From April 19 and April 21, 2022, U.S. climbers Anna Pfaff and Priti Wright climbed the challenging 1,200m Harvard Route on Mount Huntington in Alaska.
However, after the successful ascent, Pfaff has been dealing with extreme frostbite on her feet. Over the last month, her toes have not improved and Pfaff will now face the amputation of five toes this week.
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Priti Wright (left) and Anna Pfaff (right) on the summit of 3,731m Mount Huntington, Alaska. Photo: Anna Pfaff
The climb
Wright and Pfaff found the climbing harder than expected. It was early in the season on Mount Huntington, and the pair were the first to summit. The climb and descent took them three days.
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Climbing up the Harvard Route on Mount Huntington. Photo: Anna Pfaff
After ascending the Harvard Route, Pfaff and Wright returned to base camp down the West Face Couloir.
“I pulled my boots off as soon as I arrived in the tent and changed out of my socks and clothes. At that time, I noticed my right foot was swollen and whitish,” recalls Pfaff. The whitish color is the first sign of frostbite.
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Pfaff in the tent, warming up her feet. Photo: Anna Pfaff
Frostbite
Pfaff, a trauma nurse by profession who has completed several difficult expeditions, knew she had to warm up her feet as soon as possible. She kept her feet in her sleeping bag and felt relief during dinner.
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The challenging 1,212m-long Harvard Route. Photo: Anna Pfaff
Pfaff had been wearing an excellent pair of boots. She changed socks at night and hydrated during the climb. Pfaff says that her feet never felt extremely cold, and the two climbers made no obvious mistakes. However, the temperature dropped noticeably during the night as they descended to Base Camp.
They told Talkeetna Air Taxi (TAT), the operator that provides logistical support in the area, that they needed to leave the mountain. However, the weather worsened and there was no visibility for the plane to reach the glacier.
“My heart sank when I realized that another night on the glacier was imminent,” remembers Pfaff. This second night was even colder.
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On the Harvard Route. Photo: Anna Pfaff
When the two women checked Pfaff’s feet again in the morning, they were shocked by the state of her frostbitten toes, especially those on her right foot. The plane finally managed to pick them up from the glacier on April 23, and Pfaff was rushed to hospital.
Could anything be done?
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In the hyperbaric oxygen treatment cabin. Photo: Anna Pfaff
When a vascular surgeon first examined her in the Anchorage ER, he told her that nothing could be done. She was too late to receive blood-thinning meds.
However, with the help of fellow climbers Priti Wright, Andres Marin, and also Wright’s partner, Jeff Wright, Pfaff was treated in the Harborview of Seattle burn unit. Later, in Louisville, Colorado, she began receiving Hyperbaric Oxygen Treatment (HBOT). The treatment, still classified as experimental in the US, has been shown to help reactivate and improve circulation in similar cases.
Doctors told Pfaff that the mild cold injuries she had sustained through more than 15 years of alpine climbing had likely contributed to what she was dealing with now. Even light frostbite to your extremities might lead to worse consequences during subsequent frostbites.
Pfaff has now received several HBOT sessions, consisting of two hours of treatment twice a day. The temporary side effects are not nice, affecting her hearing and vision. Coping with this process has not been easy. Pfaff describes these weeks as an emotional rollercoaster.
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Anna Pfaff in Patagonia. Photo: Camilo Lopez
Necrosis
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The frostbitten toes. Photo: Anna Pfaff
At first, Pfaff noticed improvement. However the injury is very serious, and when the necrosis is deep or comprehensive, not much can be done.
A few days ago, Pfaff stated on social media that this week was her “last dance” with her toes. The climbing community has expressed its support and empathy for Pfaff, who is one of the best rock and ice climbers in the world.
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Things I wish I knew about frostbite and treatment
I wish I would have known the capillary damage that occurs with mild frostbite and how long that takes to heal. I didn’t know my previous exposures would contribute to my body not being able to recover from the past exposure.
Initially in the ER I would have liked to know the time frame in which TPA can be given. I would have liked to have the option to leave or be transferred to a facility that offers Illoprost. Even if insurance doesn’t cover or its out of the US I would have liked to have that information on where I could go to try the medication. Even if it meant traveling.
I was given no information about hyperbaric oxygen while in the ER. I only came across it because a physician from Europe reached out to tell me to try it. It was hard to find an HBOT facility that would do the treatment without insurance approval. It would be great to list the “cash pay” locations here in the US and the difference between medical grade, settings etc etc. I got all this info from Europe and only because I am connected as a North Face Athlete. this info should be available to everyone. I do believe HBOT helped me keep some of my foot on both the right and left.
We were given very little instruction on dressing changes or how to deal with the dying tissue. I was basically seen in the ER in Anchorage then discharged on my own to be seen in the burn unit in Seattle. There they did very little and I was sent home to “wait”.
I would have liked a more accumulative place to find information about supplements, after care, holistic treatment, mental health and what to look for in term of infection. I think I was able to care for myself only because of my nursing background not because of the information provided.
I think medications that can be taken in the field are important for people to know. Ibuprofen, Nifedipine etc that can be kept in a first aid kit for remote places.
Its important for people who have had amputations due to frostbite to be in contact with others such as a support group etc, Its really painful and mentally challenging to watch your body literally turn black and have to make the hard decisions to amputate.
The medical field here in the US seems to have little knowledge of frostbite treatment and information. Even as a nurse this was very frustrating for me to deal with. A list of facilities that specialize in frostbite care would be helpful as not all ERs can deal with and its written off to go home and wait.