ALTITUDE SICKNESS (SOROCHE)

Prepare yourself for travelling to high elevations
Basic Concepts

At high elevations, the amount of oxygen in the atmosphere, percentage-wise, is the same as at sea level. But when barometric pressures diminish, so does the pressure of oxygen present in tissues (thereby causing Hypoxia). This physical phenomenon explains why the quantity of oxygen molecules per breath inhaled is lower at higher elevations than it is at sea level. Faced with this type of challenge, individuals evolve acclimatization procedures that engage most of their systems: respiratory, blood & circulatory, renal, and nervous. The evolved physiological mechanisms tend to normalize the amount of oxygen in their tissues.

peru adventuresFor there to be normal activity, an adequate supply of oxygen must first be secured. Peripheral chemoreceptors, or nerve endings, serve as sensors of the amount of oxygen that enters into the bloodstream. Nerve endings swiftly react to changes of oxygen pressure in arterial blood, and inform the nervous centers that control breathing and cardiac cycles. This information brings about a progressive increase in pulmonary ventilation, which can be observed during the first few days at high elevations (3 to 5 days). This process is called “Ventilatory Acclimatization.” Concentrations of Nor-adrenaline and Adrenaline in the blood increase. This brings about a rise in cardiac frequency, regardless of whether the individual is in repose or working out.

If the exposure to high altitudes is long enough, the first adaptation strategies - respiratory and cardiovascular adjustments - give way to less strenuous mechanisms - mainly an increased production of red blood cells - that improve the transport of oxygen from the environment into the tissues. Adaptive reactions to high elevations may cause certain disorders, however, either by the over-functioning or under-functioning of the mechanisms involved in the acclimatization to high elevations.

These disorders can and should be avoided, by following the recommendations set forth in the second part of this brochure. The time and quality of the acclimatization process varies from person to person. It has nothing to do with previous physical training, or the number of times a person has been in high elevations. If you have to travel to elevations higher than 3,500 meters (11,480 feet) above sea level and have to stay there, it’s very important to prevent the onset of two distinctive pathologies produced by high elevations: pulmonary edema or brain edema.

These pathologies can manifest themselves in people intolerant to high elevations - mainly the first week - but can be avoided by being aware of what their initial symptoms are, and stopping them from fully developing.

Inca Trail - ALTITUDE SICKNESS (SOROCHE)

Medication

  • Acetazolamide (NC.Diamox)
    1 tablet every 12 hours, 24 hours before the trip.
    Half a tablet every 12 hours until the third day in high elevations
  • Paracetamol
    1 tablet every 8 hours, in case of headache.
  • Ibuprofen
    1 400 mg pill before the trip and in case of headaches that don’t lessen with Paracetamol, take one Ibuprofen every 12 hours after meals (it may produce stomach ache).
    In case of continued altitude sickness, seek medical help. You must receive oxygen or be promptly removed to a lower elevation.

medicamentos para el sorochePart II: General recommendations for people traveling to high elevations
The day before your travel:

Sleep well.

Don’t eat foods that are hard to digest.

Don’t drink alcoholic beverages.

 

 

The day you arrive:

  • Refrain from strenuous physical activity.
  • Drink at least one liter of water a day.
  • Eat small quantities of food, preferably carbohydrates.
    Wear appropriate clothing to stay warm.
  • Complete rest is recommended for people with altitude sickness scores higher than six points (see below).
  • Don’t take sleeping pills or tranquilizers.

The second to the fourth day after your arrival

  • Refrain from strenuous physical activity.
  • Drink plenty of liquids, commensurate to your physical activity.
  • Don’t eat foods that are hard to digest.
  • Wear appropriate clothing to stay warm.
  • Don’t take sleeping pills or tranquilizers.

During your first four days in high elevations refrain from any strenuous physical activity.

agua cieloIf you feel like you are choking or are breathing noisily, your lips and/or ears turn purple or blue (cyanosis), you have a persistent cough and your sputum is foamy or pinkish in color, you may be developing a serious pulmonary edema caused by the high altitude. If that is the case, immediately seek medical help.

You need oxygen or to be promptly removed to lower elevations.
If you feel fatigue or acute weakness, feel nauseous (sometimes vomiting explosively), and have a severe headache that pain relievers won’t ease, you are probably developing a brain edema. If you don’t have a headache, but feel extremely tired and have difficulty keeping your balance, you may also be developing a brain edema. Immediately seek medical help. You need oxygen or to be promptly removed to lower elevations.
Symptoms and Indications of Altitude Sickness (soroche).

Inca Trail - ALTITUDE SICKNESS (SOROCHE)

Source: Pontificia Universidad Catolica del Perú

  Headache
1 point
  Nausea or lack of appetite
1 point
  Insomnia or difficulty sleeping
1 point
  Dizziness–vertigo
1 point
  Headache that pain relievers won’t ease
2 points
  Vomiting
2 points
  Difficulty breathing when lying down
3 points
  Extreme fatigue
3 points
  Lessening volume of urine
3 points
Score
Intensity of Altitude Sickness
1 to 3
Light
4 to 6
Moderate
More than 6
Severe (complete rest is recommended)

COST AND PAY CONDITIONS

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Testimonials

May 8, 2010

There is nothing  this group could  have done to make my trip more enjoyable
The guide  was always there  to assist me when I needed assistance which was frequently. Jorge the guide was extremely knowledgeable about the whole trip
The whole group was very friendly made me feel  home
The chef exceeded  all expectations I had about food.  I cannot describe how good Ceferino was with food  in an outdoor location- I would like to see what he could do in a restaurant

Mr. Barber

May 5, 2010

The tour guide coped excellently with a varied group . Full + clear explanations were given along the trail. Good sense of humor
Excellent punctuality. Keen to explain part of interest . Enthusiastic, cheerful and helpful
A special thank you to the porters who do an amazing job with courtesy and good humor
The food was FANTASTIC!! Amazing  food produced in very basic conditions. The food surpassed all expectations
Super tents! Dinning tent was fisrt calss

The Inca Trail has been the experience of my life

Miss Phillys Paddock

May 5, 2010

Exellent!! Exellent!! Exellent!!
Fantastic, wonderful team, beautiful surroundings, stunning hike made perfect by this caring team!!
Everything has been perfect. I am so impressed with everything !!, Ruben was friendly, knowledgeable  and considerate.
Wilmer was just so sweet ! good knowledge
Fantastic meals! Varied, tasty, beautifully presented!  Beats most  restaurants in Cusco!!

Mrs. Hilde Harrison

April 28, 2010

Alex is a fantastic guide  from the moment we started  the trek he helped us  have a great experience , always telling us: “ there’s no rush “ and “have a positive attitude” . He is very knowledgeable!
Victor is fantastic cheff. He could open his own restaurant , the food was well prepared , well presented , healthy and tasty

Mr. Simon Couled

April 23, 2010

English was amazing , very knowledgeable  as a tour guide , very accommodating to a older trekker (68), a hard working person – very courteous
Food was just  EXELLENT!!!!!!!!!!!, it was well served  - artistic – different
The whole services was equal + better than two other American services I have used

Mr. Dennis Collette

April 21, 2010

The guide was very punctual at all times, helpful and friendly, his knowledge on all parts of the trek is excellent. All the equipment was in good order and very clean, tents were already pitched and made ready for our use

Miss Mary Pemberton

April 21, 2010

Jamil was very friendly, his help on the trek was invaluable as we were rather slow, he encouraged all the way, his knowledge was great specially with flora. The food was excellent , we were all very impressed with what was produced in such a difficult  circumstances, quantity were more than enough and cleanliness was perfect

Mr. Vivianne Perry

March 3, 2010

It was a perfect tour. I enjoyed every moment , It was carefully organized. Our guide was very attentive  and experienced, the English level  was excellent  and it was a welcoming and kind host ship. We had information about local culture, plants what made tour incredible and unforgettable.
I liked food, it was sophisticated, tasteful, meal times were joyful and delicate.
The equipment was good
Everything was environmentally  sensitive , very responsible. Events were planed carefully

Mrs. Hayriye Elbi

March 3 , 2010

A memorable trip – due to the  nature, history; guide very calm and  knowledgeable , made us feel safe; told many stories and plants and nature ……. Very enjoyable!!
Wonderful trip, amazing, difficult trek with a very experienced guide, nice Peruvian people, very helpful and warm!

Mrs. Berna Uluc

March 1. 2010

Alex was an excellent tour guide, he was very knowledgeable and helpful. He made this experience even more memorable. He went out  of his way to tailor and suit the tour to our needs and our liking
Victor did an outstanding job  with all the meals . The food was delicious and even the presentation was beautiful
I was very impressed with the quality of all the equipment

Miss Alejandra Muffler