Here's the deal on dex and summit day
May 3, 2007 12: 04 EST
As summit fever builds, I'm republishing the advice of my good friend Dr. Robert "Brownie" Schoene, who in 2005 wrote an editorial piece about the use of dexamethasone in high altitude climbing. He minced no words -- and gave a cogent opinion and resounding NO to the question about whether dex can safely (or fairly) be used -- not as a medical treatment -- but as a climbing aid.
Dexamethasone is a lifesaver in cases of HACE when combined with oxygen and descent, and its' use in those cases is absolutely endorsed in the mountain medicine community. However, the question always comes up -- climbers want to know whether they can safely use dex on ascent to feel better and climb faster. I've excerpted some of Dr Schoene's discussion below and have cited the reference for those interested in reading the entire piece. If you're using or advising folks to use dex in altitude climbing, this editorial is a must read, written by one of the world renowned authorities on altitude medicine:
"The more controversial area of discussion about dexamethasone falls into the realm of the misuse of a potent and valuable drug. As a physician, I feel that judicious use of dexamethasone is warranted, but no one, having been treated for altitude illness, especially early HACE, should ascend on corticosteroids. For trekkers and recreational climbers who develop symptoms of more severe AMS, the drug is a safe adjunctive therapy that will make the descent safer. One must be aware though that this drug can give a false
sense of security (steroid euphoria) and lure one to altitudes higher than the body has acclimatized to. In other words, the drug should not be taken by healthy individuals who are doing well at altitude and who want an “ergogenic” aid, just to go higher, faster. Drugs should prevent and treat disease, not enhance performance, especially in an environment where the margin of safety is precariously thin. To use dexamethasone as an ergogenic aid is a foolish risk advocated by some guides and accepted by inexperienced, ambitious, and vulnerable climbers..."
Read on:
Schoene R: Dexamethasone: By Safe Means, by Fair Means. HIGH ALTITUDE MEDICINE & BIOLOGY
Volume 6, Number 4, Dec 2005.
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