I´m doing some touristy stuff in Peru, anybody interested in the full report can watch my personal website for however long it will take me to put it together. I'm not planning to climb any notable summits so this trip probably is of little interest to the Summitpost audience. But I thought I´d share my Diamox experience for what that´s worth.

Skip this thread if explicit discussion of urination bothers you.

Oct 4, 9 PM: took first pill, about 12 hours later than instructions indicated. (Totally forgot about it in rush to catch the boat for Ballestras Islands. I recommend that trip if you're a nature lover.)

4 AM: Woke with painful sensation of full bladder. (I *never* wake up at this hour.) Actual volume and pressure of urine was moderate to less than normal. Urine was pale. (I'm usually a bright-yellow kind of guy, going to dark orange when exercising for extended periods. Friends tell me I should drink more water.)

Went back to sleep until alarm woke me two hours later. Vivid dream involving gunfight and martial arts. (I usually don´t remember my dreams at all.)

Drank about half a liter of water, urinated again.

9 AM: Took second pill in the Lima airport. Drank another half liter, urinated. Urine pale and cloudy, like pineapple juice or coconut milk.

On plane, had snack, and a tiny airplane cupful of Inca Kola (horrible tasting, but I figured caffeine might substitute for mate de coca). Urinated again in Cusco airport.

Dropped our stuff at the hostel. Noticed the altitude while walking up the stairs, felt fine otherwise. Went for a stroll. Drank 0.3 liters of mango juice along the way. After maybe half an hour in the sun, noticed a headache. Sat in the shade for a few minutes, decided to return to hostel for a nap. On return to hostel was frequently short of breath (took a "shortcut" involving stairs).

A couple years ago I hiked up South Sister (about 10,000 ft) from essentially sea level [without diamox]. I remember going slowly and very much regretting when I tried to run uphill, but I think I feel worse now. Even lying down to take a nap was not very comfortable. Could be the extra thousand feet, could be the suddenness of the change, could be that I'm not in good physical shape, could be the diamox isn't doing much for me.

I have two traveling companions. Neither took diamox. All of us live at sea level and have followed the same itinerary on this trip. One seems to be in about the same condition as me (possibly better - he has an appetite and is less thirsty), the other is definitely worse (but that is hard to separate from an unrelated illness that started a day or two ago). We bumped into a couple who'd flown to Cusco yesterday or the day before (having stayed at the same hostel in Lima as us. They seemed fine and said they had a bit of altitude sickness that only lasted a day.

I'm urinating two or three times an hour now. Always with the sensation of a very full bladder, but it seems my bladder capacity is reduced. I have very little appetite, but am frequently thirsty. Will take another pill tonight in hope of interesting dreams, but I think I'm done after that. I feel like I have the bladder of a ninety-year old, and I doubt it´s having any effect on my acclimatization. (Should have started earlier for a fair experiment, of course.)

Increased urinary output is a symptom of your body adjusting to altitude, with or without diamox. I remember quite vividly in Namche Bazzar last year (3,440 m) constantly peeing and that was without diamox.

I started peeing in Lima, seven hours after my first pill. Like I said, the need to go woke me up in the middle of the night, and believe me, that´s not normal for me. Also my companions are not peeing nearly as frequently as me.

Back on the topic of first time drug use, I just had my first cup of mate de coca. Tasted pretty good, and I do believe it made me feel a lot better. I walked uphill at a pace I wouldn't have attempted twenty minutes before. Though I still have a slight headache and my lungs and heart were working pretty hard during my uphill trip, I wouldn't even have noticed the symptoms if I hadn't stopped to evaluate myself. It's like a change in attitude more than anything. I still have symptoms but I feel pretty darn good.

Second night on diamox, first night at altitude: slept twelve hours. No vivid dreams that I remember. Woke with feeling of full bladder, but not until morning.

I do remember that at one point I had a burning sensation in the balls of my feet, and an impression that the skin was splitting open. This was right after pressing my feet against the covers and/or bed-frame. Never felt that before.

I feel a little less thirsty. Right now I have a very slight headache but no other symptoms. I won't be surprised if I feel worse when I start walking around.

Companions are complaining of headache and sensations of dehydration (e.g., dry lips) so maybe I'm recovering a little faster than them.

Oct 6: did not take diamox in morning. Urine frequency returning to normal, appetite returning. Urine still paler than usual for me, and I'm drinking plenty.

Went to scout out the route to sacsawayna, felt good and just kept going. Developed a headache after a little while on top, but it didn´t slow me down.

Still out of breath easily on staircases, but feeling mostly acclimated.

Companions both took long naps while I went for my walk, so I think I'm doing better than them.

My 2c diamox experience: I've taken it in small dosages - 1/2 to 1/4 tablet. Used it this way on Denali, in Bolivia, and even in Rockies this year (there was a reason for that). Frankly, I've never felt any effects such as increased urination or tingling. Who knows, maybe there was no improved accimatization either but I didn't have any major discomfort.

Night of oct 6-7. No diamox since 24 hrs. Had trouble falling asleep for first time in Cusco. Felt dehydrated and thirsty.

The first day or two in Cusco I'd been forced onto an essentially liquid diet. This had the side benefit of interrupting a rather severe irritable-bowel cycle (alternating constipation and diarhea). Yesterday I drank less and ate more solid food, and had mild digestive symptoms again. (Less travel stress and more balanced diet, so it wasn´t bad.) Trying a some-solids some-liquids strategy today, seems to be woring so far.

Took a bus to Ollantaytambo, which is a little lower. Felt mostly good, but didn´t set any uphill speed records. Headache returned with return to Cusco. Turns out that feeling good enough to hike around is not the same thing as being fully acclimated.

Also bumped into same couple from Lima hostel, the male said he got bad altitude sickness yesterday, but it cleared up after he took the locally-available pill (Sirojchi: online sources say it´s mostly aspirin plus some "salofeno" [not sure what that is] and a little caffeine, this guy thought it was Diamox).

So you're around 11k feet?

It is nice that you're documenting, but why take it if you don't necessarily need it? Like on the flight, airport and what not.

I already posted this in another forum a few years ago, but here's my experience with diamox:

In January 2007 we went to climb some of the big volcanoes in Ecuador. I ended up getting food poisoning in the Houston Airport (USA) on the way down. I was bed ridden for several days once reaching Ecuador. Because of this, I missed our first two acclimatization climbs (but still did one of the others). I was worried about AMS and not being as acclimatized as the rest of the group since I missed the two climbs, so I popped (too much?) Diamox before climbing Cotopaxi. I also drank a lot of water since I knew that hydration can improve acclimatization and Diamox can dry you out more since it makes you urinate more frequently.

Anyway, I peed a lot. A whole lot. It is an unpleasant side effect of the Diamox. Anyway, we were staying on the upper floor of the Cotopaxi hut. In order to try and not wake anyone I went to go find a pee bottle. I found a 2 liter bottle and cut the top off to use as a pee bottle. After a few hours, I filled the bottle full. Unfortunately, I also ended up spilling the full bottle. I didn't want to wake everyone up and it was dark and I didn't have anything to clean it up with, so I decided to leave it on the floor and clean it up when we were to wake up.

A few hours later I heard stirring downstairs and people speaking different languages. I assumed that they were getting a head start on the mountain and starting to pack up their gear early. Not soon after I heard in plain English WHAT THE @#$%, THE @#$#-ING CIELING'S DRIPPING! Since my wife was planning on reading her novel in the hut instead of climbing the peak I woke her up and quietly told her I needed her shirt. Kim: What? Me: I need your shirt; please take it off. Kim: Why? Me: I need to clean up my pee. Kim: What? Why not use your own shirt? Me: I need my shirt to climb the mountain. You can just wear your jacket. She took off her shirt and gave it to me and I cleaned it up. I never told anyone else in the hut what happened.

Anyway, I don't think I'll ever use Diamox again.

kyle: Yep, Cusco's at about 3400m (a bit over 11,000 ft), depending what part of town. I'd read that the adjustment to Cusco's altitude can be a pain (as in many folks are flat on their backs for a couple of days), and I was curious to see if Diamox would help. Getting a prescription was no problem given my itinerary, and I knew more about Diamox and AMS than my doctors did. Diamox is supposed to be most effective if you take it starting at least 24 hrs before you reach altitude, so (even though I in fact forgot to take until 12 hrs before my trip) that's why I was peeing like a racehorse in the airports. When you arrive in Cusco, you don't really feel the altitude (unless you run uphill) for a couple of hours at least, but *staying* at altitude, in my very limited experience, is a lot rougher on your body than climbing to altitude and descending quickly.


Oct 8: Started the day with a few push-ups, didn't suffer for it. Another bus excursion, this time to Pisac. (Awesome, unending temple complex with terraces impossibly perched on all faces of a high ridge.) A little out of breath on the uphills, and pretty thirsty, but generally feeling good. Again some headache by the end of the day, but able to run on flat sections, enjoy some optional scrambling sections along the trail, and climb the hostel steps two at a time.

Fair enough. I've never been above 9k for more than about 20 hours continuously, a few overnight trips. Although I intend to at some point.

Been doing some hiking to test acclimation. Two days ago we walked with daypacks from Cusco to Tambomachay (3700m), a gentle road walk with plenty of long stops to visit ruins along the way. Felt fine except for sunburn. Yesterday tried something short but steeper, the unnamed hill above Cusco with "Viva Peru" written on it (just under 3700m), with a little more weight in my pack. Had gastric issues halfway up (luckily there was a slightly sheltered spot so I could do my business without being in full view of downtown Cuzco), combined with some breathlessness. I dumped some of the ballast water from my pack, and finished the hill slowly. I was still slightly out of breath, with elevated pulse, after returning to Cuzco. (resting pulse was 88, normal for me is 60). Nothing serious, but a bit sobering after so much time acclimating. I´m hoping rest and rehydration today will be enough to get me over Dead Women´s Pass (4000m) with a full pack. (I also did a ruthless purging of my pack - saved about five pounds on things like spare underwear.)

Sounds like you are taking your time to acclimatize as well as taking the diamox. You should do fine at huarmihuanuska; the trail isn't too steep -just take it slow. I tried diamox once or twice, but don't seem to need it. I had the tingling sensation and the sodas tasted off. It can help prevent nausea and headaches and help with sleeping by preventing cheyne-stokes respiration. What it doesn't do is increase the amount of oxygen in your blood; so you don't get any boost from it - you're still going to get out of breath going uphill, so you just have to take it slow.

Yeah, I needn´t have worried. Our guide set a gentle pace, with frequent, LONG breaks especially the first couple of days. The trail was not a total walk in the park, but completing it was no problem. Plus we got great food that we didn´t have to cook or carry, a very luxurious way to travel.

SP isn´t really the place for discussion of tours to Macchu Picchu, anybody interested in details can PM me.

Sounds like a cool adventure, Natreb! congratulations! I'm jealous.