Altitude sickness in Cusco!

If you’re heading to Cusco, you probably know that it’s at high altitude – 11,200 feet, or 3,400 m. Not Mt. Everest-type high, but enough that perhaps 50% of people will feel some altitude sickness symptoms if they arrive in Cusco without spending a few days (or more) at intermediate altitudes to let their bodies acclimatize!

cusco is beautiful - but watch out for altitude sickness!
Cusco is beautiful – just watch out for altitude sickness!

So what is altitude sickness? In Cusco, for most people, it’s just a headache — maybe a nasty one — that might last for a couple of days. For the unlucky, perhaps some stomach issues as well. Of course altitude sickness can progress into life-threatening HACE or HAPE, but at Cusco’s not-that-extreme elevation this is quite unlikely for most people.

The thing about altitude sickness is that it’s unpredictable – as I found out. And it can stop you in your tracks. A couple of years ago I’d been in La Paz, Bolivia, which is even higher than Cusco – the airport is over 14,000 ft! Altitude sickness? Nope. I was exploring the city and its steep hills on the first day after flying in from sea level without much trouble. So why would I worry about the altitude in Cusco?

But, sadly for me, my luck was less good in Peru than in Bolivia. After an awesome (and tasty) few days in Lima, we took a short, cheap (1 hour, ~$60) LATAM flight to Cusco. A vastly preferable option, in our opinion, to the 18+ hour bus ride from Lima, which isn’t even that much cheaper! Beautiful views of the mountains, and if you pay attention during the airplane’s descent you might notice that the airplane isn’t re-pressurizing – that’s because the air on the ground in Cusco is actually thinner than the air in the cabin at cruise altitude!

Stepping off the plane, we slowly trudged along with the other oxygen-deprived tourists (many of them inexplicably in full hiking gear) up the ramp into the airport. If you’re from sea level and think you’re in shape, walking up stairs at altitude might just chop your ego down a bit! We were feeling totally okay at this point – I’d been a bit sick in Lima for the past couple days, but was improving – until now, at least.

But once we got to the hostel (the highly recommended El Tuco), I began my descent into a somewhat embarrassing state of full-blown incapacitation. Maybe my previous illness combined with the altitude to cause havoc. Who knows. Whatever it was, 12 hours after arriving in Cusco I could barely sit up and felt like someone was trying to hammer a nail into my head. I stayed in this position for approximately 2 days, not eating and popping Diamonx and ibuprofen to no avail. But my time was running out – we had to go to Machu Picchu!

So after some prodding and convincing, I dragged myself out of bed and into an Uber at the fine hour of 5am (what!?) to head to the Traveler’s Medical Clinic. Best decision I’d made in days! The very nice and English-speaking doctor took one look at me and surely knew in about 5 seconds that they had their first mountain-sick tourist of the day. My blood oxygen was 79%, far from the 95%+ that it should be. So, on went an oxygen mask, and incredibly, within a minute my symptoms mostly vanished.

We told the doctor that we were on a tight schedule – unless I was dying, we needed to be out of there in an hour so we could get to our train to Machu Picchu! I guess they’d seen this sorry situation before, because they were prepared. The doctor brought me a tiny portable oxygen tank that I could breathe out of whenever I felt like it, and sent us off. Amazingly, the final bill for about 2 hours in the clean, modern hospital was only $170! Not even enough to meet the deducible on my travel insurance, just like the last time one of us was hospitalized in South America.

Aguas Calientes, the small town near Machu Picchu, is much lower than Cusco – only 6,600 feet, or 2,000 m. Once we arrived, my symptoms were basically gone, and I was good to go.

But not to dissuade you from visiting Cusco! It’s a great city! Whether you fall ill or fare just fine, while you’re in Cusco don’t miss the awesome pizzas at La Pizza Carlo! I may have felt like death and was barely able to eat when we went here, but I had to force myself as the pizza was just too tasty.

Yummmmmmmm

Hopefully you’ll have better luck than me! Probably you will, especially if you follow a few guidelines to preventing altitude sickness:

  1. Take Diamox before you travel to Cusco. You’ll need a prescription for this if you’re coming from the US or Europe, but it is one of the only medications that can speed acclimatization to the thinner air at high altitude. You start taking it a couple days before climbing to altitude, and continue for a few days once you arrive. If you’re flying to Cusco from Lima — giving yourself zero time to acclimatize — Diamox might be a good idea to reduce the chances of becoming ill!
  2. Travel to Aguas Calientes and Machu Picchu before spending time in Cusco! This is probably what I would do if I re-did our trip. Aguas is at about 6,600 feet, where few people will have altitude sickness. Machu Picchu is closer to 8,000 feet, which is still not likely to cause problems for many. Spending a couple days at these intermediate altitudes will give your body some time to acclimatize before ascending to 11,000 ft!
  3. Chew coca leaves if you want – they might have some effect, although they are surely not the magical cure for altitude sickness that many people seem to think they are. They’re even free to take at the Cusco airport!

Did you feel a little ill in Cusco? Tell us your story in the comments!

You might also be interested in:
How to Get to Machu Picchu
What to Bring to Machu Picchu (and what to leave behind!)
Lima, Peru Food Guide (for vegetarians and everyone else!)
Lima, Peru: Is It Safe?
Daily Budget for Lima, Peru
How to Get a SIM Card in Lima, Peru

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