Altitude sickness on mountains

[petit plateau]

EV,

Without knowing exactly what you have in mind I hope this is useful:-

To the best of my knowledge cabin altitudes will not trigger acclimatisation. You need to get to 10,000 feet (3,000m) and do exercise to even begin the process and more realistically go higher still. I have taken quite a lot of parties above 6000m and I found that for decently fit people any more than a day or so (two nights) at 3000m had negligible additional benefit (and in my experience the locals were not often better than the sealevel dwellers once the altitude got to 6000m). At each height you must do exercise to trigger the acclimatisation process - several hours walking is better than an evening run. This is not to say that you cannot get into difficulties lower down and medical (or expedition) textbooks will quote 8,000 feet as a trigger level because they are being cautious (so, sorry but you cannot just rely on a textbook).

In my experience most serious altitude sickness has a combination of HAPE and HACE although the textbooks deal with them as if they are binary. Stay well hydrated and take it easy at the beginning. Best to start your trip fit but chubby as you will burn off fat reserves quickly - the ones who start off as racing snakes tend to burn up. Try to descend for sleeping whilst acclimatising if you have the luxury. Stay alert to the symptoms - since one of the most useful common symptoms is a headache you should also avoid doing other things that may provoke a headache (so stay hydrated; use SF15+ suncream; wear sunspecs; use a sunhat; wear a collar/bandanna; sleeves; avoid getting the ****s) and try to stay away from the headache tablets. Tell other people about it early if you are feeling unwell so that they can keep an eye on you.

Anecdotal evidence is that once a person has had a HAPE or HACE experience then they are increasingly susceptible at lower altitudes (CE and PE can be gotten at sea level, the HA bit is optional !) and I knew one individual who eventually had to give up alpine holidays after initially contracting altitude sickness at 5000-6000m. Moral is always play it safe.

Indian Army etc has done lots of work on Diamox etc to aid acclimatisation (they have a need to be able to reinforce high altitude locations swiftly) but when I was last up to date on the subject (a decade ago) there was concern that Diamox might be masking the early onset symptoms rather than giving genuine acclimatisation advantage. Since time to react is at a premium anything that masks the symptoms is a no-no in my opinion. But the French and Russians used to swallow them like candy nonetheless.

Note that I am not a medic but have done a fair amount at altitude (>8000m, sans O2) including dealing with the unhappy consequences of folk that thought they knew it all and tried to prove it, or who got plain unlucky.

Hope this helps.

pp