SummitPost.org

So sad to read about this. My condolences to family and friends.

Preliminary autopsy results for a climber who died on Mt. Shasta last month indicate he died of cerebral edema, or brain swelling caused by high altitude sickness.

Acute high-altitude sickness likely caused the cerebral edema, said Siskiyou County sheriff’s Detective Sgt. Mark Hilsenberg. He said the official determination...will be released once toxicology tests are finished in about three weeks.

Source:
http://www.redding.com/news/2010/apr/07/autopsy-brain-swelling-led-to-climbers-death/

I once struggled to the top of Langley alone despite symptoms and decided afterward that I should have gone with a partner...like someone of Peluccid Wombat's caliber.

Condolances to Tom's family and friends. Mark, you've been in my thoughts and I can't imagine what this experience has been like. I wish you well.

96avs01 wrote: We were carrying dexamethasone, and its administration did significantly improve my ataxia enough to allow us to successfully return to camp at 17K together.

Now I wonder if dexamethasone should become part of a high-altitude 1st-aid kit. It is an Rx drug, and misuse can be dangerous.

SeanReedy wrote:

Preliminary autopsy results for a climber who died on Mt. Shasta last month indicate he died of cerebral edema, or brain swelling caused by high altitude sickness.

Acute high-altitude sickness likely caused the cerebral edema, said Siskiyou County sheriff’s Detective Sgt. Mark Hilsenberg. He said the official determination...will be released once toxicology tests are finished in about three weeks.

Wow, that is really scary if no pre-existing conditions were at play.

Luciano136 wrote:

SeanReedy wrote:

Preliminary autopsy results for a climber who died on Mt. Shasta last month indicate he died of cerebral edema, or brain swelling caused by high altitude sickness.

Acute high-altitude sickness likely caused the cerebral edema, said Siskiyou County sheriff’s Detective Sgt. Mark Hilsenberg. He said the official determination...will be released once toxicology tests are finished in about three weeks.

Wow, that is really scary if no pre-existing conditions were at play.

The first reports said the autopsy was inconclusive. I wonder how certain they really are. How can they detect brain swelling when the autopsy was done 4 days after he died? It doesn't seem to fit the symptoms of his rapid deterioration, which is more in line with a clot or stroke.

Alpinist wrote:

Luciano136 wrote:

SeanReedy wrote:

Preliminary autopsy results for a climber who died on Mt. Shasta last month indicate he died of cerebral edema, or brain swelling caused by high altitude sickness.

Acute high-altitude sickness likely caused the cerebral edema, said Siskiyou County sheriff’s Detective Sgt. Mark Hilsenberg. He said the official determination...will be released once toxicology tests are finished in about three weeks.

Wow, that is really scary if no pre-existing conditions were at play.

The first reports said the autopsy was inconclusive. I wonder how certain they really are. How can they detect brain swelling when the autopsy was done 4 days after he died? It doesn't seem to fit the symptoms of his rapid deterioration, which is more in line with a clot or stroke.

Yeah, I kinda hope so. Maybe there was something else at play that eventually caused the altitude sickness and hence brain swelling.

twoshuzz wrote:Many are awaiting conclusive results for various reasons. For myself, I hope the findings give Mark and the family of the deceased the peace found in the closure they are looking for.

This is definitely and by far the most important.

I'm just curious to see if there's anything we can learn from it as well. I never heard of altitude sickness coming on THAT fast...

Since some people have been concerned about my reasons for asking 'why' or 'how' with Tom's edema, I'll just go into my thoughts and motivations here.

At this point, my questioning what happened is more for a piece of mind about the events than about decisions I made and any guilt attached to them. I know any of my feelings of guilt (mild as they are) at this point are irrational and I think it will fade if I'm just open about what happened and can come to a better understanding myself as to the circumstances. I like to know and understand things, especially when they directly affect me or are more salient (HACE is no longer a theoretical idea now - it is very personal). The mystery of this and the signs counter to AMS that I witnessed up until Tom's sudden ataxia and blindness just really bother me.

So I just want to talk with some experts, as providing a first-hand account of Tom's self-assessments and behavior leading up to the edema (and in light of autopsy findings) may bring to light some insights if there are any known explanations (possible or probable) within the field of high altitude medicine, or if this case was just a major outlier and Tom was extraordinarily unfortunate. I'll be satisfied with '*&%# happens, case closed' as an explanation once I at least contact some experts in high altitude medicine and hear that from them.

--- by the way, if any media folk are wanting to lift quotes here, please do me the courtesy of asking first. This is a public forum for discussion, NOT a blog, so to me common sense and courtesy says that I am talking in public, but I am not necessarily speaking publicly. You have done the courtesy of asking to take photos and film from a distance when I declined interviews, and I'd say that same spirit of courtesy applies here.

Sam - right now we are planning a memorial for Tom in the Bay area for when I get back. You and everyone who was at the Sacramento slideshow this spring are invited to come, and to share any memories/impressions you had of Tom. As brief as that get together was, it stood out in Tom's mind as the beginning to a great weekend and he really enjoyed meeting everyone there. He had talked several times about an eagerness to do a climb with you this summer and play some more bluegrass together.

I'm bad with names and didn't quite know all of the people's SP handles who were there, so if all of you send me a PM with your e-mail, I can keep you in the loop on the plans for the memorial.

A memorial photo album for Tom (under construction).

I haven't reviewed the timeline of events in much detail. But my understanding is:

1) Both climbers spent a night near the summit
2) The following morning, Tom was confused and ataxic, with vision problems, etc...all consistent with cerebral edema.

It isn't clear to me why some people feel that there hadn't been enough time for cerebral edema to develop? How long were they hunkered down near the summit? A night, which was probably at least 8 hours, is certainly enough time.

Tom Fralich wrote:It isn't clear to me why some people feel that there hadn't been enough time for cerebral edema to develop? How long were they hunkered down near the summit? A night, which was probably at least 8 hours, is certainly enough time.

Yeah, but he was fine all night and even in the morning. The symptoms came on really fast while he was putting on his gear. That's what's strange. If he gradually developed symptoms throughout the night, then it would seem normal.

Luciano136 wrote:

Tom Fralich wrote:It isn't clear to me why some people feel that there hadn't been enough time for cerebral edema to develop? How long were they hunkered down near the summit? A night, which was probably at least 8 hours, is certainly enough time.

Yeah, but he was fine all night and even in the morning. The symptoms came on really fast while he was putting on his gear. That's what's strange. If he gradually developed symptoms throughout the night, then it would seem normal.

Plus, they were on the mountain for 2.5 days before the trouble began. That seems ample enough time to acclimatize for a 14K peak, at least enough to prevent a serious AMS condition. A "sudden event" would be easy to understand. His symptoms don't seem to fit with what we know of HACE.

PellucidWombat wrote:A memorial photo album for Tom (under construction).

Very nice!

Luciano136 wrote:

Tom Fralich wrote:It isn't clear to me why some people feel that there hadn't been enough time for cerebral edema to develop? How long were they hunkered down near the summit? A night, which was probably at least 8 hours, is certainly enough time.

Yeah, but he was fine all night and even in the morning. The symptoms came on really fast while he was putting on his gear. That's what's strange. If he gradually developed symptoms throughout the night, then it would seem normal.

Symptoms aren't always noticed. The only case of HACE that I've seen, the guy had very few symptoms (headache, a little dizziness). He later passed out. He could barely walk or talk and had to be helped off the mountain. All symptoms were gone after dropping below about 16,000'.