Trekkers Wanted! (Adventures in Peru: Part 1)

“The mountains are calling, and I must go.” – John Muir

The Andes called to me, their thunderous voices promising beauty and adventure. I listened to their Siren song, strapped inside the belly of a small airplane, my body crunched into the unnatural seated position that civilization all too often forces me into. I dreamed about stretching my long legs out and hiking thru the Andes. It was a dream that I’d visited often in the 6 months since I booked my trip to Peru, but now, from my achingly small seat in the plane, the Andes were so close it felt like I could reach out and touch them.  “Soon,” I reminded myself, “soon I’ll be hiking in these mountains!”

Back in March I’d responded to an ad reading, “Trekkers Wanted: departs September 11/ returns September 23: 12-Day Choquequirao, Salkantay Pass, Inca Trail to Machu Picchu.” It sounded like the perfect adventure for me. It was the longest (and most rigorous) guided trek that I could find that included the Inca Trail and Machu Picchu. The itinerary for the trek listed ascents of 5000 to 6500 feet (~1500 to 2000 m) per day, and involved trekking up to altitudes of ~16,000 ft (~4950 m)… The elevation gains and the daily mileage of 6-11 miles/day (11-18 km/day) seemed very do-able, but being asthmatic and living at sea level, I couldn’t help but worry about how the altitude might impact me…

Though I’d done treks to higher altitudes without any trouble (eg, Kilimanjaro 19,341 ft/ 5,891 m), my asthma had made me slower than most of my fellow PCT thru-hikers whenever we were at altitudes above ~9,000 ft (~2,743 m). Would I end up being the slowest person in the group if I joined this trek? It was possible. The listing told me very little about the group I would be joining, just that they were an American group from the midwest, they welcomed people of all ages, and their previous international trekking experience included high altitude adventures in Nepal (the Annapurna Circuit).

The Plaza de Armas (Cusco, Peru)

When my flight finally touched down in Cusco (11,152 ft/3,399 meters) I was so excited about finally getting off of the plane that I forgot all my worries about the altitude. As I carried my luggage through the airport, took a cab to my hotel, and settled into my room I still hadn’t noticed any effects of the altitude. It wasn’t until I set off at brisk walk to go explore the Plaza de Armas in downtown Cusco that it hit me. I’d made it across the street and halfway down the block (~20 steps), when suddenly I was out of breath…Was my asthma acting up here in Cusco? Was it the altitude? Was it a combination of both?

Statue of Pachacuti in the middle of the Plaza de Armas

I stopped and inhaled deeply. The air was cool, dry, and full of diesel fumes. As cars and buses rattled down the cobblestone street beside me, I exhaled slowly… If I was out of breath because my asthma was acting up, exhaling would trigger an asthma attack (never fun). If I was out of breath because of the altitude, I would be able to exhale cleanly.

I exhaled cleanly and smiled… My body was just a little cranky because the high altitude in Cusco meant that I was getting about 33% less oxygen per breath here than I get at home. I reminded myself that my body would adjust to the altitude, but that I should try to take it slow for a couple of days to give my body the time it needed to make those adjustments. Maybe it had been a good idea to spend the extra $$ on a hotel that pumped extra oxygen into the room at night!

• Boston, USA:
  • elev. 142 ft/42 m
  • atmospheric pressure ~101.325 kPa (760 mmHg)
  • % of 0xygen available compared to sea level: 100%
• Cusco, Peru:
  • elev. 11,152 ft/3,399 m
  • atmospheric pressure ~68 kPa (512 mmHg)
  • % of oxygen available compared to sea level: 68%
•  Recommendations for exercising at altitude:
  • Days 1-3: 25% – 50% reduction of activity level compared to sea level is recommended as your body begins to adapt to high altitude
  • Days 4-7: Resume normal amount of exercise, but keep a slower pace/lower intensity than sea level activities

A quechuan woman rests with her baby llama (Plaza de Armas, Cusco)

Moving slowly, I continued exploring the narrow streets leading to the Plaza de Armas. The layout of the streets and the distinctly Spanish architecture reminded me of wandering through the streets of Toledo, Spain… In many places, however, the old stonework looked like something different, something that I would learn had roots in the masonry of the Incas.

As I wandered through the plaza I was bombarded by people trying to separate me from my vacation dollars. “Massage! Lady, would you like a massage?” cried young women as I walked by. Other people frantically waved artwork and prints in front of my face, “You want?!” Women in traditional dress carrying baby llamas or herding young llamas constantly approached me offering to let me pet the llamas (or take my picture with them) for a small fee. Everywhere I turned someone was trying to get my attention in the hopes that I might buy something.

Quechuan woman with baby llama in traditional dress on the corner near my hotel (Cusco).

A curt,”No,” and a firm nod was my response to every query. I quickly scanned the plaza de Armas looking for a quieter, less hectic area where I could relax for a minute and soak in the sights unmolested.

Paradoxically, the corner of the plaza that seemed to be the quietest was also the most crowded. A group of ~50-60   young(ish) people were clustered together, motionless, and quietly staring into their cell phones. Although I’d frequently seen the same phenomenon in the plazas and squares around Boston, my mind didn’t put two and two together until someone noticed that I was staring at the crowded corner and said, “Pokemon. They’re playing Pokemon Go.” I laughed and decided to keep exploring in the plaza even if that meant continuing to practice the art of saying “No” every 10 seconds.

Although the Plaza was beautiful, it was with relief that I finally excused myself from it and started walking out of the central tourist district, towards the office where my pre-trek briefing would take place. The adventure I was about to embark on may have started with a “Trekkers Wanted” ad, but I was more than ready to leave the city and head off into the mountains for a couple of weeks. I wanted my trek!!

— Next Installment: Home Again! (Trekking in the Andes: Day 1) —

Confessions of an Asthmatic (PCT Days 63-65)

Hello, my name is Patches. I’m a thru-hiker and an asthmatic. It’s been 10 days since I last took a full, deep, lung and chest expanding breath and 3 hrs since I last used my emergency inhaler. I can already feel my lungs beginning to constrict again in an angry protest against my attempts to breath while climbing up this mountain and I’m counting the minutes until I can use my inhaler again.

Asthma is the reason why I quit my job and hiked the Appalachian Trail in 2013.. After I returned from my Appalachian Trail journey I checked in with my pulmonologist and I’d regained 100% normal lung function. I was incredibly excited… My plan had worked, hiking the Appalachian Trail had helped my asthma… 100% normal lung function!!! I hadn’t imagined that it would get that much better! Since my asthma had been occupational asthma and I no longer had that occupation, maybe my asthma would be gone for good?!

My continuing good health (and lack of asthma attacks) slowly reinforced the idea that my asthma wasn’t something that I needed to worry about anymore (as long as I took my maintenance meds). As I hiked through the desert sections of the PCT I felt strong and my lungs felt strong. I’d gone to Burning Man (a desert festival) twice, and both times the dust storms had aggravated my lungs leading to nasty bouts of asthmatic bronchitis followed by pneumonia, so I had been extremely nervous about desert dust storms on the PCT… But I’d gotten through the desert without any trouble with my asthma… During the first 700 miles of the PCT I’d only used my emergency inhaler once.

As I left the desert behind, I left my worries about asthma behind too… I even sent all but one of my emergency inhalers home (I’d been carrying 2 or 3 in case I lost one, or miscounted how many doses were left in them).

It came as a real shock to me when I entered the high Sierra and started routinely having breathing issues… I’d hiked over 700 miles, keeping pace with my peers, and my asthma hadn’t been a problem… Despite the daily maintenance meds I take for my asthma, I’d managed to completely forget that I was asthmatic.

At elevations above ~9000 feet, the second the trail started going uphill, I started slowing down, way down. At first I thought that the same thing was happening to everyone else too… “Aha,” I thought, “I can explain to people that being asthmatic is like constantly trying to hike uphill at high elevation.” I clearly remembered that this was exactly what it had felt like trying to climb the three flights of stairs up to my apartment when my asthma had been really bad… My body had shifted to moving very slowly and taking the fast shallow breaths that would keep my blood oxygen levels high, but that wouldn’t trigger an asthma attack, and I was taking frequent breaks… A break after every step or two.

It took me a couple of days before I realized that nobody else was responding to the altitude in quite the same way that I was… To realize that it wasn’t just one bad day… The people that I had easily outpaced in the desert and at lower elevations were all passing me. Everyone else seemed to be adapting to the altitude… But not me… My friends were all outpacing me… It wasn’t a choice… I just couldn’t keep up… And suddenly the thin veil of denial melted away…

I have asthma… It didn’t go away… Asthma doesn’t go away.

I would have taken a deep breath as I processed the realization, but I hadn’t been able to take a deep breath in days. I would have laughed at myself for being in such denial that I didn’t recognize that it was asthma until I actually had an asthma attack on top of Pinchot Pass, but laughing triggers my asthma attacks when my lungs are being cranky. Instead, I sighed… It seems like no matter how bad my asthma is I can always manage to sigh.

I have asthma. In the last year I had gotten so much better that I’d been able to forget what it was like to struggle to breath… I’d fallen back into denial (despite the pound and a half of maintenance meds I was carrying with me and taking everyday). Being at altitude wasn’t like having asthma, it was triggering my asthma, especially since the altitude was combined with lots of cold dry air.

My rescue inhaler which had been left largely unused throughout the latter portion of the AT and the beginning of the PCT was being used on a daily basis again… When I’d forced myself to keep working at the job that had triggered the asthma I remembered that after 2-3 hrs I’d start watching the clock to see if I could use my inhaler again… Here at the higher altitudes I found myself doing the same thing… Was it time yet? How about now? How about now?

I carefully monitored myself for signs of altitude sickness… Could I tell the difference between high altitude and cold temperatures triggering my asthma and HAPE (high altitude pulmonary edema)? I wasn’t 100% sure, but I did know that the inhaler helped for 2-3 hrs and that carefully controlling my pace meant that I could keep breathing at 8000ft, 9000ft, 10,000ft, 11,000ft, 12,000ft, 13,000ft and 14,000ft…

It felt like my asthma to me… and it wasn’t getting progressively worse or coupled with any other symptoms of altitude sickness… No nausea, no headaches. Just breathing issues and asthma attacks that frequent breaks and using my emergency inhaler seemed to keep at bay.

Though slowing down and having to stop to catch my breath more often meant having to hike alone, it also meant that I had more time to just watch and absorb all of the spectacular scenery around me… The high Sierra is breathtakingly beautiful!!

As I hiked through the snow-covered mountains and forded the icy streams of the Sierra I thought about how I hadn’t really believed that I had asthma until I was hospitalized for it. Why did I have so much trouble admitting, even to myself, that I have asthma?

Close your eyes and try to picture an asthmatic. When I did that, the first image that came to mind was that of a ten year old boy wearing a blue shirt and a red baseball cap staring longingly out of his bedroom window at his friends playing baseball… It’s an image from some tv show or movie from my childhood which lodged a stereotype in my head, “asthmatics don’t get to go outside and play.” But I love to go outside and play! I don’t want to be sick, weak, and trapped inside… With those images of asthma lodged in my head it’s no wonder that I didn’t want to accept that I have asthma.

Clearly I needed to exchange those old images of asthma and asthmatics for newer ones. I thought of myself standing on top of Mount Whitney at sunrise… Triumphant and strong… On top of the world… That’s the image of an asthmatic that I want to hold on to, that I want to come to mind first and foremost when I think about asthma. To get to the summit of Mount Whitney I needed to admit to myself that I had asthma, I needed to use my inhalers, I needed to respect my body, and I needed to go my own pace. I worked really hard to get there, but I did it, and it was absolutely amazing. My asthma didn’t prevent me from going outside and playing and living my dreams.

My name is Patches, I’m a thru-hiker, and I have asthma. My asthma is still there, I’m still hiking at high altitudes, I’m still going slowly, and I’m still out here living my dreams on the PCT in the high Sierra and loving it… Me, my backpack, the mountains, and my inhaler! :)