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First Aid - Diamox
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I'm off to Nepal to do some trekking - may do the Thorung La (5416m). I'm taking Diamox for AMS but don't wish to use it prophylactically but rather, to help with sleeping and periodic breathing. Has anyone used the drug for this purpose? Is it effective  or is it only good as an aid to acclimatisation?

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According to the latest reaserch viagra is better.

I have read the the problem with Diamox is that it masks symptoms rather than aleviating them. Not tried it though sorry.

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I was on an organised trek including the Thorung La & Kala Pattar in 1996. The trekking organisers had recommended Diamox and so all of us used it (7 teenagers, two adults). We took it regularly (prophylactically) and nobody suffered any significant altitude sickness. I imagine that it is the sort of thing that has to be used 'as per instructed dosage' because it is intended to promote physiological changes that take a number of days to occur. I haven't heard of it being used as you suggest, but I'm not a medic.

This site seems to give the same impression. If you are thinking of taking it at all, what is your concern about using it regularly?

John

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Hi John

Firstly I would like to say I am very green eyed at the minute! I went to Nepal in December last year for 3 weeks and had the trip of a lifetime and would go back tommorow if I could! You will have a great time.

As for diamox, well, it depends on how quickly you will be ascending? If you take your time and follow the recommended guidlines above 2800-3000 meters then you shouldn't need it at all. We took some on our trip but did not use them.

Are you going to be ascending quickly?

Rgds, Adam

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Thanks for the advice guys. We are in no hurry so i don't plan on skipping acclimatisation days or ascending rapidly + I would prefer to acclimatise naturally but, i am known for being a little paranoid and i've only been to 2700m in the past, hence my concern...
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Of course, before someone corrects me, I meant the Cho La near the Khumbu Glacier. I also tried to complete the Annapurna Circuit in '98 but it turned into a snow-bound dysenterial epic!

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Diamox can be used to reduce the risk of problems or used to treat problems if/when they have developed. Like lots of other medications it has a long list of potential side effects & complications.

Limiting the rate of ascent to acclimatise without the diamox is probably the best option, though some do choose to take diamox prophylactically. If you do opt to take it prophylactically try it several weeks beforehand for a few days to see if you can tolerate it. 

Diamox must be avoided by those allergic to sulpha antibiotics. 

More information is available at the following site and in the mountain medicine section of the BMC site: http://www.basecampmd.com/expguide/diamox.shtml

Viagra is effective in treating high altitude pulmonary oedema.

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I'v just got back from doing the Huayhush Circuit in the Peruvian Andes (we reached just under 5000m) and i used diamox each day over 3000 metres. I didnt get any side effects, didnt have much trouble breathing, and slept fine.

However, a friend was airlifted off the mountain despite taking diamox...

also, iv heard its not possible to get diamox as an acclimatisation drug in the UK, so perhaps best to try and get from america.

Shay.

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I'm off to Everest Base Camp with BHF Feb 08 and any advice on anything would be great. Thanks
Edited: 02/09/07 17:21
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The best way to oversome altitude sickness is very stringent acclimatisation.

using drugs to overcome it sometimes works, and sometimes doesnt, but proper acclimatisation usually works (obviously there have been times where people have got very ill even when thought acclimatised, but normally will work)

acclimatisation will take different amounts of time and energy for different people.

Shay

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I've been to altitude a few times now - Andes and Himalaya - and used Diamox once, out of curiosity. I know from experience that if I ascend sensibly, I generally acclimatise well, which is the case for most trekkers and climbers, though some people just seem not to be altitude friendly and don't really adapt well.

What I did notice with Diamox is that it makes your extremities tingle - fingers particularly - which I found unpleasant, is also a diuretic and seemed to affect the taste of food and drink. It didn't seem to make any difference to my acclimatisation either, but then as I said, I tend to acclimatise okay anyway.

I think it's reasonable to be wary of altitude, particularly if you've not been high before, but most people using a sensible height gain programme will be okay. Key is to take things steady, don't be tempted to break height gain guidelines, drink lots of fluid - not alcohol - and listen to your body.

As I understand it, Diamox - which is primarily a glaucoma treatment drug - changes the acidity of your blood and effectively tricks your body into taking deeper breaths, but that's just off the top of my head. It clearly does help some people, but equally the majority of trekkers manage fine without it. Your choice, but be aware of the minor side effects as well. 

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Yeah i also acclimatise well, and have never got alt. sickness, but then i dont know how the diamox affected this in the andes. I did find very much that it makes extremities tingle, i found it affected my face, fingers, toes and sometimes entire feet. Although i didnt find this especially enjoyable, some others with me didnt mind it. Ironically many of these people got sick higher up!

i agree, its a matter of choice, and perhaps to an extent is a placebo.

 also, i think it depends how high up you're going. 5, 500 shouldnt make it vital, but be wary of how quickly you ascend.

Shay.

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Thanks Shay and Jon, its good to hear your opinions. I got some Diamox off my Dr without any trouble. I will take it with me but i don't plan on using it. 
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John,

don't forget that diamox, when used in the manner described above, is intended to accelerate your adaptive reactions to altitude. It is not for treatment of severe altitude sickness, heloing in some cases of mild AMS. The only advice for severe altitude sickness is descend descend descend!

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I used Diamox on Killi earlier this year.  I started taking it prophalactically on the first day of the trip with no problems at all except a bit of tingling in the fingers.   Most of the group were taking Diamox but in different strengths.  Half of us made it to the top but it was extreme conditions with one person from another group dieing that day. 

I got mine of my GP who 'googled' it on his computer during our consultation and gave me the script with all the info - great GP.

Our local guide had made the summit over 20 times but had to go down due to feeling the effects of altitude that day, just goes to show that AMS can affect anyone, no matter how experienced

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Let me guess, you went up in about 5 days?
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I think the advice we had to take diamox was overkill. We did ascend quite quickly to Namche (3800m) from Lukla airstrip (2860m), but spent about a week in Namche working on a reafforestation project on the hillsides above the town.

It was very hard work at that altitude, carrying the saplings from the tree nursery the few miles up to the planting site, digging holes and then bedding in the trees. In total I think we planted over 500 trees - long before all this talk of offsetting our carbon footprint! The point being, however, that we spent a week acclimitising, doing aerobic work at slightly higher altitudes and then returning to Namche to sleep.

It was text-book acclimitisation technique as far as I can tell and I think this is the main reason that none of us had serious problems later on (around 5600m). Diamox may have helped but it is hard to say. We did experience tingling in the extremities and other minor side effects...


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