High Altitude Pulmonary Edema...a month later?
October 28, 2015 12:04 PM   Subscribe

I think I might have suffered High Altitude Pulmonary Edema during a hike a month ago. Why do I still have scratchy lungs and a "gasping" sound when I inhale?

Obviously, YANMD. However, I love non-professional medical opinions and would love yours!

A month ago, I went on a moderately strenuous hike for me—a 35-year-old, semi-out-of-shape person— at almost 12,000 feet. I started hearing a "gasping" sound after every inhale, plus shortness of breath, and rapid heartbeat (no nausea, headache or pain). It calmed down once I descended and drove back to Denver, where I live.
About two weeks after the hike, I ran up about 12 flights of stairs to the gym on my building's roof and did some stationary bike. I started feeling very sick, exhausted, out-of-breath and too-rapid heart beat. I haven't exercised since because it scared me.

Even now, when I inhale sharply, I can still hear the gasping sound (it sounds a bit like a balloon blowing up, after the normal rush of air when you inhale), and my lungs feel irritated and scratchy, like I'm always on the verge of (dry) coughing. No pain, isn't an emergency, but I just want to know what the problem is.

My first question is this: Does my attack during the hike sound like High Altitude Pulmonary Edema?

And here is my second question: A month later, could I still be suffering symptoms from that attack, or shouldn't my lungs have returned to normal?

Finally, my third question: If I don't still have HAPE, then what else could be causing my scratchy lungs, gasping inhaling sound?

Oh, and I have no history of asthma or other lung issues. Thanks in advance!
posted by straycatinthewildwest to Health & Fitness (13 answers total)
It's possible that you still could be having symptoms from your initial attack, but we, the internet, are not going to be able to diagnose you. You need to visit your GP.
posted by Specklet at 12:15 PM on October 28, 2015 [3 favorites]

Go to your doctor. Breathing is important, yo.
posted by fluffy battle kitten at 12:57 PM on October 28, 2015 [9 favorites]

If the information on Wikipedia is to be trusted, HAPE is both a) quite rare:

"The U.S. Army Pike's Peak Research Laboratory has exposed sea-level-resident volunteers rapidly and directly to high altitude; during 30 years of research involving about 300 volunteers (and over 100 staff members), only three have been evacuated with suspected HAPE."

and b) a medical emergency that is pretty deadly if not treated immediately:

"HAPE remains the major cause of death related to high-altitude exposure, with a high mortality rate in the absence of adequate emergency treatment."

It's way more likely that you have something simple like seasonal allergies, or maybe some mild asthma that's continuing to bug you when you exercise. For any definitive information, you need to your medical provider, because no one on the internet can diagnose you or advise you about treatment options.
posted by jesourie at 12:57 PM on October 28, 2015

It could be bronchitis which is an inflammation of the airways caused by any number of things. Or adult-onset asthma which is apparently a thing that can happen. In my experience, waiting around on breathing issues hoping they go away rarely works.
posted by muddgirl at 1:08 PM on October 28, 2015

Specklet's dead on. In a lot of training in wilderness first aid I've received it's always noted that even for trained professionals it can be difficult to do on the spot diagnosis between HAPE, bronchitis, pneumonia, certain underlying chronic pulmonary conditions, and even asthma. Even simple dehydration can be misdiagnosed as altitude sickness. You need to see your doctor; your problems may stem from simple exertion from being out of shape to "standard" altitude sickness to something more complex. Your doctor can also recommend an exercise program appropriate for how in shape you are.

One thing you don't bring up is any kind of mental impairment. One of the standard signs in any kind of altitude sickness, including HAPE, are problems with judgement, confusion, apathy, disorientation, etc. That and the lack of nausea and headache makes me, a random person the internet with zero actual medical training, think you didn't have an episode of HAPE, which is just another good reason to go to the doctor. I'm only saying this because I know what it's like to be 35 and in not great shape, and wanting there to be some reason why I can't. . .do what I want to do as easily, if that's at all part of it (not saying there is.) :) HAPE or not you should see your doctor to figure out what it is.

Oh, and after you go to the doctor and you're cleared to do stuff, and you'd like a companion to go do wilderness stuff but need someone who has to take it slow or moderate, send me a MeMail! I'm in Denver as well, and am recovering from a broken knee - I have to go slow.
posted by barchan at 1:13 PM on October 28, 2015

Even now, when I inhale sharply, I can still hear the gasping sound (it sounds a bit like a balloon blowing up, after the normal rush of air when you inhale), and my lungs feel irritated and scratchy, like I'm always on the verge of (dry) coughing.

This sounds to me like a partially collapsed lung which finally inflates only when the relative vacuum you generate with every indrawn breath reaches its maximum -- possibly due to a blocked or collapsed bronchial tube?

Which would be pretty serious, and I think you should see a doctor as soon as possible.
posted by jamjam at 2:59 PM on October 28, 2015 [1 favorite]

Cardiac edema can also interfere with breathing and give a cough, fluid around the heart. So do as your mefite buddies suggest and see your doc soon, especially if your coloring has become pale to bluish. I have a friend who has bad episodes of a fib, they present as tiredness, cough, pallor, cyanosis.
posted by Oyéah at 4:22 PM on October 28, 2015 [3 favorites]

I have exertional asthma, meaning I can breathe find most of the time but if I really push it with exercise all of a sudden I feel like I'm almost choking, and your symptoms sound a lot like what I have. It's pretty easy to get this checked out at a doctors office, and if it turns out that's what it is it's really easy to manage with medication and/or some small lifestyle changes.
posted by jessamyn at 4:22 PM on October 28, 2015 [1 favorite]

Go see a doctor, because even the milder options for what this could possibly be are things like mild asthma or bronchitis which are likely to respond much better to an inhaler than to just waiting for them to get better.
posted by Sequence at 4:58 PM on October 28, 2015 [2 favorites]

Could be silent acid reflux, too.
posted by easter queen at 5:11 PM on October 28, 2015

One of the main signs of HAPE is shortness of breath while you're at rest. Or, in other words: you're not exercising but you are still having trouble breathing. So it seems unlikely that this problem is HAPE.

Nevertheless, you are having trouble with your breathing and it has been almost a month and it isn't going away, so you should go to the doctor and get checked out.
posted by colfax at 4:59 AM on October 29, 2015

There is a lot of pertussis (whooping cough) going around. It sounds like you may have it. But check with your GP -- there are antibiotics that can cure you.
posted by prk60091 at 8:54 AM on October 29, 2015 [1 favorite]

IANYD and this is not medical advice, just some general medical information. You asked for non-professional opinions, so maybe that doesn't include me, but I'll give my opinion anyway.

The usual onset of HAPE is 1 to 4 days after ascent of 8000+ feet altitude. Denver residents are already at over 5000 feet altitude normally, so they have a degree of acclimatization, and would be unlikely to develop HAPE by only ascending another 6000 feet (besides which, as noted, regardless HAPE is quite rare.

Cardiac pulmonary edema or a collapsed lung don't resolve quickly after you stop exercising. I agree with those who say more likely asthma or similar, and also that you should see a doctor right away, because there are a number of possibilities and difficulty breathing is nothing to mess around with.

Disagree with reflux, for which symptoms should not be related to exercise but rather to lying down or what/when you're eating.

Disagree with whooping cough - you didn't mention coughing at all, and the symptoms of whooping cough don't get better when you stop exerting yourself. For the same reason it's unlikely to be pneumonia or bronchitis.
posted by treehorn+bunny at 5:27 PM on October 30, 2015

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