The Hard Right: When Descending is the Best Option
She has HAPE, now what?
(High-Altitude Pulmonary Edema)
Any responsible mountain guide will tell you one of the toughest decisions is sending a client down the mountain ending their trip.
Tusker’s South America guide Andrew Springsteel had to make that hard, but right call this spring in Peru’s Cordillera Blanca. After two-a-day medical checks, Sharon, one of the trekkers had developed early signs of high altitude pulmonary edema at 13,000 feet. To continue upward to the trek’s 16,000 foot goal would have risked her. She had summited Kilimanjaro twice and knew what HAPE could lead to. Still it was hard for her to accept Andrew’s assessment telling her to head down to Huaraz, the city below the Cordillera.
“I’m a bit competitive, and I hoped that my symptoms might also be caused by an unrelated GI infection, which might pass. Andrew gave us a few minutes to shed a few tears, catch our breath, and let logic take hold. Andrew’s recommendation was not made lightly. He knew what we had invested in the trip. We knew that there was only one thing more important than completing the trek and that was safety,” Sharon says.
When ego gets in the way
Sharon was disappointed, but didn’t let her ego get in the way of a chance to take another high altitude trek or more importantly risk her life. However, there are some trekkers who refuse to go down despite their life threatening symptoms and that’s when things get tense. Tusker founder Eddie Frank has been in these situations during his 40 years leading worldwide treks and expeditions.
“It takes serious convincing, but this is what a good guide needs to do. It’s a balancing act, where you need to be friendly but professional You need to do some hand holding but at the same time be firm,” Eddie says. “Climbers pay a lot of money and invested dream capital in this trip and often are in denial about being ill, but altitude sickness does not go away over time, only after descent.“
The hardest to convince are the type A’s who come on Tusker trips. These are often a successful professional or star athletes who have a hard time accepting failure. “We had an executive with pulmonary edema who refused to accept that he was ill, but when we got him down to the hospital they said we had saved his life, yet he was troubled for years because this represented failure.”
Mitigate and continue upwards
Nearly all forced descents and evacuations are due to altitude sickness and are most prevalent on Kilimanjaro, the highest Tusker destination at over 19,000 feet. On Tusker’s shorter routes up the mountain the forced descent rate is around eight percent while on the longer nine day routes the failure rate is just one to two percent.
When Tusker guides have a climber with altitude sickness, they make every attempt to fix their the problem including giving them oxygen and delaying the ascent. The general rule is caution, and that means taking climbers down with an accompanying guide, Eddie says.
Non-altitude related problems most frequently includes stomach bugs. A few years ago, when a bug hit a group they blamed Tusker for not keeping a sanitary kitchen. Even though Tusker keeps a highly sanitary kitchen, they continued to blame the food. It turned out that the energy bars the group had eaten where tainted by salmonella from bad peanut butter that came from a now shuttered Georgia factory. There are many elements about an adventure travel trip that are beyond a leader’s control, but they must make that hard-right call to protect trekkers’ health when things go bad.
In a remote corner of Mongolia, Ravi dislocated his shoulder while on a Tusker Trek. With his deep medical training, Eddie reduced the dislocated shoulder and kept Ravi in the field.
Do the right thing
But for those who fail to complete the journey it still stings. Some like Sharon can sympathize with Eddie and Andrew’s hard-right decisions.
Sharon concluded, “I was provided with great care and recovered enough to continue with plans to experience Machu Picchu and the Galapagos Islands. I am disappointed; however there will be more opportunities.. Abandoning the trek wasn’t much fun, but it was the right thing to do,” Sharon advises that trekkers should trust their guides and accept it when they have to make a decision that’s the hard-right.