I had a mother call me the other day worried about her teenager going to Ecuador with a group of other teens lead by a very popular outdoor group. They expected to be at an altitude of 14 to 15000 ft. The mother was worried because some of the travellers had received medication for prevention of altitude sickness, some had received medication for treatment of altitude sickness and some had none. Sounds like the 3 bears and like the 3 bears there is nothing wrong with either choice. The group was going to be acclimizing for 3 days at a lower altitude, which is the recommended time line, they were not going to be sleeping at altitude, which makes a big difference and they were with a group leader who was prepared to descend if anyone appeared to be ill, which is the number 1 treatment for altitude sickness. I told the Mother to stop worrying, tell her teenager to continue on with the original plan of taking the drug only if she developes symptoms.
This mother did a couple of things right. She took her teenager to a real Travel Clinic before she traveled. Our consultants are up to date on all of the recommendations for altitude travel and are trained to discuss all of the choices. When she received conflicting information from other parents and the group leader she called the Travel Clinic back and we were able to reassure her that what she was doing for her child was the right choice. Unfortunately not all people who profess to know travel medicine keep up to date or attend conferences where they learn what the best practices are.