There is no way of predicting your response to travel to altitude (either trekking, bus or flights to cities eg. Cusco). Even the experienced sherpa can develop alttitude sickness on his first season climb.

It is remarkable how many travellers believe that a 'headache' at altitude is normal, it is not ! If you are carrying altitude medication, always carry a package insert in the actual medication container to refer to so you know when, how to use and how to titrate so you achieve the optimum therapeutic dose ( with the least side-effects)

Preventative medication include gingko, acetazolomide and dexamethasone. The treatment of altitude sickness is descent, however some of drugs can be used as treament .

Denial is also common - be willing to admit that you have altitude sickness, as that is the first step to stay out of trouble.

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