Mt. Whitney Portal Store & Hostel Forums General Mt. Whitney Portal Store Message Board Doctor altitude medication exp. in Orange County

Mandy,
In the past I've had only had mild AMS when sleeping over 10K--that go away after a day. But, I wanted to do everything I could to assure success on my first Whitney attempt in 2007 and knew that over 60% of the folks who don't make it attribute it to altitude.

My doctor, Eric Munro, MD 310-378-2234 is in Torrance. His is a board certified internal medicine doc, Johns Hopkins grad--young, with it. Great guy. He knew exactly what I was talking about with the Diamox. The dose is based on your weight. I take my dose 2 X day for two days before acending to altitude, then stay on it until I decend. Note: it is a sulpha drug and some folks are allergic, so if you don't know for sure, take one long before your trip (that's what I did) to make sure there are no reacations. I took the diamox last year and this year and summitted successfully both times. I know the meds helped. You need to push tons of fluids--even in the flatlands I was drinking 3 litres/day of water and electrolyte replacement too. You will pee constantantly, but it's worth it. No headaches, no dizzy, and decent (not fantastic) sleep at 12K. Also, go up slow. Stay at Portal, stay at Outpost, stay at Trail Camp. I know it means more gear, but you can vastly mitigate the altitude problems.

Good luck!

Great, thanks Karen. I will give this guy a call next week. See if he will maybe help me over the phone save a trip to Torrance.

We did Whitney slow I thought, we left at 2.30am, and we are slow walkers. Rather not camp, but will if I need to to summit.

Mandy

I hear what you say. I am a novice hiker and spent a year training on the fitness, and did not want to camp especially, and I thought the hotels in Mammoth were higher that Lone Pine. Plus never been to Mammoth. Hydration may have been a problem, I certainly did not drink enough the day before Whitney. But hydrated like crazy before San Jacinto this weekend and felt no better. (Saw lots of tree stumps and restrooms though )

I would prefer to get my body to deal with better without drugs, but I never want to go through what I put myself and my hiking buddies through to get me down again. So if ends up Diamox is the only way I will certainly try it. And hear what you say about dosing. I have 10 months so lots of time.

At 250 mg. x 2/per day I suspect you have a bunch of tingling in the extremities and it might more than 24 hours before you can drink carbonated beverages.

My guess is you weigh less than my 175 lbs. but are taking more a greater total dose than I am.

I'm surprised you did not pick up your problem with elevation during your practice hikes this year prior to going to Mt. Whitney.

That aside, if you are going next year you will have plenty of time to figure out what works for you. The only way you are going to figure it out is by going to these elevations a bunch. I only go to these elevations 5 or 6 times a year that is why it to me 5 years to figure out what works best for me. Therefore, I would suggest a few trip to the High Sierra next summer prior to your Whitney trip, trips that will keep you over 10,000' for 24 hours or more.

Although I have not had full blown AMS, I was prone to raging headaches at altitude. What worked for me? - Ginko Biloba! A quick Google on this will get you numerous references on Ginko's use as an AMS preventative.

Ginkgo has failed in a double blind test at Everest basecamp. It worked as well as a placebo.

http://www.bmj.com/cgi/content/full/bmj%3b328/7443/797

He won't. That is not because he is not a great guy, but because it is illegal.

> ...but because it is illegal.

Thanks, Ken. I wondered about that issue.

Well, it seems that if you end up taking Diamox you'll be in good company...

Couple questions:

- What kind of aerobic shape are you in?
- How much sleep did you get prior to either of the above two hikes?

Reason I ask:

My first trip up Whitney I prepared by filling my pack with weights and climbing up/down local hills. Was weight lifting at the time anyway, so figured I'd be good and strong. Wrong. In addition to not getting much sleep the night before, and running all around in my excitement as we went up the trail, I wasn't in good aerobic shape. When we got to Trailcamp, I thought I was going to die.

Learned from that. It only makes sense: The better aerobic shape you're in, the more efficiently your cardiovascular system can transport oxygen, nutrients, etc., throughout your body, and hence the better you will do at altitude.

Sleep a big factor also. I tend to not get much during the week (due to plain 'ol stupidity mainly), and when I try to get in an early Saturday hike, especially if I have to travel to get to it - I can easily hit "the wall".

BTW, when my wife and I use the Portal/Outpost/Trailcamp method, we sleep like babies at 12,000'. I know you seem to be more sensitive to altitude, but most folks say they sleep poorly at Trailcamp. So, slow acclimitization helps. Us anyway. YMMV.

Good luck!

I doubt aerobic shape has much to do with being affected by high elevations. I move up the trails with more than a bit of rapidity and can maintain a high level pace for 6 or more miles, +4,000', usually the only ones passing me are my freakish friends, still, I have a major problems with elevation when not proper dosed with Diamox on trips above ~8,500' lasting more than 8-12 hours.

Some people are going to have problems sleeping at higher elevations with or without drugs or acclimation. I am one of them...especially at around 12,000'.

I've come to believe if you have these problems, it is going to take a while to solve them to your satisfaction.

The whole process is YMMV.

I agree: I think how you're affected by high elevations has lots to do with aerobic shape.

Well you didn't mention your assessment of what you consider your own aerobic shape, so it's hard to put your comments into a context. However, can you really assert that if your cardiovascular system is extremely efficient at pumping blood and moving oxygen, etc., throughout your body, and your muscles are toned and extremely efficient at the processing thereof, that you would perform no differently at 14,000' than a couch potato?

That would defy common sense. Now, while things often do; I don't think so in this case.

I have no medical evidence handy, nor do I care enough to go look it up, but based purely on anecdotal evidence and personal experience, I disagree with your disagreement.

For example, my brother in law, who swims laps (highly aerobic) every day, was literally skipping his way down the trail past Trailcrest. My own experience, as alluded to in the prior post, was night and day when I conditioned one way vs. the other.

But, feel free to disagree. I don't mind. I'm just suggesting the O.P. might consider some alternate approaches before just giving up and resigning herself to doing it the "modern" way.

I read up on the literature, consulted with my doctor and was aware of the fact that it takes a day or so to have any effectiveness. I planned on a three day trip which is why I took it along. If I struggled at 10,000 or 12,000 feet, then I would have prolonged my ascent higher. As it turns out, I felt great up until a little beyond Trail Crest. When I decided to try one on the way down it was with recognition of the side-effects and contraindications.

That aside, whether by placebo effect or because of the descent, something made a difference. Not only did my symptoms go away, but I felt fantastic. As many have commented upon, each person's body chemistry is different and may react differently. That was my reaction.

Brent N.

Based on your original comments, it seems you might have some real altitude issues. If you really want to do Mt. Whitney you need to start early and hike more often. Do as many hikes as possible above 8000 feet from now until you are ready to go to Mt. Whitney. In the spring time take multiple trips above 10000 feet. Then spend some time adjusting in Mammoth or some other high elevation - say Horseshoe Meadows @10000 feet.

You will be ready. Your body needs to learn how to adjust to higher elevations. This only comes from doing over a long period of time. Some can't just adjust the last week and expect success. Then take along Diamox as an extra advantage. If you prepare in this way, you will be much more likely to make it without serious altitude illness.

I personally don't take Diamox that often, but I did the first time I summited Mt. Whitney. I still remember that night before, trying to sleep at Whitney Portal campground with my feet tingling.

I was talking about in the context of AMS.

I write extensively in on my website and blog about aerobic capacity being extremely important to a trip to Mt. Whitney but not when it comes to being affected by ravages of AMS...which I have personal experiences. I consider myself to be in very good aerobic state...Baldy in 2:15 and Icehouse Saddle in 1:25 recently. These times are at an average heart rate in 70 to 75% of max range.

There actually may be some correlation between higher aerobic conditioning creating worse AMS results. Those who can climb faster get themselves into higher altitudes sooner.

That would explain my having my worst AMS experiences decades ago when I could haul a 40 lb pack 5000 vertical feet in a day.

I wonder just how much genetics or some other inherent body composition that allows one person to do well at altitude and be less susceptible to AMS and others not. I am 100% sure that there are many on this board that are in many times better aerobic shape than I am and have much more experience but are susceptible to AMS and/or have problems sleeping above 12,000' whereas in all my many trips above 10,000 (and Trail Camp) sleep has never been an issue and never had much problem with altitude (other than sucking wind!). I've never really done any acclimatization other than Horseshoe Meadows the night before. Just lucky? Or maybe there is more to it.

Clyde Soles in this book "Climbing: Training for Peak Performance" stated "that those with the biggest aerobic capacity tended to experience the greatest losses."(in VO2Max). As aerobic activity requires a greater amount of oxygen it makes sense that ones capacity in that regards becomes less important as oxygen decreases the higher one goes thus much of our effort becomes anaerobic (utilizing less oxygen). I can only hypothesize that all that weight training I've done over the years has perhaps helped me in surprising ways by helping increase at least that aspect of dealing with altitude.

I guess I am slightly off, since I will talk about altitude in Chile.

I am a geologist from Canada working in Chile. I regularly live at sea level (Halifax) and I went up to camp at 4,200m on Sunday. Today is Wednesday, and after no symptoms other than the worst headaches of my life at night, I am fine.

Well, I am worried about the headaches on the back of my head and neck. I only get them at night, but they are horrendous. They are so bad that I had to go to town (500m) today Wednesday.

Now, to add to the mystery diagnosis, I am on my 30s, average weight, do not smoke, and have been at 4,000+ before without more than mild headaches. To add to the mystery, a colleague measured my blood pressure this morning (at 4,200m) and found it to be 120/60, which is low on the second reading. I am a 120/80 at sea level.

Does anybody have any suggestions about how health-threatening the headaches might be combined with the low blood pressure?

Are there any suggestions as to what I can do, considering we are in the middle of nowhere and there are no 'stations' for acclimatizing between town and camp?

If I understand your situation, you have been at altitude for several days, correct?

Assuming that - are you staying well-hydrated? Perhaps over-hydrating a bit? Getting plenty to eat?

If answers to the above are "Yes", you might consider a regime of moving to altitude over several days as going from sea level at 4,200m in one jump is alot. You might consider descending to 8,000' (sorry, can't make the meter conversion quickly) for sleep for several days, and return to elevation for work. Then, increase your sleeping elevation by about 2,000' per week until you can work and sleep at 4,200m without discomfort/pain.

Let's see... 4,200M = 13,800 feet

That headache sounds like classic AMS. You're probably experiencing some cerebral edema -- fluid on the brain.

You did the right thing by descending to a lower elevation. I'll bet you have no symptoms tonight.

If you can find some acetazolamide (Diamox), I would take some (125 mg twice a day is what I have seen suggested.) You could discontinue its use after 3-5 days.

If the symptoms disappear, try going back up tomorrow. If the travel time is not too bad, I would return to the lower elevation to sleep. After 3-4 days at the high elevation, you will probably be ok.