For a 48-hour high-altitude ski weekend, what single acute mountain sickness prevention tactic has worked best for you or your athletes? Which dose and timing did you use for hydration, sodium, or acetazolamide, and what metric like resting HR, sleep quality, or headache-free hours confirmed it?

For a short, 48-hour ski weekend at altitude, the single tactic that's been most reliable is arriving already hydrated and staying ahead of fluid and sodium loss from the moment you land. In people I've worked with, problems started when hydration was treated as something to "catch up on" after symptoms appeared. The approach that worked best was increasing fluid intake the day before ascent, then maintaining regular fluids with added sodium rather than plain water once at altitude. That helped reduce headache and overnight restlessness. In individuals prescribed acetazolamide, low dose use started the day before ascent and continued through the first night made a noticeable difference, but only when paired with hydration and pacing, not as a standalone fix. The clearest metric for success was sleep quality on the first night and waking without a headache, along with a steadier resting heart rate the next morning. My takeaway is that AMS prevention for short trips is about preparation and restraint. Hydrate early, replace electrolytes, avoid overexertion on day one, and use medication only as an adjunct under medical guidance. When those pieces are in place, people enjoy the weekend instead of enduring it.