Quito - Altitude sickness med???

[SandyR5]

Hi - What is the name of the medication for altitude sickness that is recommended for Quito? I want to give my family physician the name so she can write a prescription. Just want to know what others have used...if it was necessary. Was it necessary for you??? Thanks

[Gimpster]

Diamox and/or Dexamethasone.

[canderson]

Be certain that this will be an issue for you. Note the four conditions for which it's recommended in prophylactic use. Since I live my life at 5280' (give or take), it's never been an issue to be climbing around even at 14,000.

 

Here's the thinking of one of the more respected doctors in the field:

 

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Let me say a few words about acetazolamide (Diamox®). This is a medication that forces the kidneys to excrete bicarbonate, the base form of carbon dioxide; this re-acidifies the blood, balancing the effects of the hyperventilation that occurs at altitude in an attempt to get oxygen. This re-acidification acts as a respiratory stimulant, particularly at night, reducing or eliminating the periodic breathing pattern common at altitude. Its net effect is to accelerate acclimatization. Acetazolamide isn't a magic bullet, cure of AMS is not immediate. It makes a process that would normally take about 24-48 hours speed up to about 12-24 hours.

 

 

I do not recommend acetazolamide as a prophylactic medication, except under specific limited conditions outlined below. Most people who have a reasonable ascent schedule will not need it, and in addition to some common minor but unpleasant side effects it carries the risk of any of the severe side effects that may occur with sulfonamides. I feel that acetazolamide is indicated under the following conditions:

 

- Treatment of persons with AMS

- Treatment of persons bothered by periodic breathing at night

- Prophylactically for persons on rapid forced ascents (such as flying into Lhasa, Tibet)

- Prophylactically for those persons who have repeatedly had AMS in the past

 

 

Acetazolamide is a sulfonamide medication, and persons allergic to sulfa medicines should not take it.

 

Common side effects include numbness, tingling, or vibrating sensations in hands, feet, and lips. Also, taste alterations, and ringing in the ears. These go away when the medicine is stopped. Since acetazolamide works by forcing a bicarbonate diuresis, you will urinate more on this medication.

 

Uncommon side effects include nausea and headache. I have seen a few trekkers whose vision became very blurry after taking only one or two doses of acetazolamide; fortunately they recovered their normal vision in several days once the medicine was discontinued.

[canderson]

Forgot a useful detail -- the definition of AMS symptoms:

 

RECOGNIZE AMS. In the context of a recent ascent, a headache, with any one or more of the following symptoms above 2500 meters (8000 feet) qualifies you for the diagnosis of AMS:

 

- Loss of appetite, nausea, or vomiting

- Fatigue or weakness

- Dizziness or light-headedness

- Difficulty sleeping

- Confusion

- Staggering gait

 

It is remarkable how many people mistakenly believe that a headache at altitude is "normal" when it is actually AMS. Be willing to admit that you have altitude illness.

[SandyR5]

canderson - Thank you for all that information. I don't expect to need it, but I wanted to know in case. My physician said she would give me a prescription if I wanted.

[kay0522]

Sandy,

 

Have to agree with Canderson. My husband has climbed 47 of the 53 14,000+ feet mountains in Colorado. I've done Longs and a couple of other day climbs. Five days ahead of the climb we start on Diamox and usually discontinue it about 3 days into our climb time. It works great, takes away altitude headaches, finger and hand swelling and overall dizziness. Neither one of us has ever had problems with side effects - the frequent urination is not bad. The only thing we have noticed is if you are a soda drinker - especially Cola drinks, they tend to taste like the tin can when taking Diamox. We switch to lemonade, iced tea, water, or anything else not carbonated. Enjoy your trip - and good luck with the AS - Diamox has certainly worked for us.

[canderson]

Sandy,

 

Have to agree with Canderson. My husband has climbed 47 of the 53 14,000+ feet mountains in Colorado. I've done Longs and a couple of other day climbs. Five days ahead of the climb we start on Diamox and usually discontinue it about 3 days into our climb time. It works great, takes away altitude headaches, finger and hand swelling and overall dizziness. Neither one of us has ever had problems with side effects - the frequent urination is not bad. The only thing we have noticed is if you are a soda drinker - especially Cola drinks, they tend to taste like the tin can when taking Diamox. We switch to lemonade, iced tea, water, or anything else not carbonated. Enjoy your trip - and good luck with the AS - Diamox has certainly worked for us.

Wouldn't recommend tea or Coke in any case. You want to avoid any diuretic of any kind up here else you'll have to work twice as hard yet to stay hydrated.

[greeneg]

Let me just add here, as a retired MD who has gone to Ecuador the past 3 years on a medical service trip, I think that you have to remember the basics: slow down, pace yourself, and listen to your body when it talks to you. IF you feel tired, rest for a moment. Drinking plenty of fluids ( carry bottled water with you) and good hand hygiene are also good suggestions.

 

I would also suggest a good quality folding walking stick; Quito streets can be irregular and it also gives you something to "rest" on for a moment if you happen to need it.

 

Ecuador and Quito are fascinating and wonderful; just try not to overdo if you can help it and you are in for a wonderful experience.

[SheilaNC]

My two cents, I totally agree with Ed Green. We were in Quito in May and found that not overexerting (noone needs to prove how strong he is), drinking plenty of water and avoiding caffeine and alcohol, made all of the difference. Listen to your body and respond appropriately - rest when feeling tired, slow down if short of breath - we felt this way just disembarking from the plane carrying hand luggage and walking quite a distance to the customs and baggage areas. I got a headache our last night there that went away after reaching a more normal (for me) altititude. Don't take symptoms lightly, however, since altitude sickness can be quite serious. See http://www2.ncid.cdc.gov/travel/yb/utils/ybGet.asp?section=NIR&obj=altitude.htm for the CDC information

[SandyR5]

Sheila - Did you or any of your fellow travelers need to take medication?

[SheilaNC]

I took medication with me, but did not need to take it, since my symptoms began as we were leaving Quito and I didn't have any problem when we returned there (used that day for spa treatments and to relax by the pool :))

 

A few others took it prophylactically (which I don't think is wise).

 

I've been a nurse for more than 40 years and I try not to take medications unless they are carefully prescribed for specific reasons.

 

Also found out while in Quito that the larger hotels (we were at the JW Marriott) have oxygen available if needed.

[SandyR5]

Sheila - I knew I could depend on you but didn't want to bother you with an e-mail. :) You are truly a great source of information. Years ago, in Mexico City, I did experience light headedness and nausea so I think we will fill a prescription and bring it just in case. Somehow, with all the really active adventures we've been experiencing, I don't think we'll need it, but one never knows. ;)

[canderson]

Sheila - I knew I could depend on you but didn't want to bother you with an e-mail. :) You are truly a great source of information. Years ago, in Mexico City, I did experience light headedness and nausea

Mexico City? That was probably just the tequila.:D "Flatlanders" in otherwise good health don't typically have any problems at that altitude (7400') unless they overexert or overimbibe!

[SandyR5]

Canderson - Hmmm. could be. :) We climbed the Sydney Harbour Bridge, ziplined 100 feet above the rain forest and hiked many National Parks. I think we'll be OK, but I like to be informed.;) I guess we are Flatlanders. No hills here on Long Island.

[canderson]

Canderson - Hmmm. could be. :) We climbed the Sydney Harbour Bridge, ziplined 100 feet above the rain forest and hiked many National Parks. I think we'll be OK, but I like to be informed.;) I guess we are Flatlanders. No hills here on Long Island.

No hills, just one LONG stretch of highway! Seriously, if you think of the number of people that come from sea level to ski out here at places like Vail (8120 feet at the BASE, mind you, with 3300 VERTICAL feet of trail!), and about half of them run into at least minor issues with the altitude and still do run after run...

 

Most of the ones that run into trouble don't operate by the guidelines that the ski resorts recommend:

 

1) 3 to 4 QUARTS of water/juice per day

2) try to avoid caffeine and the booze, even after the last run of the day

3) even light activity during the day is better than sleeping because you won't breathe as much as normal when you sleep