Escape from La Paz

After a couple of weeks exploring Argentina’s vineyards and flavors, I boarded a flight bound for La Paz—aware that I was heading into one of the world’s highest cities, perched over 13,500 feet above sea level. Acclimatization was essential, but I arrived at 9 p.m. feeling calm and as soon as I reached my Airbnb, I drifted into a deep sleep.

To my surprise, I woke up feeling remarkably well—no pounding headache, no breathless panic. Encouraged by the calm, I set out to explore the city on foot, clocking nearly six miles through La Paz’s historic heart. Plaza San Francisco buzzed with morning energy, Plaza Mayor offered a quieter rhythm.

One of the most striking features of La Paz was its teleférico—the sprawling cable car system that stitched the city’s steep hillsides together.

Bolivia was celebrating its 200 years of independence. There were people everywhere.

And then, rising in the distance, Illimani revealed itself—its snow-capped peaks shimmering against the blue sky, a silent sentinel watching over the city. It was my first glimpse of Bolivia’s grandeur, and it felt like the beginning of something unforgettable.

La Paz is a city that clings to the mountains and at night, the steep hillsides—layered with homes stacked like bricks in a mosaic—begin to shimmer. The teleférico cars continue their quiet glide overhead.

The streets of La Paz pulse with color and character, thanks in part to the city’s iconic minibuses. These are decked out in chrome, decals, and bold paintwork that echo the jeepneys I once saw in the Philippines.

Each bus is a personality, ferrying passengers from point A to B for just a few bolivianos, weaving through traffic with practiced agility.

In the heart of La Paz, I stepped into the San Francisco Church—its ornate façade rising like a stone tapestry above the plaza, carved with indigenous motifs and colonial flourishes.

I joined the congregation for part of the service, letting the rhythm of Spanish liturgy wash over me. Outside, the plaza buzzed with life, but within those walls, time seemed to pause.

In the city center, I wandered from one trip organizer to another, each offering a different flavor of adventure. Huayna Potosí at a staggering 6,088 meters (19,974 feet), Pico Austria at 5,320 meters (17,454 feet), and the majestic Illimani towering at 6,438 meters (21,122 feet).

As I mulled over which hike to tackle first, I met a few fellow travelers whose enthusiasm was contagious. I spent the day walking the streets and climbing—gaining over 2,000 feet in elevation. My body felt strong, but by evening, a slight fever began to simmer.

Was it the altitude creeping in, or just a flu-like bug I’d picked up on the flight? The symptoms were subtle -- fatigue, a mild headache, and backache.

Back in Argentina, I’d befriended a fellow traveler who, like me, was managing diabetes. He spoke highly of Jardiance—a relatively new medication that lowers blood sugar by helping the body eliminate excess glucose through urine. Intrigued, I consulted my doctor, got the green light, and decided to give it a try for a month. The first few days were marked by increased thirst and frequent bathroom breaks, a known side effect as the body adjusts. It was a small price to pay for better control, especially while navigating the unpredictable rhythms of travel.

In La Paz, on the second night, I awoke multiple times to urinate and was constantly thirsty, as it was the 4th day of Jardiance, I did not think much of it. The fatigue and fever were high, so I slept 19 hours non-stop.

On my second evening, feeling better, I took a taxi to a great dinner spot and returned to my Airbnb by 9 p.m., ready for another restful night. But sleep came in fragments. I woke each hour feeling progressively worse—feverish, short of breath, coughing and increasingly sore. By 4am, I turned to ChatGPT, pouring out every detail in search of clarity.

Still unsure whether I was battling altitude sickness or a lingering bug, I checked my Apple Health app on a whim. What I saw was alarming: for the past two days, my SpO₂ levels had hovered between 64% and 77%—alarmingly low. No wonder I felt so off. That kind of oxygen saturation could signal serious trouble. The data confirmed what my body had been trying to tell me: I wasn’t just uncomfortable—I was in danger.

ChatGPT confirmed this and said the condition was not self-correcting and fatal if ignored. It suggested immediate reporting to ER or to going to a lower altitude place.

By 5 a.m., I was running out of options—and oxygen. Every city on my Bolivian itinerary sat stubbornly between 8,000 and 9,000 feet, still too high for comfort. But Santa Cruz de la Sierra, nestled at just 1,500 feet, offered a lifeline. A one-hour flight on BoA, Bolivia’s national carrier, could take me there. It felt like a gamble, but also a chance to breathe freely again. I booked the 7:25 a.m. flight, packed in slow motion, and braced myself for the journey ahead.

By 6:15 a.m., I was at the airport— breathless and walking slowly, carrying a relatively heavy backpack. At check-in, I leaned in and asked softly for medical assistance. Within minutes, a man in a green coat appeared: Dr. Edwin, armed with an oxygen tank and a pulse oximeter. He clipped the device to my finger, nodded gravely, and turned the valve. Ten minutes of deep breathing later, my SpO₂ climbed to 94. Without a word, he hoisted my heavy backpack and walked it to the counter. I slipped a folded bill into his hand—gratitude in paper form—and took my boarding pass.

My heart rate was going high with the exertion and headache too. The folks at the boarding gate again requested a doctor and promptly Dr Edwin was back with the oxygen.

I boarded, the cabin sealed shut, and with it came the fragile promise of relief. As the engines roared and the plane climbed, the cabin pressure inside the airplane began to work its quiet magic. My headache dulled, my pulse steadied. I leaned back, eyes closed, letting the oxygen-rich air do its work.

By the time we began our descent into Santa Cruz de la Sierra—just 45 minutes later—my SpO₂ had climbed to 88. Not perfect, but a far cry from the danger zone. As I exited the airport, I had escaped La Paz and was on the mend.

I continued my interaction with ChatGPT and it recommended I visit a doctor in Santa Cruz de La Sierra.

I discovered the Bolivian medical system to be efficient and thorough. After about 15 different blood tests, and a chest X-ray, they needed a CT scan, which showed the damage wreaked by the 2-day SpO₂ range of 64-77%.

All in all, the decision to relocate to a lower altitude was the saving grace, as 12-24 additional hours in that high altitude environment with low oxygen saturation, overexertion, and over-dehydration due by the use of a new Diabetes drug - a perfect storm -- would have resulted in respiratory failure or death during sleep.

In retrospect, the blood oxygen graph on the iPhone's health app fed by automatic regular measurements on the Apple Watch showed me the dangerous trend, which made me act fast, but if there was an alarm on the health app, it would have alerted me to the situation way before I looked for it 48 hours after its onset.

Three days after the escape, I continue to feel better and hopefully have had no permanent damage.