Avoiding the Dangers of Hyponatremia. Kilimanjaro Climber Shares Experience

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Kilimanjaro Climber Paige Dobkin Shares Her Experience With Hyponatremia, a Potentially Deadly Condition. “I don’t think people really realize that, how important salt really is.”

Marathon runner and personal trainer Paige Dobkin climbed Mount Kilimanjaro with Fair Voyage in July 2019 and suffered from severe hyponatremia, a potentially deadly condition, during her climb. In April 2022, we caught up with Paige and she shared her experience with us, to help increase awareness about the importance of salt for your safety when climbing Kilimanjaro or undertaking other strenuous physical activities.

Paige on Mount Kilimanjaro

Hear Paige share her experience directly with you in the video above, and scroll down to find the full video transcript and photos shared by Paige from her Kilimanjaro climb further below.

For more information about staying safe when climbing Kilimanjaro, you might also like to watch our interview with Ivan Braun, Founder of former Kilimanjaro Search and Rescue (KSAR), who operated the High-Altitude Medicine Clinic, and make sure to read our article on avoiding the dangers of altitude sickness when climbing Kilimanjaro.

Credit for all photos on this page and special thanks for the interview and helping to increase awareness about hyponatremia and safety for Kilimanjaro climbers to Paige Dobkin!

 


Video Transcript

Conversation between Kilimanjaro climber Paige Dobkin and Fair Voyage Founder Alexandra Pastollnigg, April 2022

Alexandra: Hello, I’m Alex, Founder of Fair Voyage. And I’m here today with Paige Dobkin. Paige climbed with us Kilimanjaro – when was it, in 2019?

Paige: Yes. In July

Alexandra: And she had quite a serious safety incident, and we are currently doing initiatives to increase awareness about safety on Kilimanjaro, and so we thought it would be a good idea to catch up with Paige for her to share her experience with you. Paige, thanks so much for joining us today, and being here with us.

Paige: Thank you for having me. I’m happy to help hopefully prevent this from happening to others.

Alexandra: So tell us Paige, let’s jump right into it. What happened to you? So you had this dream to climb Kilimanjaro, and then – what happened?

Paige on Mount Kilimanjaro, July 2019

 

Paige: So in a nutshell, I was going to climb Mount Kilimanjaro, and I was training for that, which is essentially running a lot. So another bucket list item for me was to run a marathon, and I’m not a runner, so I trained for six months. The peak of my training coincided with summer, where I live in Bangkok. So, I live in Thailand, it was really hot and humid, and I was running four times a week for six months. I didn’t realize it at the time, but my salt level was decreasing. I was taking electrolytes, and adding some salt to my food. But I’m aware that salts can be really dangerous. So I went easy, and I was a little bit nervous about adding salt. So I ran the marathon, no problem, and then went to Kilimanjaro, I think four days after that. I’m not exactly sure but within a week. One way to prevent altitude sickness is to drink a lot of water. And water can flush salt out of your body and you need some salt to hold the water in.

“One way to prevent altitude sickness is to drink a lot of water. And water can flush salt out of your body and you need some salt to hold the water in.”

So I didn’t know this at the time, but our guide Francis kept asking everyone: “Are you okay? How do you feel? How’s your headache?” – thinking about altitude sickness – and I felt really bad, I assumed that I had altitude sickness.

Paige With Guide During Daily Safety Check on Kilimanjaro

 

And then I threw up, which is really unusual for me. Also, I had to go to the bathroom a lot, number one and number two, I had diarrhea. So what I realized now when I look back is that my body was getting rid of water anyway it could because I drank, I think, three liters one day, and four liters the next. So I had seven liters within two days. It’s nothing extreme, but it was enough to push me over the edge.So I ended up having a grand mal seizure, and I don’t remember that or anything after that for 36 hours.

“I had seven liters within two days. It’s nothing extreme, but it was enough to push me over the edge. So I ended up having a grand mal seizure, and I don’t remember that or anything after that for 36 hours.”

And so they evacuated me. I think it took 12 porters and two shifts of six to carry me down. I’m not sure but maybe six or eight hours. And then I went to the High-Altitude Medicine Clinic in Moshi, and I regained my awareness there about 36 hours after I’d had my seizure. So I think around 24 hours after I’d come down from the mountain.

High-Altitude Medicine Clinic, Moshi

 

And when I got back to Bangkok, I went to a neurologist who did an MRI and saw that my brain structure is fine. But from blood tests, they knew that I had low salt. So he said, I’m really lucky. I’m not epileptic, that wasn’t the cause of my seizure. And they know what provoked it. So the idea is that if you’re drinking a lot of water, even if it’s not an extreme amount, you also need to ensure that you have enough salt.

“If you’re drinking a lot of water, even if it’s not an extreme amount, you also need to ensure that you have enough salt.”

Another factor for me is that I’m vegetarian, and I learned, afterwards, of course, reading about what happened to me, that all animals need salt to survive. So if you eat meat, you eat another animal and you get salt through that. And if you eat processed foods, which I don’t really eat that many of, you get salt as well. So there are a lot of things that are really specific to my situation with the marathon training, being a vegetarian, not eating processed foods. But I also am a personal trainer and I know that this condition called hyponatremia is the number one cause of death in marathon runners in marathons.

“I know that this condition called hyponatremia is the number one cause of death in marathon runners in marathons.”

It’s because people think that they’re running and they need to drink a lot of water, and then it gets really easy to overdo it if you’re not also taking in minerals like salts.

Alexandra: Thanks so much for sharing. It sounds almost like you’ve become an expert now on – what’s it called, hypo…

Paige: Hyponatremia.

Alexandra: Hyponatremia. And that occurred to you – it was on the second or third day on the mountain?

Paige: I think it was on the fourth. Yes, sorry. My memory is not great, but I think it was on the fourth. I don’t know where we were, like which camp we were…

Paige With Group on the Fourth Day of Their Climb, 8-Day Lemosho Route

 

Alexandra: Right. And so, initially, you felt on the mountain, when you had nausea and diarrhea, it was a normal form of altitude sickness, until the seizure came. And the seizure. Did you have any warning? Did it just happen, very quick…?

Paige: No, so I was in the tent. After I threw up, I went to the tent. And Francis, our guide came in to check on me and he asked, “since you just lost a lot of energy, would you like some bread or something before dinner?” So I said, “Okay”, and I laid in bed and ate a piece of bread. And I could hear the people outside my tent, I could hear Francis talking to my boyfriend about what they were going to do if I didn’t get better. And I kind of had a giggle because I was like: “Oh, now that I’ve thrown up, actually, I feel better”. And so I was like, “they don’t have anything to worry about. But they can talk. They can do whatever they want.” And the next thing I knew – I was in the hospital.

“I kind of had a giggle because I was like: “Oh, now that I’ve thrown up, actually, I feel better”… And the next thing I knew – I was in the hospital.”

But, my boyfriend said that, I’m not sure about the timing, but at one point he came in to get me for dinner, and I was sleeping. And so he just said “hey, wake up. You have to put on your socks and shoes, so we can go to the tent”, the other tent for dinner. And apparently, I sat up and I started to put on my sock. And that’s when I had the seizure. But I don’t remember anything after eating bread. So I think I responded to him. I responded when he said to put on my socks and shoes. But then immediately after the seizure, he asked me, like: “how many fingers am I holding up?” And I didn’t respond. And he asked me: “what’s my name?” His name is Marcus. But I said “smells good”. And obviously, after a few days on the mountain, he did not smell good. And after that I didn’t respond to anything for 36 hours.

Alexandra: Was it dark already? Was it during the day?

Paige: I think it was getting dark. It was just around the time of sunset.

Alexandra: And so it would have been too late for a helicopter evacuation. Right? You had to be carried down because it was already getting dark.

Paige: Yeah, I think they tried to get a helicopter. And it was too late.

Alexandra: Right. And what is your boyfriend’s recollection of that time? What did he share with you? Did he come down with you?

Paige: He did. And we had an agreement that if one of us had altitude sickness and couldn’t make it, the other one should still continue, that we were okay with that. If one person got sick, we shouldn’t sacrifice the other person’s trip because of that. But he knew that something serious was happening because I had a seizure, and he saw me have it.

Paige With Boyfriend Marcus on Kilimanjaro

 

So yes, he came down with me, and he also stayed in the hospital with me. And he said, the nurses and the doctors were really, really good, and he was very impressed. So apparently, what happened is they gave me an injection in my bum, and actually I did react to that. I think I tried to get rid of them when I felt this injection. They said it will help the swelling of my brain because they thought that I had altitude sickness. But actually, I didn’t. My brain wasn’t swollen, which is why I didn’t get better immediately on descent, and why I didn’t get better in time. So they gave me this injection and there was no change, essentially.

The other thing is, apparently, I threw up the whole way down. I was wearing a hat, they got me dressed for the cold and to go in a sleeping bag to take me down. And when I opened this garbage bag afterwards, I saw my yellow hat inside this bag, and there was vomit on the hat and so I thought “oh, what a situation this must have been if I threw up somehow upward!”

But yeah, apparently in the hospital they were really good. But they just assumed that I had altitude sickness because that’s the natural assumption and the symptoms are pretty much the same, as in a headache and nausea.

“In the hospital they were really good. But they just assumed that I had altitude sickness because that’s the natural assumption and the symptoms are pretty much the same, as in a headache and nausea.”

And then, when I didn’t get better after 12 hours, they gave me another injection and said “Okay, she should be better in another 12 hours”, and that still didn’t happen. So they took me for a CAT scan, and, I don’t know why, but to do that they had to test my blood. And when they tested my blood, they saw that I had extremely low salt, severe hyponatremia, actually.

“When they tested my blood, they saw that I had extremely low salt, severe hyponatremia.”

And then they started giving me an IV, which apparently I tore out of my hand. And, yeah, I think it was just like, I mean, it wasn’t me doing it. But I think that I was really like a bad patient. I was sick. I didn’t know where the bathroom was, I threw up, I had diarrhea. I peed, like, and I couldn’t pee, because my brain didn’t release the signal. This is something that happens with hyponatremia. The brain doesn’t allow your body to release the pee. So they tried to give me a catheter. Four people tried and it didn’t work. So I finally peed in the bed. And then the next time I had to pee, I stood up and looked around on the floor for a place to go. So actually, my boyfriend knew I was getting better. But then he was like [laughter] “no!” and ran me to the bathroom.

So yeah, he was with me the whole time. And at one point, he said, I was really uncomfortable, because I couldn’t pee. And I was like, “but how do you know this?” And he said that I was just like, agitated, and really moving. And they could see my bladder was like bulging out from my lower abdomen. So when the catheter didn’t work, one of the doctors said, “well, what we can do is puncture”, like through the outside puncture the abdomen, and the bladder, and take the pee outs. And then my boyfriend said, “uh, she’s not going to like that”. And so they decided to wait, but I was still uncomfortable. And then finally, I think my brain just allowed the release naturally.

So everything I’m telling you now has been told to me by Marcus. I don’t remember it.

Alexandra: Right. Well, I cannot imagine that you were… there’s no such thing as a bad patient, you were just really sick. And I will remember this day for the rest of my life: I wake up in the morning, I log into my email, and I have the news that you, one of our clients, was in coma. We were so worried about you, so anxious. So, seeing you all cheerful and happy and sharing your experience, I feel very relieved.

What would you now do differently? Or what advice would you give? You mentioned a few things earlier. But to summarize, what would you do for yourself differently? Or what advice would you give to other climbers?

Paige: It’s interesting you ask this question because I’m dreaming every day of going back to Kilimanjaro, because for me it’s an incomplete project. And our guide Francis said, when he found out that it was hyponatremia and not altitude sickness and that there was a known cause of my seizure, he said that he would take me, which is a massive honor to be able to go with him again in the future.

Paige and Climbers Singing and Dancing With Guides and Porters on Kilimanjaro

 

But this happened in July of 2019 and then the pandemic happened. So I’ve been waiting now for an additional two years to go back and thinking about all the time what I would do different. I would definitely bring salt with me and ensure that I have it. But even now I forget to put salt on my food, so what I do now is I take salt tablets. Every second day I take, it’s like a vitamin essentially and it has salt in it. So I would take more of those because I would be drinking more water against altitude sickness and I would bring electrolytes.

“What I do now is I take salt tablets… So I would take more of those because I would be drinking more water against altitude sickness and I would bring electrolytes.”

I live in Thailand and we can get these sachets… I don’t have any with me, but little powders. So I would just add that to my water and, honestly, that should be enough to prevent this from happening again. It’s really not rocket science but without salt, that seems like such a simple thing, but it can be deadly. And I don’t think people really realize that, how important salt really is.

“It’s really not rocket science but without salt, that seems like such a simple thing, but it can be deadly. And I don’t think people really realize that, how important salt really is.”

Alexandra: Yes. I was completely unaware until the incident with you, that this can be such a dangerous thing. Obviously, we’re very aware of altitude sickness, which also can happen very suddenly, and is often underestimated. But especially the condition with lack of salt I think a lot of people, marathon runners are probably aware, but typical Kilimanjaro climbers may not be. So I think this can be potentially lifesaving information that you’re sharing here. Thank you so much.

Other than that, you wouldn’t be worried at all, that the same thing happens to you, if you climb again?

Paige: No.

Alexandra: You would be confident?

Paige: What I would be worried about is that I haven’t been training for a marathon anymore. So I’ve lost this high level of fitness that I had at the time. But no, since in the past two and a half years since this happened, I’ve had ups and downs with my salts, and I’m really learning and being aware. The neurologists that I met said, don’t drink more than two liters of water a day. So I know that when I have had more than two liters of water a day, I need to ensure that I’m getting enough salt. And it’s happened.

For example, I’m a scuba diver and we were on a liveaboard, where you sleep on the boat and then do four dives a day. I had such a headache, and I thought “this is really unusual. Why do I have a headache”, and I thought, “well, I’m thirsty, and I drank two and a quarter liters of water. So maybe I overdid it.” But actually, because of diving, I spit into my regulator, I don’t swallow. So after three days of diving and a lot of dives, I was severely dehydrated because I was spitting so much. So I thought, “Okay, I need to replace the water,” and then I had to take extra salt tablets to compensate, and then I felt fine. Within a few hours, I just drank a couple of liters of water and had some salt and some electrolytes, and I felt better. So I’m learning as I go along.

But in terms of, like, I know how it is on Kilimanjaro, I just haven’t been to the top. So for this, yeah, I would feel very confident, just drinking extra water to be sure, but also having salt on the other side.

“I know how it is on Kilimanjaro, I just haven’t been to the top. So for this, yeah, I would feel very confident, just drinking extra water to be sure, but also having salt on the other side.”

Alexandra: Right. And I’m sure when you make it back, Francis will be excited to welcome you again, and the local team. What a story. And one thing I’d like to assure you, and everyone who is listening in, people don’t need to be marathon runners to climb Kilimanjaro. In fact, there is statistics that show, of course, we all need a certain level of fitness, and you’re looking like a very fit person still, though there is a tendency for people who are overly fit and athletic to walk up too fast, and then it becomes a problem with altitude sickness. So we are always a bit worried when people are overly athletic, because then you’d be overly ambitious, and then that causes other problems. So I think on the fitness level you’re fine.

Paige: Good to be average.

Alexandra: Exactly.

Very insightful. Thanks so much for sharing all your experience and what you’ve learned. Is there anything else, final words you’d like to share before we close?

Paige: I have one thing actually. I’m so sorry I don’t know his name, because a lot of this time was foggy for me, but when I regained my awareness in the hospital, I felt fine, actually. I was a little bit slower than usual, but really no big deal. Although I was slow ultimately for about three weeks. But I was talking to people and they said would you like some food, and like, yeah, maybe, and the doctor came in and said I had to drink electrolytes. And then a nurse came in, a local male nurse came in. He saw me and he really looked at me deep in my eyes, and I was like, “who is this man? And why is he looking at me?” And he just got tears in his eyes. I was like, “what is going on that I have such an impression on this man?” So, I’m sorry I don’t know his name, but I was like, “wow, he’s such a sweetheart.” And in retrospect, I thought he didn’t think I was going to make it. So I wish I had learned his name. But he was amazing. And then he said, “would you like to shower and brush your teeth?” So I think I really needed to shower. [laughter] But he was really nice and my boyfriend said all the nurses and all the doctors were really, really good.

Alexandra: I’m so relieved to hear that. And that we have this happy ending with you.

Paige: And one doctor was Swiss at the time. She was a volunteer.

Alexandra: Yes, I did speak to her afterwards. Sorry, I can’t remember her name now, but I did have a conversation with her afterwards. And I think it was also a lucky coincidence that she happened to be in town at the same time.

Paige: Yeah, exactly.

Alexandra: Well, Paige, thanks so so much for sharing your experience with us, and – we very much look forward to welcoming you again for your this time final Kilimanjaro climb to the summit

Paige: We hope. Thank you so much.

Alexandra: Thank you.

Paige: I will definitely let you know when I’m ready to go back.

Climbers Heading Towards the Summit of Kilimanjaro

 

Credit for all photos on this page and special thanks for the interview and helping to increase awareness about hyponatremia and safety for Kilimanjaro climbers to Paige Dobkin, and thanks to all the doctors and nurses who used to work at the High-Altitude Medicine Clinic in Moshi for their excellent care back in 2019!

 


 

For more information about staying safe when climbing Kilimanjaro, watch our interview with Ivan Braun, Founder of former Kilimanjaro Search and Rescue (KSAR), who operated the High-Altitude Medicine Clinic, and make sure to read our article on avoiding the dangers of altitude sickness when climbing Kilimanjaro.

To climb Kilimanjaro with Fair Voyage, contact us here to speak to a Fair Voyage Kilimanjaro advisor and get a free quote including full package details. We are happy to tailor your ideal climb with you private guide for you, and send you our latest availabilities for small groups that you can join.

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