Hello. Yes, I did carry steriods (Dexamethasone). The lead guide also had steriods. I did not use them. Had the pulsating headache persisted, I would have given up on further climbing and possibly broken out the Dex--there was no ambiguity about the pain.
I want to emphasize that my biggest surprise and takeaway was how amazingly great I felt on summit day, all the way to 19,300' feet. I did not know it was possible to feel so great at such a high altitude. The relatively small issues I experienced were in the days before the summit, and I believe tied to a number of issues (Diamox dosage, GI issues/dehydration, acclimatization, etc.).
What occurred was little more complicated, with a few more factors, than what my prior postings conveyed. For those who are interested in the details of such things, here is some more context. For those who are not...please ignore!
The first time my 02 dropped during the trip into the 70s (i.e., 78% oxygen sat) was on Day 4, when we camped at around 15,000 feet. I was battling dehydration, caused by a bad GI reaction to water treatment used by the outfitter (PUR water treatment packets I think). That night I had a mild, diffuse headache (nothing scary), was a bit spacey (and aware of it), and did not sleep well. My appetite stayed high,though. I rebounded by (1) doing my own water treatment from then on (Steripen), (2) taking a single dose of Immodium,(3) swigging water and electrolytes like there was no tomorrow, (4) taking a pre-dinner acclimatization hike up to Arrow Camp before sleeping on Day 4, and finally (5) having the benefit of a good acclimatization route, as on Day 5, we went back down and slept at 13,000. So by day 5, I was back in the 90s.
Then we went up to 16,300' (Crossover Camp) on Day 6. I did not take Diamox that morning when we left 13,000'(a mistake, I came to believe). I was fine for most of the hike up to our lunch stop, except as we got close to our lunch stop at Barafu Camp (15,400'), I started getting mild headaches whenever we stopped moving for rest breaks. I could manage the headaches to a tolerable level by staying in motion while everyone rested, and doing some pressure breathing. After our lunch break at Barafu Camp, though, I ran into trouble. We had another 800-900 feet or so to get to Crossover Camp. As we got close to our destination, we had a small scramble, and then a short rest, and during the rest, my head exploded into a pulsating, frontal lobe headache. Moving slowly and pressure breathing helped, but it was still scary. When we started climbing again, the headache subsided. When we got to Crossover Camp, everyone else got into their tents for a nap. I just circled the campsite slowly for an hour, not wanting to stop moving right away. The headache did not come back, but I did feel a little spacey, and was back in the 70s (74%) at dinner when we were tested. My appetite remained good. Everyone else was in the 80s or 90s, and everyone else was taking full doses of Diamox.
That night, which was the night before our summit, I took 62.5 mg before going to sleep, and but experienced periodic breathing. So, at midnight, I decided to up my Diamox dosage, and took another 62.5 mg, which did solve the periodic breathing problem. After talking with the guide in the morning, I took another 62.5 six hours later (i.e., 6:30 a.m.), and another 62.5 mg after lunch (12:30 p.m.). I had no more headaches. I felt great going up to the summit. I literally danced at several points on the trail I felt so great. I had a good appetite for lunch at 19,000 feet. I was astounded by how good you could feel at 19,300 feet. Except for not wanting to run fast, I felt 100 percent the entire day. That night, my numbers reflected how good I felt...I was back in the 90s, and my pulse was way low.
I have some thoughts about what was going on here, but I am not a scientist or a doctor. What I think I will do in the future, based on my own experience, is continue with my low dosage of Diamox at sleeping altitudes below 13,000 feet (i.e., 62.5 mg once a day before sleep), but increase my dosage when sleeping above 13,000 feet (to 62.5 mg twice a day). This is what seems to work for me, based on my gender, weight, genetics, physiology, serendipity, what-have-you....
