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Altitude sickness

Paris, France
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Altitude sickness

Once you are at a high altitude, is it better to stick to travelling on high land?

Our current itinerary is as followings; three days in Sacred Valley and Machu Picchu area, then two days in Cusco, two days in Puno, followed by a low-land trip in Tambopata. However, it looks like a particular lodge we like in Tambopata is already fully booked on the day we planed… If we squeeze Tambopata between Cusco and Puno, we can make a reservation at the lodge we like in Tambopata, but then we would need to go directly from Tambopata to the highest altitude in our itinerary, Puno, at 3,800 meters, potentially losing all the climitization we accomplished during our stay in Cusco days before.

Is it a terrible idea if we go to high altitude, then go down, then go high again?

Due to the festival and our travel date, we have to go to Cusco and Machu Picchu area in the beginning of our trip, which can’t be changed.

Umeå
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for Leh
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1. Re: Altitude sickness

You don´t lose acclimatization anywhere near this fast : you should have several days before the negative effects of low altitude really hits.

Houston
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2. Re: Altitude sickness

I would disagree with the "several days" advice. It would be responsible to cite a source or explain exactly why this is recommended. The lack of these makes me go "HHhhhhmmmm.....".

I also didn't realize that low altitude can cause negative effects. HHhhhhmmmm.

I am especially sensitive to altitude and am very ill in places as low as Vail (Colorado). Arequipa, Huarochiri, Puno, Cuzco, MP, and Quito (Ecuador) are my foreign destinations that all left me very ill. These were all visited over 2 weeks time and going down for 2 days made me start the pain again. Pretty much everyone DOES recommend to do your best to stay up once you are up and not play yo-yo. If you are one of those lucky schmucks who doesn't feel the effects of altitude, knock yourself out, though.

We went from sea level to Puno and yes, I was ill. (I didn't realize at that time the sensitivity I have and I certainly am not the one who planned the trip--it was an experienced traveler who doesn't get AMS ever.) I won't do it again. We were 3 days at sea level after 3 days in Arequipa. 2 nights in Puno, then 3 nights in Cuzco. I was sick until we left Cuzco and flew back into Lima. Then, I was just exhausted.

My own personal advice is to look at you past traveling experiences--mountain visits, for example and base your plans on how you reacted to those. If they didn't ever happen, then go ahead and make your plans and be prepared to take it easy in Puno, if necessary. Be mentally ready to seek medical attention if you need to in Puno and if you get sick enough to leave, just chalk it up to being part of the adventures of traveling while knowing that it is a very, very small percentage of folks who actually get sick enough to seek medical care and even smaller group that has to move down.

Note: It is very popular to recommend Diamox here on this site--it is a pretreatment for prevention of AMS. If you DO decided to investigate this, please do your research. After you have done your research, THEN talk to your dr. Mine admitted to me that I probably knew more about it than he did and it was all up to me. His knowledge of it (we are at sea level) was simply that it exists. I have the exact same resources to learn about this than he does. It is contraindicated in people who have a common condition (that I have and is certainly more life threatening than the issues I had with the altitude). I did choose to take an emergency drug with me for pulmonary edema and kept that on my person throughout traveling. I never felt that I was ill enough to consider taking it but was educated and prepared in advance. The sickness that I "enjoyed" did not stop me from having the best trip of my life. (I did spend a disproportionate amount of time on my knees throwing up, though.)

Lima, Peru
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3. Re: Altitude sickness

As some say before, visit your doctor and tell hime about your travel. He will advise you better about your health, in Peru if you fel seek you can go to a drugstore and ask for a pill, My advice is that you must have extra becarefull with the food because if you travel with full stomach there is more probably to feel sick

Umeå
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4. Re: Altitude sickness

Apart from personal experience : CDC states , and has data to support it :

"Having a high-altitude exposure at more than 9,000 ft (2,750 m) for 2 nights or more, within 30 days before the trip, is useful."

The shortlink , again : http://korta.nu/cdcalt

Increase in red blood cells is not a major factor , still , I have checked this at work a number of times after returning from the Himalyas . Still high one week later , normalised in two.

Can't imagine why Diamox comes up here - not recommended in guidelines when you start in SV , unless you've had prior episodes of AMS.

".. look at you past traveling experiences--mountain visits, for example "

NB : Max elevations , like a picknick on a mountain top , will tell you very little how you will react to actually staying in place or even a lot lower. Sleeping elevation is the key factor. In the US for example you have massive numbers going via the highest road tunnel in the world , and hitting ski slopes higher than Lhasa - this is not a working prediction to how they will react in going to Tibet by plane or train.

california
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5. Re: Altitude sickness

My guide said that sometimes she got sick and sometimes not when going from Arequipa to Colca Canyon over the high pass (over 4900 meters). She was born in Chivay but lives now in Arequipa. She was doing this trip once or twice a week, with a night or two at the rim of Colca Canyon, about the same elevation or slightly higher than Cusco.

My only point is that even for those born and raised at altitude, sometimes it's a little random. And for her, going back down to Arequipa (still about 2300 meters) for a week in between trips would be enough to lose any advantage. (And also that Arequipa isn't really high enough to prepare you for that severe an increase in elevation).

New York City, New...
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6. Re: Altitude sickness

Really, altitude sickness is going to affect everyone in different ways, so you just won't know until you get there. I spent two weeks in Bolivia prior to hitting Lima, then Cusco, then Manu, then back to Cusco and the Inca Trail. The first 3 nights in La Paz I woke with throbbing headaches and nausea, although I had felt absolutely fine during the day. After that, I was fine the rest of my trip. I did acclimatize in Bolivia and then had no further problems in Cusco, even after breaks at sea level (in Lima and Manu).

Chicago, Illinois
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7. Re: Altitude sickness

"Can't imagine why Diamox comes up here - not recommended in guidelines when you start in SV , unless you've had prior episodes of AMS."

Actually the guidelines recommend Diamox in most situations. Both Ollantaytambo and Urumbamba in the SV are above 9100 feet. The guidelines on the link poster 4 put up say Diamox is "beneficial" for anyone ascending to 9100 feet in one day even with no prior history of AMS. So per the guidelines, anyone flying from sea level and staying in the SV would benefit from Diamox.

Also, the elevation difference from Ollanta to Cusco is over 1600 feet, so if you go from SV to Cusco in one day, as almost everyone starting in the SV does, you are again in the moderate category where Diamox would be beneficial.

Umeå
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8. Re: Altitude sickness

Let the hairsplitting begin : CDC says Diamox is to be "considered" on single day ascents to 2800+ meters , so Ollantaytambo @ 2850 is at the lowest possible end of that category. Same with going to Cusco after Ollantaytambo , again fifty meters in to the moderate/benificial category. I wouldn't base decisions solely on that , even more so with two nights of acclimatization first.

What I do nowadays is to take the lower dose at night only , first two nights around 3000 on fast ascents , which is an easy decision for anyone who has already taken it. Never thought of it as a problem before , but I sleep so much better now.

Edited: 17 May 2013, 09:56
Appleton, WI
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9. Re: Altitude sickness

Stick with the higher altitudes in one shot if you can.

I was concerned about altitude sickness and no one in our group of four had any major issues. Slight headaches and dizziness were the worst of it. Drinking the Coca Tea helped me with energy levels and it is supposed to help with the altitude as well. If you like jasmine tea it tastes similar.

We did Cusco/Sacred Valley/Machu Picchu in that order. By the time we got to MP we were acclimated and completely enjoyed the "highlight" of our vacation.

Umeå
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10. Re: Altitude sickness

Machu Picchu will be the lowest point for practically all Peru travellers once you leave Lima : you definitely don't need to acclimatize for sleeping at Aguas Calientes ( 2040 meters , well below the "altitude"/pressure inside airplanes ) , and MP peak elevation is near identical to Arequipa. One night high will take care of your acclimatization needs for MP, nine times out of ten.