Altitude Sickness On reaching heights above 3000m, heart pounding and shortness of breath are a normal response to the lack of oxygen in the air. However, for some visitors these symptoms can deteriorate into a conditions known as Soroche (or acute mountain sickness) when you can start to experience headaches, loss of appetite, extreme tiredness, sleeplessness and often nausea. Symptoms usually develop within the first day or two at altitude. To prevent Soroche, try to take things easy as soon as you arrive. Once settled in your hotel room have a lie down for a while and drink plenty of fluids. Don't plan any strenuous treks until you've acclimatized for a few days. Avoid alcohol, cigarettes and heavy food. Drinking mate de coca (an infusion of coca leaves - and perfectly legal in Peru) may help. If symptoms become more severe and prolonged it is best to quickly seek medical attention and make arrangements to descend to a lower altitude. On recovery one can re-ascend slowly or in stages. The drug Diamox is often used by many visitors to speed the acclimatization process and counter the symptons of Soroche.
Cusco is located 3400m above sea level so it is important that you have a healthy respect for the altitude. If arriving from sea-level (Lima) try to spend at least 2 days in Cusco prior to starting the Salkanaty (2 days is recommended). This period will allow you to acclimatize and also give you time to enjoy the city of Cusco, the nearby Inca ruins of Sacsayhuaman, Q'enko, Pucacpucara and Tambomachay, as well as taking a day trip out to the Sacred Valley of the Incas to visit the traditional Quechua market at Pisac and the stunning Inca village and ruins at Ollantaytambo.
What to bring
The key to packing for a trip to Peru is to pack for a variety of conditions while keeping the weight to a minimum. Easier said than done when you have to deal with the intense heat of the equatorial sun and the cold mountain nights spent camping on the Inca Trail. The best way to deal with these extremes is to dress using several layers rather than one thick jumper. If you forget something, don't despair since most things can be bought in most Peruvian cities frequently visited by tourists including excellent and cheap alpaca jumpers.
Suggested Inca Trail packing list: