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high altitude

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high altitude

Now worried about the high altitude in Cuzco. Not so worried about Lima (should I be?). The drugs for high altitude have awful side effects. Do we really need them? What is the best way to cope?


Lima, Peru
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for Cusco, Lima, Arequipa, Peru
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1. Re: high altitude

Lima is at sea level.

Cusco at 3400 meters above sea level , but the Sacred Valley is at around 2800 meters. So, your best bet is to go the SV upon arrival to Cusco for an easier acclimatization process.

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2. Re: high altitude

thank you for that.

Tucson, Arizona
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for Quito, Ecuador
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3. Re: high altitude

Most people cope with the altitude without the drugs. Those drugs were developed for mountain climbers and should, as you note, be used with caution. They weren't meant for casual visitors to places like MP. It's normal to experience shortness of breath and probably a mild headache at first; staying hydrated, avoiding alcohol, and taking it easy for the first day or two help a lot.

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4. Re: high altitude

You can minimize impacts by not overexerting when you first arrive in Cusco. Walk slowly and don't exert yourself at first. It can take several hours for the effects of altitude to manifest. Go to your hotel (preferably in the Sacred Valley which also includes Ollantaytambo) and rest for a few hours.

Don't eat a heavy meal especially for dinner and enjoy the coca tea (even if it doesn't help much).

Within a day or two you should start to become acclimated and hopefully avoid any severe effects. Bring some Tylenol or Advil for a headache, especially if you plan to return to Cusco at the end of your stay. Even after 4 days in Ollantaytambo I still had a slight headache in CUZ,

I have gone as high as 16,000 feet without taking the drugs and without any major upsets, just by building up gradually.

However everyone is different and younger fit people often have worse effects than healthy seniors.

Edinburgh, United...
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5. Re: high altitude

Hi Anne,

Here is some general advice about altitude. Diamox or other drugs are designed for much higher altitudes than you are going to, and it's always better to not take them, and to acclimatise properly, than to take them.


Being at altitude, especially in the tropics, is usually a pleasure as it isn’t so hot, there are few insects and the air is clear. However, when gaining altitude, air pressure drops and the amount of oxygen reaching the lungs is reduced. Although we build plenty of acclimatization time into our itineraries, certain ill-effects are possible. Nevertheless, all of these can be minimized or prevented if care is taken.

On reaching heights above 3,000m (approx 10,000 ft), especially when ascent has been straight from sea level, heart pounding, mild headache and shortness of breath are normal, especially on exertion.

To avoid the effects of AMS (accute mountain sickness, a syndrome known locally as soroche, whose symptoms can include of bad headache, dizziness and nausea), you should:

Rest for a few hours on arrival at altitude and take it easy for the first couple of days. Note: you may feel fine on arrival and tempted to exert yourself as normal. Don’t be fooled: you might be benefiting from oxygen brought in your blood from sea level.

Drink plenty of water to avoid dehydration (altitude is a diuretic). Coca tea (mate de coca) helps alleviate symptoms.

Eat light meals, with high carbohydrate and low fat and protein content. Dine early, allowing digestion time pre-sleep.

Avoid over-exposure to the strong highland sun (UV rays are very powerful) - especially in the early stages - making sure you wear a broad brimmed sunhat. Apply lip-salve to prevent chapped lips.

Avoid or minimise consumption of cigarettes and alcohol. Avoid sleeping pills.

If you do get AMS: Rest, take non-aspirin painkillers (for headache) and coca tea. Symptoms should subside after a day or two.

Pregnant women, people with a history of heart, lung, kidney or blood disease or blood pressure problems, should consult their doctor before traveling to high altitude.

All the best

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6. Re: high altitude

"The drugs for high altitude have awful side effects."

Having seen both the disease and the cure : the disease is worse. I go regularly to the same altitude as Cusco ( mainly Leh @ 3500 meters ) and flyins effects come for many in the full spectrum of hangovers : from mild distraction to the more epic version. And a very small group do go to hospital , even though they don´t need anything more dramatic than oxygen , steroids and TLC.

"Do we really need them? What is the best way to cope?"

You are very , very unlikely to need them if if you plan your first nights well : ideally first one around cabin pressure on airplanes ( i.e. around 2400 meters ) ,following nights max 500 meter higher... see http://korta.nu/5c3a

As already mentioned the main point here is not spending the first night in Cusco. Arequipa is near ideal for a first acclimatization night , Ollantaytambo is ok for most , and the rest of SV should not be a problem for the vast majority ( apart from shortness of breath , fatigue ... normal physiological reactions ).

Unfortunate that you start from eastern US , those coming from the western parts have a number of options to spend a weekend first at 2000+ meters.

"Diamox or other drugs are designed for much higher altitudes than you are going to"

The CDC view ( http://korta.nu/cdcalt ) view on this : Diamox is " benificial and should be considered " for a first night spent around 2800 meters ( i.e. Ollantaytambo ) and "strongly recommended" for flyins to Cusco , Lhasa etc.

You´ll find the same line echoed on any good medical source on this , like ismmed.org , WHO etc.

"Drink plenty of water to avoid dehydration (altitude is a diuretic)"

Drink around one extra liter of fluids , not just plain water , to compensate for the extra urine production of alkaline urine that makes it possible to increase your breathing. Not a lot more : the the effects of excessive water drinking gives exactly the same the same effects and symtoms as severe altitude sickness : nausea , headaches , vomiting and worse.

Avoid ASA/aspirin since it interacts with Diamox ( and some more reasons) . You´ll probably see "soroche pills" displayed and suggested : this is basically ASA and caffeine.

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7. Re: high altitude

So helpful and reassuring. Thank you.

Los Angeles...
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8. Re: high altitude

I am impressed with all the responses and want to add a tale of caution. We recently returned from a small group tour that started in Lima. Of the 17 travelers probably half had some form of altitude issues when we arrived in Cusco. I am allergic to Sulfa drugs but did succumb to the Diamox as I did not want to suffer during our adventure. I had no negative affects from the drug and followed all other suggestions as well. There is oxygen in all the hotels and at the airport we bought a portable oxygen bottle that also seemed to help. Peru is amazing and should not be missed!

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9. Re: high altitude

As someone who spent a lot of time in Colorado, I poo-poo'd the idea I'd get altitude sickness...

...and spent an entire day throwing up in ziplock bags on a tour bus (as bad as it was for me, I felt terrible for the others on the bus who had to be in the same vicinity as that).

Be smart, hydrate and go slow down. If you start to feel woozy, stop and take a breath. Odds are, you'll be just fine.

10. Re: high altitude

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