In a backcountry ski hut, 40 miles from civilization in the middle of the night, Julianne Boylan knew something was seriously wrong with her 8-year-old son, Evan. When he tried to put into words what he was feeling, she realized the worsening wet cough he had developed that night wasn’t from a cold or the flu.

“About 2 in the morning, he said, ‘Mom, I feel like I have snot in my head, it’s coming down my throat, and it’s clogging the holes in my lungs and heart,’” Boylan said. “When he told us that, that was our, ‘All right, it’s going downhill.’ ”

In the Betty Bear Hut at 11,100 feet near Hagerman Pass, in the Sawatch Range 34 miles east of Basalt, Evan was experiencing symptoms of high altitude pulmonary edema (HAPE), a form of altitude sickness that can be fatal if victims don’t descend in elevation. The Boylan family was in a party of nine adults and five children from Boulder, including Evan’s 10-year-old sister, Eva. Their dream ski trip, in a place of stunning beauty with views of Mount Massive, was turning into a nightmare.

Thanks to a dramatic evacuation in the dark that night that involved four men skiing 2 miles down the mountain roped to a toboggan carrying Evan, followed by transport provided by a snowmobile rescue party sent by Mountain Rescue Aspen and an ambulance ride to a hospital in Glenwood Springs, the Boulder third-grader is doing fine.

That night three weeks ago was scary for all involved, though, and a lot of things went right for him to arrive at the hospital seven hours after the decision was made to evacuate him.

“He had a crackly breath,” said Evan’s father, JP Boylan. “He’d have a coughing fit, clear it, and then five minutes later it would be crackly again. It was getting worse, and no one was sleeping.”

The first fortuitous factor in Evan’s medical emergency: One of the members of the party, Josh Emdur, is a family practice physician.

“Evan is typically a very energetic kid,” Emdur said. “He was just sitting there, breathing fast, and his cough just sounded awful. It wasn’t the typical cough we’ve all heard over the past couple of years with COVID or flu. What he was spitting up didn’t look like mucous. He told me he felt like he couldn’t breathe. I tried listening to his chest by putting my ear on his back. His left side felt like it had fluid in it, compared to the right side.”

And his skin was turning purple around his mouth, Emdur added.

HAPE typically resolves by itself when the patient descends in elevation, but it would take hours to get Evan down. Emdur advised immediate evacuation, even though it was snowing, sunrise was more than three hours away and the first 2 miles down the mountain involved skiing a steep descent with numerous switchbacks.

“There was no reason for us not to do it,” Emdur said. “He could have died. We never know how much time someone has. Generally it doesn’t kill within hours, but when you’re in a remote backcountry situation, you just don’t know how long an evacuation is going to take. We knew he was in trouble.”

Julianne said she was able to keep herself calm because Emdur was there to make the expert call.

“It’s snowing, and we’re hours from anything,” Julianne said. “I’m a pharmacist, I have medical knowledge, but there’s no way I could have made that call on my own, because we were initiating a self-rescue at three in the morning.”

Evan also was fortunate there were others in the party who knew how to handle a tricky evacuation. Stephen Price has 18 years of experience with Rocky Mountain Rescue Group, a team that performs search-and-rescue operations in Boulder County. Tom Lukas, who also participated in the evacuation, has ski patrol experience.

“As soon as we realized we wanted to get him out of there, I woke up Stephen and Tom, and I was like, ‘Hey, we have a rescue,’” Emdur said. “Stephen popped right up and was like, ‘OK, what’s going on? What’s the mission?’”

JP has a Garmin device called InReach that pairs with cellphones by Bluetooth, allowing users to send SOS alerts and text messages via satellite communication when they are out of cell range. JP activated InReach so Mountain Rescue Aspen, the local search-and-rescue team, could be notified. He let them know the evacuation party included strong backcountry skiers with experience in rescues, and they were able to track the evacuation party’s descent through InReach.

It was dark and snowing when they left the hut just before 5 a.m. JP went down with the four-man toboggan crew — Emdur, Price, Lukas and Stefan Griebel — who were wearing headlamps.

“There were a lot of tight turns with trees,” Price said. “It was two miles and a thousand feet of technical skiing, going down to the road.”

The rescue snowmobiles met the evacuation party moments after they reached the road, around 6:10 a.m. After a 5-mile ride that took about 15 minutes, they reached the trailhead where the ambulance was waiting for the 55-mile trip to Valley View Hospital in Glenwood.

Emdur warns Coloradans that they shouldn’t assume HAPE only happens to visiting flatlanders. Evan is an active, fit boy who plays soccer and is a member of a Boulder cross country ski team.

When HAPE strikes, there is an accumulation of fluid in the air sacs of the lungs. That’s why it can be deadly.

“There is failure of the pulmonary system, and it’s a life-threatening emergency,” Emdur said. “Without treatment, which includes going down to a lower elevation, it can result in death. At the beginning, it’s subtle. It does usually start with acute mountain sickness, where people have the typical symptoms of headache and fatigue and nausea, but not always, which is tricky. HAPE generally starts with a non-productive cough, shortness of breath and fatigue. As it worsens, people become more markedly short of breath, the cough gets worse, and then they can become confused because of lack of oxygen.”

Evan was back in school the day after he returned to Boulder. His parents and Emdur hope their scary experience can give other backcountry users reasons to think through what can go wrong when they are far from civilization.

“Everyone goes into a hut trip thinking it’s going to be good skiing, good party, good friends,” JP said. “You need to have a plan in the back of your mind if something happens. You play through the scenarios in your head, especially after it’s happened, but I would urge people to play through scenarios before they go to the hut. Have a game plan.”

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