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#17406 - 08/10/11 04:01 PM Diamox
Beer1 Offline


Registered: 08/10/11
Posts: 1
Loc: California, US
What are your suggestions for the proper dosage and when to start taking it before climbing Whitney

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#17410 - 08/10/11 05:09 PM Re: Diamox [Re: Beer1]
Bulldog34 Offline


Registered: 11/12/09
Posts: 1255
Loc: Atlanta
Beer1, the prescription will likely be for 1 250 mg tablet twice a day, beginning several days before ascending to elevation and continuing several days after descending. At least that's what it was for my wife and daughter for their first attempt to hike above 12,000 feet this year. Most people on this board will tell you to moderate that dosage and schedule, and I agree.

The tabs are scored in quarters, so you can chop them down to 125 mg or 62.5 mg. The dosage needed can vary by individual, but the main thing to be aware of is that the noticeable side effects (frequent urination, tingling in the extremeties, and taste sensitivity) increase with the dosage. Most folks I know who use Diamox in the mountains take either 62.5 or 125 mg twice a day beginning the day before ascent above 11-12K', and stopping the regimen once below the target elevation.

I used the stuff myself for the first time just last month. Elevation has never affected me as long as I acclimate at least 2 nights at/above 8000 feet. This time, though, with my wife and daughter attempting elevations they had never hiked to before, I elected to go on Diamox with them - just to be sure I had the best available capacity if either of them got in trouble in some way.

We all took 125 mg the night before acsending above 12,000 feet, and for the duration that we were above that elevation. We did this for Mt. Dana (13K') as well as Mt. Whitney. None of us experienced any AMS symptoms, nor did we feel any of the bothersome side effects of the drug. I should note, though, that we spent 1 night at 8000 feet just before Dana, and a total of 5 nights above 8000 feet immediately before Whitney. Diamox is a great aid, but it ain't a magic bullet - be sure not to bypass acclimation. We ran into several folks on Whitney who were retreating with AMS who were on Diamox. If you combine Diamox with proper acclimation, you've covered your bets as best you can.

Still, be sure to discuss with your physician - your mileage may vary.

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#17418 - 08/10/11 07:38 PM Re: Diamox [Re: Bulldog34]
Akichow Offline


Registered: 04/07/10
Posts: 659
Loc: SF Bay Area
Note. Diamox comes in 125 mg tablets too. So, in my case, I take just a half a tablet at a time. Based on my weight and sex, a high altitude specialist recommended 62.5 mg twice a day (although I have now reduced that substantially based on my personal experience). As you will see if you search on "diamox," there is a lot of debate here as to dosage, and whether prophylactic use is appropriate. An issue for you and your doctor....

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#17432 - 08/11/11 09:04 AM Re: Diamox [Re: Akichow]
Ken Offline


Registered: 10/29/09
Posts: 742
Loc: Los Angeles
There is a certain amount of confusion over the optimal dosing regimen.

The trend for hikers has certainly trended towards a lower and lower amount over the last 20 years.

What is published in the actual package inserts of the medications is probably the original info, and it is probably related to helicoptor military operations, where you had people being inserted into higher altitudes in very short times, not hiking in.

One advantage of the lower dosing, is the freedom it gives with respect to the frequency. The manufacturer states:

"The dosage employed in the treatment of chronic simple (open-angle) glaucoma ranges from 250 mg to 1 g of acetazolamide per 24 hours, usually in divided doses for amounts over 250 mg."

So for doses of 250/day or less, it can be administered in a once a day dose, which is more convenient.

For the last couple of years, I've recommended, and used myself, a 1/2 tab of a 125 at bedtime (to maximize the impact on the disturbed breathing involved with AMS, probably the most commom form of AMS symptom, which is well known to be best treated with diamox)

As for onset and duration of treatment, the manufacturer also states:

Quote:
Acute Mountain Sickness: Dosage is 500 mg to 1000 mg daily, in divided doses. In circumstances of rapid ascent, such as in rescue or military operations, the higher dose level of 1000 mg is recommended. It is preferable to initiate dosing 24 to 48 hours before ascent and to continue for 48 hours while at high altitude, or longer as necessary to control symptoms.


And I think that is a good guideline to follow, with the one caveat:
if a person has never taken the medication before, I think it is a good idea to take a dose or two a few weeks before a trip to make sure that one will not have some sort of unusual or bizarre reaction, that would screw up one's trip!

Diamox does contain the molecule sulfa, but it is NOT the same as a sulfa antibiotic, and people who are allergic to sulfa antibiotics generally are not at greater risk of reactions, than any other people who get allergic reactions to things OTHER than sulfa. However, they should know this, and if considering taking Diamox, should take a dose in civilization, not out in the boondocks.

Also, the generic acetazolamide is every bit as good as the brand name Diamox.

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#17441 - 08/11/11 12:02 PM Re: Diamox [Re: Ken]
Harvey Lankford Offline


Registered: 11/10/09
Posts: 1024
Loc: Richmond, Virginia
Ken, as you and I and others have discussed here,side effects often limit the dose. For me personally anything over 125 twice daily causes significant and bothersome paresthesias (tingling) in the hands,feet, and face to the point of interfering with sleep. The one time I took the sustained release 500 I vowed never to do it again . Others of course will vary, but the 1000/day seems unimaginable

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#17447 - 08/11/11 01:32 PM Re: Diamox [Re: Harvey Lankford]
tdtz Offline


Registered: 08/26/10
Posts: 511
Loc: CA
Hi Harvey,
I had heard that paresthesias could be caused by Hypocalcemia and then I read that in some cases diamox can cause Hypocalcemia. Speculating on a connection between the Hypocalcemia and paresthesia, this past trip I decided to eat a tums a bit after I took my diamox (125mg twice a day). This is the first time that I haven't had tingling in my feet and fingers. I'm guessing that I just got lucky, but I'm going to try taking tums when I take diamox again to see if the tingling stays away (really more pins and needles, than tingling, but who's counting).

it's funny, after the first time taking diamox, I really hated the taste of sodas. Now I really enjoy it. It seems to give it an extra sharp burn.

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#17448 - 08/11/11 02:01 PM Re: Diamox [Re: Akichow]
Cindy Abbott Offline


Registered: 09/24/10
Posts: 98
Loc: Irvine, California
Originally Posted By: Akichow
Note. Diamox comes in 125 mg tablets too. So, in my case, I take just a half a tablet at a time. Based on my weight and sex, a high altitude specialist recommended 62.5 mg twice a day (although I have now reduced that substantially based on my personal experience). As you will see if you search on "diamox," there is a lot of debate here as to dosage, and whether prophylactic use is appropriate. An issue for you and your doctor....


Ditto - same for me.
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#17455 - 08/11/11 06:59 PM Re: Diamox [Re: Cindy Abbott]
Akichow Offline


Registered: 04/07/10
Posts: 659
Loc: SF Bay Area
Now I just take the one 62.5 mg dose at night before sleeping at altitude, and I no longer take any at all in the days prior to reaching altitude. I take it specifically to address periodic breathing (Cheyne Stokes), the issue to which Ken alludes, since I experienced that phenomenon once on White Mountain, and prefer to avoid it in the future. So far, so good. Even at 62.5 mg/day, I still get some hand tingling....

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#17457 - 08/11/11 09:10 PM Re: Diamox [Re: Harvey Lankford]
Ken Offline


Registered: 10/29/09
Posts: 742
Loc: Los Angeles
Originally Posted By: Harvey Lankford
Ken, as you and I and others have discussed here,side effects often limit the dose. For me personally anything over 125 twice daily causes significant and bothersome paresthesias (tingling) in the hands,feet, and face to the point of interfering with sleep. The one time I took the sustained release 500 I vowed never to do it again . Others of course will vary, but the 1000/day seems unimaginable





Exactly my experience.

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#17468 - 08/12/11 07:48 AM Re: Diamox [Re: Ken]
bobpickering Offline


Registered: 02/07/10
Posts: 431
Loc: Reno, Nevada
You guys make me feel so lucky. I've been above 14,000 feet 244 times and never had a problem. I'll admit to using a little Diamox to help me sleep on Denali, but I felt pretty good at 20,320.

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#17469 - 08/12/11 07:58 AM Re: Diamox [Re: bobpickering]
Burchey
Unregistered


Originally Posted By: bobpickering
You guys make me feel so lucky. I've been above 14,000 feet 244 times and never had a problem. I'll admit to using a little Diamox to help me sleep on Denali, but I felt pretty good at 20,320.


Oh bobby, if only we all were so tough as thee wink I've been above 14k 245 times, but who's counting?

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#17519 - 08/15/11 01:37 PM Re: Diamox [Re: ]
bobpickering Offline


Registered: 02/07/10
Posts: 431
Loc: Reno, Nevada
Burchey:

I know you're jerkin' my gherkin a little because I teased you on another thread, but I'll give you a straight answer anyway.

If you get AMS, push on to the summit, and make it out OK, you're tough. If you get AMS, push on anyway, and need help getting back down, you're stupid. If you don't get AMS in the first place, you're lucky.

People who are fitter and stronger than I am get AMS and perform poorly at altitude. I occasionally get a hint of a headache, but a few extra deep breaths make it go away. One of the reasons I play at altitude so much is that I just naturally don't have problems with altitude. This thread made me appreciate my good fortune.

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#17520 - 08/15/11 02:02 PM Re: Diamox [Re: bobpickering]
Burchey
Unregistered


Got it. Thought you were just taking advantage of another opportunity to remind us how awesome you are. We are very aware. Saw your trip report for the Willy/Tylly in one day - beating your old record.

BTW, who keeps exact track of how many times they've been above X altitude?

Originally Posted By: bobpickering
Burchey:

I know you're jerkin' my gherkin a little because I teased you on another thread, but I'll give you a straight answer anyway.

If you get AMS, push on to the summit, and make it out OK, you're tough. If you get AMS, push on anyway, and need help getting back down, you're stupid. If you don't get AMS in the first place, you're lucky.

People who are fitter and stronger than I am get AMS and perform poorly at altitude. I occasionally get a hint of a headache, but a few extra deep breaths make it go away. One of the reasons I play at altitude so much is that I just naturally don't have problems with altitude. This thread made me appreciate my good fortune.

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#17522 - 08/15/11 02:18 PM Re: Diamox [Re: ]
CMC2 Offline


Registered: 11/04/09
Posts: 160
Loc: CO
Unfortunately I do, much to the annoyance of my climbing buddies. I only keep track of climbed peaks/mts over 14k, and now some of them have started doing it too. Peaks/Mts range from Sunshine, CO 14,001' to Kilimanjaro 19,340'

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#17523 - 08/15/11 02:31 PM Re: Diamox [Re: CMC2]
Burchey
Unregistered


Originally Posted By: CMC2
Unfortunately I do, much to the annoyance of my climbing buddies. I only keep track of climbed peaks/mts over 14k, and now some of them have started doing it too.


Maybe I'm the oddball. I couldn't tell you how many women I've been with either, unless I think really hard and count. That's not bragging either, it isn't that many. I'm just not into tracking, I guess. To each his own.

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#17524 - 08/15/11 03:06 PM Re: Diamox [Re: bobpickering]
Bee Offline


Registered: 09/22/09
Posts: 1261
Loc: Northern California
Originally Posted By: bobpickering
You guys make me feel so lucky. I've been above 14,000 feet 244 times and never had a problem. I'll admit to using a little Diamox to help me sleep on Denali, but I felt pretty good at 20,320.


Bob, do you use any sort of pre-climb aclimatization program? (one night at 10k....two nights?) I am curious, because, I too do quite well at altitude if I sleep high the night before (I have done 13,800 from sea level as a turn and burn (day hike) but I had been at altitude the weekend before)
_________________________
The body betrays and the weather conspires, hopefully, not on the same day.

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#17528 - 08/15/11 03:46 PM Re: Diamox [Re: Bee]
Steve C Offline


Registered: 09/22/09
Posts: 7870
Loc: Fresno, CA
I returned last night from a trip to Thousand Island Lake, and was really surprised at my AMS symptoms.

We stayed 36 hours in Mammoth, 8000' with no symptoms. Then traveled into T.I.L. at 9800'. I had symptoms for another 24 hours! They weren't that bad, but I felt wasted -- tired, with occasional slight nausea. I was able to eat, though.

Finally, Saturday morning, over 72 hours after being at or above 8000', I felt good. I was able to climb Banner Peak, ~13000' symptom-free.

I have used Diamox in the past, because I usually get the symptoms. But this trip, with the initial stay at 8k, and the fact we were only going to ~10k, I thought I'd skip it.

Next time, I'll know better!

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#17533 - 08/15/11 05:50 PM Re: Diamox [Re: Steve C]
gmisk Offline


Registered: 12/03/10
Posts: 5
Loc: CentralCal
Someone hacked Steve's login. I'm just sayin'. shocked
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Rivers, lakes and oceans will attack you. Mountains are different. They wait for you to make a mistake.

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#17534 - 08/15/11 06:14 PM Re: Diamox [Re: ]
quillansculpture Offline


Registered: 11/13/09
Posts: 564
Loc: Murrieta, CA
Burchey..... Is that counting on one hand or two? Just kidding. And yes, I can count how many times I've been over 14,000. 3 times. So.....I'm just a tiny bit behind......summits that is. :-)
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twitter: @josephquillan

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#17541 - 08/16/11 02:48 AM Re: Diamox [Re: Beer1]
Yury Offline


Registered: 06/11/11
Posts: 57
Loc: T.O.
Originally Posted By: Beer1
What are your suggestions for the proper dosage and when to start taking it before climbing Whitney

Hi Beer1,

I believe that beer (because of its heavy weight) is OK only for car camping.
For a walk in campsite I would recommend a more concentrated medicine like whiskey or cognac.
Actual dosage depends on your personal physiology but it should be sufficient to have good sleep.

Note: Actually I know a few people who believe that such beverages is a good AMS prevention medicine. What's important - it works for these people!


Edited by Yury (08/16/11 02:50 AM)

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#17544 - 08/16/11 06:52 AM Re: Diamox [Re: ]
CaT Offline


Registered: 09/24/09
Posts: 694
Loc: Blacklick, OH (formerly SoCal)
Quote:
BTW, who keeps exact track of how many times they've been above X altitude?

On these boards, there have been several who do this, among other similar peak-bagging/highpoint pursuits.

CaT
_________________________
If future generations are to remember us with gratitude rather than contempt, we must leave them more than the miracle of technology. We must leave them a glimpse of the world as it was in the beginning, not just after we got through with it.
- Lyndon Johnson, on signing the Wilderness Act into law (1964)

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#17545 - 08/16/11 07:03 AM Re: Diamox [Re: CaT]
Burchey
Unregistered


Originally Posted By: CaT
Quote:
BTW, who keeps exact track of how many times they've been above X altitude?

On these boards, there have been several who do this, among other similar peak-bagging/highpoint pursuits.

CaT


Understood. Perhaps I'm the oddball. However, it could probably be assumed that if one knew they'd been above 14,000 feet exactly 244 times, that person most likely kept a detailed written record. This conflicts with my own judgment of what is a good use of one's spare time. Just my opinion. I bet, if you added up all the time spent writing that stuff down, you could squeeze in another 14er.

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#17546 - 08/16/11 08:28 AM Re: Diamox [Re: ]
Bulldog34 Offline


Registered: 11/12/09
Posts: 1255
Loc: Atlanta
Speaking for the record-keepers, I use a very straightforward Excel spreadsheet to track a few basic details of each hike I do. It takes just a few seconds to enter the trail, time, distance and elevation gain. Doing so helps keep me on pace for the goals I set at the beginning of each year for distance and gain. This year my two focused goals were 400 miles and 100,000 feet, both about 30% more than last year. I'm right at 280 and 70,000 through this past weekend, so the record-keeping tells me I'm on track for both.

I know there are others who track many more details of their hikes/climbs, especially in the California and Colorado regions, but living where I do the vast majority of my hikes fall into the "training" category. I track these as essentially workout progress against a fitness goal. For those special hikes or climbs, I'll enter more details and some narrative in a Nomad hiking journal, for the sake of posterity or future reference.

It's really just a matter of personal preference. I've never kept a formal tracking system of the number of times I've been above a certain elevation, but that's because I only get to spend 2-3 weeks each year in the higher elevations of the west - at this point I can pretty much speak from memory that I've been above 13,000 feet on 11 occassions, and above 14,000 on 6. Small but very memorable numbers, which is why I don't need to keep a record of them. If I lived in the reasonable vicinity of higher elevations, I'd almost certainly keep track of elevation as well. It would take virtually no effort or time. Some people are wired that way, some aren't - it's chocolate and vanilla.

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#17547 - 08/16/11 08:46 AM Re: Diamox [Re: Bulldog34]
quillansculpture Offline


Registered: 11/13/09
Posts: 564
Loc: Murrieta, CA
Gary, What the hell are you talking about, Burchey and me were talking about women!!!!!
_________________________
"Turtles, Frogs & other Environmental Sculpture"

www.quillansculpturegallery.com
twitter: @josephquillan

If less is more, imagine how much more, more is -Frasier

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#17548 - 08/16/11 08:56 AM Re: Diamox [Re: quillansculpture]
Burchey
Unregistered


Haha, I've actually heard of people keeping a diary or list of partners. Like he said, some people are just wired to be more organized, I guess. I think with the mountains, even though I appreciate the air up there and the natural beauty of it all, perhaps I'm not putting as much weight to my accomplishment of getting up there as I should. It probably stems from me not taking myself too seriously - perhaps I should take this a little more seriously.

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#17549 - 08/16/11 09:02 AM Re: Diamox [Re: ]
tdtz Offline


Registered: 08/26/10
Posts: 511
Loc: CA
" perhaps I'm not putting as much weight to my accomplishment of getting up there as I should"

Or perhaps it is more of an accomplishment for some of us than it is for you...

Let's do the math here....from your photos, you look about 170lbs. I'm about 250lbs. So I weigh 1/3 more than you...so when I climb 14k it is like you climbing 21k. Do you know how many 21k peaks you have climbed?

On the other hand, I couldn't tell you how many times I have been above 10k which would be 1/3rd less elevation.


.
.
.
.
.
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.
.
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.
.
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and yes, I am kidding.


Edited by tdtz (08/16/11 09:03 AM)

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#17550 - 08/16/11 09:03 AM Re: Diamox [Re: Steve C]
2600fromatari Offline


Registered: 10/18/10
Posts: 453
Loc: San Diego
Steve,
I feel your pain. AMS is a strange thing. I've been fit as a fiddle on Whitney, and have stumbled around like a drunk on San Jacinto. I never know what's going to happen. Oddly enough, I've had multiple trips now where I started to get headaches as I go DOWN. I was fine on the way up. At first, I thought it was an unusual anomaly, but it happens more often than not now which baffles me, and is contrary logic.

Originally Posted By: Steve C
I returned last night from a trip to Thousand Island Lake, and was really surprised at my AMS symptoms.

We stayed 36 hours in Mammoth, 8000' with no symptoms. Then traveled into T.I.L. at 9800'. I had symptoms for another 24 hours! They weren't that bad, but I felt wasted -- tired, with occasional slight nausea. I was able to eat, though.

Finally, Saturday morning, over 72 hours after being at or above 8000', I felt good. I was able to climb Banner Peak, ~13000' symptom-free.

I have used Diamox in the past, because I usually get the symptoms. But this trip, with the initial stay at 8k, and the fact we were only going to ~10k, I thought I'd skip it.

Next time, I'll know better!

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#17551 - 08/16/11 09:14 AM Re: Diamox [Re: tdtz]
Burchey
Unregistered


Originally Posted By: tdtz
" perhaps I'm not putting as much weight to my accomplishment of getting up there as I should"

Or perhaps it is more of an accomplishment for some of us than it is for you...

Let's do the math here....from your photos, you look about 170lbs. I'm about 250lbs. So I weigh 1/3 more than you...so when I climb 14k it is like you climbing 21k. Do you know how many 21k peaks you have climbed?

On the other hand, I couldn't tell you how many times I have been above 10k which would be 1/3rd less elevation.



You might be right. I've often looked with jealously at my 165 pound buddy scaling the hill compared to my 190 pounds (most of it is head).

21K peaks? I've climbed 244 of them.

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#17552 - 08/16/11 09:15 AM Re: Diamox [Re: ]
quillansculpture Offline


Registered: 11/13/09
Posts: 564
Loc: Murrieta, CA
Originally Posted By: Burchey
I think with the mountains, even though I appreciate the air up there and the natural beauty of it all, perhaps I'm not putting as much weight to my accomplishment of getting up there as I should. It probably stems from me not taking myself too seriously - perhaps I should take this a little more seriously.


To tell you the truth, I think the fun of hiking, the enjoyment of being in the mountains gets a bit lost when you hike with your goal being to "summit". My favorite Whitney hike as far as pure enjoyment was my first and I didn't make the summit. Just walking through the pines during a full moon, taking long breaks at several points, especially Trailside Meadow really made it fun. My partner, Karyn, a botonist/biologist, couldn't go 50 feet without pointing out types of plants, animal life, rock structures. Fun stuff.

That said, when I did summit, I cried at the top. This mountain we walk has a certain draw like no other.
_________________________
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twitter: @josephquillan

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#17553 - 08/16/11 09:19 AM Re: Diamox [Re: ]
2600fromatari Offline


Registered: 10/18/10
Posts: 453
Loc: San Diego
Well, all of you can kiss my a**!!! I'm not even 150 lbs and slow as a tortoise AND gets AMS all the time. By the formula you guys use, I've never been above 10K. frown

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#17554 - 08/16/11 09:42 AM Re: Diamox [Re: 2600fromatari]
tdtz Offline


Registered: 08/26/10
Posts: 511
Loc: CA
Burchey, 190lbs? damn dood, and I remember your trip report from this past winter/spring on Mt Mallory where you had all your weight on the ice axe in a precarious situation. Impressed.

Q, my first time in the WZ I only made it to Trail Crest and it was a day hike. My subsequent trips have all been over night. And I expect that all of my future hikes in the eastern sierra will be overnight. And it isn't so much making the summit for me now. The eastern sierra is the only place other than Alaska where I have had that sense of overwhelming awe with nature.

2600FA, it sounds like we could hike together. Don't tell anyone, but a big part of why I like to hike alone is because I know that I am slow and I hate for anyone to be waiting for me. And the tortoise analogy is very apt for me as well. I can go forever and I will make my destination, but I do it at my own pace. (thank god I haven't had AMS since my first hike up whitney)


Edited by tdtz (08/16/11 09:42 AM)

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#17555 - 08/16/11 09:48 AM Re: Diamox [Re: tdtz]
quillansculpture Offline


Registered: 11/13/09
Posts: 564
Loc: Murrieta, CA
Okay.... this got me thinking. Don't any of us work?
_________________________
"Turtles, Frogs & other Environmental Sculpture"

www.quillansculpturegallery.com
twitter: @josephquillan

If less is more, imagine how much more, more is -Frasier

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#17556 - 08/16/11 10:17 AM Re: Diamox [Re: 2600fromatari]
Bulldog34 Offline


Registered: 11/12/09
Posts: 1255
Loc: Atlanta
Originally Posted By: 2600fromatari
Well, all of you can kiss my a**!!! I'm not even 150 lbs and slow as a tortoise AND gets AMS all the time. By the formula you guys use, I've never been above 10K. frown


Now, that was one of the best posts I've read in a long time! laugh

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#17557 - 08/16/11 12:27 PM Re: Diamox [Re: ]
CaT Offline


Registered: 09/24/09
Posts: 694
Loc: Blacklick, OH (formerly SoCal)
Quote:
Perhaps I'm the oddball.

You wouldn't be the first. In fact, I think that's probably a prerequisite for being part of this unique community. crazy

Quote:
It probably stems from me not taking myself too seriously - perhaps I should take this a little more seriously.

But then you wouldn't be you. smile

Quote:
compared to my 190 pounds (most of it is head).

LMHO!!! (no pun intended)

Quote:
That said, when I did summit, I cried at the top. This mountain we walk has a certain draw like no other.

Boy, can I relate to that....

Quote:
The eastern sierra is the only place other than Alaska where I have had that sense of overwhelming awe with nature.

I largely feel the same way, but that feeling modified somewhat to include the Alps in Europe and coastal Norway, upon seeing both at different times. Oh, yeah ... and definitely Alaska, too!

Quote:
Don't any of us work?

On what? wink

CaT
_________________________
If future generations are to remember us with gratitude rather than contempt, we must leave them more than the miracle of technology. We must leave them a glimpse of the world as it was in the beginning, not just after we got through with it.
- Lyndon Johnson, on signing the Wilderness Act into law (1964)

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#17558 - 08/16/11 02:30 PM Re: Diamox [Re: Bee]
bobpickering Offline


Registered: 02/07/10
Posts: 431
Loc: Reno, Nevada
These Diamox - AMS discussions are so fun! Here are a few thoughts, some relating to comments above:

Joe: No, I don't work, but Gary still does.

Burchey: Yes, I keep a log of every climb I do. I also keep logs of my running (almost nonexistent now), my cycling, and my horseback riding. I picked up the habit from the guy who got me started climbing. Look me up on summitpost.org if you're interested in the climbing log. There are 1,113 summits on 379 different peaks. The last time I failed to make a summit was when I got blown off Shasta in May, 2003. That was 271 summits ago.

Bee: I live at 5,000 feet. I think that helps a little, but it's not a big deal. I'm not climbing nearly as much as I did in the 90's, but I try to get up one of the nearby 10K peaks every week or two if I'm not doing something bigger. That helps acclimatization, but I don't think an hour or two above 10K makes a lot of difference. I have never spent extra time at a campground or trailhead just to acclimatize.

One controversial point is sleeping altitude. Some people try to misapply the "climb high; sleep low" mantra to short Sierra trips. "Climb high; sleep low" applies to climbing big mountains expedition style. You climb high to string fixed lines, establish a high camp, etc. Then you sleep "low" (which may mean 20,000 feet) before moving to the higher camp or making a summit bid. Nobody does Sierra peaks that way.

Everyone agrees that you can climb higher than you can sleep. However, the best sleeping altitude is the highest one at which you don't get sick. I didn't retire at 59 by spending $100 for a low-altitude hotel room every time I tagged a peak. I'm a cheap bastard, and I always sleep at the trailhead if I can. It helps me acclimatize, it saves money, and I can sleep later and still get an early start.

Take care of your body. Get enough sleep, food, and water. Eat what you like, but take it easy on greasy/fatty foods. I don't believe in frequent breaks. When you stop, your breathing may slow way down, promoting AMS. Try to keep moving at a pace you can sustain, eating and drinking as you go.

The last few years, "everybody" has been recommending taking Diamox before you go to altitude. You should probably do that if you have good reason to expect AMS. However, Diamox does work if you wait until symptoms develop. I had mild Cheyne-Stokes breathing high on Denali, and Diamox fixed it in a few minutes on both trips. It's better to climb without using drugs if you can, so you might want to bring some Diamox but not use it until you need it.

Finally, I want to tell a story that explains my original comment about being lucky with AMS. There were two guides and four clients on my first Denali trip in 1994. We carried some pretty heavy loads low on the mountain. I was by far the weakest member of the team. We traveled in two rope teams, and the guys ahead of me literally pulled my sorry ass up the glacier. Things changed as we got higher. I was about as strong as everybody else by 11K. At 12,800, I was the only one not taking Diamox. At 16K, I ate three dinners while some of the others couldn't finish one. At 18,360, I was feeling great and would have welcomed a much faster pace. We turned around because one of the guides and two of the clients were too slow and weak at altitude.

The point is that some people are just more susceptible to AMS than others. It's not just a matter of acclimatizing, being tough, drinking enough water, or whatever.

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#17560 - 08/16/11 03:49 PM Re: Diamox [Re: bobpickering]
Akichow Offline


Registered: 04/07/10
Posts: 659
Loc: SF Bay Area
Originally Posted By: bobpickering
However, Diamox does work if you wait until symptoms develop. I had mild Cheyne-Stokes breathing high on Denali, and Diamox fixed it in a few minutes on both trips.


This was my experience the one time I got Cheyne-Stokes (last year while trying to sleep at the White Mountain trailhead). Less than an hour after taking a Diamox, the problem went away and I fell fast asleep with no further problems. Since then, I've started taking 62.5mg before going to bed at altitudes at 11,000 or more, and have had no recurrence. It seems so fast-acting, I have wondered why folks are recommended to start taking it a day or so earlier (something I no longer do).

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#17561 - 08/16/11 04:18 PM Re: Diamox [Re: bobpickering]
Bulldog34 Offline


Registered: 11/12/09
Posts: 1255
Loc: Atlanta
Originally Posted By: bobpickering
Look me up on summitpost.org if you're interested in the climbing log. There are 1,113 summits on 379 different peaks. The last time I failed to make a summit was when I got blown off Shasta in May, 2003. That was 271 summits ago.



Bob, I couldn't resist :

20,320 AK Mt. McKinley
14,494 CA Mt. Whitney (31)
14,433 CO Mt. Elbert
14,421 CO Mt. Massive
14,420 CO Mt. Harvard
14,410 WA Mt. Rainier
14,375 CA Mt. Williamson (5)
14,345 CO Blanka Peak
14,336 CO La Plata Peak
14,309 CO Uncompahgre Peak
14,294 CO Crestone Peak
14,286 CO Mt. Lincoln
14,270 CO Grays Peak
14,269 CO Mt. Antero
14,267 CO Torreys Peak
14,265 CO Quandary Peak
14,265 CO Castle Peak
14,264 CO Mt. Evans
14,255 CO Longs Peak
14,246 CO Mt. Wilson
14,242 CA White Mountain Peak (9)
14,242 CA North Palisade (12)
14,238 CO Mt. Cameron
14,229 CO Mt. Shavano
14,200~ CA Starlight Peak (11)
14,197 CO Mt. Princeton
14,197 CO Mt. Belford
14,197 CO Crestone Needle
14,196 CO Mt. Yale
14,172 CO Mt. Bross
14,165 CO Kit Carson Peak
14,162 CA Mt. Shasta (33)
14,159 CO El Diente Peak
14,156 CO Maroon Peak
14,155 CO Tabeguache Mountain
14,153 CO Mt. Oxford
14,153 CA Mt. Sill (17)
14,150 CO Mt. Sneffels
14,148 CO Mt. Democrat
14,132 CO South Massive
14,130 CO Capitol Peak
14,110 CO Pikes Peak
14,092 CO Snowmass Mountain
14,086 CA Mt. Russell (10)
14,083 CO Mt. Eolus
14,082 CO Windom Peak
14,081 CO Challenger Point
14,080+ CA Polemonium Peak (12)
14,073 CO Mt. Columbia
14,067 CO Missouri Mountain
14,064 CO Humbolt Peak
14,060 CO Mt. Bierstadt
14,059 CO Sunlight Peak
14,058 CA Split Mountain (5)
14,048 CO Handies Peak
14,047 CO Culebra Peak
14,042 CO Mt. Lindsey
14,042 CO Ellingwood Peak
14,040 CA Middle Palisade (5)
14,039 CO North Eolus
14,037 CO Little Bear Peak
14,036 CO Mt. Sherman
14,034 CO Redcloud Peak
14,027 CA Mt. Langley (5)
14,022 CO Conundrum Peak
14,018 CO Pyramid Peak
14,018 CA Mt. Tyndall (5)
14,017 CO Wilson Peak
14,015 CO Wetterhorn Peak
14,015 CA Mt. Muir (11)
14,014 CO San Luis Peak
14,014 CO North Maroon Peak
14,005 CO Mt. of the Holy Cross
14,005 CO Mt. Huron
14,003 CA Thunderbolt Peak (11)
14,001 CO Sunshine Peak
13,990 CA Mt. Barnard
13,986 CA Mt. Humphreys (7)
13,980 CO Obstruction Peak
13,977 CA Mt. Keith (2)
13,963 CA Mt. Stanford (2)
13,962 CA Peak .5 ESE N Palisade
13,960 CA Mt. LeConte
13,955 CO Fletcher Mountain
13,950 CA Trojan Peak
13,927 CA Peak .6 W Mt. Russell AKA Morgenson
13,920+ CA Norman Clyde Peak (9)
13,917 CA Disappointment Peak
13,913 CO Gladstone Peak
13,911 CO Mt. Meeker
13,904 CO Emerald Peak
13,891 CA Mt. Agassiz (2)
13,888 CA Junction Peak (2)
13,881 CO Iowa Peak
13,850 CA Mt. Mallory (2)
13,842 CO Mt. Spalding
13,832 CA Caltech Peak
13,830 CA Mt. Darwin (5)
13,828 CO Peak 1.2 N of Mt. Lindsey
13,804 WY Gannett Peak
13,803 CA Peak .5 SSW Split Mountain
13,799 CA Mt. McAdie
13,779+ CA Peak .8 SE Mt. Stanford
13,770 WY Grand Teton (3)
13,770 CA Mt. Irvine (2)
13,768 CA Mt. Winchell (3)
13,760+ CA Mt. Corcoran
13,753 CA Discovery Pinnacle (5)
13,748 CO Mt. Sheridan
13,748 CA Mt. Morgan S (2)
13,715 CA Mt. Abbot (2)
13,714+ CA Peak .65 ESE Mt. Barnard
13,713 CA Bear Creek Spire (6)
13,711 CO Twining Peak
13,711 CA Mt. Gabb
13,704 CO Glacier Point
13,694 CO Kismet
13,691 CA Mt. Mendel (5)
13,680 CA Peak .8 NW Junction Peak
13,665 CA Birch Mountain
13,659 CA Mt. Williams
13,652 CA Mt. Tom (2)
13,648+ CA The Shark Tooth
13,632 CA University Peak
13,608 CA Mt. Ericsson
13,600+ CA Mt. Dade (3)
13,590 CO Matterhorn Peak
13,576 CA Peak 1. N Mt. Bolton Brown
13,570 CA Mt. Brewer
13,568 CA Mt. Goddard
13,565 CA Tunnabora Peak
13,559 CA Mt. Dubois
13,553 CA Palisade Crest
13,552 CA Mt. Carillon (5)
13,540 CA Peak .8 WSW Mt. Tyndall
13,538 CA Mt. Bolton Brown
13,528 UT Kings Peak
13,524 CA Mt. Fiske
13,523 CO Browns Peak
13,521 CA Peak .4 SSE of Jumpoff and Jumpoff (2)
13,510 CA Mt. Marsh
13,510 CA Mt. Gayley (5)
13,501 CA Cloudripper
13,495 CA Mt. Pinchot
13,494 CA Mt. Thompson (2)
13,494 CA Mt. Hale
13,485 CA Mt. Pickering (2)
13,480 CO Iron Nipple
13,470 CA Mt. Versteeg
13,468 CA Mt. Mills
13,441 CA Montgomery Peak (2)
13,435 CA Mt. Haeckel
13,417 CA Mt. Lamarck (3)
13,410 CA Mt. Newcomb
13,404 CA Peak .8 NW Mt. Lamarck
13,397 CA Cardinal Mountain
13,390 CA Mt. Jepson
13,388 CA The Thumb
13,385 CA Peak .5 NW Mt. Mendel
13,377 CA Mt. Wallace
13,364 CA Peak 1.4 SE Mt. Wallace
13,364 CA Mt. Powell
13,361 CA Mt. Hilgard
13,356 CA Pk 1.1 ENE Chocolate Pk
13,355 CA The Cleaver
13,332 CA Peak .5 SE Mt. Darwin
13,330 CA Black Giant
13,329 CA Mt. Prater
13,327 CA North Guard
13,326 CO Storm Peak
13,325 CA Joe Devel Peak
13,323 CA Ski Mountaineers Peak (3)
13,320+ CA Courte-Echelle
13,298 CO Pecks Peak
13,289 CA Mt. Bradley
13,289 CA Black Mountain
13,281 CO Mt. Lady Washington
13,278 CA Picture Puzzle Peak
13,273 CO Mt. Merriam?
13,271 CA Mt. McDuffie
13,270 CA Peak 1.0 NE of Mt. Morgan S
13,268 CA Pipsqueak Spire (2)
13,267 CA Clyde Spires
13,265 CA Deerhorn Mountain
13,265 CA Aperture Peak
13,264 CA Mt. Goethe
13,259 CA Peak .6 S Striped Mountain
13,253 CA Royce Peak (2)
13,248 CA Peak .9 NE Mt. Darwin
13,242 CA Feather Peak (2)
13,241 CA Gendarme Peak
13,240 CA Basin Mountain (2)
13,231 CA Mt. Warlow
13,225 CA Mt. Emerson (4)
13,224 CA South Guard
13,224 CA Peak 0.9 WSW of Basin Mountain
13,211 CA Mt. Carl Heller
13,198 CA Ruby Peak
13,198 CA Peak .7 ESE Mt. Lamarck
13,196 CA Mt. Julius Caesar
13,184 CA Mt. Hitchcock
13,183 CA Acrodectes Peak
13,179 CA Striped Mountain
13,179 CA Mt. Wynne
13,177 CA Mt. Young
13,169 CA Mt. Chamberlin
13,165 CA Peak .9 NNE of The Thumb
13,164 CO Kelso Mountain
13,163 CA Red Slate Mountain (2)
13,161 NM Wheeler Peak
13,160+ CA Peak .6 S Bear Creek Spire
13,157 CA Mt. Ritter (2)
13,140 NV Boundary Peak (4)
13,126 CA Diamond Peak
13,125 CA Mt. Baxter
13,120+ CA Picture Peak
13,120+ CA Ericsson Crags
13,120+ CA Broken Finger Peak
13,117 CA Mt. Huxley
13,114 CA Mt. Lyell
13,112 CA Checkered Demon (4)
13,103 CA Mt. Gilbert (10)
13,092 CA Mt. Goode (4)
13,091 CA Charybdis
13,081 CA Peak 1.1 E Mt. Goddard
13,077 CA Merriam Peak (2)
13,075 CA Seven Gables
13,070 CA Peak .6 N of Diamond Peak
13,063 NV Wheeler Peak (2)
13,061 CA Peak 1. W of Mt. Prater
13,060 CO Middle Mountain
13,058+ CA Pinnacle Ridge
13,055 CA Mt. Genevra
13,053 CA Mt. Dana (9)
13,051 CA Mt. Mary Austin
13,046 CA Peak 1.2 SSE Black Giant
13,040+ CA Peak .6 WNW Mt. Thompson (2)
13,040+ CA Peak .6 E Shepherd Pass (2)
13,040+ CA Peak .4 W Mt. Goode
13,040 CA Mt. Barcroft (5)
13,030 CA Peak 1.1 SSW Caltech Peak
13,020 CA Wheeler Peak
13,016 CA Peak 1.2 SW of Lone Pine Peak
13,016 CA Mt. Solomons
13,005 CA Mt. Morgan N
13,005 CA Mt. Gould
13,002 CA Kuna Peak
13,000+ CA Peak 1.3 ESE Mt. Wallace
13,000+ CA Peak 1.0 NNE Mt. Thompson
12,999 CA Temple Crag (5)
12,984 CA Peak .65 WSW of Mt. Morgan N
12,960+ CA Mt. Maclure
12,959 CA Arrow Peak
12,945 CA Banner Peak
12,944 CA Lone Pine Peak (2)
12,937 CA Muriel Peak
12,936 CA Mt. Clarence King
12,928 WY Mt. Owen
12,911 CO Cross Mountain
12,907 CA Mt. Gardiner
12,900 CA Cirque Peak
12,871 CA Mt. Johnson
12,851 CA Mt. Stanford N
12,850 CA Red and White Mountain
12,804 WY Middle Teton (2)
12,799 MT Granite Peak
12,790 CA Goodale Mountain
12,770 CA The Miter
12,764 CA Mt. Gibbs (2)
12,760 CA Center Peak
12,720+ CA Four Gables
12,662 ID Borah Peak
12,652 CA Columbine Peak
12,633 AZ Humphreys Peak
12,614 CA Mt. Baldwin
12,605 WY Mt. Moran
12,598 CA Kearsarge Peak
12,590 CA Mt. Conness (14)
12,567 CA Peak .4 S. of Simmons Peak
12,564 CA Piute Mountain (2)
12,561 CA Mt. Tinemaha
12,552 CA Bloody Mountain (2)
12,522 CA Peak .95 E of Mt. Stanford N
12,503 CA Simmons Peak
12,497 CA Sheep Mountain (2)
12,480+ CA Peak .8 S. of Simmons Peak
12,446 CA Excelsior Mountain
12,374 CA Dunderberg Peak (2)
12,355 CA East Vidette
12,352 CA Mt. Morrison
12,325 WY Teewinot Mountain
12,311 CA Mt. Davis
12,307 CA Notre Dame Peak
12,300 CA Thor Peak
12,281 CA Clyde Minaret
12,276 WA Mt. Adams
12,268 CA Mt. Morrison
12,264 CA Matterhorn Peak (3)
12,255 CA Eichorn Minaret
12,242 CA North Peak (22)
12,240+ CA Michael Minaret
12,226 CA The Humpback
12,200+ CA Peak .4 N. of Simmons Peak
12,160+ CA Rice Minaret
12,126 CA Peak .7 NNW of Excelsior Mountain
12,123 CA Olancha Peak
12,117 CA Mammoth Peak
12,100~ CA Kuna Crest
12,080+ CA The Dragtooth
12,080+ CA Parsons Peak
12,080+ CA Bedayan Minaret
12,033 CA Whorl Mt.
12,000+ CA White Mountain
12,000+ CA Adams Minaret
11,982 CA Amelia Earhart Peak
11,920+ CA Dawson Minaret
11,915 NV Charlston Peak
11,812 CA Laurel Mountain (2)
11,760+ CA Ken Minaret
11,760+ CA Jensen Minaret
11,760+ CA Cleaver Peak
11,760+ CA Blacksmith Peak
11,760+ CA Black Mountain
11,755 CA Tower Peak
11,711 CA Waller Minaret
11,680+ CA The Doodad
11,680+ CA Dyer Minaret
11,673 CA Mt. Patterson
11,663 CA Wheeler Peak
11,658 CA Chocolate Peak
11,600+ CA Turner Minaret
11,600+ CA Leonard Minaret
11,565 CA Mt. Aggie
11,543 CA Campito Mountain (2)
11,516 CA Vogelsang Peak
11,512 CA Starr Minaret
11,501 CA Volcanic Ridge
11,459 NV Sonora Peak
11,440+ CA Kehrlein Minaret
11,408 CA Fletcher Peak
11,278 CA Blanco Mountain
11,239 OR Mt. Hood
11,233 NV Stanislaus Peak
11,229 CA County Line Hill
11,120 CA Rafferty Peak
11,120+ CA Echo Ridge
11,070 CA Johnson Peak
11,040+ CA Echo Peak #9
11,040+ CA Echo Peak #8 (2)
11,040+ CA Echo Peak #5
11,040+ CA Echo Peak #4
11,040+ CA Echo Peak #3
11,040+ CA Echo Peak #2
11,040+ CA Echo Peak #1
11,040+ CA Cockscomb
11,004 CA Gaylor Peak
10,960+ CA Pridham Minaret
10,960+ CA Echo Peak #7 (2)
10,960+ CA Echo Peak #6 (2)
10,960 CA Charlotte Dome
10,940 CA Cathedral Peak (54)
10,935 CA Highland Peak
10,912 CA Ragged Peak
10,886 CA McGee Mountain
10,881 NV Freel Peak (2)
10,880+ CA Unicorn Peak (2)
10,823 NV Job's Sister (2)
10,776 NV Mt. Rose (208)
10,772 CA Silver Peak
10,633 NV Job's Peak
10,601 NV Church Peak (5)
10,560+ CA Tresidder Peak
10,560+ CA Riegeluth Minaret
10,483 NV Mt. Houghton (139)
10,457 CA Mt. Lassen
10,381 CA Round Top
10,324 NV Relay Peak (4)
10,280 CA Tenaya Peak (2)
10,243 NV Snowflower Mountain (2)


I fully understand why you keep a log. A quick calculation shows that, on average, you've successfully bagged a peak of at least 10K' almost once per week over the 24 years since 1987. Just damn . . .


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#17563 - 08/16/11 05:23 PM Re: Diamox [Re: Bulldog34]
quillansculpture Offline


Registered: 11/13/09
Posts: 564
Loc: Murrieta, CA
Okay Gary, I can't resist either.....

14,507 Mt Whitney (3)
_________________________
"Turtles, Frogs & other Environmental Sculpture"

www.quillansculpturegallery.com
twitter: @josephquillan

If less is more, imagine how much more, more is -Frasier

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#17564 - 08/16/11 05:44 PM Re: Diamox [Re: tdtz]
2600fromatari Offline


Registered: 10/18/10
Posts: 453
Loc: San Diego
tdtz, I'm planning on heading up Russell the first week of October if you're interested. If I have any strength left, I'll head up the Mountaineer's Chute and sleep on the summit. The recent trip reports with the night shots have inspired me. Of course, all of this is dependent on the weather. I hate hiking heavy, so if it's too cold, it'll be Russell only. I don't want to carry a tent, more clothing, etc. You're welcomed if interested, but my plans are always changing. (You too if inclined Burchey).

Bob, you're awesome!

quillansculpture, I only post during lunch hours while at work. wink


Edited by 2600fromatari (08/16/11 05:48 PM)

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#17571 - 08/16/11 08:06 PM Re: Diamox [Re: 2600fromatari]
Burchey
Unregistered


Atari, it will be cold as hell. I appreciate the invite, but I think I'll have been up Russell twice by then, so we'll see. You and I have to tackle something new. Also, think about sleeping on the summit - if you have a history of funk higher up, that might be a miserable night.

Bob, thanks for all the insight on climbing high. Your experience provides invaluable info for the newbies in the group ( me ).

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#17572 - 08/16/11 08:14 PM Re: Diamox [Re: ]
2600fromatari Offline


Registered: 10/18/10
Posts: 453
Loc: San Diego
Only thing I'm worried about right now is that coldness, probably more than the AMS. I was hoping some thermals and a zero degree bag would be enough. I HATE packing heavy. More than likely I'll head down after Russell/Carillion. Those guys with those night shots are really killing me.

The Palisades someday soon it is then dude. LOL, by the time I'm ready, you'll be at Denali.

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#17581 - 08/17/11 07:51 AM Re: Diamox [Re: 2600fromatari]
Burchey
Unregistered


Atari, Denali won't be for another couple years. That requires a lot more experience, time, and money than I'll have any time soon.

You'd probably be okay on the summit in a 0 degree bag, just watch the wind. Wind will suck your heat out of your bag if you aren't prepared - sleep behind a wall/under a shelter/windstopper shell on your bag.

BTW, thread drift

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#17582 - 08/17/11 08:33 AM Re: Diamox [Re: ]
wagga Offline


Registered: 10/07/09
Posts: 2249
Loc: Humbug Reach (Pop. 3)
We have prepared a short video explaining the forum rules regarding threadjacking, thread drift & so forth.
_________________________
Verum audaces non gerunt indusia alba. - Ipsi dixit MCMLXXII

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#17583 - 08/17/11 08:45 AM Re: Diamox [Re: wagga]
Bee Offline


Registered: 09/22/09
Posts: 1261
Loc: Northern California
Excellent hijack -- I absolutely love this movie! It portrays guys before they became sensitive 90's kinda guys!
_________________________
The body betrays and the weather conspires, hopefully, not on the same day.

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#17584 - 08/17/11 09:10 AM Re: Diamox [Re: Bee]
quillansculpture Offline


Registered: 11/13/09
Posts: 564
Loc: Murrieta, CA
Thread drift, thread drift......we don't need no stinkin thread drift!!!!

Possibly because Diamox has been beaten to death on about 100 different threads. Besides, this thread has been fun.

Question: Can you tell me what I should eat on Mt Whitney (Aaaaaaaarrrrrrggggghhhhhh!!!!!!!)

Answer: Check the other 100 threads on what to eat! And, oh yea, learn to use the "search". My God, I am pissy when I haven't had enough coffee.

p.s. 1 Burchey....Denali???? Please don't call yourself a newbie. I'm way too jealous and not brave enough.

p.s. 2 Atari .... same with you. I love reading your posts. Russell/Carillion in October!!!! It will be cold, but if snow keeps away.....One GORGEOUS month to go up. Didn't you go up Whitney in June? Snow? Straight up the chute?

p.s. 3 Tom, we need to hike together. I'm 200, but 55 lb's lighter than three years ago. The new hip likes less weight.

p.s. 4 CaT, Yes, I summited a week before the date you put down. I wish I had met you either at the portal or the hostel while you were at Whitney.....bummed about that.

p.s. 5 Gary is the fastest hiker downhill I've ever seen. Sucks for me because I hate downhill and try to keep it slow and less stress on my legs, knees, hip.

p.s. 6 I've got permits for Oct 2nd, but am considering doing the MR in mid September instead. It will be my first time doing the entire route. I checked the calendar and didn't see anyone doing the MR at all in Sept. Is anyone hiking the MR in Mid Sept?

p.s. 7 Bee Hijack, hijack, hijack :-)

p.s. 8 wagga.....great video and movie

My favorite is Val Kilmer (select from about 5 different scenes) in Tombstone

asta.....and it's almost lunch time. I have a show tonight in San Diego in case anyone is there.
_________________________
"Turtles, Frogs & other Environmental Sculpture"

www.quillansculpturegallery.com
twitter: @josephquillan

If less is more, imagine how much more, more is -Frasier

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#17585 - 08/17/11 09:40 AM Re: Diamox [Re: quillansculpture]
tdtz Offline


Registered: 08/26/10
Posts: 511
Loc: CA
Joe,
I'm definitely game. My weekends are booked for the foreseeable future...However, I am pretty flexible on weekdays.

I've had overnights in June, July, August and September. I need an october overnight. Atari is going up Russell in October, which is very tempting.

I'm pretty good on downhills. I think that comes from the skiing. Last year when we had storm clouds on the summit, I booked down to trail crest pretty damned fast.

Oh, and I'll be taking diamox...125 x 2. (just to keep on topic).

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#17586 - 08/17/11 09:49 AM Re: Diamox [Re: quillansculpture]
2600fromatari Offline


Registered: 10/18/10
Posts: 453
Loc: San Diego
Burchey, I was actually planning on using the summit hut to help with the wind. Otherwise, plenty of boulders to hide behind/under @ Iceberg.

quillansculpture, yes on June. It was actually a walk in the park due to consolidated snow and being able to glissade down which cut quite a bit of time, and stress on the knees. I'll be up the North Fork next April-June if you're interested.

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#17587 - 08/17/11 11:22 AM Re: Diamox [Re: quillansculpture]
Bulldog34 Offline


Registered: 11/12/09
Posts: 1255
Loc: Atlanta
Originally Posted By: quillansculpture
My favorite is Val Kilmer (select from about 5 different scenes) in Tombstone


"I'm your huckleberry . . . "

Got a T-shirt I bought in Tombstone a few years ago that says that, with a silkscreen of Kilmer's Doc Holiday. Love that shirt.


Originally Posted By: quillansculpture
p.s. 5 Gary is the fastest hiker downhill I've ever seen. Sucks for me because I hate downhill and try to keep it slow and less stress on my legs, knees, hip.


That's just to offset my very deliberate, granny-gear pace uphill. I have a naturally fast gait, but it's taken a lot of conscious effort to dsicipline my uphill pace so that I don't wind up stopping every 10-15 minutes to suck wind. That's just how I've generally always hiked. John Whitworth (catpappy) and Bob Pickering can mostly be thanked for finally getting me over my jackrabbit uphill tendencies after a few hikes in Death Valley back in March, particularly a day on super-steep Corkscrew Peak. I truly learned to pace myself on the uphills from those two guys.

I still tend to fly on the flats and downhills, though, especially if I'm using trekking poles and feel like I've got the stability of a mountain goat. It's not an issue for me since I can keep it up for hours, but it does sometimes create problems with hiking partners. Joe gave me quite a bit of grief over my pace coming down Whitney last year, especially on the switchbacks. I think we covered Trail Crest to Trail Camp in about 30 minutes of hiking time. My wife has learned to keep up with me on the flats and downs, but my daughter still occassionally yells her patented, "slow-down-dad!"

Besides Joe, I took it pretty easy coming down Whitney last month. We had heavy packs and I was deliberately not moving very fast since Brianne was with us. Other than the times we got separated due to talking to others on the trail, you were right there with me. Didn't I ask you several times if you were OK with the pace? You gotta let me know if not, bro!

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#17590 - 08/17/11 02:56 PM Re: Diamox [Re: bobpickering]
Ken Offline


Registered: 10/29/09
Posts: 742
Loc: Los Angeles
Quote:
Bee: I live at 5,000 feet. I think that helps a little, but it's not a big deal. I'm not climbing nearly as much as I did in the 90's, but I try to get up one of the nearby 10K peaks every week or two if I'm not doing something bigger. That helps acclimatization, but I don't think an hour or two above 10K makes a lot of difference. I have never spent extra time at a campground or trailhead just to acclimatize.


Bob, I was kind of amazed by your post, above, and some of the other things that you'd said in your associated post, in which you'd generally dismissed acclimatization, diamox, in general.

clearly, you start off by saying you live at 5,000 feet, so you are acclimatized to that altitude. but then you mention that you climb to 10k every week or so. So you are essentially acclimatized to 10k, inasmuch as you do that on a constant basis. In our last study, we could show an effect if someone had simply been above 10k in the previous MONTH. At all. I think that what you do has a huge effect. What then happened on Denali would then bear that out, as altitude increasingly had an effect on them, but not on you.

Diamox does have it's effect on the breathing aspects of AMS very quickly. It does NOT have such an effect on the other aspects of AMS, however. As you saw on Denali.

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#17591 - 08/17/11 03:13 PM Re: Diamox [Re: Ken]
Steve C Offline


Registered: 09/22/09
Posts: 7870
Loc: Fresno, CA
(Jerking this thread back from you hijackers... wink  )

Bob's post brought to mind a comparison with Colorado hikers and climbers. We don't hear nearly as much about issues with AMS in that state, because everyone lives at 5k or so. Even though people don't have AMS symptoms at 5k, I am sure there is a benefit. For a person living in Denver, or near Reno, they's have to hike to 19.5k in order to experience similar effects as we lowlanders do when climbing Whitney.

I know from personal experience, when in the past I had the opportunity to spend weekends at a cabin at 5k, that I'd feel unusually lethargic the first day there.

I think Bulldog34 (or someone else), mentioned recently that they were consulting with a Colorado AMS physician at some clinic, and this physician was surprised to hear about AMS problems climbing to 14k. Seems pretty clear to me that the 5k threshold for people in CO provides a completely different reference point.

...and I, too, am in awe of BobP's climbing numbers! smile

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#17594 - 08/17/11 04:15 PM Re: Diamox [Re: Steve C]
Akichow Offline


Registered: 04/07/10
Posts: 659
Loc: SF Bay Area
This brings to mind the post, either here or on the other site, from the guy who brought cans of Coors and Budweiser to the summit. The Coors cans were intact, but the Budweiser cans burst. He implied a difference in manufacturing quality, but I wondered whether the fact that Golden, Colorado where Coors is brewed (and often bottled, I think) is at 5,700 feet elevation. The local Budweister bottling plant in Fairfield, CA, by contrast, is between 15 and 400 feet above sea level, depending where you are.

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#17624 - 08/18/11 10:11 AM Re: Diamox [Re: Bulldog34]
CaT Offline


Registered: 09/24/09
Posts: 694
Loc: Blacklick, OH (formerly SoCal)
Bulldog - Sounds like our hiking styles are very similar, esp. the downhill part. Richard P. had a hand in helping me learn to pace myself also back a few years ago.

CaT
_________________________
If future generations are to remember us with gratitude rather than contempt, we must leave them more than the miracle of technology. We must leave them a glimpse of the world as it was in the beginning, not just after we got through with it.
- Lyndon Johnson, on signing the Wilderness Act into law (1964)

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#17640 - 08/18/11 06:06 PM Re: Diamox [Re: Steve C]
Harvey Lankford Offline


Registered: 11/10/09
Posts: 1024
Loc: Richmond, Virginia
Originally Posted By: Steve C

Bob's post brought to mind a comparison with Colorado hikers and climbers. We don't hear nearly as much about issues with AMS in that state, because everyone lives at 5k or so. Even though people don't have AMS symptoms at 5k, I am sure there is a benefit. For a person living in Denver, or near Reno, they's have to hike to 19.5k in order to experience similar effects as we lowlanders do when climbing Whitney.

mentioned recently that they were consulting with a Colorado AMS physician at some clinic, and this physician was surprised to hear about AMS problems climbing to 14k. Seems pretty clear to me that the 5k threshold for people in CO provides a completely different reference point.


Ready for some Lankford trivia about that 5k?

Although the official definition of altitude illness begins at 8k, the FAA recommends that general aviation pilots flying above just 5k at night in non-pressurized aircraft use supplemental oxygen. Of course most of them ignore this recommendation, but it is there because the retina (which is actually an extension of the brain) is the most sensitive body part to hypoxia. So the small amount of lowered O2 available at 5k is enough to subtlely impair night color vision. I gave a talk to pulmonary MDs once and this older codgy pilot tried to argue with me in front of the audience. I used a paraphrase of the great line in Top Gun where Charlie tells Maverick something like, "The government sees to it that I know more about than you do."

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#17641 - 08/18/11 06:27 PM Re: Diamox [Re: Harvey Lankford]
Bee Offline


Registered: 09/22/09
Posts: 1261
Loc: Northern California
Fascinating info, Harvey! I have had my pilot's license for about 20yrs, and I did not know about the O2/brain/retina connection. Most of the pilots that I know do not use O2 unless they were at 10k or higher....
_________________________
The body betrays and the weather conspires, hopefully, not on the same day.

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#17648 - 08/19/11 05:30 AM Re: Diamox [Re: Bee]
Harvey Lankford Offline


Registered: 11/10/09
Posts: 1024
Loc: Richmond, Virginia
Bee, most everyone (pilots) does what you say (above 10k and not 5.) The key words are "night" flying where color perception is more affected ...but, I gather most VFR does not happen at night anyway. The other key word is "subtle" loss of color vision. The explanation to me was that this would not be problem in familiar surroundings, but if you were flying in a novel situation (ie, different plane, new runway, or inclement conditions ) then you would not want to miss any visual clues, no matter how minor.

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#17656 - 08/19/11 04:14 PM Re: Diamox [Re: Harvey Lankford]
Harvey Lankford Offline


Registered: 11/10/09
Posts: 1024
Loc: Richmond, Virginia

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#17659 - 08/19/11 09:13 PM Re: Diamox [Re: Ken]
bobpickering Offline


Registered: 02/07/10
Posts: 431
Loc: Reno, Nevada
Ken:

The last time we disagreed, you said some pretty outrageous things on WPSMB, deleted your posts, and then suggested in a PM that I had exaggerated or distorted what you said. I've quoted you here, complete with grammatical/punctuation/capitalization errors, so I won't find myself responding to a post that got deleted.

Originally Posted By: Ken
Originally Posted By: bobpickering
Bee: I live at 5,000 feet. I think that helps a little, but it's not a big deal. I'm not climbing nearly as much as I did in the 90's, but I try to get up one of the nearby 10K peaks every week or two if I'm not doing something bigger. That helps acclimatization, but I don't think an hour or two above 10K makes a lot of difference. I have never spent extra time at a campground or trailhead just to acclimatize.


Bob, I was kind of amazed by your post, above, and some of the other things that you'd said in your associated post, in which you'd generally dismissed acclimatization, diamox, in general.

clearly, you start off by saying you live at 5,000 feet, so you are acclimatized to that altitude. but then you mention that you climb to 10k every week or so. So you are essentially acclimatized to 10k, inasmuch as you do that on a constant basis. In our last study, we could show an effect if someone had simply been above 10k in the previous MONTH. At all. I think that what you do has a huge effect. What then happened on Denali would then bear that out, as altitude increasingly had an effect on them, but not on you.

Diamox does have it's effect on the breathing aspects of AMS very quickly. It does NOT have such an effect on the other aspects of AMS, however. As you saw on Denali.

You say in your first (somewhat confusing) sentence that I "generally dismissed acclimatization, diamox, in general."

Here is what I said about Diamox:
Originally Posted By: bobpickering
The last few years, "everybody" has been recommending taking Diamox before you go to altitude. You should probably do that if you have good reason to expect AMS. However, Diamox does work if you wait until symptoms develop. It's better to climb without using drugs if you can, so you might want to bring some Diamox but not use it until you need it.
That certainly isn't "dismissing" the use of Diamox.

The subject of acclimatization, which you accuse me of dismissing, is more complex. My answer to Bee's question, which you quoted, says that I live at 5K and often take a quick trip to 10K. I acknowledged that this helps acclimatization, but I also said that I don't think it's a huge advantage. In another paragraph, I said that I try to sleep at the trailhead to help acclimatize. Is that dismissing acclimatization?

You claim that a few hours a month at 10K means that I am "essentially acclimatized to 10K." If that were true, people who spend 12-48 hours at or above Horseshow Meadow wouldn't get AMS on Whitney any more than I do. Either that, or I simply tolerate altitude better than most people. Which one is it?

People who climb often develop the right muscles, pace themselves, climb efficiently, and take good care of themselves. People who run on the beach and then decide to head up a big mountain are going to have more trouble. A survey that finds a slight negative correlation between AMS and being above 10K in the last month proves nothing. Climbers climb better than non-climbers. Duh!!

On the Denali trip, we spent four nights at 12,800 and six nights at 14,700. After all those storm days, we should have all been equally acclimatized. (After all, you claim that just a few hours at 10K has a "huge effect.") However, three members of the team still performed poorly. All of them had a history of not performing particularly well at altitude.

If living at 5K had a "huge effect," you would expect all my local climbing partners to perform well. They don't. On one fast trip up Shasta with three younger guys, one of them started pushing me at Red Banks. I pushed hard and waited 40 minutes for him on the summit. On a Whitney trip, another guy who consistently kicked my butt at running and cycling got AMS, leaving me to solo the East Face. I have a great photo of another local partner puking on the summit of Shasta. Another regular partner was consistently stronger at lower elevations, but I always turned the tables above 12K. I could go on, but I can assure you that there are plenty people living at 5K who don't perform especially well at altitude.

BTW, I know a member of this board who lives at sea level, rarely gets above 10K, and regularly performs better as the air gets thinner. Some of us are just lucky and don't have to worry much about AMS.

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#17660 - 08/20/11 04:20 AM Re: Diamox [Re: bobpickering]
Harvey Lankford Offline


Registered: 11/10/09
Posts: 1024
Loc: Richmond, Virginia
Originally Posted By: bobpickering

Some of us are just lucky and don't have to worry much about AMS.


Bottom line

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#17673 - 08/20/11 05:27 PM Re: Diamox [Re: bobpickering]
Ken Offline


Registered: 10/29/09
Posts: 742
Loc: Los Angeles
Originally Posted By: bobpickering
Ken:

The last time we disagreed, you said some pretty outrageous things on WPSMB, deleted your posts, and then suggested in a PM that I had exaggerated or distorted what you said. I've quoted you here, complete with grammatical/punctuation/capitalization errors, so I won't find myself responding to a post that got deleted.

Originally Posted By: Ken
Originally Posted By: bobpickering
Bee: I live at 5,000 feet. I think that helps a little, but it's not a big deal. I'm not climbing nearly as much as I did in the 90's, but I try to get up one of the nearby 10K peaks every week or two if I'm not doing something bigger. That helps acclimatization, but I don't think an hour or two above 10K makes a lot of difference. I have never spent extra time at a campground or trailhead just to acclimatize.


Bob, I was kind of amazed by your post, above, and some of the other things that you'd said in your associated post, in which you'd generally dismissed acclimatization, diamox, in general.

clearly, you start off by saying you live at 5,000 feet, so you are acclimatized to that altitude. but then you mention that you climb to 10k every week or so. So you are essentially acclimatized to 10k, inasmuch as you do that on a constant basis. In our last study, we could show an effect if someone had simply been above 10k in the previous MONTH. At all. I think that what you do has a huge effect. What then happened on Denali would then bear that out, as altitude increasingly had an effect on them, but not on you.

Diamox does have it's effect on the breathing aspects of AMS very quickly. It does NOT have such an effect on the other aspects of AMS, however. As you saw on Denali.

You say in your first (somewhat confusing) sentence that I "generally dismissed acclimatization, diamox, in general."

Here is what I said about Diamox:
Originally Posted By: bobpickering
The last few years, "everybody" has been recommending taking Diamox before you go to altitude. You should probably do that if you have good reason to expect AMS. However, Diamox does work if you wait until symptoms develop. It's better to climb without using drugs if you can, so you might want to bring some Diamox but not use it until you need it.
That certainly isn't "dismissing" the use of Diamox.

The subject of acclimatization, which you accuse me of dismissing, is more complex. My answer to Bee's question, which you quoted, says that I live at 5K and often take a quick trip to 10K. I acknowledged that this helps acclimatization, but I also said that I don't think it's a huge advantage. In another paragraph, I said that I try to sleep at the trailhead to help acclimatize. Is that dismissing acclimatization?

You claim that a few hours a month at 10K means that I am "essentially acclimatized to 10K." If that were true, people who spend 12-48 hours at or above Horseshow Meadow wouldn't get AMS on Whitney any more than I do. Either that, or I simply tolerate altitude better than most people. Which one is it?

People who climb often develop the right muscles, pace themselves, climb efficiently, and take good care of themselves. People who run on the beach and then decide to head up a big mountain are going to have more trouble. A survey that finds a slight negative correlation between AMS and being above 10K in the last month proves nothing. Climbers climb better than non-climbers. Duh!!

On the Denali trip, we spent four nights at 12,800 and six nights at 14,700. After all those storm days, we should have all been equally acclimatized. (After all, you claim that just a few hours at 10K has a "huge effect.") However, three members of the team still performed poorly. All of them had a history of not performing particularly well at altitude.

If living at 5K had a "huge effect," you would expect all my local climbing partners to perform well. They don't. On one fast trip up Shasta with three younger guys, one of them started pushing me at Red Banks. I pushed hard and waited 40 minutes for him on the summit. On a Whitney trip, another guy who consistently kicked my butt at running and cycling got AMS, leaving me to solo the East Face. I have a great photo of another local partner puking on the summit of Shasta. Another regular partner was consistently stronger at lower elevations, but I always turned the tables above 12K. I could go on, but I can assure you that there are plenty people living at 5K who don't perform especially well at altitude.

BTW, I know a member of this board who lives at sea level, rarely gets above 10K, and regularly performs better as the air gets thinner. Some of us are just lucky and don't have to worry much about AMS.


you know, Bob, I'd posted a somewhat scathing response, and then I'd deleted it, saving Steve the bother.

Basically, the topic of this thread boils down to the use of diamox, the prescription drug.

Bob, you are basically saying that the best strategy is to plan to have the best genetics so that one does not need the support of acclimatization or drugs. I agree.

Everyone should follow that advice.

As for the use of a prescription drug, people should do what they think is safe and effective.

Otherwise, with respect to the prevention and treatment of altitude illnesses, it seems odd to be getting advice from someone who goes to great lengths to describe how they dont ever get it. Sort of like getting advice on how to put on makeup.

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#17676 - 08/20/11 05:55 PM Re: Diamox [Re: Ken]
quillansculpture Offline


Registered: 11/13/09
Posts: 564
Loc: Murrieta, CA
Okay, okay.... I hope this doesn't go from being an informative thread, degenerating down to fun thread.....then back to an informative but pissy thread.
As a note.......we ALL enjoy reading your (Bob and Ken) posts.
You guys promote some of the best educational info from LIFE experience on both sites. You both provide information that many of us would need a lifetime to acquire. With that said, this site and the other wouldn't be the same without your knowledge and participation. And, if you check all the new posts on this site, there's a whole lot of them......and they just want to know how the heck they can get to the summit without throwing up, getting a splitting headache, getting too cold, hit by lightning, keep from getting rescued by SAR, etc. I look up to you guys, many of us do.....now give the new posters some real life experience they can remember you guys by. That's all they want, a hug a kiss, a spank on the butt for good luck.....and then sending them on their way.

nuff said
_________________________
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www.quillansculpturegallery.com
twitter: @josephquillan

If less is more, imagine how much more, more is -Frasier

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#17678 - 08/20/11 06:54 PM Re: Diamox [Re: quillansculpture]
Akichow Offline


Registered: 04/07/10
Posts: 659
Loc: SF Bay Area
Originally Posted By: quillansculpture
Okay, okay.... I hope this doesn't go from being an informative thread, degenerating down to fun thread.....then back to an informative but pissy thread.


I say, if you use Diamox, you have to use a wag bag. Or at least store it in a wag bag, preferably unused. Or wag your butt while you bag your Diamox.

Oh, and is there a solar toilet somewhere? (And are they safe refuge in a lightning storm?)

smile

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#17680 - 08/20/11 07:07 PM Re: Diamox [Re: Ken]
dbd Offline


Registered: 11/09/09
Posts: 216
Loc: San Diego
Originally Posted By: Ken
...
Basically, the topic of this thread boils down to the use of diamox, the prescription drug.
...

Ken

If you had limited your contributions to this thread to your expert knowledge of the use of diamox, no one would have been able to muss your makeup about the unexpected illogic of some of your statements concerning acclimation.

BobP has been an advocate of the understanding of personal characteristics and the application of that knowledge when traveling in the mountains. He has illustrated this in the contexts of traveling style/pacing on the trail and acclimation. Why do you seem find to that so objectionable?

Dale B. Dalrymple

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#17681 - 08/20/11 07:08 PM Re: Diamox [Re: bobpickering]
Yury Offline


Registered: 06/11/11
Posts: 57
Loc: T.O.
Originally Posted By: bobpickering
I live at 5,000 feet.

Originally Posted By: bobpickering
I try to get up one of the nearby 10K peaks every week or two

Originally Posted By: bobpickering
I always sleep at the trailhead if I can.


Spending about a day each weekend at a higher elevation (sleeping at a trailhead and hiking) and living at 5,000 feet makes Bob well adjusted to high altitude regardless of his interpretation.

Another person also told me that spending each weekend in the mountains allowed him to be well adjusted to higher altitude.

It seems to me that the above approach would work almost for everybody.

On another hand last year I was able to hike in Sierra only every other weekend and have not noticed any significant effect on my adjustment to altitude.


Edited by Yury (08/20/11 07:08 PM)

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#17724 - 08/23/11 10:02 AM Re: Diamox [Re: Ken]
Aaron Offline


Registered: 08/23/11
Posts: 1
Loc: Reno
The only time, I have had severe hypoxia in the Sierra was when I had been on diamox. I started dosing a few days before the trip, went from Reno to Whitney Pass, got caught in a weird July snowstorm, pushed hard to make it over the Pass (skipped going to the top because of the weather and was cold), on the way down I realized I was hypoxic and was having to stop going downhill--breathing too hard. Camped low at Hitchcock Lake. The next day, I was at Tyndall Creek, I remember walking really slow on the flats, the third day went over Forester Pass, that took awhile, climbed down to 10,000, next morning I had a bad case of pulmonary edema. My dad had to walk me out through Cedar Grove, ruined the trip. Now wondering if I had a reaction to Diamox.

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#17726 - 08/23/11 11:36 AM Re: Diamox [Re: Aaron]
Harvey Lankford Offline


Registered: 11/10/09
Posts: 1024
Loc: Richmond, Virginia
Maxim
Illness at high altitude is high altitude illness until proven otherwise.

Besides, your symptoms fit for HAPE and not Diamox (and the use of Diamox does not prevent all altitude-disorders anyway - you can still get it).

This story sounds familiar. Did I read about this episode somewhere?

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#17792 - 08/25/11 08:20 PM Re: Diamox [Re: Beer1]
hydrae Offline


Registered: 06/30/11
Posts: 7
Loc: California
A $100 Pulse oximeter (measures oxygen saturation and pulse) could come in handy to give you a quantitative correlation to your "sick" feeling.

Late last June was the first time I was attempting Mt.Whitney. I drove from San Diego, checked out overnight permit, and camped at Outpost camp the same night. Although in the past I have driven from San Diego and hiked to 11500ft (San Gorgonio summit) and back in a single day, this was the first time I was camping overnight above 10000ft. I had carried a Pulse Oximeter with me. If I did experience any sickness, I wanted to quantify it. That night I had a restless sleep. I could totally feel my pulse pushing my sleeping bag up and down.

Next morning when I woke up (after whatever sleep I got), I felt sick and uneasy. My pulse oximeter read a resting HR of over 100 and oxygen saturation at 85%. I thought this was the time to test my DIAMOX and swallowed one pill. I packed my backpack, and proceeded towards Trail Camp. It was a very slow go, but sometime after I crossed Mirror lake (maybe an hour or so later) I started getting better. Day 2, I setup camp at Trail Camp. Second night I had a disturbed sleep for a different reason. I was peeing every hour or so (This should have been a result of Diamox I guess). I didn't attempt summit the next morning because I didn't have the right gear to scale the chute. But I didn't have the sick feeling anymore. My oxygen reading now was 99% and HR was under 70. Right in time to enjoy the alpenglow of the morning sun on Sierra Crest.

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#17793 - 08/25/11 08:50 PM Re: Diamox [Re: hydrae]
quillansculpture Offline


Registered: 11/13/09
Posts: 564
Loc: Murrieta, CA
Originally Posted By: hydrae
I could totally feel my pulse pushing my sleeping bag up and down.


That's really interesting because my resting heart beat at sea level is around 58 beats a minute. When I was with Gary on the last trip, I took my heart beat while I was laying down at Consultation Lake. 85 beats a minute RESTING!

So, doctors on the board......what's up with that?
_________________________
"Turtles, Frogs & other Environmental Sculpture"

www.quillansculpturegallery.com
twitter: @josephquillan

If less is more, imagine how much more, more is -Frasier

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#17794 - 08/25/11 09:37 PM Re: Diamox [Re: quillansculpture]
Ken Offline


Registered: 10/29/09
Posts: 742
Loc: Los Angeles
Your heart was compensating for low oxygen pressure by increasing the heartrate, Q

Oh, and the price on a fingertip pulse ox has plummeted. You can get one for about $35 on Amazon.

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#17800 - 08/26/11 07:02 AM Re: Diamox [Re: Ken]
quillansculpture Offline


Registered: 11/13/09
Posts: 564
Loc: Murrieta, CA
Thanks Ken, I don't want to sound stupid and this may have been covered somewhere else, but I haven't seen it. Does the higher heart rate have anything to do with getting a light headache (or more) at altitude? Also, I was thinking that if your body is concerned about bringing itself back down to a normal level (possible start of survival mode), does it stop sending oxygen to your stomach, thus possible nausea?

You can tell by my questions that I wasn't a rocket scientist at Chemistry, and thus became an artist. But the subject of why you start acquiring symptoms is interesting. It great you are here to answer some of the "dumber" questions, especially from me.
_________________________
"Turtles, Frogs & other Environmental Sculpture"

www.quillansculpturegallery.com
twitter: @josephquillan

If less is more, imagine how much more, more is -Frasier

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#17803 - 08/26/11 07:39 AM Re: Diamox [Re: quillansculpture]
Harvey Lankford Offline


Registered: 11/10/09
Posts: 1024
Loc: Richmond, Virginia
Originally Posted By: quillansculpture
Does the higher heart rate have anything to do with getting a light headache (or more) at altitude?


Great question Q.

Lots of factors on plain AMS headache, and its ultimate manifestation as HACE. Some of these are:

*increased cerebral blood flow as the arterial vasculature dilates in response to falling O2, hyperventilation, and resultant falling CO2.

* mechanical shifts in fluid/edema. This occurs in many parts of the body. Swelling in the brain is, well, cerebral edema. Some parts of the brain like corpus callosum are more susceptible than others. Not completely understood.

* humoral change (not funny, but meaning hormonal or other metabolic). These cause shifts between extracellular and intracellular fluid/electrolye balance.

* Size of cranium! There has been suggestion that those with more space in their skulls may have less risk from swelling. I am not making this up.

* faster heart rate? (your question). If you have a headache for any reason, AMS or otherwise, the faster pounding aggravates it. Think of a pulsating mass of tender brain pulsating faster.

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#17813 - 08/26/11 08:31 AM Re: Diamox [Re: quillansculpture]
Ken Offline


Registered: 10/29/09
Posts: 742
Loc: Los Angeles
"Also, I was thinking that if your body is concerned about bringing itself back down to a normal level (possible start of survival mode), does it stop sending oxygen to your stomach, thus possible nausea?"

For the most part, any nausea associated with AMS is caused by changes up in the brain, I'd say. It would be true, I think, that blood would be shunted away from the stomach, but I don't think that would be the cause, generally, so your reasoning about survival is logically correct....send the critical stuff to the "vital organs".

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#17839 - 08/26/11 01:51 PM Re: Diamox [Re: Harvey Lankford]
hydrae Offline


Registered: 06/30/11
Posts: 7
Loc: California
I would like to avoid DIAMOX to Mt.Whitney in future. I know I can take my time acclimatizing as an alternative. But I am seeking natural ways to achieve what DIAMOX does. Reading about DIAMOX, it says it works by lowering the pH of blood. Does it mean you take any acid forming food (supposedly lentils, soy etc) and get a similar effect?

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#17845 - 08/26/11 04:18 PM Re: Diamox [Re: hydrae]
Harvey Lankford Offline


Registered: 11/10/09
Posts: 1024
Loc: Richmond, Virginia
Diamox does cause urinary secretion of bicarb that would tend to lower the blood ph. However, the primary metabolic effect at altitude is hyperventilation- to get oxygen in the thinner air. By blowing off CO2, hyperventilation raises the blood ph. This is called respiratory alkalosis and dominates at extreme altitudes.

Diamox also affects the brain respiratory centers and a lowered ph there in the brain and/or spinal fluid (as opposed to the blood) may be much more important in stimulating respiration. This is especially helpful at night when many sojourners to high altitude have abnormal breathing. Diamox may also reduce spinal fluid production, thus alleviating headache. Strange drug - does several things.

For a detailed graph of what ph does to the very important oxyhemoglobin dissociation curve at Everest -like altitudes see what I posted at
http://www.whitneyportalstore.com/forum/...age=2#Post86499
A high ph is necessary for survival at extreme altitude, but not at Whitney.

Lentils? The Sherpa people eat a lentil-based gravy on their rice called dal bhat. Quite good, but they do well at altitude for other reasons. I agree with you that longer time for acclimatization is best, and it works for those who do not have a low ceiling. For those people, there is a limit to height they can go.


Edited by Harvey Lankford (08/26/11 04:45 PM)

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#17853 - 08/27/11 08:11 AM Re: Diamox [Re: hydrae]
Ken Offline


Registered: 10/29/09
Posts: 742
Loc: Los Angeles
Originally Posted By: hydrae
I would like to avoid DIAMOX to Mt.Whitney in future. I know I can take my time acclimatizing as an alternative. But I am seeking natural ways to achieve what DIAMOX does. Reading about DIAMOX, it says it works by lowering the pH of blood. Does it mean you take any acid forming food (supposedly lentils, soy etc) and get a similar effect?


Don't know of any thing else that does what Diamox does.. There were some preliminary reports of Ginko having some positive effects, but more definitive testing proved to be useless.

The natural way is to acclimatize. Everything else is either an attempt to accelerate the body's process (diamox), or to cover up what is going on (steroids, NSAIDS).

There is just no doubt, the absolute best thing, is to acclimatize.

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#25246 - 06/20/12 11:59 AM Re: Diamox [Re: Harvey Lankford]
hydrae Offline


Registered: 06/30/11
Posts: 7
Loc: California
I am reviving this thread to post my recent experience WITHOUT the use of Diamox. One thing I learnt in-between my last post was "Forced exhalation" (aka "Kapalabhati", "Pressure breathing"). Forced exhalation is the same action as blowing a candle. As I later found it, doing this through my nose was more effective, than doing through my mouth (although I had to deal with my sinus discharge every now and then).

Last weekend I drove from San Diego and rested in Horseshoe meadows (10000ft) and within 6hrs I was on trail (5AM) to hike Mt.Langley (14042ft). After crossing the top of Old Army pass (12000ft), I was starting to feel lightheaded. As I neared 13000ft the landscape ahead was turning blurry and I was losing appetite as well. At this point, I started to consciously perform "forced exhalation". Voila!! The lightheadedness vanished within just 10-12 such exhalation. I was also amazed to see my Pulse oximeter reading jump from 85% to 95% within seconds. From then on I didn't have any trouble pushing my way to the summit doing this periodically. After reaching the summit, I felt as though I could have a gone another 1000ft repeating this process.

Bottomline, In an unacclimatized body
- normal sea-level breathing / shallow breathing just accelerates AMS at high altitude.
- "Deep breathing" doesn't help.
- "Forced exhalation" does wonders.

As a result I successfully reach a 14er from sea-level to 14000ft in 24hrs without Diamox. Hopefully my experience helps others deal with onset of AMS.

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#25250 - 06/20/12 03:21 PM Re: Diamox [Re: hydrae]
Eugene K Offline


Registered: 08/15/11
Posts: 40
Loc: San Diego, CA
Interesting. Do you do much, if any, endurance exercise at sea-level (the kind that would regularly bring your heart rate to 150 or so)? Do you have any idea what your pulse was when you were starting to get light-headed?

Maybe I should get one of those pulse oximeters next time I get back into the Sierras. I want to see if I can day-hike Langley in 10 hours round trip. Is Old Army Pass snow-free already?

BTW, it's not widely known, but Diamox hinders your athletic performance. At the typical 250 mg 2x/day dosage it makes you 10-15% slower than if you were hiking without it.

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#25251 - 06/20/12 03:40 PM Re: Diamox [Re: Eugene K]
Steve C Offline


Registered: 09/22/09
Posts: 7870
Loc: Fresno, CA
> BTW, it's not widely known, but Diamox hinders your athletic performance. At the typical 250 mg 2x/day dosage it makes you 10-15% slower than if you were hiking without it.

That is a curious effect, Eugene. Is it described someplace? I Googled "diamox athletic performance" and found this article from the Journal of Applied Physiology:

Title:  Effects of acetazolamide on aerobic exercise capacity and pulmonary hemodynamics at high altitudes
Quote:
We conclude that acetazolamide does not affect maximum exercise capacity or pulmonary hemodynamics at high altitudes.


And from the American Alpine Journal via Google Books:
Quote:
Diamox does not improve athletic performance.



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#25252 - 06/20/12 03:48 PM Re: Diamox [Re: hydrae]
Steve C Offline


Registered: 09/22/09
Posts: 7870
Loc: Fresno, CA
hydrae wrote:
> As I later found it, doing this through my nose was more effective, than doing through my mouth

How can you pressure breathe through your nose? I can't quite grasp the concept.

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#25255 - 06/20/12 04:10 PM Re: Diamox [Re: Steve C]
Eugene K Offline


Registered: 08/15/11
Posts: 40
Loc: San Diego, CA
I'll take that back. The effect is apparently inconsistent and it only appears in some studies, others find no difference.

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#25257 - 06/20/12 04:57 PM Re: Diamox [Re: Eugene K]
hydrae Offline


Registered: 06/30/11
Posts: 7
Loc: California
Originally Posted By: Steve C
How can you pressure breathe through your nose? I can't quite grasp the concept.

Tighten your diaphragm and expel the air. Imagine blowing a candle through the nose.

Originally Posted By: Eugene K
Interesting. Do you do much, if any, endurance exercise at sea-level (the kind that would regularly bring your heart rate to 150 or so)? Do you have any idea what your pulse was when you were starting to get light-headed?


I climb Black mountain (San Diego) regularly and push my HR to 160+ whenever I do. I occasionally run too. But, even when I am hyperventilating at sea-level doing these workouts, my O2 reading doesn't go below 98%. On the other hand when I was feeling light headed, although my HR was around 110s (of course I took my readings after I came to rest) I really paid attention only to my low O2 reading.

Originally Posted By: Eugene K
Is Old Army Pass snow-free already?


There was a small 30-40ft section just nearing the Old army pass. But, I didn't need to wear any spikes although I carried one.


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#25258 - 06/20/12 06:05 PM Re: Diamox [Re: hydrae]
Harvey Lankford Offline


Registered: 11/10/09
Posts: 1024
Loc: Richmond, Virginia
Originally Posted By: hydrae
even when I am hyperventilating at sea-level doing these workouts, my O2 reading doesn't go below 98%.

This is normal physiology.
You cannot "desaturate" at sea level with any degree of normal exercise unless there is something else seriously wrong, like say cyanotic congenital heart disease.

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