R03/R01 TR: Kearsarge Follies & The German Jedi of Yosemite Sept 2023

[bobby49]

Few of us have extensive experience with Diamox. I was going on an expedition up to almost 23000 feet, and a majority of the members were going to use Diamox. Being a technoid, I wanted to gather some statistics during the climb. As it later turned out, of those members who were successful on the summit, a majority were using it. Of those members who were unsuccessful, a majority were not using it. The trend is clear.

To minimize the side effects, I started on a half-dose the day before we reached the high trailhead, so I was on that half-dose for three days or so. Then once we reached a staging camp at 14000 feet, I shifted to a full dose and continued that until I was descending from the summit.

Following that trip, I made a trips to 18000 and 19000 feet. One trip, to Kilimanjaro, I carried Diamox with me, and I was monitoring my vital signs carefully. As long as I saw normal vital signs, I went without consuming the Diamox. Upon reaching 18500 feet, guess who needed it and asked for it... the local porters. Why? Because they were not drinking much water.

So, Diamox seemed to be best suited as a preventative measure, but you have to give your body enough time to adapt to it and the water balance changes that it causes.

[Gogd]

i have no idea how many times i have driven up from near sea level to a trailhead at night intending on sleeping in my vehicle and hiking in the morning, to getting zero sleep and finally driving down the mountain at 1 or 2 AM sick as a dog. Pretty sure I have done this at just about every high elevation trailhead in the sierra at least once. some multiple times lol

wierd because when I get altitude sickness while backpacking, I ended up passing out and sleeping for 14-16 hours and wake up refreshed. I have done this not once or twice, but like 10 times.

My brain is probably fried

Some people are genetically predisposed to altitude sickness. In which case you may consider bring Diamox. But first make sure you are not conducting yourself in a manner that is known to increase the chances of getting sick in the first place.

About your observations:

• The best solution to altitude sickness always includes getting the victim in bed, keeping them there until the next morning, forcing liquids and making sure they eat. So your long sleep is actually what the doctor ordered!
• Think back on your overnight recoveries in the backcountry. Did the day's hike take you over a high pass, or otherwise involve travel at an elevation higher than where you camped. There is a truism in mountaineering: climb high, sleep low. That will partially explain your experience.
• Also the evening prior to these hikes did you get your rest or start out sleep deprived. Lack of sleep can increase the likelihood altitude sickness.
• Lastly, while hiking were you diligent on staying hydrated. You want to drink enough such that your urine pees clear. If you are not doing this you predispose yourself to get sick. Also if you are not peeing clear back in town, before you leave that will also affect the situation.

Ed

[Gogd]

Few of us have extensive experience with Diamox. I was going on an expedition up to almost 23000 feet, and a majority of the members were going to use Diamox. Being a technoid, I wanted to gather some statistics during the climb. As it later turned out, of those members who were successful on the summit, a majority were using it. Of those members who were unsuccessful, a majority were not using it. The trend is clear.

To minimize the side effects, I started on a half-dose the day before we reached the high trailhead, so I was on that half-dose for three days or so. Then once we reached a staging camp at 14000 feet, I shifted to a full dose and continued that until I was descending from the summit.

Following that trip, I made a trips to 18000 and 19000 feet. One trip, to Kilimanjaro, I carried Diamox with me, and I was monitoring my vital signs carefully. As long as I saw normal vital signs, I went without consuming the Diamox. Upon reaching 18500 feet, guess who needed it and asked for it... the local porters. Why? Because they were not drinking much water.

So, Diamox seemed to be best suited as a preventative measure, but you have to give your body enough time to adapt to it and the water balance changes that it causes.

Respectfully, I would posit that evidence gleaned from a few high altitude trips may have different factors that influence the results you observe. I would further expound on your statement about few having extensive experience with Diamox to state: very very few elite mountaineers have extensive experience with it. Most well traveled mountaineers may have a couple dozen expeditions high up under their belts. Anecdotal experience is a inadequate basis for asserting scientific facts. On the other hand the formal research that was conducted spans decades, involved hundreds of individuals, and included medical diagnostics delving into issues beyond the obvious symptoms of altitude sickness, for example vision tests, reflex response time, memory and cognitive performance, blood work, respiratory gas analysis, urological assays and a host of other metrics. In any case the context of this post is the Sierra, all of which is well below 15K', and in most cases preventing altitude sickness could have been avoided by better preparation and management of activities.

Your observations, as compelling as they seem, didn't address other day to day factor that may have affected the team members, such as genetics, pack and body weights, BMR stats, sleeping, eating and hydration habits, adequate insulating garments and bag, or fitness levels. You correlate altitude sickness to Diamox, but each of the variables I listed, herein, may also correlate. Alas many factors influence altitude sickness. If you are still conducting high altitude excursions by all means by all means dig up the formal research. You can wiki some of it, but the AAC and Air Force possess much of the original research efforts, and have the unabridged versions of the research and experiments on the subject.

Ed

[ironmike]

I would refrain from offering medical advice or information on a forum like this. Not our forte. Not questioning good intentions, but this is not the forum for recommendations regarding protocols for high altitude medications or treatments.

[kpeter]

I would refrain from offering medical advice or information on a forum like this. Not our forte. Not questioning good intentions, but this is not the forum for recommendations regarding protocols for high altitude medications or treatments.

I presume that one cannot get these drugs without a prescription from your doctor, so any of us who desired to use them would have to get medical advice from a professional first. I appreciate knowing the experiences of others so I can decide whether I would even want to approach my doctor for the discussion and what questions I should ask if I did.

I also presume that most doctors will know very little about this subject--although maybe others have had experiences with their doctors that are positive. How easy is it to find a medical professional with some expertise in altitude sickness, or maybe physicians who have expertise on backpacking and wilderness travel in general? Particularly if you live far away and at sea level?

[FrankPS]

I've been using Diamox for years. I use it under two conditions:

1. Going up several thousand feet the same day from the motel or my home at sea level (including driving to the trailhead).
2. Anytime I'm going over 12K.

It does require a prescription. For me, the side effect of peeing frequently (diuretic) is offset by the benefit. The Diamox does not prevent me from being short of breath, but it does prevent headaches or nausea from altitude. I'm a fan.

[Gogd]

I agree, this is not the source that should guide your decisions, ergo why I suggested to do your own research. If you are looking for doctors competent in this subject:

Join the AAC, place a post on their forum, asking for referrals to doctors that are well versed on the topic. In fact AAC generated content on their web cite may already contain such info.
or
Contact international guide services that specialize in high altitude expeditions, and ask if they can refer you to a doctor.
Ed