bailey123

We will be visiting Cusco, Sacred Valley and Machu Picchu in March, 2023. We arrive Cusco @ 4:00 pm on 3/5. We depart Lima for the States at noon on 3/10. We are staying at the Sanctuary at Machu Picchu on 3/7. We are taking the rail to Aguas Calientes from Ollantaytambo on 3/7 and returning to Ollantaytambo on 3/8. We know luggage is very limited on the train and plan on leaving most luggage at a hotel while traveling to and from Machu Picchu. Our questions relate to the logistics of where to stay and how to travel on the nights of 3/5, 6, 8 and 9.
1. Should we go straight from Cusco airport to Sacred Valley and spend nights of 3/5 and 3/6 there returning to Cusco via Ollantaytambo on 3/8 or would it be best to spend the night of 3/5 in Cusco and go to Sacred Valley the day of 3/6, spend the night of 3/6 in Sacred Valley before Machu Picchu and the night of 3/8 after Machu Picchu, returning to Cusco on 3/9?
2. Should we spend the night of 3/9 in Cusco catching a 7:30 am flight on 3/10 to Lima arriving 3 hours before our flight to the States or should we not rely on Latam Air to get us to our connecting flight in Lima on time therefore plan to fly to Lima on 3/9 to be safe?

jeterray

I plan on doing the same trip in March. My trip has been cancelled 3 times, mostly because of covid. I read your options, and can only respond based upon what others have told me. First, don't rush your intro to the altitude. We will fly from the US to Lima, then to Cusco on the same day. We will travel directly to our hotel in Urubamba, where we will rest for what's left in the day. Since the Sacred Valley is much lower, we will do a local half day tour the next day. More rest. The next day we plan to tour MP, returning to the hotel for a couple of days. We may arrange another Sacred Valley tour, but mostly plan on visiting some local cities. Then we will finally transfer to Cusco, which is the highest altitude, but a charming city. While there, we plan on a local tour. Some great sites in Cusco. Spend 2 nights in Cusco, before leaving for Santiago. I don't know much about Latam airline, but on our previous trips and this trip, they seem a bit unreliable. However, it sounds like your 3 hour time will be ok.

karrma

How exciting. We have been thinking of this trip for years now, and finally going in May of this year. Altitude is the big factor for us in planning our stay. especially as we live at sea level. We know how we felt flying in to 11,000 feet, or 3500 meters in the past: severe headache for my husband, and a cough and severe fatigue for a few days for me, and not able to do much of anything for a couple of days but rest. We've also flown in to 8000 ft elevation, or 2500 meters. Fatigued, mild headaches, but better the next day. We are definitely planning on staying in the Sacred Valley and seeing it first. We are heading up to Cusco after 2 nights down there, in order to acclimatize for our Inca trail hike, and touch base with our tour guides. But if we were not hiking, we would do Sacred Valley, then Machu Picchu, then Cusco last when we were feeling the best. Sounds ike a great trip.

jeterray

Karma- Considering your history, I would consider getting a prescription for Diamox. I've never taken it, but others seem to think it works well for altitude sickness. You may be able to get it at a pharmacy in Cusco without a prescription. I understand altitude sickness is not as common in older people like me. Best of luck.

crellston

Hi Bailey,

I trust you are aware it will still be the rainy season in the Andes in March? Not the best time.

As far as acclimatisation is concerned, it is always best to ascend as gradually as possible. In your case this means going straight to the sacred valley from Cusco airport. A few days there at an altitude of 2800 m asl will enable you to begin the acclimatisation process. Machu Picchu and Agauas Calientes are at a slightly lower altitude of c 2400m so you would have few issues there. By the time you get back to Cusco you should be pretty well acclimatised and able to cope with the higher altitude there of 3400 m.

Unless you particularly want to hike up on elf the mountains at MP I would suggest just doing MP as a day trip from Ollantaytambo. An early train there and alate train back would allow sufficient time for most people.
Make sure to allow time to visit the sights along the Sacred Valley between Ollantaytambo and Cusco. We often use taxidatum.com to take a taxi tour between the two stopping of at Chinchero, Moray and Maras along the way . Some details and photos on our blog @ https://accidentalnomads.com/category/peru/

As far as flights are concerned, I would definitely want to stay the night in Lima before your flight home . Cusco is a high altitude airport and delays and cancellations are not unknown , particularly at that time of year.

karma - your symptoms are quite common for those going to altitude. I had pretty much the same my first time. Indeed probably worse. Since then I have been to altitude many times with fewer problems. My wife has virtually no issues! Acetazolamide (aka Diamox ) may alleviate the symptoms but, given your previous issues, you should consult your GP to make sure you are ok to take it. It is NOT a substitute for proper acclimatisation. Further info here @ https://www.nhs.uk/conditions/altitude-sickness/

NB - most responsible Inca Trek operators will insist on a min of 2 nights in Cusco before your trek.

karrma

jeterray I feel I have to reply here as many people read this info over many years. Diamox or acetazolamide should be given under a doctors orders, and you need to know which meds cannot be used with it, such as Bisthmus or peptobismol. Also some people with sulfa allergies may not be able to take it. I recommend people trying the acetazolamide prior to using it in the middle of an expensive and remote trip to see if it works for them. Our group of 4 already know how they respond to this medication and 3 will take it and one not. We also plan on 4 days at 7000 ft elevation in Arequipa, then the 9000 ft at Sacred Valley for 3 days, and then Cusco at 11,000 ft for 2 days prior to our Inca Trail trek. This is our first trip after retirement, and we purposely chose it as our first trip then because 1. we still have the knees (sorta) and youth (relatively) to hike and 2. We are old enough to have the luxury of time, to acclimatize. This may be our only trip to Peru in our lifetime so we don't want to experiment with new meds there.

mlgb

Correct, you should not take Diamox with any salicylates that includes aspirin and Pepto! I pretty much agree with all that crellston has said.

I do not suffer as much as others from altitude sickness, other than normal breathlessness, feeling a bit drowsy and perhaps a mild headache on the first day. Never have spent my first night in the Sacred Valley at as high an altitude as Cusco, but Ollantaytambo or Pisac instead. It's often where you are overnight that gets you more so than what you do during the day.

I have never used Diamox, just gradual increase in altitude, taking it easy for the first few days (no boozing it up, eating lightly especially at night, avoiding dehydration and an Advil or two if I start to get a headache.) Book a transfer in order to have someone waiting for you at the airport to handle your luggage, walk slowly when first arriving off the plane.

Some people experience nausea and don't sleep well. If that happens on your first few nights, ask your hotel if they can supply oxygen. The initial treatment for people who don't cope well on the Inca Trail is to send them down to Ollantaytambo.

By the way Lake Titicaca and Puno are higher than Cusco so if you are susceptible then I might not go there (or to Bolivia).