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Re: Need feedback on Diamox
bobpickering #52050 09/05/17 06:30 PM
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Thanks Bob, appreciate the advice, especially regarding dex.

Re: Need feedback on Diamox
SierraDave #52054 09/05/17 07:34 PM
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That's my understanding too. Dex is for an acute emergency, not prevention.

Re: Need feedback on Diamox
SierraDave #52093 09/07/17 09:38 AM
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I haven't heard of that scoring system. I turned back last year from AMS near trail crest and from my score (I got a 6), I figure I did the right thing. I attempted the climb again this year but failed for entirely different reasons. The mountain is still there and I'm still living so perhaps next year?

Re: Need feedback on Diamox
SierraNevada #52094 09/07/17 09:45 AM
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For whatever it is worth, Dr. Peter Hacket at Telluride recommended for me that before I go to Whitney, I get a prescription from my doctor of Diamox, Dex and Zofran. Diamox was a preventative, and he said I could "try a short course of dexamethasone the first few days at altitude."

When I get altitude sickness, I see double vision and get lethargic, reserving all my energy for uncontrollable vomiting.

What I have found is my best preventative is spending 2-3 weekends sleeping at 10,000 in the weeks leading up to Whitney, and then a slow 3 day progression up Whitney--1 night at Outpost, 1 night at TC (with a hike that day if I feel up to it up to Trail Crest) and then the third day summit and descend.

Re: Need feedback on Diamox
Brent N #52110 09/07/17 08:41 PM
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> reserving all my energy for uncontrollable vomiting.

smile grin laugh

Re: Need feedback on Diamox
SierraNevada #52125 09/09/17 08:06 PM
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Originally Posted By: SierraNevada
That's my understanding too. Dex is for an acute emergency, not prevention.

Although they do recommend that it be reserved for treatment, according to the CDC Dexamethasone is effective both for prevention and treatment of AMS, HACE, and even HAPE:

From https://wwwnc.cdc.gov/travel/yellowbook/2018/the-pre-travel-consultation/altitude-illness

DEXAMETHASONE

Dexamethasone is effective for preventing and treating AMS and HACE and prevents HAPE as well. Unlike acetazolamide, if the drug is discontinued at altitude before acclimatization, mild rebound can occur. Acetazolamide is preferable to prevent AMS while ascending, with dexamethasone reserved for treatment, as an adjunct to descent. The adult dose is 4 mg every 6 hours. An increasing trend is to use dexamethasone for “summit day” on high peaks such as Kilimanjaro and Aconcagua, in order to prevent abrupt altitude illness.

Re: Need feedback on Diamox
Norris #52127 09/10/17 05:06 PM
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Originally Posted By: Norris
An increasing trend is to use dexamethasone for “summit day” on high peaks such as Kilimanjaro and Aconcagua, in order to prevent abrupt altitude illness.


Amazing. I found Kilimanjaro to be the easiest big peak that I've ever done. Although I carried Diamox, I did not consume it. I had been closely monitoring my vital signs, and I never saw any stress, so I never started it. Most climbers never monitor, so they don't know whether they are stressed or not. Two on the same trip had to be re-routed or evacuated due to AMS.

Re: Need feedback on Diamox
bobpickering #52140 09/12/17 07:45 AM
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Originally Posted By: bobpickering
It’s best to pace yourself and keep moving. If you can’t comfortably go ten minutes, and preferably twenty minutes, without stopping, you’re going too fast.


Great advice. When I was younger, I would jack rabbit. That is, just crank out the miles without stopping. Then, as I got older, I began to take breaks while still trying to maintain a fast pace.

Finally, over the past 2 years, I've conciously forced myself to slow down & walk at a pace where I don't have to stop. Not only is my hike more fun, but it allows my mind to take in the scenery, as opposed to focusing inside & just muscling it up a pass.

It's still a bit of a new sensation - I'm going pretty slow (around 1.5-1.75mph uphill on trails with 600-700' gain/mile - MMWT is 590'), but it feels great not to feel tired or stressed. Just a nice, pleasant hike without feeling like I'm dying.

The plus side is I can hike for hours at this slower pace without stopping, so I do eventually reach my destination. For example, it took me 6 hours to hike up Sawmill this past July (Sawmill gains 6,755' over 9.2 miles = 734'/mile.)

So yeah, listen to what Bob says.

Last edited by Hobbes; 09/12/17 07:57 AM.
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