It's kind of a funny story...
In the course of doing research for the trip, I found many cautionary tales about Altitude Mountain Sickness (AMS). Gradual ascent was recommended to allow for acclimatization, but we would be flying right into Lahsa, Tibet, with an altitude of 3656 meters, or nearly 12,000 feet. (For reference, Denver, Colorado is just under 5700 feet.) Many recommended consulting with a physician about using Diamox to help with the adjustment.
Trying to find a doctor in Thailand with knowledge of AMS was a challenge, to say the least. General practitioners seem to be non-existent. We have access to a service here that helps us with finding doctors, arranging appointments, etc. I explained our somewhat unusual request to this service, and an appointment was made for me just days before our departure. I received confirmation for the appointment, with a note that said, "This doctor is a medical doctor, but he is in the Mental Health department." Having been here for a couple of years, I have learned to just go with the flow, and not ask too many questions.
I assumed seeing a doctor meant having some sort of physical evaluation to determine whether using the Diamox would be advisable for us. So when I reported to the front desk at the hospital, the staff seemed somewhat puzzled by the fact that I wanted to see this mental health doctor for a check up! They led me up to the mental health department, and a nurse brought me into a room to check my weight and blood pressure. She asked me what was wrong, and I told her nothing was wrong, I just needed a check up - in Thai-English, "check body." She got the most puzzled look on her face, and asked again, thinking we might have misunderstood each other. Her puzzled look grew, and I started to giggle at her reaction. She asked me, very seriously, why I was laughing. Thinking about this later, I imagine she probably has patients who laugh inappropriately from time to time!
Led back out to the waiting room, I was finally called in to see the doctor in his office. The little room just contained his desk (piled high with papers) with a couple of chairs facing. I wondered what kind of examination I would get when there was no examining table present. He invited me to have a seat, and asked me what the problem was. I had assumed the service would have filled him in about my request, but he clearly had no clue why I was there. So I tried my best to explain that we would be travelling to a very high altitude, and wondered if we would benefit from the use of Diamox. He asked me if this was some kind of antibiotic or anti-anxiety medication. Visions of red flags danced in my head!
I spelled the name of the drug, and he proceeded to google it on his computer. I am not joking. (An American doctor would have at least left the room to do his googling). At this point I had zero confidence in this consultation, but realized this would be my only opportunity to get the medication before our trip. It felt much more like a team effort than a consultation with an expert, which I guess isn't so bad; they say you should be an active participant in your health care decisions. He read what he could find, then called and consulted with the pharmacy department. He decided we should start using the medication two days before we begin our trip, and continue taking it until two days after we left the high altitude. He indicated that one should exercise and prepare for months before such a trip - I think he believed we were planning to scale Mt. Everest. He also said we should avoid alcohol, coffee, or any kind of stimulants. No questions you might expect about other medications we might be taking, just a check for allergies to sulfa. And he included enough in the prescription for both of us. Very accommodating.
From my own googling, I learned one could expect side effects such as loss of appetite, tingling in the fingers and toes, dizziness, etc. After my visit, I still wasn't sure whether we should take the medication or not.
What would you do in my position??
Such is the state of health care in my neck of the woods...
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Thanks for reading!