Well worth the pain! They run a smooth operation and they expose you just the right amount to the elements.
Our guide was very knowledgeable and spoke English pretty well.
We started in Cusco where they told us how much of what to pack. Then we took a bus to a breakfast spot and onward to the starting point. Our guide had a good sense of humor along the way. He was good at setting expectations and encouraging us along the way.
At one point we missed the chance to pick up our bags and he got them for us and brought them to our hotel.