UKC

As the title says:

For a trip to Killi in January.

Thanks

In reply to Carpe Diem: Your GP ?

In reply to Carpe Diem: Your GP since it should be free for you. It's benefit is marginal, if at all, keeping well hydrated is better.

In reply to m0unt41n:

I'd echo the comment re: hydration (especially as Diamox has a diuretic effect).

Some GP's may not be familiar with Diamox and might not be keen to prescribe something they don't know about so it's worth finding a journal/clinical trial/review article with info on it - for example http://www.bmj.com/content/345/bmj.e6779

In reply to Carpe Diem:

You'll probably have to pay, a private prescription, but it's not expensive.

In reply to Carpe Diem:

I suggest showing your GP this recent review article from the New England Journal of Medicine (and reading it yourself).

http://jvsmedicscorner.com/Medicine_files/Acute%20High-Altitude%20Illnesses...

In reply to Carpe Diem: My GP was with the Glossop MR and used to be the GP on the Army skiing team. He suggested Diamox to me when I got my Jabs for Everest/Tibet region.

In reply to m0unt41n:

It's benefit can be a good bit more than marginal according to the research but there is of course the ever present risk of side-effects. The papers can be tricky to understand to the layman so a more layman friendly link is here (Diamox is a trade name for Acetazolamide):

http://en.wikipedia.org/wiki/Acetazolamide

In reply to Carpe Diem:

Could just buy it over the counter in Tanzania

In reply to Carpe Diem:
"phospho- diesterase-5 inhibitors are indicated for high-altitude pulmonary edema" (from the NEJM article)
I didn't realise Viagra was a treatment for HAPE. Is there anything that drug can't do?

In reply to splat2million: Viagara still has little evidence of actually being of benefit, although the pharmacology makes sense. Descent, O2 and Nifedipine are still 1st line.

In reply to Offwidth:

Actually, the NEJM article I linked to above is maybe the exception. As a lay person myself I found it very readable and understandable. The case vignette describes the OP's plans exactly. The article is interesting, in that it does suggest diamox is not the only drug worth taking.

My view of this article is that, for moderately high altitude (5000m - 6000m) it is best not to take anything prophylactically but to take a hefty cocktail of drugs for treatment if (despite appropriate efforts to acclimatise) symptoms do develop - especially if you will be in situation where it is not possible to descend quickly to low altitude. E.g. stuck half way up long technical climb, or on a large high-altitude plateau such as Pamir plateau etc.

In reply to all:

Thanks all. I used it in 2012 when I did the EBC trek. Started taking it at Dingboche ( provided by our guide if we wanted too )

No side effects, and didn't have any AMS symptoms apart from a little loss of appetite. Not sure how much of that was me, or the Diamox though....

Thanks

In reply to Carpe Diem:

Nomad Travel may be able to sort it out for you.

I did a WMT Far From Help course at Glenmore Lodge and it allows me to self cert prescriptions from Nomad.

In reply to lost1977:


You could, but it might not actually be diamox!

In reply to Carpe Diem:
Just remember there are 2 versions of Diamox there's Diamox,SR (slow release) used as an aid to acclimatization and the the faster acting version for those not on SR, used in conjunction with the drugs Nifedipine (for HAPE) and Dexamethasone (for HACE). For your information I had a group of 11, 17 year olds and 2 in their 50s up Kili this summer, all were on Diamox SR, I was not. I was checking their O2 saturation both morning and evening and their levels were several points above mine and well within limits. As an experiment I went onto the Diamox for 24hrs, the following day my O2 levels were comparable with the other adults. However I discontinued after 24hrs, as I viewed the side effect of getting up for a piss 5 times that night and the negative effects of lack of sleep outweighed the benefits to me, there again I've been to Altitude a number of times and it doesn't effect me like it used to. Also as a footnote not everyone had the diuretic side effect but everyone got the tingle toes/lips etc

In reply to pec:


actually the UK has a massive risk of fake drugs (probably higher than Tanzania)

In reply to lost1977:


I'm not going to say that you're talking balls, but I would be VERY interested to see your source for that statement... assuming you're talking about legal non-recreational drugs, that are bought or supplied via prescription, rather than 'from my mates mate dave'.

In reply to sweenyt:

http://www.independent.co.uk/life-style/health-and-families/health-news/ris...

In reply to Carpe Diem:

Which route are you doing? And who are you going with?

I went with Jagged Globe and did the Western Breach. We spent the first part of the trip on Mt Meru and it was a great part of the trip in itself and great for acclimatization. On kili itself, after camp one, we trekked to camp two, had a night, a full day and another night there as part of acclimatizing. You need to drink plenty!

In reply to lost1977:
No disrespect, but that's not really a source...

That's a paper writing emotionally stirring articles. Have you got any links to actual facts and figures detailing the number of genuine drug sales vs fake drugs sold? The number of those fake drug sales/supply that take place in chemists/hospitals etc rather than over the internet?

I'm not trying to have a go at you, but the way you made it sound I got the impression that you're quite likely to go to hospital and instead of getting (generic drug type - antibiotic/anaesthetic etc) you're gonna get some sugar water. A bit of a different situation than getting knock off viagra from t'interweb.

In reply to pec:

Esp if it has a smiley face on !

In reply to sweenyt:

this any better

http://news.bbc.co.uk/1/hi/health/7865569.stm

your never going to get detailed figures of real vs fake but the fact that the MHRA has seized 40,000 packs of an estimated 70,000 that were already in the supply chain makes for worrying reading.

In reply to pass and peak:


Just for clarity, I take it you are NOT suggesting that Nifedipine or Dexamethasone should be taken routinely, or as a prophylactic? I understood them to be very much for emergency treatment only.


Curious. One of the benefits I found from Diamox in the Himalaya was that it increased both the amount and quality of sleep that you got. In fact, this effect was more pronounced than the reduction of AMS>

I got some off my GP for a trip. Didn't find it particularly helpful, but it did give me tingly fingers. I stopped taking it in case it masked the onset of frost nip.

In reply to Simon4:

You are correct, I'm not suggesting that they should be taken routinely!
Nifedipine and Dexamethasone are very much emergency treatment ONLY. Plus if it comes to the point when you need those drugs you might not be in a state to correctly self administer anyway, Really needs to be your Guide/Expedition leader taking care of those issues and going down is mandatory.

As for improving sleep your right one of the main benefits of Diamox is it regulates/increases your breathing rate and very much helps to reduce the likelihood of getting sleep apnea (Chaney strokes) But I haven't suffered from them for many years, so it was of little benefit sleeping wise, "horses for courses"

In reply to MattJP:

Hi Matt, We're going up the Rongai route from the North,and back down the Marangu route.

Booked with 'The Adventure company' - Did the EBC trek with them last year - no complaints... actually our trek was used in the official promo video for the trek....

In reply to Carpe Diem: good background info on all of the problems about travelling at altitude is included on a free downloadable booklet called "Travel at High Altitude"
http://www.medex.org.uk/medex_book/about_book.php