Some of you may have seen on twitter, but I had a partially disastrous trip to Peru. I developed High Altitude Pulmonary Edema (HAPE). Apparently HAPE is really hit and miss. Could be genetics, could be I was a little sick and over compensated, could be my lungs were damaged from COVID last fall. Anyway here is my somewhat running journal of what happened.
I hiked a 15,700’ mountain pass in the Andes with High Altitude Pulmonary Edema (HAPE) and survived to make this description.
I’ve been planning an Andes adventure for a couple of years now with the trip postponed last year due to the pandemic. Finally got it set for first two to weeks of Sept. I trained by walking around the St Paul hills and lots of stair work too. Unfortunately you can’t train for altitude in Minnesota.
I arrived in Cusco (elev 11,000’) 2 days early, did some walking around and included a steep walk to a religious statue with a 700’ elevation gain in just over a mile. Did great. The first day was a drive from Cusco with an elevation gain of 3,000’ then a warm up hike of 7 miles all above 14,000. Did well, no ill effects. Some heavy breathing at steep parts but to be expected.
Things went bad in my tent at night. I had a constant nonproductive cough that kept me awake all night. Literally a short cough every 5 seconds from 8:00p to 6:00a. I slept, if at all, for maybe 20 minutes. Next day on hike I had literally no energy. I need constant breaks and while I was gasping in buckets of air, other hikers just waiting breathing somewhat normally.
After a beautiful mountain glacier lake we we headed up to a pass at 15,700 feet. I made it but a big struggle. Rest of the route was generally downward but some rises too. Overall 9.65 miles of hiking, all over 14,500 feet in elevation.
We checked my o2 sats at camp and I was hitting about 60 percent. 86 percent is considered pretty good at that elevation and I was given o2 to help. That night again the constant unproductive cough. And no sleep. So two days, 17 miles hiking in 14,100-15,700 elevations and no sleep.
Next day I was given remaining o2 but would now ride a horse as we had two passes at 16,665 that day. No way I was making it 9.95 miles without a horse. Camp that night at 15,700 feet. It snowed two inches on tent that night. I just hunkered in my tent from approximately 3:00p on. At one time my o2 sat was 58% and once I put boots on to pee outside tent, got back in sleeping bag exhausted. O2 sat was 50%. More o2 had to be taxied 3 hours from Cusco and then brought by horse another 20 minutes. It arrived at 11:30pm.
Next day another horse day but we would get to place where taxi could bring me back to Cusco. 7 miles of riding but I had to get off horse a couple of times because downhill was too steep to be safe riding. Taxi arrived at literally “mountain road ends at an Alpaca Hut.” But 3 hours later I was in Cusco hoping lower altitude would help. Unfortunately it didn’t help at all.
Next day Expedition company took me to clinic for Covid test (negative) and then for tests. Cat Scan showed lungs 30-40 percent compromised. Some docs thought Covid and was a big controversy. Finally the most senior doc said no Covid. But HAPE. Went to ICU with regimen of o2 and steroids. Numbers improved. Did hyperbaric chamber for 1 hour next day. But now docs being weird. They were ignoring me and expedition company thought they were going to try to milk my stay.
There were two other expedition events planned for Saturday and Sunday I was hoping to do. The sacred Inca Valley and Machu Picchu - both at lower elevations. No arduous hikes, sleep in city hotels. Alas Sacred Valley had to scratched. We basically broke out of hospital Saturday afternoon by insisting that I had a plane to catch back to US. My numbers looked good (enough) and I could survive. It took some cajoling but I was released.
Aside: I was in hospital 4 days, 2 in ICU and 2 in a private room. 3 hyperbaric chamber sessions, CT Lung Scan, blood work, etc. Cost: $1,650. Meds extra but less than $200. We have a serious medical cost issue in this country.
To make it to Machu Picchu for the last train of the evening we had to catch a taxi and rush through Cusco Saturday night traffic, a rock slide outside of town and police checkpoint. Lots of stimulation for a guy who just spent 4 days in hospital hooked to o2. Made the train by 8 minutes. But through some expert coordination was able to make it to Aguas Caliente that evening to meet up with the group for an early morning (5:30a) train ride the next day to Machu Picchu. Which is even at a lower elevation, roughly 8,200 feet.
And there I am, Machu Picchu, weary, woozy, kinda emotional, but breathing and enjoying the heck out of all of it. Fin.
I'm glad you made it back.
Same.
At least the trip was memorable.
Sounds like you were in some hot water getting to Aguas Caliente 😉
And I thought nighttime altitude apnea was annoying -- glad you at least got to do some of what you'd planned. And got back safely.
You mentioned Edema - did you have water buildup in your feet/ankles? Did they give you water pill?
I don't think I did have any other water swelling. To be honest I am not sure of all the drugs they gave me.
Thanks for well wishes. Saw a doc today. No lingering or other issues I should address. Doc said the Peruvians knew what they were doing to get me out of hospital and moving around after 3.5 days. Also admonished me for going hard right out of hospital. “You need to ease up now.”
Whoa. Whoa. Glad to hear you are basically all right now.
Wow, that sounds like quite an intense experience. Glad you're home and healing!
Memorable, yes. But as with the blessing of living in interesting times, the details contextualize the adjective… I’m glad you’re okay, free.
Peru is pretty high on my list of South American destinations I’d like to visit. Based on the Peruvian restaurants & food carts I’ve sampled, I am absolutely convinced that Peruvian cuisine is, like Vietnamese, one of the world’s greatest. I’d love to eat the local delicacies that probably don’t make it this far north.
¡Oh Dios! No bueno, free! Glad you're safely back home.
Yikes on a hike! As others note, glad you made it home to tell the tale.
Aside: I was in hospital 4 days, 2 in ICU and 2 in a private room. 3 hyperbaric chamber sessions, CT Lung Scan, blood work, etc. Cost: $1,650. Meds extra but less than $200. We have a serious medical cost issue in this country.
What makes you say this? /wink
Wild tale. Glad to see you are doing better.
Not sure if anyone reads the Welcome to Hell World newsletter but he recently collected stories just like this one and shared just how different the costs were. Pretty crazy.
Also I was thinking given the situation that RR mentioned today regarding ICU's near his father, how I had no problem getting into ICU. Peru is only about 33 percent fully vaccinated but I was the only one in the ICU, except for someone who came in Post-op.
Peru's COVID rate is also 1.9 per 100,000 while the US is 32 per 100,000 (according to the NY Times). I think I said above but mask usage was almost universal, both inside and outside. Busy places like clinics, bus/rail stations, airports, etc. You also needed a face shield. Sad commentary on this country.
One of the considerations for our trip next month was, of course, will it be safe?
Looking at vaccination, testing, positivity, and mortality rates, Minnesota is by far the most dangerous part of our itinerary.
The US has problems but I don't think we want to emulate Peru. They've had 199,000 deaths out of 33 million people. Current rate of infection doesn't tell the entire story.
I wasn't trying to and the Delta Variant hasn't really hit them (yet?). Will Peru get vaxxed enough to stymie it or will the aggressive masking help? Will be interesting to watch.
I hope they do.
It seems like without vaccines, masking just kicks the can down the road.