Altitude Question

Kathmandu is pretty low (I think like 4,000', but my memory can be horrible). I would try to get my hands on some Diamoxx if I were you–I went to the Kangshung Face basecamp via Kharta (originating from Lhasa) on a 10-day trek. The altitude is no joke–we acclimated for a week in Lhasa (11,000') before heading out. You might be fine, you might not–you'll probably only know once you get there.

No one can tell you for sure and not many people try it. Be very wary of altitude sickness. Rushing to 14k can get you HAPE fast, even if you've never had problems before.

I was thinking about acclimatizing to 14k before I leave.

A week before the trip.

I will have my wife drop me off at 14k and I will tramp around for the week in the Mt Evans wilderness.

Since I live at 8,000ft I figure sleeping the first night at 10k will be OK and I will only gain 1,000 ft per day.

Day 1 -Spend the day at 14k, sleep at 10k
Day 2 – 14k, sleep at 11k
Day 3 – 14k, sleep at 12k
Day 4 – 14k, sleep at 13k
Day 5-7 – stay at 14k

Day 8 fly to Nepal etc…

It would certainly be more fun acclimating to altitude in Nepal. If you really can't do that …
People lose acclimation when they go to lower altitude. Peruvians in the Andes born and raised at high altitude get altitude sickness when they spend time in Lima and return to altitude. I think that it takes more than a few days for this to happen.

BUT, why don't you ask an expert. There must be physicians in Colorado who are expert in high altitude and altitude sickness.

Beware the HAFE dude.

Walter,

I was thinking about that also.

I will have to do some serious research.

thanks guys

When will you be in Nepal? Keep in mind that they are in their monsoon season right now. That could hit you with new, wet snow above Lukla (9200') and Namche (11,300'), which would mean slower trekking and even avalanche danger. While altitude adjustment is surely a concern, I think your biggest problem could be covering that distance in just 3 days with a 30# pack, especially if you encounter new snow. Whatever you do, don't even think of hiking solo–the stakes are too high if something gets goofy.

Ditto the Diamox. It works well.

Check out Mt. Sherman. Just below the summit there is a pretty good sized flat area (probably 750 sq.ft.?). I think I read somewhere that many mountaineers make a basecamp there to acclimatize prior to expeditions in larger mountain ranges. I remember it being to my right as I approached the summit from the standard route. You can drive to 12,000 ft (assuming you have a 4×4) and the hike is only 2-3 miles to the top from there. If you don't have a 4×4, I think you can drive to 11,000 ft or so and just a bit more mileage. It's a very easy (the easiest?) CO 14er. Check out Roach's guide.

However, I guess Evans will also give you some good day hikes with Bierstadt (do the knife edge ridge between the two) and whatnot.

Ginkgo Biloba has also fared very well in even-handed research as an aid to mountaineers. In the report I've read years ago, conducted by some university, the control group had something like 50-75% experiencing altitude sickness. The gingko group experienced something like 15-25% altitude sickness. Google for some studies and you should be able to find it and then can follow their dosing schedule. It has been hypothesized that gingko increases bloodflow to the brain.

if i were you id get a perscription for diamox and deximethizone. diamox has to be started before ascending for a couple days but can really help, the worry is that it also can mask symtems of hace and hape. in some areas like aconcagua diamox is not allowed for this very reason. dex is for treating hace/hape as it works to reduce the inflemation. altitude affects everyone diffrently and your body will make the big difference. as far as trying to aclimate a head of time i dont think it will work too well youll lose it very fast. if 14000 feet dosent bother you your probly ok. i start to notice altitude at about 13000 and have always been fine up to about 18000, over that and espesaly over 20000 i get really lathagic and it takes a while for me to come around

There’s a great and detailed post on this very subject at summitpost:

Even though it’s about climbing, the altitude aspects has alot of relevancy to your situation.

Also there seems to be mixed feelings on the role of diamox’s usage and side effects that might want to take note of.

I recently went on a trip where I went from 4000-10500 ft in the first day and really felt it (dizziness, lethargy, almost lost consciousness once while standing still, and I probably was not hydrating enough too – I'm a smart one, I know). I tried 120mg Ginko every 12 hours for two days, and did not begin to take the Ginko until after first experiencing symptoms. It did not seem to be of help, but I could be part of that 15-25%, or perhaps I should have started dosing before I left – if it really works.

Edit: Just did a quick pub med search – looks like Diamox is the good stuff (in the right situations).

Chow T, Browne V, Heileson HL, Wallace D, Anholm J, Green SM.

Department of Emergency Medicine, Loma Linda University Medical Center and Children's Hospital, Loma Linda, CA 92354, USA. Drtkchow@aol.com

BACKGROUND: Acute mountain sickness (AMS) commonly occurs when unacclimatized individuals ascend to altitudes above 2000 m. Acetazolamide and Ginkgo biloba have both been recommended for AMS prophylaxis; however, there is conflicting evidence regarding the efficacy of Ginkgo biloba use. We performed a randomized, placebo-controlled trial of acetazolamide vs Ginkgo biloba for AMS prophylaxis. METHODS: We randomized unacclimatized adults to receive acetazolamide, Ginkgo biloba, or placebo in double-blind fashion and took them to an elevation of 3800 m for 24 hours. We graded AMS symptoms using the Lake Louise Acute Mountain Sickness Scoring System (LLS) and compared the incidence of AMS (defined as LLS score > or =3 and headache). RESULTS: Fifty-seven subjects completed the trial (20 received acetazolamide; 17, Ginkgo biloba, and 20, placebo). The LLS scores were significantly different between groups; the median score of the acetazolamide group was significantly lower than that of the placebo group (P=.01; effect size, 2; and 95% confidence interval [CI], 0 to 3), unlike that of the Ginkgo biloba group (P=.89; effect size, 0; and 95% CI, -2 to 2). Acute mountain sickness occurred less frequently in the acetazolamide group than in the placebo group (effect size, 30%; 95% CI, 61% to -15%), and the frequency of occurrence was similar between the Ginkgo biloba group and the placebo group (effect size, -5%; 95% CI, -37% to 28%). CONCLUSIONS: In this study, prophylactic acetazolamide therapy decreased the symptoms of AMS and trended toward reducing its incidence. We found no evidence of similar efficacy for Ginkgo biloba.

Seems like this comes up all the time, but studies have shown it to have zero effectiveness over placebo in trials for altitude sickness.

Diamox is great. I've used it with much success. Your hands may tingle a bit, but at least you're not puking and grumpy. =)

That was my same experience w/ Diamox–once a day for about 5 minutes my fingers and toes would tingle. As far as I know, that is the only side effect? I don't think that it has any bad or long term effects. It allowed me to go from Chengdu, China (~1000' elev) to Lhasa (~11,000' elev) in a 2 hour flight. My wife and I definitely felt the altitude (like pausing mid-sentence to catch our breath), but we didn't get any serious problems like others that we met who were on our flight.

I would second the point by Nat to:

http://www.summitpost.org/phpBB2/viewtopic.php?t=47289&sid=07420fcea3d7f55fc3919e03cd361cca

This is very interesting about HAPE at 10k (around page 5 or 6). Makes me think I won't be touching the diamox either.