Leah was nervously tapping my shoulder.
The tapping had become shaking, and was increasing in intensity.
“I thought you were dying!”
Leah was yelling, scared to death that I had stopped breathing in my sleep. Apparently I was going longer and longer stretches without taking a breath, then finally gasping for air. Such was our welcome to Cusco, the city in the clouds, literally at 11,000 ft. above sea level, and prior capital of the Inca Empire. At altitudes this great, especially having just arrived from our home near sea level, the reduced oxygen levels can actually induce sleep apnea, even in young, healthy people. This was a terrifying way to learn such a unique fact, but it made us even more thankful we had chosen to spend a few relaxing days in Cusco for the very purpose of trying to acclimate to the altitude. We would soon be setting off for a week-long trek that would have us ascending an additional 5,000 ft. before the end, and we were currently struggling to walk up a couple flights of stairs.
Peruvians, particularly those who call this part of the Andes home, have developed numerous antidotes and even physiological attributes to cope with the altitude. Give a hug to a local and you will notice that, though they aren't tall, your arms won't be able to fully wrap around them. Their large, barrel chests are specifically adapted to the lower levels of oxygen that are the cause of altitude sickness, and you could bet they would crush you in a foot race with all of the extra red blood cells they have. Yet even if you weren't born and raised here, there are still things you can do to help relieve those headaches and fatigue from performing normal activities at a high altitude.
Relax for the first few days in Cusco
This is one of the smartest decisions you can make, and one you won’t regret. Even if you’re young and fit, give yourself at least 3-4 days in Cusco to simply rest, enjoy the wonderful city, and acclimate to the altitude. Cusco sits at the base of the Andes, and is still over 11,000 ft. above sea level. Taking time to acclimate is one of the smartest things you can do when you arrive here.
Try the local Coca tea or raw leaves
Coca leaves are not only legal, they are common here, so much so that our hotel not only offered a pitcher of water in the lobby, but a pitcher of coca tea. A mild stimulant, similar to caffeine, it is said to help with the symptoms of altitude sickness. If you simply can't wait for the tea to steep, there is also an ample supply of dry leaves set out for you to take and chew. Though don't be surprised if your gums go numb for a little while...
Stay away from alcohol and drugs
Alcohol is a natural depressant, while also dehydrating you at the same time, both of which increase the symptoms of altitude sickness. Cusco has some great cocktails (pisco sours!), but it is best to stay away for at least the first 24-48 hours, and then stick to a glass or two at the most.
Instead of drinking alcohol, make sure to drink a generous amount of water. Higher altitudes, increased physical exertion, and more frequent breathing all combine to more water loss. Counteract that with drinking water more than you typically would.
Eat light meals
Remember how you feel after eating a large meal during your lunch break? You have to fight nodding off in your next meeting. That’s because your body is routing all of your blood to help with digestion. Your body still reroutes your blood at higher elevations, except you already have less oxygen available, causing double the effects of altitude sickness.
Consider staying at a 5-star hotel
Many luxury hotels will actually pump extra oxygen into your room. Some even have oxygen stations! This may not exactly help you acclimate, but it will increase your comfort level.
Train before you leave home
Being in good shape, eating healthy and regularly exercising help tremendously with staving off altitude sickness. If you are physically fit, your body exerts less energy performing physically strenuous tasks, and is well equipped to handle the stresses of higher elevations as your blood will have more red blood cells ready to carry oxygen where your body needs it. Do yourself a favor and do some training prior to departing.
Consult your doctor
Prior to leaving home, schedule a meeting with your doctor to discuss your general level of fitness as well as preventive measures for altitude sickness. Consider asking for a prescription to bring along medication. Diamox is typically prescribed. While you likely won’t need it at all, it can be a good idea to carry some in case symptoms do set in.
if you do show symptoms, do not continue to climb!
Sufferers of altitude sickness often make matters worse by ignoring their symptoms and continuing onwards, further away from safety, and closer to a worse situation. Even though you spent hours planning and your hard earned money in order to make this journey, remember that there are many ways to get to Machu Picchu, and they don't all involve climbing to uneasy elevations. Machu Picchu itself sits at less than 8,000 ft. above sea level, which for the vast majority of people means easy breathing. The worst thing you could do is make matters worse by pushing on after you begin to feel symptoms. Stop, rest, and consider going back to lower elevations.
Making the journey to Machu Picchu is an unforgettable experience. Don't let a little less oxygen keep you from the trip of a lifetime! Prepare, plan ahead, and give yourself plenty of grace. Happy trekking!