Im hoping for imput from others who have experienced altitude sickness and get it enough that they have tried Diamox or other drugs. If I start off at a trail head 9000 feet and go up it seems that I will be very sick for sure for at least a few days.Two years ago I tried spending the night at 9000' before I started and still got sick.Last year I went up to 9000' spent a few hours then came back down to 8000' spent the night then started off the next day back at 9000 ft and spent the night around 10,000' and got sick I never seem to have problems on trips where I start out around 7000 feet or below and climb gradually But this is not always desirable. What drugs have you tried (for altitude sickness)? Do they work ? Work well? Do they have side effects ? I appreciate any imput on this subject as I love the high country and dont get enough vacation time To spend days aclimenting or worse yet laying around a camp sick for days. It does help ot stay hydrated but that only goes so far

Mark, I'm not sure that you will get a completely straight answer from anybody. Diamox works, but it depends.

First of all, you might try to explain your symptoms when you get above 9000 feet. Then you might want to decide if there is some very ordinary reason involved besides altitude. In my experience, about 80% of the symptoms that are experienced are a result of dehydration. Some people seem to feel bad, but it turns out to be a result of working too hard carrying a heavy backpack, and it has little to do with altitude. One guy used to get bad headaches at altitude, but then he discovered that it was from lack of sunglasses, and the extreme UV light was doing it through his eyeballs.

I admit that I have carried Diamox on three occasions, and I have actually consumed it on only one occasion. The side effects are well-documented, and some people claim that they vary with dosage, so some people try to keep their dosage minimized. I experienced those side effects exactly as documented. One guy I know eats the stuff like it was candy (several times the recommended dosage).

Diamox is a carbonic anhydrase inhibitor. It is easier to think that it simply changes your water balance and your blood chemistry.

Decades ago, there were one or two other drugs that competed with Diamox, and I don't think that those are widely accepted anymore. Diamox is not always well-understood by every physician, so you might need to bring references when you request a prescription. On the first time that I requested Diamox, the physician asked me if I had congestive heart disease. Uh, no. Then he looked it up online and saw that it was recommended for altitude also. Then he asked me if I was allergic to any sulfa drugs. Uh, no. Then more and more questions. It is not exactly the sort of prescription drug that you want to take for fun. On the other hand, it has few serious negatives, and it seems to have a beneficial effect on a large percentage of those who take it for altitude. Some people claim that they get sick with or without it. It doesn't seem to be a foolproof preventative for all forms of altitude illness, but rather it seems to give you a wider safety margin compared to going without it. There are several ways that you can screw it up, so you want to speak to your physician about this.

--B.G.--

Edited by --B.G.-- on 05/23/2011 10:17:48 MDT.

It works for Me.
I live at sea level and have spent years doing short weekend trips to the Sierras, almost always getting headache and nausea due to lack of time to acclimate on a short trip.
Two years ago I broke down, got some Diamox.
What a difference.
First night, trailhead camp at 9,000 ft ... no problem (I used to get headaches above 8,000 ft).
Second day, straight to 11,500 ft ... no problem.

By no problem I mean no headaches or nausea. I was still huffing and puffing from the thinner air.

I'm a Diamox convert.

"I'm a Diamox convert."

Art, what is your daily dosage? Do you start taking it one day before you arrive at the trailhead?

--B.G.--

It works.

Most meds have side effects, for diamox:
http://www.drugs.com/sfx/diamox-side-effects.html
It sounds like you've worked out what you need to do to avoid altitude sickness -- start at 7000' and go up gradually. Why not continue with that.
I've carried diamox in case of problems but not used it. I'll ask my respiratory physician about it the next time I see him.

Thanks all for the imput. Bob I get splitting headaches and nausea and dont feal like doing much for two or three days then Im fine I do good my first day on the trail but when I stop the first night it always sets in and this has usually been a 10,000'+ last year I even took a shorter easier first day then hung at a lake for a full day layover then hiked a fairly easy 3rd day and layed over (fished) the fourthday and even day five was bad then my next three days were good But I only had time for 8days on the trail and had to reroute my trip due to time. Art and Cameron how many days ahead do you start taking it and for how long. I will most likely have to educate my Dr on this one

Thanks Walter but starting a 7000 feet and only climbing 1000 feet per day can really slow a trip down. Might as well go back to a 55-60lbs pack to have things to amuse myself at camp :) Its mostly wanting to do certain routes and make the most of my time. Some high lakes Id like to fish and use my layover days doing that rather that taking it easy getting there in the lower elevations

Sounds like typical symptoms of Acute Mountain Syndrome, so you might be a good candidate for the drug.

It is possible that the side effects will bother you, plus it takes a day or two for the drug to take full effect. So, most people I know start taking it 24 hours before arrival at the trailhead, and they continue it until they've hit the highest elevation of their trip.

I prefer to get it started for that day before I arrive at the trailhead. I don't want to be started up the trail when the side effects suddenly kick in.

--B.G.--

I have climbed with others who have employed it and I was amazed at how well it worked when taken properly (2 others were physicians who prescribed themselves the drug)

Since most of us are not doing blood tests on the way up a mountain, I wanted another measure of whether it had worked. On one high expedition, about 90% of the Diamox users were successful on the peak, and only about 50% of the non-users were successful. That doesn't prove anything. There could be self-selection going on and a host of other factors. It just seemed like a good indicator that something was working.

Just to show that it does not work magic all of the time, on another high trip the first person to get sick from altitude was a Diamox user.

--B.G.--

I've never completed weekend trip above 8500 feet without vomiting, unless I was on the diamox.
It might not be magic, but going without has very predictable consequences for me.

Bob
I take diamox for 2 days before arriving at trailhead.
250mg pills, 1 pill twice daily.
I continue the pills while at altitude.

Some have told me you can stop taking them after a while, but I'm talking about short 2-5 day trips so I continue the dosage.

Some have told me I could get roughly the same benefit by halving the pills, but I haven't tried it yet.

art

Edited by asandh on 05/23/2011 11:46:28 MDT.

"Some have told me I could get roughly the same benefit by halving the pills, but I haven't tried it yet."

Yes, it becomes anecdotal from here on.

One physician told me that if I was going after a big peak (maybe 18,000 feet or higher), then I ought to take the full 500mg daily dose. If I was going after some moderate peak (maybe 12,000-18,000 feet), then 250mg daily might be sufficient. For anything less than 12,000 feet, not to bother at all. However, that is just what he told me based on my past history. For the next person, the recommendations might be completely different.

On one trip, I started 250mg daily the night before arrival at a 9000 foot trailhead. Then when we got to 14,000 feet, I started the full 500mg daily dose. As soon as I hit the summit, I stopped it all.

Oh, one side effect is that it completely screws up the taste of any carbonated beverage, like beer. I know that is a deal-killer for some.

--B.G.--

Thank you all for the input I think its best that I try it this year hopefully its half way reasonable priced

I started at 10000 feet, took diamox 2x a day starting a day in advanced and then proceeded up to about 20000+ feet over the course of the next two days. yah my ears were ringing, but I doubt i'd have made it anywhere near that far if I hadn't had it.

Mark,

Bob said, a lot of the symptoms are sometimes due to dehydration- but I will say that dehydration can lead to alt sickness (imho of course). Ymmv

I live at sea level. When I am on trail, it's often at elevation with a substantial amount of gain along the way (several thousand ft a day). I don't have time (or budget) to climatize. On one of my first outings (@ just 10k) I was suffering horribly. Headache, nausea, lack of hunger-the whole gambit. At one point, I had to stop every 15 min. I was so frustrated as I am incredibly fit. I managed to make it through but I could not enjoy it.

My next trip I was worried. Higher elevations and almost double the gain. I read a great deal and found hydration and breathing technique were the most successful solutions short of drugs. (I try and go natural unless necessary)

The day before we set out I loaded up on water...really loaded up. I have never drank water like I did. I was in the John every 30 min. When I woke up the next morning at 3am I drunk a liter and a half then broke trail. During the hike I practiced breathing technique (exhaling forcefully through parsed lips).

We put in some mileage and I not once felt anything more than a little winded. I have repeated the ritual on every hike since with no problems. I tend to burn more calories than most. My system is fast which also means I dehydrate fast. Being properly hydrated (even slightly overly hydrated) before I set out is the only thing that has worked for me.

Safe travels,
Jason

"The day before we set out I loaded up on water...really loaded up. I have never drank water like I did. I was in the John every 30 min. When I woke up the next morning at 3am I drunk a liter and a half then broke trail"

Jason,

A word of caution: Hydration is important, especially when hiking at altitude, but if carried to extremes it can lead to a condition known as hyponatremia, a low level of sodium in your blood, which can be fatal. You might want to consider at least adding some salt to the water you drink to avoid a potential disaster on one of your trips. It also might not be a bad idea to google hyponatremia and learn a little bit about it to help you manage your pre trip hydration in a safe way.

ya know this could be the problem I suppose cause when I drive out I do it in a hurry 1200 miles straight thru and I dont like to stop to wizz to much so I dont drink to much while driving. Once I hit the trail I start drinking quite a bit but not so sure how much on the first day and if I am already dehydrated Im of to a bad start. If I can get away for two weeks this summer as I would like maybe I will give it one more try B4 medication This would give me time to go in at alower elevation also but THEN I WONT KNOW!!! But I do know every time I go to the winds and leave from elkheart park It gets me. Same In medicine bow. I can go somewhere like Glacier and no problemo as the elevations are mostly lower. The only time in my life I have ever got car sick ( without booze) was in Yosemite hmmm wonder what the elevation is car touring the park. The 1st time it hit me was the snowey range many years ago and the ex kept me going and made me eat and drink (cause I wasnt) but alone I may tend to suffer through as Im nausous and dont want to eat or drink Thanks again for everyones input

"Yosemite hmmm wonder what the elevation is car touring the park"

The very lowest elevations are around 3000 feet. Yosemite Valley is 4000 feet. The Yosemite high country road is 7000 to a maximum of almost 10,000 feet. The highest peaks are a little over 13,000 feet.

It is not unusual for some sea level resident to drive straight up to Tuolumne Meadows (8600 feet), get a wilderness permit, and head out on the trail. When they arrive at a 10,000-foot destination lake, they feel like crap.

If I were trying to go to the same place, I would stop and sleep a night at 6000 feet, then continue to the trailhead and to the lake, and it wouldn't bother me at all.

--B.G.--