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Crag & Route Beta

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Advice for preparation to Everest B.C... 15-Jan-2010 At 4:42:56 PM vwills

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I have never taken Diamox when going to altitude, but thats because if I can control my acclimatisation schedule I know what works for me. I would consider Diamox if I had to fly/ ascend to above 3500m from sea level, and did not have the opportunity of spending a few nights between 3000-3400m.
Above this I would not sleep more than 600m higher every 2nd day. You can go as high as you like during the day as long as you descend to sleep. Could Diamox cause harm? Unlikely if you are not allergic to it. Its very important to stay well hydrated whether you are taking it or not.

The important thing with alltitude is that it is normal to feel pretty bad at times and not take it as a sign of personal weakness, give your body time to undergo its adaption process.

Aspirin works well for AMS headaches with the potential useful side effect of being an anti platelet agent (and thus reducing your risk of thrombosis). Trials have demonstrated efficacy for headache prevention but I tend not to take it prophylactically as a headache is a good sign that you should not sleep any higher. The number needed to treat to prevent stroke/ DVT etc is too large to be feasibly tested- ie the benefit is quite small.

Acute mountain sickness in itself isnt dangerous and usually improves providing you dont ascend. So dont panic if you get a headache.

HAPE and HACE are serious and the most important management is DESCENT. Nifedipine, dexamethasone, frusemide, gammow bags and oxygen are adjuncts that should be available on large mountaineering expeditions but not included in a personal first aid kit to Everest BC.

There is an excellent review article on altitude medicine in the British Medical Journal about 2003 that is woth checking out if you want to read more. .

Most doctors who are interested in travel medicine and or Wilderness medicine in Australia should be able to give you quite appropriate advice about altitude and be prepared to prescribe Diamox and I would have thought proper preparation for China should entail a visit to at least talk about vaccinations. Sounds like its too late for that!

Have fun.