay down breathing became difficult and intense coughing fits would erupt.  After a particularly violent episode Kris asked, “Are you all right, man.”

I thought for a few seconds and then replied, “No, I’m pretty sure I have pulmonary edema.”  In fact, I was sure I had pulmonary edema, a build up of fluids in the lungs.  By now a low gurgling could be heard with my every breath.  There was no choice.  Our midnight stroll would no longer take us towards the summit; we had to descend while I still had the strength to do so under my own power.  It was an extremely daunting task but both Kris and I knew time was of the essence.  We knew the entire mountain was listening to our radio transmissions, waiting to respond.  Kris and I have relied on each other many times in the past and I was now relying on him to escort me through the night to safety.  A rescue was the last possible option.

High Altitude Pulmonary Edema (HAPE) is one of the bodies less understood reactions to altitude.   There are two primary causes for the accumulation of fluid in the lungs.  The first is a build-up of pressure in the pulmonary vessels called pulmonary hypertension.  Second is a spontaneous increase in the permeability of the vascular walls.  The combined increase in vascular pressure as well as permeability of vessel walls allows plasma, the fluid portion of blood, to seep through vessel walls and into the lungs.  It is not completely understood why these reactions occur, but the outcome can be fatal.  Beyond medications and oxygen, which can help stabilize a patient, descending is the only cure for HAPE.

The decision to descend was easy, but that doesn’t mean that it wasn’t emotional.  It had taken a lot of time, effort and luck to get us to where we were and our goal was within sight.  Until this point the expedition had gone according to plan and both Kris and I, aside from a few hard days, had felt strong and confident throughout the trip.  It was all unraveling in the 11th hour.  I had to go down, that was clear.  What killed me, though, was that Kris was healthy and my condition was shattering his hopes of success as well.

Partnerships are what enrich your experiences in the mountains.  You see each other at your highest highs and your lowest lows.  You carry each other when your down and you allow each other to achieve things that normally wouldn’t be attainable alone.  The flip side is sometimes you are forced to make sacrifices.  Sometimes you have to put your ambitions aside for the sake of your partner.  I knew there would be no discussion.  Kris and I have had a long and very strong partnership.  Once my condition became apparent Kris never once mentioned the summit.  We had a new objective, to get me down safely.

Kris, Hennie and I would all agree, this was an amazing expedition.  The amount of laughter and smiles shared along the way more than make up for the disappointing outcome.  If you’ve played in the mountains long enough you know that things can change in an instant, and they did.  I know Kris will never hold the outcome of this trip against me.  It’s just how things shook out.  There will be other expeditions.   For this I will always be grateful.  The Selfless nature of our partnership is why Kris and I will continue to venture into the mountains together for many years to come.  I hope Hennie is there to tag along as well.

Thank You Kris.

Jamie Laidlaw

  1. drewski says:

    Congrats on the effort and coming home safely. Pulling off a rescue at high alt is no small feat. You deserve all the credit for putting your goals aside. Get strong, get healthy, and hope the remainder of the trip is good for you.

  2. Andy Olavarria says:

    I can feel the pain in your decision, but I’m glad that you’re all survivors. See you when you get back. Congrats for the expedition and the grand attempts you experienced.

  3. Hennie Snr. says:

    I’m so glad you guys made it down safely. Thank you for allowing us to share in your trip.

  4. Jordan P says:

    Damn dude. Gnar story. good to hear you have a real friend.

  5. Hettie says:

    Sorry that you did not make it all the way. Very thankful you all made it down safely, though!

  6. Kaz says:

    well done Jamie…best of luck on rest of trip. Travel safe and maybe see ya soon!

  7. Derek says:

    Way to be smart guys. Best of times on your journey home.

  8. drew s says:

    Wise decision. Glad you are safe and well. While I’m sure you’re disappointed, it is an impressive expedition. See you stateside.

  9. steve says:

    tough luck…but you are both honorable men.

    thanks for sharing your adventure.

    • Eric Knoff says:

      Amazing effort Jamie and Kris – Glad you are both heading home with everything attached. Enjoy the rest of the journey.

  10. Tad Jones says:

    Glad you were able to recognize the symptoms in time and had the will to act. Thanks for sharing such an amazing journey!! All the best to the members of your team & glad to hear you all made it down the mountain safely.

    • Kath Blackadar says:

      Way to go guys!!! You make us so proud!! Great adventure and thanks for sharing!!! So glad your are back for more adventures at home!

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