[miclo18d]

I hope I'm not butting in here too soon as I'm fairly new to the site.

I can certainly understand a discussion about the merits of this tx or that tx and you should always have a plan in place for AMS/HAPE/HACE when in the mountains, but you also have to consider what is really going to happen.

Nothing.

Now, what I'm talking about here is going into the mountains with steely-eyed-snake-eaters with hyper-alloy combat chassis. You know, those guys that where the funny looking green hats from France.

I served on two teams and deployed to mountainous regions in S. America ans the A-Stan (15,000ft in the Andes/ 7000-8000 ft in E. A-Stan). In all cases, I never treated one case of AMS, HAPE, or HACE (not that I didn't think my commanders weren't suffering from any or all of these from time to time). Not that I wasn't prepared (didn't have Gamow bags). Acclimatization and peak physical fitness (I know this can be difficult when your Team Daddy insists on taking you to M & D's Pancakes & Waffles once a week) is your #1 defense followed by Acetazolamide Prophylaxis and/or descent if it turns out to be acute.

Now when you move on to your local populaces, they should already be acclimatized to the region. If they are suffering from PE, it's probably isn't caused by the altitude.

If we are talking about civilian mountain climbers, then you probably aren't going to be treating them without medical authority to do so anyway so descent is your #1 option.

I know that your team guys want you to carry a prescription ED meds around with you so they can feel more potent, but really they might as well just ask the 3rd Group guys to get them some Rhino horns or the 1st Group guys for some tiger penis. It's gets about the same effect for those without ED.

What it really comes down to is this:

1.) $$$ -- Do you want to spend your med funds on making your team rock hard for the ladies and maybe/possibly treat HAPE/HACE?

2.) SPACE -- Do you want to use up the space in your aidbag with something you probably won't use and has only one purpose?

I would have told my guys to buy it on the local economy for their own conquests and saved the room for some Zpacks for when the Bravo came to me with drippy-drip that he got from some mountain girl and if any of them had suffered AMS/HAPE/HACE I would have treated symptomatically, descended or called in a MEDEVAC to get definitive tx.

Disclaimer: Not a scientific solution but a common sense one.