Interesting feedback! Thank you! We land at the Cusco airport, then Urubamba 2 nights, Machu Picchu two nights and Cusco two nights...So I think we have the elevation acclimation right. But, when you land in Cusco, is that a big sudden jolt to the system before you decend to Urubamba? Great suggestions. Thanks again!

No its not a huge jolt. The most people usually feel is a little breathless, some not even that.

I feel my heart rate speeding up as soon as I exit the plane! I think if you expect it, and don't rush to get off and grab your luggage, it helps. Remember to walk slowly, and relax. I'd also hire a driver ahead of time, they can handle your luggage.

Even in the Sacred Valley, I recommend doing little on your arrival day, after check in have a rest, drink some coca tea or water, maybe a short walk in the afternoon. Often it takes 24 hours to sneak up on you, and you may already be tired and dehydrated from the international travel. I find slowing down the first day means I can be active the next.

Darn, I was hoping to do a little touring on my one full day in the sacred valley. Car trip with a little walking....But maybe not...

Landed in Cusco, stayed in Cusco, took it easy and I didn't feel a thing. The following day we went to various places including Pisac, I really felt it hiking there but still made it to the top

It really is impossible to generalise, as age, fitness, sex etc. seem to have little correlation with how individuals may be affected. A "car trip with a little touring" should be perfectly fine for most people.

I thought you had several days in Urubamba?

The second day you should be fine for touring. The arrival day I wouldn't plan a gung-ho agenda. Rest for a few hours, unpack and see how you feel. The hotel can call you a taxi to take you to Ollantaytambo if you want (it is only about 30 minutes plus traffic). You don't need to book a tour for that, and it's easy and safe to hire a taxi to take you bakc to Urubamba. In Ollantaytambo, you can walk around the old town section, and if you have time, go into the ruins. If you're not into climbing up to the top at Ollantaytambo there is still plenty to see at the plaza level.

Personally, I would save the Moray circles and Salineras for the second day or the return trip back to Cusco, since they are at pretty high elevation. It's worthwhile to walk down to the salt pans but you have to walk back up hill. I'm not sure if you are still allowed to walk down into the Moray circles but it's also a bit of a workout getting back out.

Thanks! Decided to not book a day tour for Urubamba and just play it by ear with the other folks I'm traveling with. I am going to get some Diamox though. Thanks again!