Altitude Sickness - Soroche, Cusco
We flew from Lima at sea level to Puno at 4000 m and were taking Diamox and drinking lots of coca tea. We're both very fit - this is irrelevant with altitude sickness. Don't make the mistake of thinking you're super fit and healthy and you won't be affected. Your body must maintain adequate blood oxygen levels and that's not within your control.
We had shortness of breath, slight nausea, headaches. I had no problem sleeping, but did notice that I was breathing faster and shallower. We were extremely out of breath with any form of exertion, even climbing 5 or 6 steps in our hotel, so plan on lots of time to get places, strolling not rushing. I was sick to my stomach the first night and then felt great although I did have 10 mins of oxygen in our hotel. I also have asthma and had no problems at all with this. Just take it easy, keep hydrated, and be familiar with warning signs of problems. After 3 days in Puno, we were in Cusco and had no problems as we had apparently acclimatized at the higher elevation. However we continued to take the meds and drink coca tea until we left Cusco. We are in the 50-55 age range.
Yes, it can be avoided ... we´re living proof. I´m sitting in Cuzco as I write ... hoping to benefit others planning to do a fast Machu Picchu trip like we are doing.
Planning a quick visit: Unlike many stronger-younger visitors, we´re 60. And, we only have 3 days. So we decided to fly into Cuzco (from Vancouver) and go directly to Aguas Caliente (which is about 2K+ ft lower). Stay the night and visit Machu Picchu in the morning, return to Cuzco in the afternoon, spend the next day in Cuzco-areas, and fly out early the following morning.
First, we got the prescription meds (Acetazolamide as suggested by 53nana) and started taking it (3 x per day) as soon as we get on the plane at 1 pm. About 18 hours later, we´re in Cuzco.
Next, we had pre-arranged a car service pick us up (from the Cuzco airport) to take us to the Ollantay train station. It takes about 1.5 hours. We arrived 30+ mins before the train departs. 1.5 hours later, we´re in Aguas Caliente, before 4 pm.
Yes, I find I get out of breathe sooner than usual ... only because I feel good enough to not realize that I´m at a high altitude and go my usual pace. Other than that, drink lots of water, I had 2 coca tea so far, and had little alcohol and meat - i.e. no steak meals.
So, we´ve avoided it altogether, with no symptoms (that so many others talked about)
We´re now all done and ready to fly out of Cuzco at 7 am tomorrow morning to continue our 7 week vacation.
We have just returned from a trip to Peru. While there we went to Cusco and Machu Picchu. Hearing all the horror stories about altitude sickness I went to my own Doctor to ask for medication to help. I was prescribed Acetazolamide and started it the day before flying to Cusco taking 2, 125mg tablets daily. We arrived in Cusco expecting problems but apart from my travel partner having a bad headache the first night we had no problems. He took the cocao tea every morning we were ther as well as the tablets for 2 more days and apart from being a little winded climbing the stairs to our hotel room we had no problems. If you are worried about the altitude I would sugest seeing your own family doctor for medication before traveling to Peru.
This is very real and can be extremely dangerous if you don't take care.
Most people will get mild symptoms including breathlesness and tiredness. The first day may also give you a headache and nausea. One symptom I had which is not usual but also not uncommon was not being able to breath well when lying down. I had to sleep with a number of pillows like you do when you have a severe head cold.
There are various forms of medication available which have their different directions and side effects. You need to discuss these with your travel doctor. I chose not to take medication and managed quite well by drinking cocoa leaf tea, staying well hydrated and taking it easy.
This can be difficult when climbing ruins like Ollantaytambo but take a few steps at a time, stop, take a few photos, and keep going.
Our sea-level dwelling team had headaches & huffed & puffed, but rested. I felt like I had a brick up under my diaphragm which stayed there. Headed off for the Inca Trail. Day 1 of the trail - cruisy, day 2 - HARD - make no bones about it. Day 3 - easy & here's the key - drink LOTS of water this day. DON'T ease off - DON'T! If you're heading even higher to Titicaca the altitude will suck you dry - DRINK, DRINK- water that is! I eased off a little on Day 3 & started retaining fluid. By Day 2 on Titicaca I began to resemble a balloon & felt half dead. The noise in my lungs overnight meant I requested a Doctor on return to Puno. BP good, pulse good, blood/oxygen 71% - not good. Ventolin & litres of fluids required. Staggered about a few more days then blessedly boarded the pressurised, oxygenated steel tube - yes, the aeroplane and within minutes of take off I began to recover. Marvellous to be alive!
The altitude in Cusco can kick your butt. I struggled the first two days and finally got to a Cusco pharmacy and was prescribed Diamox. It really saved my vacation. I started feeling better within hours and while I wasn't running marathons, staircases and inclines became a minor nuisance rather than a daunting obstacle to be dreaded. If I had to do it over I would have had Diamox prescribed at home prior to leaving for Peru, tried it in a safe environment (i.e. close to my doctor and competent medical staff availability) and had it in my system several days prior to reaching cusco altitudes. I did suffer some of the side effects. Mainly this manifest itself as a tingling or needle like feeling in my feet and hands. This lasted for about ten minutes and then subsided.
This website is a good place to get information about altitude sickness and preventative measures.
If you're a flatlander, as most people in the States are, you're in for quite a surprise at 11,000'. We live at 9000' and are comfortable at Cusco's altitude as our blood is capable of giving us the necessary oxygen. Still, the body dumps a lot more liquid into the air at high altitudes and dehydration is at least as big a danger as oxygen deprivation. Acclimation has nothing to do with increased water loss, so carry clean water with you and drink frequently. If you get thirsty, you've waited too long.
Cusco is above 10k in elevation, so soroche can be a problem. Even the fittest of us do need some time to adjust, so don't be brave and try to exert yourself for the first day in Cusco. Or you'll have severe headache like I did...
It may sound stupid, but be aware that the coca leaves is the raw form that cocaine is made from.
Local people use mate de coca (coca herbal tea), and chew coca leaves to alleviate some of the problems with high altitude sickness. Word of reminder, if you will be subjected to any drug test when you arrive back to your home country, give yourself at least 72hr. after consuming any coca products, because it will show up positive, even though the amount of alkoid in those leaves are very minimal. If you have consumed any coca products for an extended duration, give yourself plenty of time off before subjecting yourself to any random drug screen.
At 11,000 ft in elevation, altitude sickness can be a real problem. Remember not to over exert yourself until you have acclimitzed. I had no problem but did notice that I was huffing and puffing for breath up even the slighest incline.
I've read alot of anecdotes about altitude sickness. Many times people mistake dehydration with altitude sickness. At altitude it is essential that low-country folk drink about a quart or 2 litres of water a day to prevent dehydration.
However, mountain sickness symptoms include headache, fatigue, stomach illness, dizziness, and sleep disturbance. Exertion aggravates the symptoms. There is a rare extreme condition called high altitude pulmonary edema (HAPE) or high altitude cerbral edema (HACE) that has been known to occur at altitudes of about 8,000 feet or 2,500 metres. These are usually associated with higher altitudes (and low atmospheric pressure).
Altitude sickness usually occurs following a rapid ascent and can usually be prevented by ascending slowly. In most of these cases, the symptoms are temporary and usually abate as altitude acclimatization occurs.
Now, although it's different with every person, you shouldn't be too scared about soroche AS LONG AS you follow the basic rules!! When you arrive to Cusco, don't do any great efforts on the first day, take it easy, walk slowly, drink your coca tea (mate de coca, which btw I absolutely loved!!), don't eat too much, nor have any heavy meals, and drink plenty of water. Also it's recommended that you take lots of lemon candy with you (sugar helps) and have one every once in a while. If you do all these things you should be fine, but if you're not, and you start feeling sick, contact a doctor so you can get soroche pills.
The most important thing is that you don't have to be scared, you have to be CAUTIOUS!!
I was in Cusco last june and I have "soroche". People told me that Coca tea will be useful but, it was worse, because coca's tea hide the problem but dont help. Finally I fall in the street and ending in a Hospital. Doctor gave me Dexametasona, aspirine and other drugs that I dont remenber., and he told me go to Macchu Pichu inmediatly, because it is lower than Cuzco. When I arrive to Machu Pichu I feel very well and went to the excursion without problem. When I returned Cuzco 4 days later I was fine and could enjoy the wonderful Cuzco without problem. The secret is (Doctor told me) to go firts to Machu Picchu and after that to Cuzco. I'm 55 age, but it is the same..nobody know who could have "soroche", but Cuzco is so beautiful that I'm going to Perú as soon as I can. (I hope you can understand my english) good luck. Diana
Just some food for thought regarding Diamox and sulfa allergies...
I arrived Cusco via a plane from Lima and the quick ascent made me very worried about altitude sickness. I didn't think that diamox would be a possibility because I have had mild to moderate reactions to sulfa based antibiotics in the past. That said, I didn't want soroche to limit my time in Peru so I did some online research regarding Diamox (the only medicine that actually accelerates acclimatization). As it turns out, people who have had reactions to sulfa based antibiotics are only slightly (4 times) more likely to have a reaction to diamox. (Apparently the chemical make up is different). Armed with this info, I asked my doctor to give me a trial dose. He reluctantly agreed after consulting a colleague. About two weeks prior to my trip I tried my luck. I started by taking 1/4 of a tablet and gradually increased it to 1/2 then to a whole (500) tablet for 3 days. I didn't have a reaction (only mild and expected side effects). I took the recommend dosage starting 2 days before my arrival to Cusco and all went well. *I am not recommending that anyone with severe sulfa allergies try this method. I just wanted to share my experience*
Be very careful when arriving by air especially into Cusco. Do not attempt to do anything that do as you will need to rest and drink nothing but water. I have seen people fainting at tourist sites who have arrived the same day and have tried to do too much.
Drink coca tea which is meant to help your body aclimitise, rest and drink lots of water. All hotels will have a doctor on call with oxygen etc if you need it. Don't wait if you do.
If you're going to do the Inca trail, wait at least 2 days in Cusco before you try it. There's plenty to see anyway.
My mother was severely affected by the altitude. We had to call the doctor who gave her oxygen and some injections to help her stop throwing up, ease the headache and replenish her oxygen levels. Her level was at 70%. Normal is 95%. Be careful!!
For medical references, search for "altitude sickness ibuprofen" etc. at
Aviat Space Environ Med. 1994 Jan;65(1):19-20.
High altitude headache: treatment with ibuprofen.
Broome JR, Stoneham MD, Beeley JM, Milledge JS, Hughes AS.
Royal Naval Medical Service, Middlesex, England.
Up to half of those who ascend rapidly to altitudes of over 3,000 m may experience symptoms of acute mountain sickness (AMS) and of these some 95% may suffer from high altitude headache. We report the first controlled trial specifically to assess an oral drug therapy for this common symptom. Subjects were 21 members of mountaineering expeditions to similar altitudes in the Bolivian Andes and the Himalayas in Nepal. The study was of a randomized, placebo-controlled, double-blind, within-patient crossover design. Ibuprofen was significantly superior to placebo both in reducing headache severity and in speed of relief (a mean difference of 94 min in time to no/minimal headache). Only 14% of subjects who initially took ibuprofen felt the need for further medication compared to 83% of those who took placebo first (p = 0.02). Of the 11 subjects completing both phases of the crossover, 8 (73%) favored ibuprofen while the remainder had no preference (p = 0.004). No attributable adverse effects occurred. The results suggest that ibuprofen is a safe and effective treatment for high altitude headache.
There are similar references for the use of asprin and acetaminophen.
We always take lots of ibuprofen when going to high altitude and it
has greatly reduced our headache and nausea!