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Dealing with Altitude Sickness in Peru

By Laine Hodges

You’ve booked your plane ticket to Peru. You’re ready to embrace the land of the llama, the Incas, Machu Picchu, delicious food and rich historical and cultural treasures. You’ve spent hours consulting with Google for tips and tricks and TripAdvisor pages. Your hiking boots and passport are sitting in your room, just waiting excitedly to explore new horizons.

You know all you need to know, you’re ready. Until, that inevitable and faithful day when you learn that the beautiful Andes mountains awaiting you are nestled a breath-shortening 2,400-3,400 meters (7,874-11,154 feet) above the nice comfortable sea-level you’ve been living at your entire life. Altitude sickness, mountain sickness, or soroche as the Peruvians say, can occur at heights of at least 2,400 meters (7,874 feet). It happens because there is a lower oxygen pressure at higher altitudes. Your body redistributes blood by giving more to the vital organs that need oxygen to survive: the lungs, heart, and brain.

Just like with almost anything, the body reacts differently in different people. You might be dealing with altitude sickness if after reaching the highlands of Peru you experience:

  • Headaches or Migraines
  • Nausea
  • Vomiting
  • Dizziness
  • Fatigue
  • Shortness of breath
  • Loss of appetite

Symptoms are usually fairly mild and feel a bit like a bad hangover. The best thing you can do for yourself is to be aware of the symptoms and treatments and to take it easy during your first few days at high altitude. There is no real way to know how your body will react to being at new heights. We do know that neither health, fitness level, nor age have anything to do with how likely you are to experience symptoms.

After living in Cusco for 3 months, I will share my experiences before, during, and after adjusting to life in the Andes. (*You should always consult advise from a licensed physician, which I am not. I highly recommend you schedule a visit with your doctor to discuss your travel plans and discuss any medication or vaccinations they might recommend to you.

About a week or two before my flight, I visited my doctor to make sure I was healthy enough for life in Peru and to discuss my options for altitude sickness medicine. I asked her about Diamox (acetazolamide), which she prescribed. Diamox is used to help decrease the symptoms of altitude sickness. I took this 2 days before and 2 days after landing in Cusco, and the only symptoms I ever really felt were shortness of breath and fatigue. There are, of course, more serious cases of altitude sickness. HAPE and HACE are extreme and sometimes fatal cases. These cases happen when there is excess fluid in the lungs or in the brain. Symptoms of extreme altitude sickness can be:

  • Fever
  • Difficulty breathing
  • Confusion
  • Uncharacteristic behaviors like excessive violence or emotion

Just to be extra safe, my doctor prescribed Nifedipine, a medicine that is also used to treat high blood pressure. She explained that this medicine thins the blood so that oxygen can flow more easily and help you breathe in extreme altitude sickness as well as prevent fluid buildup in the brain or lungs. Thankfully I never had to even think about using this, but it was nice to have the added security in case. If you have the chance to, I highly recommend staying with a host family during your first few days in Cusco. This will not only help you practice your Spanish and assimilate into the local culture, it will take a huge weight off your shoulders. When I first arrived in Peru, the air felt very thin to me and I found myself having shortness of breath as soon as I stepped foot of the plane. Having a kind face pick me up from the airport, invite me into their home, provide a small meal, and a warm bed was a godsend during my first day. My host mom had a cup of Coca tea waiting for me as soon as I arrived, which also seemed to help with the shortness of breath and fatigue. This is a go-to aid for altitude sickness in Peru, although I’m not sure why exactly. Keep in mind that enough Coca tea in your system can show up as cocaine in a drug test.

In my first few weeks, I felt shortness of breath when walking long distances, and had less energy than normal. I went to bed much earlier than usual, and this seemed to help. After about 6 weeks I began to feel completely adjusted and ready to exercise and go on hikes. Now I barely notice the altitude, except when I go up stairs or hills. The no-brainer treatments for altitude sickness are some of the most tried and true. Drinking plenty of water and staying hydrated will help, as well as taking it easy. It’s best not to walk around too much during your first 24 hours. If you do feel mild sympotoms there are many medicines in just about every pharmacy here. Just look for the signs with sick llamas on them. If you start showing severe symptoms, and/or your symptoms don’t resolve themselves within a few days, it’s a good idea to descend to a lower altitude. Traveling to the Sacred Valley is an easy and nice way to do this, it’s very beautiful and relaxing and 500 meters (1,640 feet) below Cusco, so your body will thank you. You can also go to one of the nicer hotels or hospitals and receive oxygen if you need.

If you are planning a trip to Machu Picchu or a hike nearby Cuzco, consider hiring a local guide, you might want to wait until the end of trip when you will be more acclimatized. If you are looking for a reliable guiding agency to help with the details, a great place to start is “Cuzco Native”.