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Below is a description of the tragic, and completely avoidable, death of a young woman from HAPE and HACE in the Himalayas.
"This is the story of my daughter Rachel Burke who went on an Adventure Holiday and came home in a crate.
Rachel was only 28 years old. She had a very active life. She had just completed a half marathon and played squash at least once a week. She loved wind surfing and diving and was a fairly competent skier. She had done some training for this holiday by going on long walks up hills (admittedly not had any walks where altitude could be a problem).
She left for Kathmandu on 15th April 2011 and after a short stop there flew to Lukla which is 2840m on 17th April 2011. After 3 days of walking they had reached Namche Bazaar which is 3440. They had an acclimatising walk of 450 m and back.
On the 20th April they left Namche and trekked to Dole which is 4040 m. She was behind with 3 other people. That night she did not get much sleep as she was coughing a lot.
On the 21st April the group then made a further ascent to Machermo. Rachel was much slower then the rest that day and her friends reported that she arrived 90 minutes after the others and she was very tired and coughing a lot. She had been given some Diamox by this time and her lips were turning blue. She had something to eat then took part in a 30 minute acclimatization walk and then returned to Machermo where they stayed for the night. Her friends have said that she was very tired by this time and they sorted out her bedding and they made sure she had the warmest part of the room. She had to sleep sitting up because of her cough but even so none of them got much sleep that night because she was still coughing sitting up. She was also having problems breathing by this time and her friends (one of them is a nurse) thought she had a chest infection.
On the 22nd it was decided that Rachel could not go on further up the mountain and two guides supported Rachel for a little way down the mountain. (The guides still did not think that Rachel was showing any signs of Altitude sickness). One of the guides returned to the main pack and she was left with only one person to help her down the trail. This is where it gets hazy and I don't really know what happened but when she got back to Dole which I think took the best part of the day she was in a very bad way and could not go on any further. Two American doctors became involved along with a Swiss trekker here. Her guide managed to find a place for her to stay and he rang the guide leader and a helivac was ordered for the first light the next day. They tried to organise porters to take her down further to Phorse Tangna but when one of the American doctors examined her he said that it was too late and that she probably only had 2 hours to live. They then tried to stabilize her on the spot by giving her 12mg of Dexamethasone and 20mg of Tadaliafil. She was then placed in a Gamow bag where she did show signs of improving. She suddenly deteriorated and it became necessary for one of the American doctors to administer CPR.
She died on 23rd April at 00.45 am in a dining room of a tea house surrounded by strangers.
She had to have a post-mortem while she was out there and the death certificate said that she died of Coronary Arteriosclerosis associated with High Altitude Sickness.
The internal examination of the lungs showed that they were both spongy and smooth surfaced. On sectioning both the lungs were congested. Is this a sign of HAPE? (this is what the Swiss trekker thought she had wrong with her).
Also her brain appeared oedematous.
I would really like to know more about my daughters last day on this planet and I would like to think that she had the best treatment that could have been given, but most of all that her life ended easily without any pain and her realising what was happening to her.
I know that the treatment of altitude sickness is to get to a lower level, but in Machermo there is a medical centre and rescue post, would it not have been better for her to go there because of her breathing difficulties and cough.
We had the funeral on Friday 13th.
I just hope that this story is told so that it will make people aware that High Altitude Sickness can be fatal."