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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: 210
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: 1015
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: 562
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: 562
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: 1015
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: 1015
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: 7583
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: 7583
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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