Puno on the Shores of Lake Titicaca
If my upcoming Peru vacation is a success, it will be because I was able to withstand life at 12,000 feet (3,650 meters) altitude. The high point (both literally and figuratively) of my trip will be at Puno, a somewhat ungainly city on the shores of Lake Titicaca. There will be short times during which I will be at 15,000 feet (4,570 meters) or more as I go over mountain passes between Arequipa and Chivay, between Arequipa and Puno, and between Puno and Cusco.
The hotel at which I will be staying—the Casa Andina Classic Tikarani on Jirón Independencia—provides oxygen for its guests as well as mate de coca if I am beginning to feel the onset of acute mountain sickness, or soroche, as the natives call it.
In the end, it is possible I am making too much of all this, but I will be traveling by myself. I have to be prepared to take immediate action in case I am one of the 1-2% of travelers in danger of High Altitude Cerebral Edema (HACE) or High Altitude Pulmonary Edema (HAPE). If that happens, I will immediately return to Arequipa and figure out a Plan B that involves visits to Tacna, Peru and Arica, Chile, cities that figured in the War of the Pacific (1879-1883), in which Bolivia lost its seacoast. (Even so, they still have admirals.)
If I find I can take the altitude, I’ll spend a night on Isla Taquile, which involves a 400 foot climb up a trail to reach the center of town. There, I will spend a night with one of the local families before returning to Puno by launch the next day.
After Puno, I head downhill to Cusco, and later still further downhill to Ollantaytambo and Machu Picchu.
tarnmoor 
Be prepared to walk slowly, and I do mean slowly. When I lived in Arizona at around 5400′, I vacationed in Colorado for six weeks. I was fine at our camping area just outside of Buena Vista but even there the people from near sea level (a few hundred feet) were getting winded easily. I had already been in Buena Vista a few weeks when I went on a hike way at higher elevation, probably around 10,000 – 12,000 feet. The level bits weren’t too bad, but when the trail went up, it was brutal. Three steps and I’d have to stop and breathe. Wasn’t carrying anything either, because I dropped my daypack early on to pick up on the way back down. I know you have read all about this and know what to expect, but wanted to give you a personal experience. Sounds like fun and I mean that, it’s not a tongue in cheek remark, lol. I can’t even imagine how beautiful it will be.
That’s good advice. When I get to Puno, I will do very little for two days. Maybe, if I’m feeling OK, I’ll go to Sillustani, which is an extra 500 feet or so. But no hikes under any circumstances with a greater gain than that.
BTW, I have eliminated Bolivia from my trip because it would take me to 14,000 feet around El Alto and La Paz.
in 1969 hiking glacier park with a new love, I got sick. an asprin would have cured it pretty sure but I had no asprin. I had love & hadn’t needed asprin for several months