These Diamox - AMS discussions are so fun! Here are a few thoughts, some relating to comments above:
Joe: No, I don't work, but Gary still does.
Burchey: Yes, I keep a log of every climb I do. I also keep logs of my running (almost nonexistent now), my cycling, and my horseback riding. I picked up the habit from the guy who got me started climbing. Look me up on summitpost.org if you're interested in the climbing log. There are 1,113 summits on 379 different peaks. The last time I failed to make a summit was when I got blown off Shasta in May, 2003. That was 271 summits ago.
Bee: I live at 5,000 feet. I think that helps a little, but it's not a big deal. I'm not climbing nearly as much as I did in the 90's, but I try to get up one of the nearby 10K peaks every week or two if I'm not doing something bigger. That helps acclimatization, but I don't think an hour or two above 10K makes a lot of difference. I have never spent extra time at a campground or trailhead just to acclimatize.
One controversial point is sleeping altitude. Some people try to misapply the "climb high; sleep low" mantra to short Sierra trips. "Climb high; sleep low" applies to climbing big mountains expedition style. You climb high to string fixed lines, establish a high camp, etc. Then you sleep "low" (which may mean 20,000 feet) before moving to the higher camp or making a summit bid. Nobody does Sierra peaks that way.
Everyone agrees that you can climb higher than you can sleep. However, the best sleeping altitude is the highest one at which you don't get sick. I didn't retire at 59 by spending $100 for a low-altitude hotel room every time I tagged a peak. I'm a cheap bastard, and I always sleep at the trailhead if I can. It helps me acclimatize, it saves money, and I can sleep later and still get an early start.
Take care of your body. Get enough sleep, food, and water. Eat what you like, but take it easy on greasy/fatty foods. I don't believe in frequent breaks. When you stop, your breathing may slow way down, promoting AMS. Try to keep moving at a pace you can sustain, eating and drinking as you go.
The last few years, "everybody" has been recommending taking Diamox before you go to altitude. You should probably do that if you have good reason to expect AMS. However, Diamox does work if you wait until symptoms develop. I had mild Cheyne-Stokes breathing high on Denali, and Diamox fixed it in a few minutes on both trips. It's better to climb without using drugs if you can, so you might want to bring some Diamox but not use it until you need it.
Finally, I want to tell a story that explains my original comment about being lucky with AMS. There were two guides and four clients on my first Denali trip in 1994. We carried some pretty heavy loads low on the mountain. I was by far the weakest member of the team. We traveled in two rope teams, and the guys ahead of me literally pulled my sorry ass up the glacier. Things changed as we got higher. I was about as strong as everybody else by 11K. At 12,800, I was the only one not taking Diamox. At 16K, I ate three dinners while some of the others couldn't finish one. At 18,360, I was feeling great and would have welcomed a much faster pace. We turned around because one of the guides and two of the clients were too slow and weak at altitude.
The point is that some people are just more susceptible to AMS than others. It's not just a matter of acclimatizing, being tough, drinking enough water, or whatever.
