Renjo La Pass/AMS/Dehydration/Group Separation

The weather in the morning appeared to be clearing and the freshly fallen snow glistened in the morning sun. The weather system seemed to have snowed itself out and the clouds only rested way lower down in the valleys. Breakfast was quick and everyone was nervous to make a decision. After discussing with guides we decided that we would climb the pass to the summit and then asses whether or not the other side could be descended. If other groups from Gokyo were climbing we would have a clear view of the trail and be able to avoid the ice and the occasional glacier. If it was not being climbed from the west then conditions would be to treacherous for a descent.
We packed our gear and took some pictures of the fresh blanket of snow and then began the climb knowing the mental and physical battle that wait for us. This was our second pass of the vacation and climbing over a Himalayan Pass is no minor undertaking. We began the climb out of Lungden up the very steep and snowy slopes. The weather was absolutely breathtaking and the views gave us extra motivation to set a strong pace. Everyone was feeling strong except Paul. He seemed to be climbing slower than normal and was struggling under conditions that he usually excels in. Logan, Seth, and Cameron arrived on top at the beginning while Bogue carried Paul's backpack and climbed with him slowly up the ridge. Paul's cognitive awareness seemed to become more foggy and every step seemed a great deal of work. Paul and Bogue reached the top to an exuberant and vibrant group taking photos and videos of the view(Logan, Seth, and Cameron). Paul sat down and Seth approached clearly seeing the he was not himself. Seth and Paul began conversing and it was realized that Paul was beginning to have slurred speech and was saying things entirely out of character. Seth informed the others that Paul had to go down immediately. With the intensity of the situation realized the group sprang into action. Cameron began assisting Paul down as fast as possible as the other discussed what course of action could be implemented. We had already sent a runner/porter ahead to arrange rooms so at least one person had to cross the pass while the others were need to assist Paul down.
It was decided that Bogue would go quickly over the pass while Logan, Seth, Cameron, Paul, and our 2 porters would descend down to Namche 8 hours down the valley and 4,500 ft lower than our current location to a clinic there. Seth ran as fast as possible down the ridge carrying Paul's backpack falling many times in the slick terrain. He saw Cameron helping Paul down the valley and caught up with them where Cameron and Seth talked. Considering it was Cameron's first time in the Khumbu region it was decided that he had the choice to climb over Renjo La Pass and meet Bogue and Indra in Gokyo in the evening. The group said a quick farewell and gave a hug and then hurried in their separate directions. Cam continued up the steep ridge again while Seth and Paul hurried down as fast as possible. Logan and the two porters continued down the valley on their way to Namche to catch up with Paul and Seth.
Both groups struggled very much throughout the day. Paul's condition improved after descending over 2,000 ft and having several liters of water. The group moved as quickly as possible and arrived into Namche at dark totally exhausted and emotionally broken from the days frightening situation. Bogue and Cameron also struggled over the pass and had a very difficult descent down the steep pass into Gokyo. They arrived late in the afternoon as well and were completely exhausted and only mustered up enough energy to eat and then sleep immediately. Paul's condition down the valley improved and he was quite lucid once arriving in Namche. Emails were sent to convey that Paul was okay and that tomorrow we would all awake and find a way to unite the group and asses Paul's status and aspirations in the morning.