Go Back  Fodor's Travel Talk Forums > Destinations > South America
Reload this Page >

To Diamox or not to Diamox - That is the Question

To Diamox or not to Diamox - That is the Question

Jul 25th, 2010, 07:03 PM
  #1  
Original Poster
 
Join Date: Oct 2007
Posts: 1,195
To Diamox or not to Diamox - That is the Question

Our trip is coming up fast and I have read the boards regarding people's experience with Diamox. I'm torn. I also haven't read anything on kids 10 and under and the drug.
We will be flying from Lima to Cuzco and immediately descending to Olly for 4 nights before spending 2 nights in Aguas Caliente and 2 more nights in Cuszo, We wont be doing any trekking. Our guide in Cuzco will be traveling with O2.
FYI - Last summer we spent time hiking in the Tetons at about 7500 feet and we felt fine.
Any advice?
MiamiBeachMomma is offline  
Jul 26th, 2010, 12:51 AM
  #2  
 
Join Date: May 2004
Posts: 7,294
As far as using Diamox with children under 10 it is essential that you obtain qualified medical advice from a Doctor or, at the very least a specialist medical practitioner taking into account your own medical history and especially that of our kids. Here is a link to a reputable site provide by the UK National Health Service:

http://www.fitfortravel.nhs.uk/advic...%28ams%29.aspx

As far as Diamox in young children it specifically states:
"It should not normally be used in young children except under close medical supervision."

the fact that you have hiked before at 7500ft is no guide as AMS does not usually start until heights of 8000ft are exceeded. Even if you had been higher than this and were o.k. even that is no guarantee you won't get it the next time.
Your plans yo go directly to Ollantaytambo for a couple of days is undoubtedly the best way of acclimatising and the chances are, after this you won't suffer in Cusco. We stayed in Cusco for the first few days and I was quite badly affected with really bad headaches and found it impossible to sleep but my wife was unaffected. On our trek I found chewing coca leaves really helped as did coca tea but less so. However THE best cure was the oxygen at hotel on the first couple of nights. Without it I doubt I would have got any sleep at all!

The key to reducing the effects of altitude is to take it easy, don't rush and, when is comes to climbing stairs walking up hills etc. do it at half the speed you normally would. Of course getting this message across to your kids is probably easier said than done!
crellston is offline  
Jul 26th, 2010, 03:35 AM
  #3  
 
Join Date: Jun 2008
Posts: 12,269
www.mdtravelhealth.com Peru Traveling with children

Really best to check with your knowledgeable Travel MD but

It is the ACUTE change that triggers the illness

You will be going from sea level to Cusco

11000-12000 ft quickly even if you go www.ollantaytambo.org

right away you will still be at 9000 ft..

Oxygen does no good just relieves symptoms

but hampers adjustment to the altitude

If you cannot adjust by GRADUAL ascent always take Diamox

the only TRUE preventive

for kids check with their pediatrician

lots of factors involved there..

Altitude sickness may develop in travelers who ascend rapidly to altitudes greater than 2500 m, including those in previously excellent health. Being physically fit in no way lessens the risk of altitude sickness. Those who have developed altitude sickness in the past are prone to future episodes. The risk increases with faster ascents and higher altitudes. Symptoms of acute mountain sickness, the most common form of the disorder, may include headaches, nausea, vomiting, dizziness, malaise, insomnia, and loss of appetite. Severe cases may be complicated by breathlessness and chest tightness, which are signs of pulmonary edema (fluid in the lungs), or by confusion, lethargy, and unsteady gait, which indicate cerebral edema (brain swelling).

Altitude sickness may be prevented by taking acetazolamide 125 or 250 mg twice daily starting 24 hours before ascent and continuing for 48 hours after arrival at altitude. Possible side-effects include increased urinary volume, numbness, tingling, nausea, drowsiness, myopia and temporary impotence. Acetazolamide should not be given to pregnant women or anyone with a history of sulfa allergy.

For those who cannot tolerate acetazolamide, an alternative is dexamethasone, which has been shown to prevent acute mountain sickness and high-altitude cerebral edema (but not pulmonary edema). The usual dosage is 4 mg four times daily. Unlike acetazolamide, dexamethasone must be tapered gradually upon arrival at altitude, since there is a risk that altitude sickness will occur as the dosage is reduced. Dexamethasone is a steroid, so it should not be given to diabetics or anyone for whom steroids are contraindicated. For those at risk for high-altitude pulmonary edema, one option is to take oral nifedipine 10 or 20 mg every 8 hours. A newer treatment is prophylactic inhalation of 125 mcg of salmeterol (Serevent)every 12 hours, which was recently shown to reduce the risk of high-altitude pulmonary edema in those with a prior history of this disorder. (See C. Sartori et al, New England Journal of Medicine; 2002;346:1631-6).

Limited evidence indicates that an herbal remedy, gingko biloba, may prevent altitude sickness when started before ascent. The usual dosage is 100 mg every 12 hours.

Other measures to prevent altitude sickness include

Ascend gradually or by increments to higher altitudes
Avoid overexertion
Eat light meals
Avoid alcohol

The symptoms of altitude sickness develop gradually so that, with proper management, serious complications can usually be prevented. If any symptoms of altitude sickness appear, it is essential not to ascend to a higher altitude. If the symptoms become worse or if the person shows any signs of cerebral or pulmonary edema, such as breathlessness, confusion, lethargy, or unsteady gait, it is essential to descend to a lower altitude. A descent of 500-1000 meters is generally adequate except in cases of cerebral edema, which may require a greater descent. Travelers should not resume their ascent until all symptoms of altitude sickness have cleared. Supplemental oxygen is helpful if available. Acetazolamide, dexamethasone, and nifedipine may all be used to treat altitude sickness as well as prevent it. In most cases, acetazolamide is recommended as prevention, and dexamethasone and nifedipine are reserved for emergency treatment. Nifedipine is preferable to dexamethasone for high-altitude pulmonary edema.

Travel to high altitudes is generally not recommended for those with a history of heart disease, lung disease, or sickle cell disease. It is also not recommended for pregnant women.Do not take it lightly a young UK tourist was lost to
this diease a few weeks ago around Titicaca.
qwovadis is offline  
Jul 26th, 2010, 09:43 AM
  #4  
 
Join Date: Jan 2005
Posts: 17,647
Since you are descending immediately to Ollantaytambo and not trekkig, I would say no Diamox. Take it easy the first few days and build up your altitude tolerance gradually.

I did virtually the same itinerary, using the coca tea in the morning. When I returned to Cusco I had a slight headache in the evening but a Tylenol was all that I needed.
mlgb is offline  
Jul 26th, 2010, 06:39 PM
  #5  
 
Join Date: Jul 2003
Posts: 121
Kaiser will not prescribe Diamox for children of any age. There were 5 of us & none needed medication. We went directly to Ollantaytambo, as well, & were fine. We didn't have any problem with Cusco later on in the trip. We used coca tea & it was sufficient.
fball is offline  
Jul 27th, 2010, 11:49 AM
  #6  
 
Join Date: Jul 2010
Posts: 1
If you go from Lima straight to Cusco like most do, you will likely experience some sort of altitude adjustments. I noticed it when I tried walking up a hill and was out of breath. I brought Diamox but didn't like the way it made me feel (note: you are suppose to take it 24hrs before you arrive). I would recommend that you go to a local pharmacy and pick up "Soroche" which worked well for me. Of course, if you have health problems, you may want to check with your doctor beforehand. Just "google" Soroche for details and consult with your doctor. I only had three days to see the area including Machu Picchu so "taking it easy" was out of the question. But if you have time, take it easy the first day and you should be fine.
edguapo is offline  
Jul 27th, 2010, 12:09 PM
  #7  
 
Join Date: Jan 2005
Posts: 17,647
The problem is more likely if you are on a rush trip and sleeping in Cusco. Luckily OP doesn't have to do this.
mlgb is offline  
Jul 28th, 2010, 10:18 AM
  #8  
Original Poster
 
Join Date: Oct 2007
Posts: 1,195
Thanks everyone. I got the script filled so I can decide later.
MiamiBeachMomma is offline  
Aug 1st, 2010, 06:41 PM
  #9  
 
Join Date: Aug 2010
Posts: 114
That's a good decision. I was in Peru 4 years ago. We did the Inca trail and spent two days in the Sacred Valley prior to the trek. I only got symptoms of altitude sickness on the seventh day at lake Titikaka, mainly shortness of breath and dizziness. The symptoms disappeared quickly once we got to Arequipa. I remember that the doctor from the travel clinic told us that there was no way to know if you will suffer from altitude sickness unless you've already been at such altitude but he suggested that we carried Diamox just in case. I never used it but it provided peace of mind.
Cattogo is offline  
Aug 2nd, 2010, 12:15 AM
  #10  
 
Join Date: May 2004
Posts: 7,294
To be effective Diamox has to be taken BEFORE arrival at altitude
crellston is offline  
Aug 2nd, 2010, 08:03 AM
  #11  
 
Join Date: Jan 2005
Posts: 17,647
And Lake Titicaca is another 1500 ft higher than Cusco.

But Cusco is certainly high enough to cause symptoms.
mlgb is offline  

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are On


Thread Tools
Search this Thread

Contact Us - Archive - Advertising - Cookie Policy -

FODOR'S VIDEO

All times are GMT -8. The time now is 10:08 PM.