Lake Titicaca and Puno

Puno is higher than Cusco. Cusco is higher than the Sacred Valley and Machu Picchu. We started in the Sacred Valley and didn't suffer much from the altitude there (slight headache the first day). Then we went to MP with no problems. In Cusco (11,500 feet), even though we'd adapted a bit in the Sacred Valley and MP, we felt the altitude. Not enough to slow us down, but we huffed and puffed going up stairs or walking uphill. In Puno (12,500 feet - 3800 meters) we definitely felt the altitude. It was much more noticeable there. My daughter and I both felt light-headed that first evening.
Regarding electricity, yes, most hotels have outlets in the room. If you're from the US, you'll need an adaptor. They're on the same currency as Europe (and use the same kind of plugs).
As for medical care, there are hospitals in both Cusco and Puno. I don't know any details, though.
Good luck!
Karen

My recent visit to Peru (June-2007) and experience w/ altitude was similar to the above poster.

After flying into Lima and spending our first day there, we headed on to the Sacred Valley and Machu Picchu. Walked slow & easy and was okay. Next we headed up to Cusco and did feel the difference however no dramatic symptoms.

Up to Puno/Lake Titicaca . . . encountered some difficulty sleeping that first night. Woke up early and went down to the front desk and asked for oxygen (many of the hotels have it available). She set me up in the lobby and I sat there for 15 minutes w/ oxygen. Felt much better and was good to go for our full day outing on Lake Titicaca/Uros Islands/Taquile.

From reading other posts on this forum as well as on the Lonely Planet (Thorntree message board), and consulting with my physician . . . . age, fitness & health factors do NOT correlate with 'soroche' (altitude sickness). Essentially some folks are impacted by the altitude while others may not be, and there's no way of knowing beforehand which category you may fall into.

FYI -- I have asthma and other than that 1st night/day in Puno, didn't have any issues.

medical care in peru is third world. given the breathing problems, if you do this trip you shuld get a med evac policy for 100K thru someone like medjet assist. I needed attention last easter after med evac from machu picchu to cusco, a 5hour train and ambulance trip contingent on getting scarce train tickets the same day at mp and the clinic which was the best clinic in cusco was not up to the standards of a middling us hospital. We were in cusco, then sacred valley, than colca canyo-15K feet, then cusco and then lacke titicacaa 16K feet and did not really notice altitude problems--but be prepared. The more distant you are from Cusco or Lima, the lesser the level of immediate care you can expect to obtain. For Cusco, I recommend you stay at the Hotel Libertador-top level and you could expect to get a good doctor on call if needed because of that. Exotic travel carries risks.

Our travel clinic recommended the prescription drug Diamox for our trip to Peru. Other than noticing the air was thin we didn't have any particular problems with the high altitude, or side effects. We went to Puno last so we may have been more acclimated.

In our small group, we had a couple of people sick with the altitude sickness in Cusco. One of them had to be hospitalzed for a day. All of them were happy with the quality of the medical care, and all of them were able to continue the journey to even higher altitudes to lake Titicaca.

Cusco's medical facilities are limited:head back to lima for serious procedures.
Clinica Panamericana TEl# 270000
24 hour medical care specially for tourist. Your hotel should be able to assist you. Got the info from the lonely planet highly recommend you purchase the bk.
Electricity is available but you should have the electical converter.
I visited Cusco first and used it as a base to go to MP and Sacred valley. Then I went to Puno and Lake Titicaca. No problems. You just need to acclimatize yourselves slowly. Drink plenty of water and mate of coca and mate of manzenia.

I broke my forearm to wrist bone after a fall at Machu Picchu when a door broke off that I had been using to support myself as I stood up. I somersaulted backwards down some stone steps and then rolled over a ledge almost 5' high onto the road. I was lucky that's all that broke. I was 57 at the time.

I was taken down the road to a doctor in the small town (clinic was open) and I had a makeshift sling made and he came up the hill in the morning to give me a shot, total cost of everything was $34. This was back in 1997. Then the next day I took the train back to Cusco as planned and a personal guide from Hada Agency who picked us up took me to what was considered a good hospital and they put my bone back in place. Very friendly folks.
The doctors put my arm in a cast and gave me authorization to go on with the trip. That made me very happy!

Had a couple of angels from the town who just made sure all was okay.

This is described along with other aspects of the trip to the highlands in my Peru PhotoDiary at
- http://www.andrys.com/indox.html

Cusco is a good stop for getting used to the heights. Even then coca leaves/tea in our room were very welcome and helped. We stopped there initially before going onto Colca Canyon, up high, which can really tax the head. We were in a private car, which helped (instead of a bus).

Taquile with its 500 steps to the top was no small undertaking but I did get up there. My travel partner had heavy cameras and stayed down a bit.

Excedrin was all I needed when feeling headachy from the height. You really need at least one night in a place like Cusco to get used to the heights.

I loved Lake Titicaca. Did almost fall through the straw ground into the lake though. It's all covered in my photodiary. There's also a wonderful article written by Miranda France, one which I wish I'd read before visiting the Uros so I'd have had a better idea of what their lives are like. Tourists too easily just complain about touristy atmospheres.

Caution. The motor boat we were on from Puno to Taquile Island took almost 4 hours to get there and there's no restroom on it. Bring water for the heat shining down at you at almost 13,000 ft above sea level though. (We didn't.)

Hmmm, reading more, from Karen, I sense that there must have been a restroom on our 4-hr motorboat ride to Taquile Island from Puno, via the Uros as first stop but we didn't see it.

I do know there was sure a dash to the one restroom on the island and a mad dash out of there too

( Purely-photo report version at http://www.pbase.com/andrys/peru )

- Andrys

Thanks everyone for the med info. I hope we have no problems but it's nice to know what to do just in case. So thanks.

I'm also concerned about high altitude problems. Would having sinus problems make it a lot worse?

Any side effects from the altitude medicine?

Is oxygen available in most places? How much do they charge you? Any portable ones?

Thanks!

Now, much later, I'm still curious. We couldn't see a restroom on our motorboat to Lake Taquile, holding about 22 people. It was a 4-hour trip. Nowadays, it's 3 hours, people say.

Has anyone been on one and did it have a restroom? We never saw it and wondered how some managed if there was a problem within the 4 hours. They say bring a lot of water always, because of direct sunlight, and at 13,000 ft at that, very hot mid-day when we were there, in May that year (some time ago but people say Peru travel sites haven't changed much.

- Andrys
Peru Photodiary: http://andrys.com
Larger photos only: http://www.pbase.com/andrys