Living in Peru : your everyday companion

There's no way of telling how the altitude will affect you, but the best advice is to drink plenty of the local coca tea and to take it easy for the first few days.

Unfortunately, not everyone follows this advice because they're so eager to reach Peru's number one attraction - the fabled lost city of the Incas, Machu Picchu.

But those who linger discover that Cusco has managed to retain much of its historic charm despite being invaded by tourists.

Wander through the intriguing maze of cobbled streets that branch off the main square, Plaza de Armas, and all around there is evidence of the Inca empire that once controlled an area four times the size of Peru. Several alleyways have the original Inca stone walls and many of the buildings have been built on top of Inca foundations.

The cathedral on the main square is a must-see and I'm glad I dragged myself out of bed at 6am for one of the morning services. Inside are several stunning chapels decorated in silver and gold, and an impressive range of 17th-century canvasses.

While the compact city is well-suited to exploration on foot, sightseeing at this altitude must be done at a different pace. The slightest incline leaves you embarrassingly short of breath and many of the city's attractions are at the top of dauntingly steep cobbled streets.

Although frustrating at first, it does at least make you slow down and appreciate your surroundings.

Catering to the hordes of visitors are the usual array of backpacker-style bars, clubs and restaurants. But if you're feeling adventurous and fancy trying some Andean cuisine, Ama-Lur restaurant does a mean roast guinea pig.

The little critter is served whole, with its legs splayed and two front teeth bared aggressively. Apparently, it tastes like chicken.

After a few days in the city, most people have acclimatised and ready to branch out a little further. Although the biggest drawcard is the mountaintop citadel of Machu Picchu, there are other important Incan ruins close by. Just 2km from the centre of Cusco, on a hill overlooking the city, are the remains of Saqsaywaman - which is pronounced, amusingly, "sexy woman".

Built in the rule of the ninth and most influential Inca king, Pachacutec, it is believed to have taken 20,000 people 30 years to build.

A little further afield are the spectacular Inca ruins at Pisac and Ollantaytambo in the Sacred Valley. Most guided tours will visit all three as part of a day-trip.

The Incas achieved an amazing amount during Pachacutec's 40-year reign, conquering large expanses of the Andes and building scores of citadels and 4000km of roads.

After hearing tales of such incredible human achievement, I'm a little embarrassed to admit that back at the hotel I had to lie down and rest after drying my hair.

Cusco is like that. If you relax you'll discover a fascinating city of immense historic importance.

It won't fail to leave you breathless, but in all the right ways.

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The correct  pronunciation is not sexy woman, but socks-aye-waa-maan

If the altitude is more than your body can handle, excellent medical clinics in Cusco can help you through.  Make sure your medical insurance covers international travel before you leave home, though.

I was in Cuzco last year in October and it was fabulous.  Even though it rain, you can still see the  beauty of Machu Pichu that made it one of the New 7 Wonders of the World.  Our taxi driver told us to keep a scarf in front of our mouth and breath though our nose so we do not inhale the cold air and drink plenty of Coca tea.  It worked like magic!! Now I understand why so many people that go to Machu Pichu say they can now die happy having seen such of Wonder

Sadly, i arrived monday night, 11:45pm or so from Bolivia, woke up 8am, showered and dressed by 9:30, breakfast completed by 11, in my bed with hot and cold sweats by 1pm, no sleep, no food, too much coca tea many bathroom visits all night, no running water after midnight, second day i was in the ER for Oxygen and Electrolight injections for 4 hours, released, then in my bed again for 3 days, BACK IN LIMA SATURDAY, FEEL LIKE A CHAMP.  But, I never did get to see the wonderful 7th wonder.  FOR MEDICAL::::  the entire cost for my 4 hour oxygen and clinic treatment was under $20.

Hi to all, Peruvian here... A while back, I got this job as a field technician for the mining industry and my duties required me to go up and down for short periods of time, visiting mining camps including some very high places like Cerro de Pasco (I believe some of the camps around this area are above 4,200 m.a.s.l.
My very first trip to Cerro was a direct trip to the hospital... pretty much as Douglas described from his experience... with oxigen and all. Later on I learned the the crutial tip for dealing with the sudden change of altitud was to keep my stomak as light as possible for the first hours of my stay... of course Coca tea was always in the menu... and a whole lime to smell at or grind my teeth in.
I hope this can help in the future.

Actually, it is better to acclimatize (the process of the body adjusting to the decreased availability of oxygen at high altitudes) to lower altitude destinations like Sacred Valley and Machu Picchu first, which are in fact 1,000 meters LOWER than Cusco, before spending time in the Incan Capital. So the best itinerary should be: Sacred Valley (spending a few days here is a must - perfect weather, moderate altitude, take your time to see the finest Incan sites: Pisac,Ollantaymbo, Maras & Moray, Chinchero), then off to Machu Picchu (overnight is ideal so you can also take your time in visiting the citadel, first thing in the morning before the crowds) and Cusco. Spend a few days in the city to explore the churches, San Blas, Qoricancha Temple and the nearby ruins. This way, you enjoy the best of the region while gradually adjusting to the altitude and avoid getting sick (soroche).   

The main cause of altitude sickness is going too high too quickly. Travelers always take this for granted. Before you travel to a high altitude destination, avoid eating too much and on the arrival day itself, eat less also to avoid altitude sickness. Your stomach can only function so much, with less oxygen. If you stay at a high altitude, rest on the first day. Limit any walking or activity. You can explore the area, but take it easy. Drink plenty of water and avoid taking alcoholic beverages. So better drink all that Pisco back in Lima! Enjoy!

November 23, 2007 my husband and I landed in Cusco in the early afternoon.  We spent the day visiting with his relatives and went to bed at about 11pm.  We ate lightly during the day and had no alcohol to drink.  At 2:00 am I woke to find him dying of a heart attack which the doctors say was caused by altitude sickness.  An autopsy revealed that his brain was very swollen and that his lungs were full of liquid.  It all happened in less than 24 hours, to a person who had visited Cusco many times, in fact had lived there in his youth.  He complained of no other symptoms other than really bad heartburn.  Please don't anyone take altitude sickness lightly.  Always keep the possiblity in the back of your mind.