Thanks Bob, Tom, Lynn and Jennifer. It's all clear as mud now :). Really, I think I get it, thanks!

Fortunately I don't consistently get a headache at altitude; I also never had to change a trip because of altitude sickness.
Bob, you're probably right, dehydration surely is a factor in headaches for me, altitude or not, especially if I'm not wearing a hat while exposed to the sun. Sleeping 2-4 hours and driving another 5 hours mostly in the dark before a trip surely doesn't help...

The reason I was considering Ibuprofen was not for blocking the headache, but for its anti-inflammatory properties. I was reading that persons affected by HACE are not usually aware of the symptoms, and was thinking it's safer to prevent HACE than sustain injury, if I suspect myself of HACE. Unfortunately taking Diamox has to start a few days before the trip it seems... not the quick fix I was looking for.
I had no idea aspirin had anti-inflammatory properties (like I said, I'm not a pill fan), thanks for opening my eyes!
Jennifer, about the leaking bucket... would one make things worse if drinking a lot of water without a diuretic?

Never have taken it unless prescribed but with the muscle/cartilage problems written about, I'll go with the pain and try to remember to stretch it out properly.

People who are completely healthy and go to high elevation without any symptoms can drink a lot of water without a problem, and it just keeps the kidneys working. People who are taking high doses of Tylenol and things like that need to drink a lot of water to avoid a kidney problem. They rest of us just drink as much as we need, and experience has taught us about how much that is. If I don't urinate at least twice per day, then I am probably dehydrated.

I understand that you report headaches, but it might be from the simpler forms of altitude illness. Full-blown HACE is kind of uncommon except at very high elevation (like 18,000 feet and above). The only person that I saw with HACE symptoms had been to nearly 23,000 feet. However, just last summer one friend got sick around 10,000 feet, and it was thought to be some combination of HAPE and HACE, or at least the symptoms were a combination.

Yes, if you do take Diamox, you need to start it a day or two before you start going high. Exactly what elevation that is will vary from person to person. A bunch of us were going up very high (nearly 23,000 feet), so we started a half-dose of Diamox the day before we started from a 9000 foot trailhead. Then we went to a full dose when we went above 14,000 feet.

Last year when I was descending from a 14,000 foot peak, I saw a large military group starting up from 12,000 feet. Apparently some were taking Diamox, some were taking some new secret drug, and probably some were taking a placebo. I would love to see the results from that test. The military people were headed to Afghanistan.

--B.G.--

Ideally you take it before you are symptomatic, but you honestly don't have to. You can start Diamox after onset of symptoms...the only time I ever took it was during a trek to the Everest base camp. I started getting loopy at about 12,000 and started then...my friend started at 16,000'. We were both fine...the symptoms went away.

Yes, if you are healthy just keep drinking...your kidneys will do the diuresis for you. But if you see how puffy your face gets at altitude, or your hands...it's a great visual to see what is happening to your tissues when the ambient pressure goes down.

The point of taking a diuretic such as Diamox is to quickly rid your brain and lungs of excess fluid that can lead to HACE and HAPE. Otherwise your body should be able to keep up with everything...when it can't, THAT'S altitude sickness.

"The point of taking a diuretic such as Diamox is to quickly rid your brain and lungs of excess fluid that can lead to HACE and HAPE. Otherwise your body should be able to keep up with everything...when it can't, THAT'S altitude sickness."

This post and your original post on Diamox provide the best explanation yet of what causes AMS/HACE/HAPE.

Thanks for posting, Jennifer.