One of the best resources I have come across online is www.Altitude.org.
This website provides an in-depth description of what Acute Mountain Sickness (AMS)/Altitude sickness, High Altitude Pulmonary Edema (HAPE) and High Altitude Cerebral Edema (HACE) are, how they differ, symptoms of each and medical management for each. They also have created a "registry" for people that have suffered from "High Altitude Pulmonary Edema (HAPE)". I would be surprised if this website does not answer or address most of your questions regarding this topic.
I will defer from re-writing definitions, causes, etc of Altitude Sickness since the website does a great job at answering those.
Current recommendations for "PREVENTION" of altitude sickness are the following:
- Acclimatization: above 8,000ft, ascend no faster than you bodies ability to acclimate. Usually 24 hours for every 1,000ft above 8,000ft (some variation in consensus here). This is the BEST preventative treatment/option available. Once above 10,000 ft. move sleeping altitude to no more than 1,600ft in a day. Sleeping at high altitude produces the most hypoxemia; day trips to high altitude with return to low altitude are much less stressful on the body.
- Avoid vigorous/strenuous exercise at elevation until acclimated (roughly 48 hours). Even after acclimatization, go easy, giving your body time to recover.
- Don't smoke, drink alcohol or use medication such as tranquillisers and sleeping pills while you're at altitude, as they could make any symptoms of altitude sickness worse.
- Stay well hydrated.
- Consume a high calorie diet
There are only a handful of evidence based medications effective for prevention and treatment of Acute Mountain Sickness currently that I am aware of.
a. Acetazolamide (Diamox)- 125mg dose twice a day, started 24-48 hours prior to altitude exposure. This is the "go to prescription medication". Higher doses have no added benefit per research studies, yet are typically prescribed. Common side effects are tingling of the hands, toes and face, nausea, & drowsiness. If allergic to Penicillin or Sulfa drugs, this maybe contraindicated for your use.
A few supportive Articles:http://jtm.oxfordjournals.org/content/19/5/281http://www.bmj.com/content/328/7443/797
b. Ibuprofen - 600mg three times a day, started 6 hours prior to altitude exposure. Contraindicated if you have a history of stomach ulcers, GI bleed, liver or kidney failure among others. (Not as widely accepted as a preventative medication but support is growing).
A few supportive Articles:https://med.stanford.edu/news/all-news/2...chers-find.html
c. Dexamethasone - typically used when one has a contraindication to Acetazolamide (I.e. sulphonamide allergy or COPD). While it is effective in preventing and aiding in treatment of AMS, some studies have shown it to inhibit the bodies ability to acclimatize. It also may cause some neurocognitive impairment, mimicking symptoms of AMS.
d. Tadalafil (Cialis)/Sildenafil (Viagra) - these are phosphodiesterase inhibitors which basically work by dilating pulmonary blood vessels thus lowering pulmonary artery pressures which decreases the drive of forcing fluid into the lung tissue decreasing pulmonary edema. These are not first line treatments of AMS Prevention but more geared towards HAPE treatments.
- If you start to develop mild symptoms stay at current altitude or descend
- DESCEND, DESCEND, DESCEND - only truly effective prevention once symptoms present
Current recommendations for TREATMENT for altitude sickness are:
- DESCEND, DESCEND, DESCEND
Really nothing else needs to be said regarding treatment. Once you have true symptoms if you don't descend, much of the above including medications aren't going to have a big impact. You have to descend down the mountain.
As for herbal remedies ie. Gingko biloba - has had widely conflicting results and is not currently recommended. Anti-oxidants (Vit C, E ,& Alpha-lipoeic acid) and magnesium have not shown to be effective. Other remedies/treatments are out there but there is little to no valid literature to support it's use. That's not to say they are not effective. Some haven't been studied in small or large trials.
In the end, use what works for you under direction of a medical professional. Common sense and educating yourself is key. I would seek medical advice prior to taking any of the above as each of us have our own problems/issues. Self medicating can get us in trouble even when it comes to herbal remedies or over the counter medications. I would encourage you to look at the Altitude.org website. Some extremely valuable information there.