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Diamox questions.

How do you prepare for the rigorous physical requirements of high elevation adventure? Strength and endurance are key, but are only part of a more complex equation. How do you prepare for changes in altitude, exposure, diet, etc.? How do you mentally prepare? Learn from others and share what you know about training in advance for outdoor adventures.
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Diamox questions.

Postby CI_Seawolf » Mon Apr 04, 2011 5:09 pm

I have suffered on many trips with altitude sickness (AMS). I am going to request a prescription of Diamox from my primary care doctor. I'm wondering if any other folks in here have used it and if they have any suggestions? I understand that you need more potassium when you use this medicine. Does anyone use supplemental dietary potassium (tablets)? Any other comments or suggestions would be welcome also.



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Re: Diamox questions.

Postby AlmostThere » Mon Apr 04, 2011 5:46 pm

I can't take it myself, being allergic to sulfa. So I guess it's a good thing I've never had many symptoms of AMS.

Does acclimation not help you at all?
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Re: Diamox questions.

Postby oldranger » Tue Apr 05, 2011 9:08 am

CISW
My wife, tired of being wasted on her first three days at elevation has talked to her doc about diamox. On our next trip above 8,000 feet she will get some. However I think her only bp trip this summer will be in the Eagle Cap Wilderness and she will not get over 8,000 feet until 3 days into the trip. She has not had problems until about 8500 ft. After a week at 4,000 feet she spent 2 nights at Tuolume Meadows last summer before hiking up to Vogelsang, it wasn't until after her second night at Vogelsang that she felt good, of course that day we hiked over Vogelsang Pass then down to Merced Lake.

Talk to your doc. Those of us who don't have a problem or acclimate rapidly can't understand how altitude sickness can undermine ones enjoyment so thoroughly.

Mike
Mike

Who can't do everything he used to and what he can do takes a hell of a lot longer!
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Re: Diamox questions.

Postby neil d » Tue Apr 05, 2011 12:36 pm

I procured some Diamox for a trip up Mt. Whitney last summer. I had not been above 9,000 feet for many years, and in the past had suffered mildly at elevation (headache, mild nausea, trouble sleeping).

I took it pre-emptively, rather than waiting for symptoms. It worked great, in that I experienced absolutely no discomfort on the trip. I slept great, and had lots of energy, enough for extra-curricular peak-bagging after dragging 50 lbs up to Trail Camp at 11,000+ ft on day 2. To me, this substantiated the claim that Diamox helps you acclimate faster. Summited Whitney with no issues, other than a bit of queasiness during my time at the top.

Of course, I'll never know how my body would have reacted had I not taken Diamox, but I am a believer. Only side effects were increased frequency of urination, and of course it makes beer (and all carbonated beverages) taste horrible. The effect wears off 12-24 hours after stopping the meds.
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Re: Diamox questions.

Postby quentinc » Tue Apr 05, 2011 6:58 pm

Potassium tablets are virtually useless. Each tablet will supply about 1% of your RDA. Allegedly, the reason for this is to reduce the chance of people taking too much potassium (which can also be a problem), but the cynic in me says that it's so the pharma companies can make you buy lots and lots. Try bananas or potatoes instead. Probably dried would work as well, if you don't want to carry the weight.
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Re: Diamox questions.

Postby artrock23 » Sat Jun 01, 2013 9:36 pm

Having suffered from AMS at altitudes above 10K ft my whole life, I got a prescription for Diamox earlier this year. Before taking it, I did some research and read the product info sheet. One thing worth noting is that Diamox does not replace (or even assist) proper acclimatization. What it does is alleviate the severity of AMS symptoms.

Since I live at sea level, proper acclimatizing has never been possible for me. I normally drive up to the trailhead on Friday, sleep that night in my truck, and hike in to where I base camp (10K-11K+ ft) the next day. My usual symptoms are a massive headache by the end of the day (that will not abate for at least 12 hrs) and trouble sleeping.

My experience with taking this medication so far has been as follows...

The headache still sets in, but is far less severe, and abates during the night. I still don't sleep soundly, but it's noticeably better than without the drug. Getting-up in the morning and preparing to tackle a summit is far better without a lingering headache. :)

There can be some side effects that can border on the unpleasant. These are the ones i've experienced...

Initially, there's a pronounced increase in urination. This seems to lessen after the first 48hrs. There is tingling to the fingers, toes, and face. And the one I just found out the hard way: they recommend that one stays out of direct sunlight :confused: . Being olive-skinned, I ignored this, and since I rarely need sunscreen, didn't use any. Big mistake! The peak I climbed required hours of snow travel... all in the direct sunlight. By the end of my three day trip, I had the worst sunburn on my face i've ever had. Next trip I bring SPF 30 sunscreen.

To sum it up, for me, even with the side effects, Diamox is worth taking.
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Re: Diamox questions.

Postby artrock23 » Wed Jun 26, 2013 10:49 pm

Experience with Diamox: update....

During a trip last weekend, I used Diamox for the third time. On this occasion, it worked perfectly. I had no AMS symptoms at all. I can only speculate as to why it was better this time. One difference was increasing my hydration... made sure to drink over 100oz of water (and Gatorade) a day. It's also possible that after doing a few three day Sierra trips in the last three months (along with some snow climbing and snowshoeing during winter/spring in the local mountains), maybe some acclimation is occurring? Whatever it may be, not having altitude sickness for a change is great. :)
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Re: Diamox questions.

Postby AlmostThere » Thu Jun 27, 2013 5:39 am

Acclimation doesn't work that way - each trip you start over again when you go back down to low elevation.

You can go into the mountains 1,000 times and have symptoms once. Or not at all. Some people have them often, some experience them each time.... It's unpredictable.

Hydration helps a lot - I'm starting to see in Yosemite literature and on signs, "drink a liter every two hours while you're hiking." That sounds about right to me.
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Diamox questions.

Postby J ney » Thu Jun 27, 2013 7:40 am

artrock23 wrote:Experience with Diamox: update....

I had no AMS symptoms at all. I can only speculate as to why it was better this time.


Probably a combination of things you listed... But instead of being acclimatized, you're overall fitness level was increased. A lot of the symptoms can also be psychosomatic... And your comfort-level could also play a huge factor.
Regardless... A good thing :-)
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Re: Diamox questions.

Postby takotruckin » Wed Jun 04, 2014 8:52 pm

AlmostThere wrote:Acclimation doesn't work that way - each trip you start over again when you go back down to low elevation.


I have not found that to be true. I usually get a little sick my first 1 or 2 weekend trips of the year (over 7 or 8k), and then I am fine the rest of the summer.
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Re: Diamox questions.

Postby AlmostThere » Wed Jun 04, 2014 9:10 pm

takotruckin wrote:
AlmostThere wrote:Acclimation doesn't work that way - each trip you start over again when you go back down to low elevation.


I have not found that to be true. I usually get a little sick my first 1 or 2 weekend trips of the year (over 7 or 8k), and then I am fine the rest of the summer.


I'm only quoting literature for wilderness medicine coursework... There's a quite detailed description of what happens to a body at high elevation in NOLS Wilderness Medicine. Among the pages it also says

"The body undergoes numerous changes at higher elevation in order to increase oxygen delivery to cells and improve the efficiency of oxygen use. These adaptations usually begin almost immediately and continue to occur for several weeks. People vary in their ability to acclimatize. Some adjust quickly; others fail to acclimatize, even with gradual exposure over a period of weeks. In general, the body becomes approximately 80 percent acclimatized after 10 days at altitude and approximately 95 percent acclimatized by 6 weeks. The respiratory rate peaks in about 1 week and then slowly decreases over the next few months, although it tends to remain higher than its normal rate at sea level. When we descend, we begin losing our hard-won adaptations at approximately the same rate at which we gained them; 10 days after returning to sea level, we have lost 80 percent of our adaptations."

and:

"Altitude illness results from a lack of oxygen in the body. Anyone who ascends to high altitude will become hypoxic (the condition of having insufficient oxygen in the blood). Why some people become ill and others don't is not known. It is known, however, that most people who become ill do so within the first few days of ascending to altitude."

Advice given is to eat a high carb diet, as they require less oxygen to metabolize, eating fats and proteins on rest days - but not at night as that increases risk of altitude illness, as the combination of decreased respiratory rate during sleep and increased requirement for oxygen to metabolize fats/proteins is a double whammy. Climb high, sleep low. Ascend slowly. Hydrate. Avoid sleeping pills.

The advice about carbs is echoed in Mountaineering: Freedom of the Hills as well.
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Re: Diamox questions.

Postby Wandering Daisy » Sat Jun 14, 2014 8:45 pm

Theory aside, many mountaineers I have climbed with and myself included, have done better with acclimation over time. I think there are a lot of subtle things going on. First, you learn to adjust pace better as you become more experienced and in shape. Second, having "been there and done that" you are more mentally prepared for the effects of altitude. I think your body also gains experience at physiologically adjusting. And you subconsciously are more careful about hydrating, eating properly, etc. And you age. Older people tend to have less altitude sickness than younger people. My first altitude sickness was upon reaching the top of Mt. Rainier (when I was 16) and eating an entire can of greasy sardines- not the best choice of a snack at 14,000 feet! More appropriate snacks on Mt Hood the following year and I did not get altitude sick. More recently, I pushed it a little too much when I had an unusually heavy pack. I stopped, hydrated with soup, and got it under control and spent the night short of my goal.

There are a group of people who do very poorly at altitude no matter what. I am lucky that I am not one of them. For them Diamox may be a godsend. For the rest of us, I feel that working on techniques that mitigate altitude problems is a better approach.
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