Drugs on the Mountain, Do They Help?

Climber and Porter working to prep oxygen tank.

Mndeme, the guide, shows a climber how the oxygen bottle works

Recently the Wilderness Medical Society (WMS) convened an expert panel to develop evidence-based guidelines for the prevention and treatment of acute mountain sickness (AMS), high altitude cerebral edema (HACE), and high altitude pulmonary edema (HAPE).  The goal was to once-and-for all cut through the myth, review the evidence and offer an expert opinion on how best to prevent and treat altitude sickness.  The research was pretty comprehensive and can be reviewed on the WMS Website.  Or you can check out a Washington Post article from a writer planning to climb Kilimanjaro and looking at the research for guidance. What is immediately clear from the research is that while Kilimanjaro may be the "everyman's Everest" it can offer a high degree of risk for AMS or worse.  For one thing, climbers ascend too quickly .  WMS recommends only 1000-1500 feet of elevation gain in a day, while climbers on Kilimanjaro frequently climb 2000-3000 in one day to reduce costs.  Also, groups tend to have a higher incidence rate of AMS than independent climbers.  This is likely because peer pressure causes climbers to push on even when they're not acclimated. Naturally, one of the biggest recommendations for adjusting to altitude is to take your time!  On Kilimanjaro you should at least sign up for a 7 day climb.  If you're thinking of attempting the Western Breach then you'll need at least 8 or 9 days to safely reach the summit and descend.  The research also found Diamox as a suitable drug to help you adjust to altitude.  Diamox, is also known by the non-brand name  acetazolamide.  They found Diamox was a safe drug with few dangerous side-effects.  It was originally developed to treat glaucoma.   But another side-effect is that it essentially tricks your body into thinking there is more CO2 in your system and as a result, you take in more oxygen, adjusting to altitude quicker. The two biggest side effects for Diamox are frequent urination and taste.  Many of the climbers I know who've taken it are up all night slinking in and out of the tent.   If you're going to take Diamox, start two days before the climb to give your body time to adjust.  The other issue is less critical, but maybe more annoying.  Diamox may change the taste of beer and other carbonated beverages, making it more metallic.  But don't worry, it's not permanent and usually goes away once you stop taking Diamox.
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