This low-lander from NYC had her first experience with altitude this year in Quito. YIKES! That first morning was awful, the second wasn't much better, and though the "morning sickness" subsided, the insomnia never did. Any advice on handling it next time, as Denali (not to mention Machu Pichu) still are on my wish list? Just to keep things interesting, I'm allergic to both caffeine AND sulfa drugs, the base of the prescription drug taken to ward off altitude sickness. Any of you mountain-dwellers have any advice? Does a gradual ascent help? Any herbal remedies? Quito hits only the 9200-foot mark, so I really think I'd need help at even higher altitudes. Thanks!

Just a suggestion: talk with a knowledgeable doctor. try the state dept. in DC and the CDC in Atlanta. Not something to fool around with. Are you sure you're suited to spend time at great heights? I ended up in an ER in Denver after 13 days there - altitude sickness. Can you take a temporary oxygen supply for use in extreem cases? Good luck.

If you went directly to Quito from NYC, you took a big, big jump. My physician friend who has a personal interest in outdoor medicine tells me that even very healthy people feel the altitude starting at about 7,000 feet if they go up quickly from sea level. Anyone with oxygen absorption problems needs to exercise great care and caution.
In years past, going to Colorado from where I live at 800 feet above sea level was something of a problem. Even though we drove out, the transisition from Colorado Springs at 6,000 feet to Rocky Mountain National Park at 9,000 feet was difficult.

The years that I went out to climb 14,000 foot peaks are very memorable.
I trained hard for months, even had a resting pulse rate less than 50. But even so, we tried to sneak up on the terrain higher than 9,000 feet by gradually increasing our altitude. I managed to get to the top of some of the peaks, but not without considerable labored breathing. One day we were going over Half Moon Pass on our way to East Cross Creek and the Mount of the Holy Cross. I was carrying about 36 pounds. The top of the pass was at 11,600 feet. Near the top, I sat down to get my energy back. I group of youngsters, about 17 to 19, came by. One snooty little girl, puffing on a joint, laughed at me and said "Cheer up grandpa, you'll make it." Why didn't I throw a rock at her? If I had had that kind of energy I would not have been recuperating in the first place. Then I dozed off. I began to dream that the waves at the seashore were washing over me. I awoke to see two huge red tongues licking me in the face. Two big female golden retrievers were giving me mouth to face resusitation. I guess I was a salt lick or something.
Although we got to the top, I think in retrospect that I needed a full 14 days at an altitude of more than 9,000 feet to make a satisfactory adjustment. As it was I had only 9 days. So I was just becoming acclimated when a stretch of crystal clear days told us we had better go up "now" or run the risk of storms and rain.
So, assuming you are basically healthy, I think you need to do some aerobic exercise, strengthen your legs, and approach it gradually. I know of no other way to make the change in altitude without headaches, breathlessness, and a sick at the stomach feeling. It is a real problem.
People who have less than perfect oxygen absorption rates are going to need medical advice.
Good luck.

Rand, the only issue you'll have with Denali will be if you climb it. The base of the mountain, and all the tourist facilities in the national park, are at quite low altitude, a few hundred to a thousand feet, maybe. (That makes the mountain, I was told, the tallest mountain in the world, measured in actual height above the surroundings.) If you DO plan to climb it, better start training now, and make your booking for a few years out.

Having been to Machu Picchu about 1986..I can tell you the remedy..and it does work.... coco tea...they gave it to all the tourists in Cuzco when we got off the plane from Lima and then told us to rest for a few hours. Parrot Pop had the headache on the train...one cup of tea (it's sold on the tourist train).. and he was hanging out the window taking pictures.. If you have to ask.. coco tea is made with coca leaves of the plant used to make cocaine.. The native indians give the leaves to their children to chew to placate them..it speeds up the heart rate.. and those dummies in this US who use cocaine..don't realize they can die from a massive heart attack..but that's another story..

Thanks to all--and especially to Bob and John--for the speedy advice. Of course, given my allergy to caffeine I can't go anywhere near coca leaf tea, but the other info was exactly what I needed and very reassuring. I didn't plan to CLIMB Denali, anyway--just wanted to see it! Thanks again--