First Aid Travel kit

[lonerider]

Dear all,

we will travel from srinagar to leh during first week of July by Car.

our planning is,

4th July-1st Night Sonamarg
5th July-2nd Night Kargil
6th July-3rd night Ule
7th July-4th Day afternoon reach Leh.

Should we need to take Diamox from 2nd/3rd July? or considering the fact that we are going to reach Leh on 4th Day, it is enough to get Acclimatized and we can avoid Diamox or if we feel some problems, then we take the tablets.

kindly share your thoughts based on some experience, as many of the doctors even has no idea of Diamox and its side effects.

Thanks

tablet diamox is acetazolamide: a diuretic (makes more urine) basically used for a lot of problems in which u need to reduce the fluid in body e.g. glaucoma in which the pressure of eyeball increases or in epilepsy where u need to reduce pressure inside the head.

its use in altitude sickness AMS is based on the fact that it accelerates acclimatization basically does what the body wud have done anyways but faster. I dont want to go into its details but basically what it does is acidifies blood stimulating hyperventilation i.e. more breathing. The body wud normally do this too and lead to hyperventilation induced CO2 washout and alkalizing the blood. By throwing out bicarb in urine diamox takes care of this alkaline blood n maintains it acidic so as to maintain hyperventilation n good Oxygen carriage.

it takes two days to work so its not a fast food therapy for AMS in fact its a poor treatment of AMS but a good prophylaxis or protection against AMS. which means it works best if taken before u get AMS.

If u plan to climb from sea level to 10000 feet in one day or more than 2000 feet per day once above 8000 feet u should start taking diamox 400 mg twice or thrice a day depending on body weight three days before u do the ascent.

a lot of books and websites will give different dosage and schedules.
The above is what i give my patients and tourists who bother to ask us here at Sikkim before goin onward to gurudongmar and it works.

trouble is a general fit person has practically little chances of AMS till 12000 feet in my experience so i wonder if diamox is really useful on a routine.

obviuosly it will make u take loo breaks more often n therefore lose water so u need a lot of water while taking this medicine.

hope this helps.

 

[pbmangarolia]

tablet diamox is acetazolamide: a diuretic (makes more urine) basically used for a lot of problems in which u need to reduce the fluid in body e.g. glaucoma in which the pressure of eyeball increases or in epilepsy where u need to reduce pressure inside the head.

its use in altitude sickness AMS is based on the fact that it accelerates acclimatization basically does what the body wud have done anyways but faster. I dont want to go into its details but basically what it does is acidifies blood stimulating hyperventilation i.e. more breathing. The body wud normally do this too and lead to hyperventilation induced CO2 washout and alkalizing the blood. By throwing out bicarb in urine diamox takes care of this alkaline blood n maintains it acidic so as to maintain hyperventilation n good Oxygen carriage.

it takes two days to work so its not a fast food therapy for AMS in fact its a poor treatment of AMS but a good prophylaxis or protection against AMS. which means it works best if taken before u get AMS.

If u plan to climb from sea level to 10000 feet in one day or more than 2000 feet per day once above 8000 feet u should start taking diamox 400 mg twice or thrice a day depending on body weight three days before u do the ascent.

a lot of books and websites will give different dosage and schedules.
The above is what i give my patients and tourists who bother to ask us here at Sikkim before goin onward to gurudongmar and it works.

trouble is a general fit person has practically little chances of AMS till 12000 feet in my experience so i wonder if diamox is really useful on a routine.

obviuosly it will make u take loo breaks more often n therefore lose water so u need a lot of water while taking this medicine.

hope this helps.

Thanks for the detailed technical reply sir,

So according to you, we should start taking Diamox from 2nd July, i.e. before AMS if any.
The other thing I have noticed that the chances of AMS is very little upto 12000 feet and as per our itinerary we will be upto 10000 feet for first 3-4 days.
So we may avoid Diamox.

 

[lonerider]

Thanks for the detailed technical reply sir,

So according to you, we should start taking Diamox from 2nd July, i.e. before AMS if any.
The other thing I have noticed that the chances of AMS is very little upto 12000 feet and as per our itinerary we will be upto 10000 feet for first 3-4 days.
So we may avoid Diamox.

if all of u are between age groups of 10 to 60 and not suffering from major illnesses like diabetes high BP or previous lung disease like TB i would suggest avoid diamox if not planning to go above 12000 feet.

but if u r goin above twelve then two days before actually going there u shud start diamox twice a day for an adult and once a day for a child.

 

[lmsnegi]

Interesting, and informative, carrying a whole pharmacy may not be an answer, I am a doctor traveling alone with family some time on bike with young twins, but never carried more medicines,
As a first responder trainer my submission is,
1- Prevention is better than cure.
2- Learn first responder(first aid) it helps at home too, My one son had Cardio respiratory arrest i.e. he stopped breathing and his heart stopped, in my profession life too come across such situations so many time. In our University bike accidents are day to day affair, 1 critical in jury every month, 3 deaths in 19 months. People dont learn how to apply pressure to stop bleeding or tie pressure bandage, how to activate EMS system. In Himanchal 108 services are available just dial 108, and they will respond. hope u make a phone call. and learn where all their ambulances are located.
do visit my site first responder.in its on first responder program as per American Heart association guidelines.
please add lists of places where medical stores are en route.
regards,
dr.(maj.)negi
dr. negi

 

[pbmangarolia]

if all of u are between age groups of 10 to 60 and not suffering from major illnesses like diabetes high BP or previous lung disease like TB i would suggest avoid diamox if not planning to go above 12000 feet.

but if u r goin above twelve then two days before actually going there u shud start diamox twice a day for an adult and once a day for a child.

we have completed our tour as per the given itinerary without Diamox and there was no problem with any of us even at Khardungla or Changla.

 

[witold]

I have Diamox in my bag, but after doing some research, it just seems like a bad idea.

There is no treatment for AMS and there is nothing you can take proactively not to get AMS. Diamox will cover up symptoms, but that is all it does: cover up. People have died from AMS while taking Diamox because they didn't feel any symptoms until it was too late.

That is why I am taking a pass on it, even though I have it.

****

In my emergency bag, I have,
- Headache/pain medicine (Ibprofin)
- Diarrhea medicine (tested and works great!)
- Quik Clot (if you have a big wound, it will clot it. Expensive but worth it.)

Everything else seems to be just taking up room.

 

[witold]

Though not officially diagnosed, I did get AMS when I arrived in Leh from Srinigar.

I think it was because on the first day of high altitude, my bike broke down and I had to push it quite a bit and exert myself.

It is not fun. Take it easy when you get to Leh and move up slowly while trekking, and you will be fine - without any drugs to cover up symptoms and potentially big problems. I ended up going to Pangong (14000) and doing Stok Kangri (20,000) with no problems at all. It just takes time. It is the only preventive measure for AMS.

 

[eklavya]

Dimox is given for acclimatization mostly 24-12 hours before starting of trek. decadron (dexamethasone) should be given when one is feeling AMS.there is no use to give Dimox when subject showing AMS symptoms because we have to provide him immediate relief not acclimatization.
we should give 1-1.5L of water to subject for maintaining right Ph level of blood.
we should not give any NSAID to subject for fatigue. we should give him asperin. becoz asprin dilute blood hence increase O2 intake capacity.
what i feel it would be better to take expert advice from Doctor before start in case of any problem.

 

[eklavya]

Dexamethasone (Decadron®) is a potent steroid used to treat brain edema. Whereas acetazolamide treats the problem (by accelerating acclimatization), dexamethasone treats the symptoms (the distress caused by hypoxia). Dexamethasone can completely remove the symptoms of AMS in a few hours, but it does not help you acclimatize. If you use dexamethasone to treat AMS you should not go higher until the next day, to be sure the medication has worn off and is not hiding a lack of acclimatization.

Side effects include euphoria in some people, trouble sleeping, and an increased blood sugar level in diabetics.

 

[pushkark]

GOOD LIST!