Your physical conditioning should be fine. You need more practice with crampons if you've only used them a few times. Learn proper rope techniques. If your partners go in a crevasse who is going to get them out? Practice self arrest and z pulleys. You don't want to be totally dependent on your partners. Guides typically spend a day or 2 practicing with clients before summit day.
Second this wholeheartedly: the need to be skilled at these, especially ice axe self arrest on hard snow, cannot be overemphasized.
While they could complicate other hazards, shortcomings in conditioning will probably just turn you around. You make it sound like you're in pretty good shape.
Shortcomings in acclimitization will probably just give you unpleasant symptoms. Life threatening HAPE or HACE are rare at Rainier elevations, but not unheard of.
But shortcomings in glacier travel skills, particularly ice axe self arrest, can easily get you killed along with the others on your rope, even on the cow path on Rainier. Self arrest should be practiced in all positions to where it is automatically, correctly, and essentially instantly done 100% of the time.
I want to second the recommendation for Diamox - I don't see it commonly mentioned for Rainier, but I'm not sure why (is it considered "cheating"? maybe just overkill?). My boyfriend had a terrible time with elevation when we did Adams, so he got a Diamox prescription for our trips up Rainier this last summer and both times he summited he felt good enough to jog across the crater. Some of this may have been placebo/psychological - he was really dreading being at elevation again, so when he had a way he felt he could address it that alone alleviated some of his anxiety. Either way, all he had to do to get it was message his PCP so it was definitely worth it for him.
I don't see it commonly mentioned for Rainier, but I'm not sure why (is it considered "cheating"? maybe just overkill?).
I speculate that it isn't used more because it requires a prescription, which would require a visit to the DR and perhaps some reluctantance to prescribe without a prior poor experience at altitude. There are risks to the kidneys and liver to be considered.
Not Rainier specific but one routine I've developed is to pop a caffeine pill before descending from the summit, or when I think a previous caffeine hit is wearing off. A lot of slips, slides, accidents, happen on the descent. I favor Walgreen's caffeine pills which are small in size and easily broken in half if you want to meter the dose. FWIW, FDA perceives caffeine's half life as 4 to 6 hours
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