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Rescue Underway between Bierstadt and Evans

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Re: Rescue Underway between Bierstadt and Evans

Postby MtnClimber82 » Fri Aug 19, 2011 7:21 am

The reason I ask is Heat Exhaustion (leading to Heat Stroke) and Hyponatremia can have very similar signs/symptoms. The difference is Heat Exhaustion patients need water; Hyponatremia patients need sodium (and, perhaps, other electrolytes). Bananas have hardly any sodium and neither does Vitamin Water (the Vitamin Water has some other electrolytes, but not sodium). The Clif bar does have some sodium, but not a great deal (maybe 6% of the "daily need" based off the 2,000 calorie diet standards - again, not a lot). It seems to me that if you had Hyponatremia the water and vitamin water intake would have worsened your condition. However, each person acts a little different when suffering Hyponatremia depending upon their level of sodium deficiency.


This was not dehydration with a history of peeing clear and no rapid fluid loss from N/V/D. Like my buddy Shaw and others have said, my first thought too was hyponatremia. Then as the story progressed, just as Emily pointed out, I was surprised that the Clif Bar and Vitamin water helped the situation. Thus I no longer think it was hyponatremia.

jimlup mentioned AMS. According to my NOLS WEMT book, S/S of AMS are Headache w/ one of the following: N/V, loss of appetite, mild lassitude or fatigue/weakness at rest or insomnia. I did not catch any complaint of a headache so to me that throws out AMS. My one question though, what happened to your body after you got off the mountain? How did you feel when you got back to your car?

I also don't think it was heat related (heat exhaustion or heat stroke) due to no account of change in level of responsiveness or mental status which are key symptoms. Also no cramping or complaint of feeling chilled (skin: pale, cool and clammy).

My conclusion without seeing the patient in the field would be general fever. This could account for the feeling of being overheated and the feeling of dizziness and exhaustion. Its hard to say without actually seeing the patient and getting some key components, but that is my guess. Or heck, it could have been a weird combination of some of the stuff discussed plus who knows what else!

skydzntcare - I'm glad that you are doing ok now and glad you took the time to share your story for us all to learn from. It is important to know your body and know your limits. I hope you continue to stay safe in the mountains.

Derek - WEMT

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Re: Rescue Underway between Bierstadt and Evans

Postby Prairie Dog » Fri Aug 19, 2011 10:59 am

I am not a medical expert, but this doesn't sound like dehydration to me either. Given the symptoms, and the fact that food seemed to help alleviate the symptoms - is hypoglycemia or some other blood sugar related issue a possibility?

Chris

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Re: Rescue Underway between Bierstadt and Evans

Postby MtnClimber82 » Fri Aug 19, 2011 1:27 pm

It is hard to self-diagnose altered mental status or level of responsiveness, but with that said...

skydzntcare, if you don't mind my asking were there any times during your incident that you didn't feel like you were thinking clearly? Or gaps in time that you don't remember or don't make sense to you? Do you remember the people that helped you asking the same questions over and over again? Also, do you live in Colorado or was this a quick adjustment to our climate? Also, let me know how you felt once you got back down to your car. We'll see if we can't get a better idea of what was happening to you that day. Again, happy you are ok!

Derek

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Re: Rescue Underway between Bierstadt and Evans

Postby skydzntcare » Wed Aug 24, 2011 6:48 pm

MtnClimber82 wrote:It is hard to self-diagnose altered mental status or level of responsiveness, but with that said...

skydzntcare, if you don't mind my asking were there any times during your incident that you didn't feel like you were thinking clearly? Or gaps in time that you don't remember or don't make sense to you? Do you remember the people that helped you asking the same questions over and over again? Also, do you live in Colorado or was this a quick adjustment to our climate? Also, let me know how you felt once you got back down to your car. We'll see if we can't get a better idea of what was happening to you that day. Again, happy you are ok!

Derek


Felt fine until the climb back up sawtooth. Got more and more tired and out of breath as i climbed back up. I tried to keep a pace and while not over exerting. The part i was climbing had alot of loose dirt and some planted rocks to use. I was mostly dizzy, faint, nauseous, and of course out of breath. Just felt nauseous when i got back to my car with maybe a little headache. I've lived in Colorado my whole life. I was coherent the whole time i was up there as far as I can recall.

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Re: Rescue Underway between Bierstadt and Evans

Postby Alpine Guy » Wed Aug 24, 2011 8:25 pm

No idea what exactly skydzntcare experienced was but it sounds eerily similar to my summit day on Rainier a few years ago. We summited on the 4th day (long route from 3000ft) so we were plenty tired and probably borderline dehydrated starting out that day. Easily the hardest day of my life. After a broiling descent back to high camp, I collapsed in my tent and would shake uncontrollably for several minutes every time I tried to drink water. I chalked it up to severe dehydration but felt fine the next day (going down's a lot easier than going up). Maybe electrolyte imbalance or endocrine depletion but probably plain old dehydration.
Jay

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Re: Rescue Underway between Bierstadt and Evans

Postby EM_in_CO » Thu Sep 08, 2011 9:46 pm

skydzntcare wrote:... And just curious is it possible to be dehydrated after you pee clear? I'd think that peeing clear would mean you were hydrated when the water went through you about a half hour to an hour ago and you wouldn't know your dehydrated since peeing last because your body is absorbing all the water it can. I'm sure it's hard to dehydrate in that amount of time but under certain conditions I wonder if it would be possible.


Sorry for my delay in response; I was traveling and away from 14ers_com. To answer your question, skydzntcare, about water intake, I will use the answers I received from a nutritionist I worked with regarding some energy problems I experienced earlier this year. Water consumption/intake was part of my energy issue.

(1) Yes, you can be dehydrated and have clear urine. This occurs with diuretics (e.g., coffee, tea, alcohol, soda (caffeine), etc). This can also occur from a volume issue; for example, consuming large quantities of water in a short period of time. On average, the human body can absorb approximately 8oz every 15 minutes. If a person chugs 32oz of water in one minute, then that person will only absorb approximately 16oz of water (during the next 30 minutes) and uninate out the remainder of the water. This can also occur from other issues, such as low blood volume, high urine glucose levels, sudden drops in carb intake (e.g., fasting), and on and on.

(2) Every person should drink enough water (ounces) to equal half their body weight. For example, a person weighing 170 pounds should drink 85oz of water each day. This amount of water is for a non-activity day (e.g., rest day). On days a person exercises, he/she should drink half their body weight in ounces of water (discussed above) and then drink 8oz of water for every 15 minutes during exercise. If the person's exercise duration is longer than 90 minutes (e.g., hiking a 14er), then that person also needs to replenish electrolytes during exercise (e.g., drink an 8oz electrolyte drink every 15-30 minutes, eating an electrolyte snack, etc). The amounts during exercise can be adjusted to meet a specific person; one can do this by weighing yourself prior to exercise and directly afterwards. If the person gained weight, they can down-adjust the liquids. If a person lost weight, they can up-adjust the liquids.

(3) Dehydration is a cumulative state in a person's body. If a person is dehydrated for three days leading up to today and today (a rest day in this example) that person drank half their body weight in water, then the person is most likely still dehydrated. It is important to monitor hydration levels the days leading up to an athletic event (e.g., half marathon, hiking 14ers, etc).

One other point I will make regarding your food intake is to make sure you are getting protein into your system. That was another concern for me related to my energy issue earlier this year. I was eating oatmeal with raisins and a banana for breakfast, eating carrots (or another veggie) for a mid-morning snack, having an almond butter and jelly sandwich with wheat thins for lunch, and eating a granola bar (or some type of homemade wheat muffin) for a mid-afternoon snack. This food intake was resulting in my body not processing my food efficiently, which resulted in my body not being able to used stored fat as a source of energy. I was feeling lethargic during my exercise because my protein levels were not sufficient enough to balance the sugar, wheat, and other carb intake from my food.

Very glad you are safe skydzntcare and are able to make adjustments prior to additional 14er hikes.
Good luck
E

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