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Diamox

Acetazolamide, sold under the trade name Diamox®, is a carbonic anhydrase inhibitor that is used to treat glaucoma, epileptic seizures, benign intracranial hypertension and altitude sickness. For glaucoma sufferers, the drug decreases fluid formation around the eye resulting in lower internal pressure on the eye. Acetazolamide can only be obtained by prescription and is available as a generic drug. more...

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Uses

General

Acetazolamide is used in glaucoma and epilepsy. In epilepsy, its main use is in absence seizures, with some benefit in other seizure syndromes. It is also used to decrease generation of cerebrospinal fluid in benign intracranial hypertension.

Altitude sickness

Acetazolamide has been shown to relieve mild cases of altitude sickness in some people. The drug forces the kidneys to excrete bicarbonate, the base form of carbon dioxide thus counteracting the effects of hyperventilation that occurs at altitude. Some take acetazolamide prophylactically, anywhere between 125 milligrams (mg) to 500 mg per day. Others only take it when symptoms begin to appear so they can tell whether the drug really has any benefits for them. Acetazolamide can also be taken to treat sleep apnea that may develop at higher elevations as it stimulates the respiratory system to breathe more regularly. Note that acetazolamide is not an immediate quick fix – it speeds up acclimatization which in turn helps to relieve symptoms. This may take up to a day or two without any further rapid ascent.

Side-effects

Common side effects of using this drug include numbness and tingling in the fingers and toes, and taste alterations (especially for carbonated drinks); both are usually due to mild hypokalemia (low potassium levels). Some may also experience blurred vision but this usually disappears shortly after stopping the medication. Everyone will experience more frequent urination as a result of using acetazolamide. One should drink more fluids than usual to prevent dehydration and headaches.

Contraindications

Acetazolamide should not be taken by individuals if:

  • They are allergic to sulfa medications
  • They are allergic to any carbonic anhydrase inhibitor
  • They have liver or kidney disease
  • They have adrenal gland failure (i.e. Addison's disease)
  • They have diabetes

Myths

  • Acetazolamide covers up symptoms. Acetazolamide speeds up acclimatization which in turn helps to alleviate symptoms. However, if you still feel sick, you need to stop ascending immediately.
  • Acetazolamide prevents acute mountain sickness from getting worse. If your symptoms are not improving, continued ascent can lead to HAPE or HACE.
  • Stopping the drug causes symptoms to worsen. Your body will just return to its own acclimatization rate. If you are already acclimatized, the drug will not change that fact.

Read more at Wikipedia.org


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Tours in review: candid appraisals of group tours
From International Travel News, 8/1/04

The following are candid appraisals of some of the tours ITN readers have taken in the last year or so. When writing to ITN about a tour, please keep it as brief as possible (200-400 words) and include the ADDRESS and/or phone number of the tour company plus the PRICE, length and MONTH/YEAR of your tour. (Write-ups may not be used without the price included, and, remember, ITN does not cover destinations in North America.)

Write to Tours in Review, c/o ITN, 2120 28th St., Sacramento, CA 95818, or e-mail editor@in tltravelnews.com (please include your surface-mail address).

INDOCHINA the two of us took a private, customized trip to Viet-Nam, Cambodia, Laos and Burma, Feb. 13-March 16, '03, arranged through Ceylon Express International (9542 Dumbreck Dr., Huntington Beach, CA 92626; phone 800/423-9566, e-mail info@ceylonexpress.com or visit www.ceylonexpress.com). They used Indochina Services as the ground operator.

For both of us, the cost of our 32-day trip, including international air, eight flights between the four countries and everything else except lunches and tips to the guides, was $12,725--about $225 per person per day (discounting the overseas air travel days). Visas cost a total of about $200. Except for Burma, for which we had to arrange visas ahead of time through the embassy in Washington, D.C., visas were purchased on arrival in each country.

Here are just a few highlights of our trip.

In VIET-NAM, the historic trading port Hoi-An is a UNESCO World Heritage Site. We stayed at the Victoria Hoi An Resort (phone 84 0510 927040 Or visit www. vietnamadventures.com/hotels/rev_victoriadad.html), located on the ocean, which was a treat. Rooms cost $150-$170.

We flew to Ho Chi Minh City where the Cu Chi Tunnels, a boat trip on the Mekong River and the War Remnants Museum were interesting.

From Ho Chi Minh City we flew to Siem Reap, CAMBODIA. The highlights, of course, were Angkor Wat, Angkor Thom, Banteay Srei, Bayon and Ta Prohm.

In LAOS, the National Museum in Luang Prabang, a folklore show and visits to numerous Buddhist temples were the highlights. The Pak Du Caves were very disappointing, but the boat ride to get there was great.

If someone wanted to bypass one of the countries we visited, we'd suggest Laos.

In BURMA, the most interesting place in the capital was the Shwedagon Pagoda. From Yangon we flew to Heho, then drove to the shore of Inle Lake. We spent seven hours the next day in our own open boat, touring various villages along the lake where the locals do handicrafts, including silk weaving, paper making, blacksmithing, lotus plant weaving (producing a very expensive material similar to linen), boat construction, cigar making, etc. Of great interest were the fishermen who each propel their small boats with one leg.

Bagan has to be seen to be believed. Everywhere you look, the area is dotted with thousands of 800-to 1,000-year-old temples and stupas of all sizes. Of modern interest is the National Museum, located in a magnificent new structure. It contains many Buddhas taken from the temples, costumes from the different states, paintings and more.

Our final visit was to Mandalay. We saw what was to have been the tallest zedi (stupa) in the world, the Mingun Paya. Work was started in 1790 and halted in 1819, and the structure was reduced to a pile of rubble in an earthquake in 1838. The Mingun bell, cast to go with the stupa, weighs 90 tons. Later we went to watch the sunset from the old teak U Beins Bridge.

On our tour there were no problems with any of the aircraft, at any of the hotels or with our itinerary. Our tour guides, drivers and cars all were good. The guides were always open to our suggestions. We did not encounter any hostility because we were Americans, nor did we see any military or civil disturbance. This is a trip for able-bodied travelers.

--WAYNE & DARLENE SCHILD, Austin, TX

SOUTHERN INDIA

I took a 20-day custom tour, Jan. 20-Feb. 2, '03., arranged for me by Ceylon Express International (Huntington Beach, CA). The entire cost of the trip, including international and domestic air, hotels, breakfasts, my own car and driver and English-speaking guides in each city, was about $6,300.

Among highlights was Madurai, where a visit to the Meenakshi Temple is a must. In Periyar, bird-watching by boat is the thing to do. In Kanya Kumari, at the southern tip of India, I toured by boat the monuments built on rocks offshore and visited the temple to the goddess Kanya Kumari.

We drove to Kottayam, where I boarded the Vambanadu Kettuvallum, a rice boat. I had my own pilot, a cook and an attendant. The meals were cooked on board in a tiny kitchen and served in an open dining room. The boat also had a bedroom with an attached bath. It was very comfortable and quite a novel experience to be waited on hand and foot. My cook prepared some king prawns for me that I bought in a nearby market.

I took a flight to the Lakshadweep Islands, where I stayed at Bangaram Island Resort. Scuba diving and snorkeling are the activities there, but, for me, watching the sea change colors was sport enough.

In Mysore, a stop at Shravan Belgola is a must. I climbed 658 steps to see a huge statue of a Jain saint. In Chickmaglur I saw the temples of Halebid and Belur, which are built of granite but are so full of carvings they look like lace.

I believe I got my money's worth on this trip. The hotels selected by Ceylon Express were all very comfortable and the food was tasty and cheap. On the domestic flights, on Jet Airways, service was courteous and efficient, and, no matter the duration, a hot meal was always served. The drivers were very good and the guides spoke excellent English.

--SHERRY PAI, Silver Springs, MD

CHINA Our trip was arranged by JMG Tibet Tours (6001 Falls Circle Dr., Ste. 301, Lauderhill, FL 33319; phone 866/548-4238, e-mail jeff@jmgtibettours.com or visit www.jmgtibettours.com).

My wife, daughter and I were escorted on our 18-day tour of Tibet and Xi'an, China, by Jeff Garrett, JMG's owner. Our tour cost $2,495 for the Tibet portion and $630 for the three of us to take the side trip to Xi'an. The April '04 tour started and ended in Beijing, and our international air from Detroit to Bejing was $893 per person from WholesaleFares.com.

Mr. Garrett accompanies all tours and has extensive knowledge of Tibet, as he has been doing this tour for 17 years. The emphasis on China or Tibet can be adjusted to your liking. In our case, we had already toured China except for Xi'an and the Terra Cotta Warriors, so we spent most of our time in Tibet.

From Beijing we flew to Lhasa, situated at about 12,000 feet. We remained there for two days to become acclimated to the altitude. We toured the city, marketplaces, several monasteries and the Potala Palace.

There were eight people on our tour plus Mr. Garrett and our English-speaking Tibetan guide. We departed Lhasa in 4-wheel-drive vehicles on the scheduled tour which led us to the base camp of Mt. Everest. En route we visited Gyantse, Shigatse, Lhatse, Shergar and Tashi Dzom, sightseeing and visiting monasteries and temples. Everywhere we went we were highly welcomed by the Tibetan people. In fact, Tibet's most notable feature was the friendliness of its people.

As we got closer to Mt. Everest base camp, which is at 17,500 feet, the number of accommodations decreased somewhat, but they were still adequate, and the food was plentiful and good. For camera buffs, the trip was a field day--exceptional picture-taking opportunities. At one of our stops, yaks, which are used as farm animals and to carry supplies, were saddled and available for rides.

Here are some precautions to keep in mind if you take this tour:

* Altitude can be a problem for some people. Mr. Garrett recommended Diamox[TM] or its generic version, acetazolamide. These tablets can help prevent altitude sickness and aid in sleeping at high altitudes. Consult your doctor prior to making the trip.

* There were many steps to climb at the monasteries, temples and other points of interest. One must take it easy because of the altitude. Mr. Garrett carefully monitored all the participants to ensure their health was okay.

* Don't drink any water except bottled, even in 5-star hotels in Beijing.

* Roads outside of the cities are generally dirt or gravel. The dust can be irritating, and I would suggest you take a paper breathing mask to cover your nose and mouth.

Final note--my wife and I are in our late 70s, and another couple on the tour was in their mid-70s. None of us had any problems on this tour.

--NORMAN C. NADON, Tijeras, NM

SCOTLAND I took a group of my college students on the 9-day/7-night "Braveheart" tour of Scotland with Passports Educational Travel Institute (389 Main St., Spencer, MA 01562-1908; phone 508/885-4600 or visit www.passports.com), visiting Edinburgh, the Highlands and Glasgow. The $2,300 price (May '04) included airfare on USAir from Denver, 3-star hotel accommodations, daily breakfast and dinner, transfers, tour and admission fees and travel insurance.

Although this company's target market is student travelers, I feel that it is worth sharing our experiences with ITN readers who may be planning to conduct a student trip or may wish to take a continuing education class for credit.

Our trip's focus was literary history. We started in Edinburgh and took in the castle, a guided city tour and a "ghost walk." Free time was spent in pubs along the Royal Mile. Into the Highlands we then went, stopping at St. Andrews, Blair Castle, Culloden and lochs Ness and Loman.

We ended in Glasgow, where we revised the itinerary. We had planned on just visiting the Burrell Collection and the Glasgow Cathedral. As it turned out, we had plenty of time for the Gallery of Modern Art and shopping in the merchant city area. The phenomenal sunny and 70-degree weather made the trip even more enjoyable.

Our courier, George, and our driver, Barry, were great fun. On our way home from a disappointing Scottish ceili dinner (haggis, neeps and tatties), we cheered up by using the coach microphone for bus karaoke. On travel days we stopped hourly--for snacks, rest rooms or photographs. The coach was a means to an end to move us from town to town. The company understands that those With a younger mindset would rather be off the bus than on.

The only drawback to this fine trip is that Passports' couriers are not tour guides, so they will not offer running commentary (i.e., "On your left you will see the ruins of Castle Leoch"). In some ways this is pleasant, as people can relax. However, there is a tremendous amount of history just outside the window, and if no one points it out, much will be overlooked. Thus, if the faculty member is not prepared to lecture, then travelers may be at a loss on travel days.

--JENNIFER EISENLAU, Boulder, CO

SCOTLAND We took a 3-day/2-night tour of the Highlands of Scotland and the Isle of Skye in May '04 with Rabbles Trail Burners (207 High St., Royal Mile, Edinburgh, Scotland; phone 011-44-131-226-3133 or visit www.rabbies.com). We had a great trip.

The cost was 99 [pounds sterling] (about $182) per person for their transportation. Rabbies will arrange accommodations on Skye according to how much you want to spend. Meals are additional.

The scenery and stories were made all the better by our guide, Alexander Beaton (Ally), and this side trip became the highlight of our 10-day stay in Scotland.

The 16-passenger minibus was able to take us on the single-track roads with ease as well as allow us to find convenient places to stop for impromptu sightseeing and picture taking.

When touring Scotland, ask for Ally, who will show you the heart and soul of his country.

--NANCY & JIM SIMPSON, Wilmington, DE

CHINA A tour of China I took Nov. 8-20, '03, which included a Yangtze River cruise with Victoria Cruises, was booked with Sharon Carr Tours & Cruises (14580 East Beltwood Pkwy., Ste. 108, Dallas, TX 75244; phone 800/648-4856, e-mail info@sharoncarrtravel.com or visit www.sharoncarrtravel.com).

I refer to another reader's comments concerning the Yangtze River cruise (Feb. '04, pg. 66). We too, due to low-water conditions, had to take a 4-hour bus ride to Fengdu on the first part of the trip and another 4-hour trip into Wuhan at the end. However, I thought the bus rides were very interesting. There were 40 or so of us, and a wonderful local guide was with us the whole trip from Beijing.

I have made many trips with Sharon Carr and have found them very reliable and reasonable. My trip cost $2,182, which included airfare from Dallas and basically everything else, including meals. It was marvelous.

--DAVID WILLIAMS, Dallas, TX

COPYRIGHT 2004 Martin Publications, Inc.
COPYRIGHT 2004 Gale Group

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