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My Worst Hike: Weary Lungs—Or a Deadly Medical Emergency?

A hiker starts experiencing coughing fits and chest pain on the trail. Is it just the aftereffects of a long day, or something more serious?

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I’m sick of chewing, I thought to myself while cramming another Built Bar down my gullet. Between spurts of speed-hiking, I knew I had to fuel myself, but food had become a nuisance. I was down to my last 3 miles out of 50 on the Colorado Trail. I’d never traveled this far on foot in a day, but I’d wanted to test my speed and endurance. And I hoped to use the mountains to fine-tune my strengths as a hiker while evaluating my weaknesses.

The miles had come easily from the start. My feet felt confident and quick while scaling rocks. I flew up switchbacks, weaved my way through downed trees, and leapt toward each mountain summit with gusto—even the 12,000-foot ones. But when I began to dip down the last stretch of trail, the cold crept in. I’d been at it for over 12 hours, and the effort was beginning to wear on me. My breathing became more labored. I figured I was probably just tired. So, I jogged forward, knowing that I’d be in my car in less than an hour.

While I plowed down the mountainside, the sensation in my lungs worsened. It felt like a thick layer of goo was covering my alveoli, and I coughed to dislodge the phlegm in my chest. It felt like I’d suddenly come down with a cold, despite having been entirely healthy when I set out that morning.

I’m infamous for self-diagnosing from Wikipedia. I can’t help it. My mind often jumps to extremes at the first sign of trouble. It doesn’t take very much to convince me that I have a brain tumor or a mysterious illness that can only be found in a small number of people. It’d be just my luck to come down with a rapidly fatal disease while in the mountains. Although I didn’t want to stop to peruse any informational websites while in the mountains, I already knew the phlegm could just be a sign or exhaustion…or it could be High Altitude Pulmonary Edema (HAPE).

I’d never experienced HAPE before, but I’d read plenty of adventure books and seen mountaineering films that portray the condition. HAPE is a potentially fatal ailment that occurs at high elevations as a result of hypoxia (when the tissues in your body don’t receive enough oxygen). Those who rapidly ascend to above 8,000 feet are at risk of this condition, although it’s relatively uncommon at those elevations. Some of the symptoms include shortness of breath, headaches, and an early dry cough that may result in pink phlegm.

“My heart thumped loudly while I witnessed the ground sliding by. It was like I was looking down on myself from somewhere else, witnessing time pass without actually experiencing it.”

I’d been running and backpacking between 10,000 and 12,000 feet all day, which seemed like a far cry from the kinds of elevation that lead to HAPE. But what did I know about the lung’s capacity to adapt to these grisly Colorado climbs? The peaks are jagged and relentless, the arid climate makes it harder for your body to hydrate, and the elevations are high enough to make you see stars.

Just when I was becoming certain of my imminent death, I checked my phone for service, and sent a friend a message. He’d spent several seasons at Everest Base Camp, and I knew he would be able to shed some light on my suspicions.

“Hey, do you think it’s possible to get HAPE at 10 to 12,000 feet?” I hit send.

My message went through. But as I descended, I watched the bars on my phone drop to one and then to none.

I was alone in the wilderness with a mysterious medical condition. Great. 

I kept moving, knowing that spending excessive time up high would likely only worsen my labored breathing. If it was HAPE, the best thing I could do was descend to an area where the oxygen is thick. And if anything dire was going to happen, I didn’t want to be alone.

The light of my headlamp bounced with each step. My watch told me it was 10:12 p.m., and I was ready to be home. I just had to make it through the dark, across a forest service road, and then I’d be back to my car. My heart thumped loudly while I witnessed the ground sliding by. It was like I was looking down on myself from somewhere else, witnessing time pass without actually experiencing it.

By the time I reached the trailhead, I could only take short breaths, erupting into a fit of coughing every time I tried to breathe deeply. I settled for quick spurts of air, feeling alert and worried despite my 50-mile day. I had a 15-minute drive to the nearby town, where I knew I could seek medical attention or make a phone call. I felt confident that descending further would ease the tension in my lungs, and it did.

I hit the gas and wound my way through a series of mountain roads, listening to the gravel sliding beneath the wheels. I blasted the heat, feeling my fingertips thaw. Although it was a mid-summer evening in Colorado, the absence of sunlight has a way of zapping the warmth from the air. The heat seemed to open my airways.

When I noticed my phone lighting up, I pulled over and read the messages from my friend. He explained that he’d be really surprised to hear that I was experiencing HAPE at the elevations that I’d described—especially since I lived in the nearby town of Golden, which is already 5,675-feet high.

“But then again, you’re American,” he wrote in his salty Aussie fashion. A smile tore across my face. His words put me at ease, and I decided to wait for a few hours to see if anything changed.

Later that night, while self-diagnosing myself on the internet despite every doctor’s recommendations, I read that it’s more likely for someone to experience HAPE under heavy exertion, cold temperatures, and if they have a pre-existing condition. I’d certainly been exerting myself. It did get cold. And perhaps I’d already had a virus in my lungs. I began wondering if I’d only managed to cheat death because of my swift thru-hiker speed. Maybe I’d been closer to danger than I’d thought.

A few days later I went to see my primary care physician to address my phobias. She furrowed her brows when I asked her whether it could’ve been HAPE.

“It seems unlikely,” she explained.

She added that the high level of exertion, paired with the elevation may have caused a reaction in my lungs. Then she handed me an inhaler in case I decided to do something stupid in the near future. I walked out of the doctor’s office with more questions than answers. Since returning to Golden, my lungs have become functional again. My body feels strong, but the memory of my sticky lungs still lingers in my mind.