Soroche suffering: How to prevent altitude sickness in Peru

After visiting Cusco, Peru and the rest of the Sacred Valley, I am now all too aware of the fragility of human beings. Specifically this human being.

I’m a sea-level creature — childhood through collegehood spent on the New York coast, and adulthood ever at eye-level with the Pacific Ocean. In the Sacred Valley I was ever aware of my blood and breath. We’re little more than slightly porous bags of fluids and innards, with some structural framework to keep us upright. Change our external environment to an extreme and things get ugly.

A moment of altitude sickness in Cusco, Peru photo

Todd getting walloped by a moment of altitude sickness in Cusco, Peru.

Peru’s Sacred Valley wavers from a little under to a little over 2 miles in elevation, so visiting means risking soroche, or high altitude sickness. My and Todd’s altitude sickness symptoms were mild but persistent. My strangest symptom: I was never hungry. Though a budget saver, it meant I was underwhelmed by and sometimes even indifferent to the local Peruvian food, a “meh” state of being that I find torturous. My most frustrating: I had a constant background headache that would swell and wash over me whenever I did anything slightly exerting.

We found that most advice on how to prevent or cure altitude sickness is flawed. So we ignored most of it and suffered a bit in consequence.

How to avoid altitude sickness (and why we ignored most advice)

Acclimatize by climbing slowly to altitude.

It’s a very long bus ride to the Sacred Valley and Cusco from most other regions in Peru. Over a day and night and part of another day, you adjust to the altitude as you wind ever up Peru’s deadly mountain roads in a poorly maintained bus. Even if you’re not susceptible to motion sickness, odds are the person behind you is and will be wetly hurling into, if you’re lucky, a bag, or if you’re unlucky, anywhere and everywhere.

Since it was just a little more money and 20 hours less time, we decided to fly to Cusco from Lima, so we didn’t have a chance to slowly acclimatize. I had a moment of vertigo on landing, but it passed.

Avoid physical activity for the first few days.

Cusco is a big city smooshed into a tiny Andean valley. The result: it’s all hills, with streets so steep that many sidewalks are actually staircases. In such a terrain, avoiding physical activity would mean sitting around doing little, which is the exact opposite of how we want to spend our precious vacation time. I’d rather have a slight headache than be bored. If we’d sat around, we would have missed Cusco’s secret Incan slide.

Stay hydrated.

At high altitudes, your lungs slough off moisture faster, so you need to drink more water. A lot more water. About three liters of water each a day. And yet…

Don’t carry too much weight around.

If you remember your high school science, three liters of water weighs about 6.6 pounds (3 kilograms). If you’re staying hydrated this extra weight is either in your bag or in your belly. Staying hydrated and limiting the weight you carry is advice at odds.

Eat light.

Since the altitude in Cusco made us lose our appetites, this was the one piece of advice we could easily follow.

Palta Rellena, stuffed avocado, at Pacha Papa restaurant, Cusco, Peru photo

Palta Rellena (stuffed avocado) at Pacha Papa restaurant makes a nice, light meal.

Take legal drugs.

Diamox, Acetazolamide, or other drugs that abate altitude sickness usually need to be started before you get to high altitude. We decided to buy the drugs in Lima, where they’d be cheaper than notoriously overpriced prescriptions (and the doctor co-pay) in the U.S. Though we purchased the right pills, the sea-level pharmacists told us a too-low pill popping frequency. Taking altitude sickness drugs might work if you get better medical advice than we did.

More than Diamox, coca leaves, or even sitting still, a couple of Advil doused my headache, and studies have shown that ibuprofen also calms altitude-caused nausea.

Take illegal drugs.

Drug Enforcement Agency be dammed, this was the advice we most eagerly followed. Tasty and potentially prophylactic, we consumed coca in as many ways and as often as it was offered — tea, candy, leaves and even as a cocktail mixer (perhaps the last is ill-advised). While mate de coca was a lovely excuse for a relaxing afternoon tea break, coca seemed to have little effect on our altitude sickness symptoms.

A mug of mate de coca or coca tea, Cusco, Peru photo

A mug of mate de coca.

Don’t drink alcohol.

Peru is to pisco sours as Italy is to wine. Avoiding pisco sours — or the other local adult beverage, chicha de jora, a corn beer — was something we couldn’t get our hedonistic heads around. Instead, we ordered pisco sour de coca whenever it was an option, in hopes that one ingredient would counteract the other.

It seems that rationalization should be listed as one of the symptoms of altitude sickness.

(All joking about our half-assed efforts aside, altitude sickness can be a serious health problem for some people, with fainting spells, dehydration, low blood/oxygen levels, and though rare, even more severe symptoms. If you are at a high altitude and feel ill, see a doctor.)