Slow ascent...help!

Flew from Lima @ sea level to Cuzco. I was definitely expecting the worst, but it wasn't so bad after all. I just took it easy for the first 2 days, took some naps, and indulged in the coca tea. Definitely helped with the headaches.

lots to see and do around Puno & Arequipa

I flew from Canada to Quito, which is a little lower than Cuzco but still quite high. I didn't have any problem. Just take it easy in Cuzco the first few days. Drink a lot a water and avoid alcohol. You'll probably be okay. If you get sick, then think about going back down. Thousands of people go to Cuzco from Lima and most are fine.

By the way Puno is higher than Cuzco.

We flew from the jungle to Cuzco. We took diamox, definitely helped.

In 1997-98 I ascended slowly and still felt dizzy after months of being on high altitude (trouble reading, out of breath after walk up steep hill, dizzy).
In 2006 I flew from Puerto Maldonado to Cusco and had only a little bit of a headache for two days, prickly eyes, very tired but after 3 days I was fine. I slept a lot and drank a lot of coca tea and bottled water.

So you never really know how it's going to affect you. Do not plan any active things for the first few days, drink lots of coca tea, water and no alcohol, sleep a lot', this should help.

I'm not a fan of masking symptoms with medication. You need the symptoms; they tell you whether you can still cope, or not.

My friend and I both experienced totally different symptoms - I was fine aside from the unexpected, periodic breathlessness, but she had frequent nosebleeds, numbness in limbs, constant headaches, nausea. She used the diamox and it helped her immensely - at least she was able to function. This was after 3 weeks at high altitudes too. Some people just don't adjust well I guess!

i guess i'd rather take diamox instead of potentially suffer for three days or more on my precious, pricey trip to peru, you know?

#6 and #7 I don't think you realise the dangers of altitude sickness. I can be fatal.

"Altitude illness is the result of traveling to a higher altitude faster than the body can adapt to that new altitude. Fluid leakage from blood vessels appears to be the main cause of symptoms. Altitude illness is divided into three syndromes: acute mountain sickness (AMS), high-altitude cerebral edema (HACE), and high-altitude pulmonary edema (HAPE). AMS is the most common form of altitude illness and, while it can occur at altitudes as low as 1,219-1,829m (4,000-6,000ft), most often it occurs in abrupt ascents to >2,743m (>9,000ft). The symptoms resemble those of an alcohol hangover: headache, fatigue, loss of appetite, nausea, and, occasionally, vomiting. The onset of AMS is delayed, usually beginning 6-12 hours after arrival at a higher altitude, but occasionally 24 hours after ascent.

HACE is considered a severe progression of AMS. In addition to the AMS symptoms, lethargy becomes profound, confusion can manifest, and ataxia will be demonstrated during the tandem gait test. A traveler who fails the tandem gait test has HACE by definition, and immediate descent is mandatory.

HAPE can occur by itself or in conjunction with HACE. The initial symptoms are increased breathlessness with exertion, and eventually increased breathlessness at rest. The diagnosis can usually be made when breathlessness fails to resolve after several minutes of rest. At this point, it is critical to descend to a lower altitude. HAPE can be more rapidly fatal than HACE. (Source: CDC website)"

Personally I'd rather not mask the symptoms and risk permanent damage or death...

P.S. I would be VERY worried if I had nosebleeds, numbness in the legs, nausea etc. after 3 weeks! No way would I stay at high altitude if that happened to me!