Mt Whitney Zone Forums General Discussion recomendations for an acclimatization route up the summit?

I think he used the "deprecated" term to mean that people are finding that the need to take Diamox at least 24 hours before you ascend to altitude is not mandatory.

I have heard the advice to take it early for a long time. My doctor advised me of that necessity when I got my prescription. So I will assume that studies have shown that it takes this advance period for the detectable concentration in blood samples to reach full strength.

On the other hand, I have seen a few places where people carry Diamox, and then take it once they experience AMS symptoms, and report that it helps. But there haven't been any studies to support this.

I will still take my 125 mg dose every 12 hours starting 24 hours before I climb high -- I am sure the advance time can only help. And at that dosage level, most people don't notice any side effects.

We did used to recommend that people take it for a week prior to the trip, but as time has gone on, that clearly was unneccessary.

I think most now talk about starting the night before (it is usually dosed as a single daily dose for most people, as that maximizes the effect on the nightime breathing problems.)

If you think about it, the effect is to accelerate one's acclimatization. It is actually hard to do that, until one is actually EXPOSED to altitude, although getting the chemical reactions going starting the night before seems reasonable.

I'm not sure that there have been any actual chemistry measurments of all this, though, but that seems to be the "best practice" currently being used by most.

I'm not sure I'd go quite that far.

I think it would be fair to say that most people would find any side effects minor and tolerable. Most will notice increased urination (although I'd not actually call that a side effect, it is actually an ACTUAL effect of the medication, and of acclimatization), and most will have the weird taste with carbonated drinks, which can be disconcerting, if you don't expect it.

My understanding is taking Diamox days early and taking many hundreds of mg daily increases side effects without conferring any additional benefit. I'm not a doctor but the relative I posted about is, actually. My understanding from him and from reading a lot about acclimatization and drugs for prevention of various forms of altitude-related illness is that recommended practice with Diamox has changed over the last decade or two from taking relatively large dosages beginning several days in advance to taking much smaller dosages just prior to and during ascent. If I were you I would continue to use Diamox on any future attempt, but the main thing is to FORGET ABOUT 3 days and commit to something more like 5, with more nights at lower elevations. Another approach would be sleep in Lone Pine, then sleep at the Portal, then sleep at Lone Pine lake, then Outpost, then Trail camp. Way overkill for most folks posting on this board, but for anyone who has suffered the way you have, it would make sense. Eventually you might find you could do it with less nights on the mountain. The Nifedipine I mentioned was only indicated because my relative had pulmonary edema, but it sounds like you didn't have any pulmonary issues so you wouldn't need that. On the other hand, you reported severe headache, and some other symptoms that could possibly be indicative of the beginnings of cerebral edema, so that might warrant a different drug such as dexamethasone which helps prevent cerebral edema. Obviously consult a physician re any drugs, although you may find that your general practitioner is not really up on the latest best practices re off-label use of drugs for preventing altitude-related illnesses. You might have to refer him/her to material you found on the web at reputable sites like the one mentioned above by Harvey Lankford (who if I recall correctly is a doctor). I would avoid a western approach to Whitney because those are more remote and farther from help/other people etc. And I would take a SPOT or similar device.

Agree with Ken.

This is a paraphrase of what is current understanding, at least to some: The kidney-metabolic effects of Diamox might take a few days to work, but they are not the main reason Diamox helps, and why taking it a few days in advance is no longer felt to be needed. Taking it beginning day-before (to get it on board) or even the day-of your ascent seems to work well as the central(brain) and CSF(spinal fluid) effects on respiratory sensors and stimulation of breathing (when asleep mainly) works more quickly
Whew!

some general advice again:
http://www.ismmed.org/np_altitude_tutorial.htm#goldenrules