Thoughts on the Run

I should have stopped at the 25k point. Learned about Hyponatrimia. First Did Not Finish (DNF).

The day started off almost perfect. I woke up at 4am and drove to Parrot’s house. He was going to drive me to Larkspur for the start of the race. While I was out cranking out 31 miles on the Greenland Open Space Trail, he would be off running the incline in Manitou Springs. On the drive we talked about everything from work to nutrition to busted toenails. Never a shortage of topics with us.

Shortly after arriving, I picked up my bib # and met several great people. They mentioned following me on Twitter, reading this blog, or connecting on Facebook. Always great to shake a hand of someone for the first time after conversations through the social media universe. It still amazes me how incredible the running community is at all levels!

At the starting line, I listened to the Race Director give final course instructions. He mentioned that it was going to be a hot day, which I kind of was expecting, so to remember to stay hydrated. Check. On the sound of a siren, we were off and heading up the trail.

The first 2 miles were slightly uphill, but nothing like Hall Ranch Trail I regularly tackle. Everyone was cruising along and I was comfortable. Hearing from my timer that I was hovering around 9:30 a mile for the first 3 miles freaked me out a bit. Coming off a PR from the Cherry Creek Sneak 10 Mile race I felt really strong. Still, I should not be running that fast on a trail.

Passing through the first aid station, I opted to just grab a cup of Heed. My Camelback contained 2 litres of water so I imagined that I should be fine. My goal was to run this race like I was running Leadville. That meant a full pack of water and fuel to get me through the entire 50k. After this aid station, I began a challenging 2.5 mile climb. Towards the top I started to power hike it just to conserve energy and plus, that is what I planned on doing come Leadville in August. Once to the top, I cruised on down still running and following the plan.

Heading over the hill, I caught up with a guy named Paul. He’s stationed out here in the Air Force and this was his first ultra. It was great to chat for a couple miles, watch the train go by, and talk about family. We rolled into the turnaround with jokes and a cup of Heed to head back onto the trail. 8 miles down and feeling pretty good.

Finishing up my first lap Heather cruised by leading the 25k runners. She shouted words of encouragement and a smile which helped boost my mental motivation. You can read more about how she crushed the course record here.

I went back into my rhythm back out on the trail and encouraging folks on the trail to keep on trucking forward. The wind was starting to pick up and the sun making itself known. I had slowed to about 11 minute miles which was still faster then I expected to be going. There was almost zero shade on the course and much of it was starting to look the same. My memory of the trail that I had just run was getting a little hazy … first sign of things going wrong.

At the aid station on the south side, I stopped a little longer then usual. Hit the bathroom (all still good), grabbed a handful of pretzels, downed some Heed, and off I go. Hiked up the hill and rolled through the hills as best I could. A mile from the turnaround, I knew I was in trouble.

I hit the end of lap 2 hearing voices. It was my brain telling me to seriously stop. Surely I could keep going. It was just that the 25k finish line was .25 mile away. Seriously, go take the 25k medal and call it a nice training run. Nah, push it on wuss.

About half a mile out from the aid station, I sent my wife a text:
Past the halfway point.

A half mile later I found myself in a wide open field. I was feeling pressure in my bladder and felt the need to really go to the bathroom. Didn’t care that I was in a wide open field. Went right there. Problem: very little came out and what did was brown. Bad.

How could this be possible? I have drank almost 1.5 litres of water. I have eaten 2 GUs and a Honey Stinger Waffle. Pressure still there in the bladder. No interest in moving faster.

Maybe it’s the circumstance or actuality of what happened, but the wind seemed to really pickup. I looked at my phone and saw I had a reply from my wife:
Nice! Feeling Good?

My response: No.
Wife: Hang in there! Or stop if you need to … I have just disposed of 2 mice – one alive and one dead, so u don’t need to do that when u get home.

She knows me well. The message was to keep going unless it’s a safety issue and here’s a joke to make sure you’re coherent.

Unfortunately, I wasn’t.

I drained the 2 litres of water in my pack and was not feeling any better. I had turned on the tunes to help get me to the aid station. My plan was to use the bathroom there and if there was no improvement, then I would seriously consider stopping. It was one of the longest 2.5 miles that I can remember. Or at least, what I can remember of it.

Arriving at the aid station, I went straight for the bathroom. Bad news. Zero improvement.

I approached the aid station tent with hands on hips and head down.
The volunteers asked: What can I get you?
I had no response. I didn’t know if I wanted water, Heed, food …
He offered me a seat in the shade and some time to think.

I sent a text to Parrot:
Debating on dropping. I put down 2 litres of water & just a little brown is coming out.

Parrot has been running ultras much longer then me. He was not having a very good day either with 2 toenails exploding on his run. Turns out we may both be using the services of medical professionals that day.

The volunteer came by to check on me again and he could tell the conversation going on in my head. I looked at him and said:
Call the medic. I am done.

I’m still not even sure how I got those words out. Even now, 2 days later, it is hard to write.

The volunteer made the call and I waited. I sent a text to my wife saying I was done and a text to Parrot letting him know. He called me and asked what was going on. I gave him the details and he said:
Hyponatremia
Let me save you the Google search:

Hyponatremia is a metabolic condition in which there is not enough sodium (salt) in the body fluids outside the cells.

and guess what? Here’s the exact diagnosis:
Hypervolemic hyponatremia — both sodium and water content in the body increase, but the water gain is greater

About then the Park Ranger arrived in his jeep to take me to the EMTs. He asked me the standard list of questions:
– Are you on medications?
– Health issues?
– Medical conditions?
– Feel like you’re going to pass out?
– Nausea?

Answered the questions as truthfully as my brain could. Then I gingerly got into the jeep and we were off on a bumpy 3 mile drive. I felt each of those bumps. Apparently I made a noise at each of them as he kept apologizing.

After arriving at the finish area, the EMTs asked me the same list of questions that the Park Ranger asked. By this point, I was 90% sure of what my condition was and what happened. The EMTs agreed that it was sounding like hyponatremia and I should have a seat in the back of the ambulance.

I sat down in the oh so nice cool shade of that ambulance while they took my blood pressure. They asked what my normal reading would be on that and I let them know I had no idea.
Me: Why? Is it bad?
EMT: Well, it’s lower then average.
Me: So I’m close to going unconscious?
EMT: Do you run a lot?
Me: Well, this is a 31 mile race, so yeah, I put in about 30-40 miles a week.
EMT: That makes sense then as runners tend to have lower blood pressure.

I’ll take that as a compliment.

EMT: So we can put in an IV now to get you recovered or drink some electrolytes to see if that helps.
Me: Let’s drink.

Another EMT went and brought back 3 cups of Heed. Didn’t take long to down that. About 15 minutes later, Parrot drove up to the ambulance and handed me a bottle of Gatorade. Parrot made some jokes and comments to see if I would laugh and respond. For the first 10 minutes I didn’t. After getting halfway through the bottle of Gatorade, I started making some sarcastic comments.

Parrot: Good to hear you’re back.
Me: I’m here. There’s just about a 2 minute delay.

Again, the EMTs brought up the discussion of putting in an IV.

Me: Nah, this magic water is helping.
EMT: Are you feeling dizzy?
Me: ummm … yes, I just spent 4 hours out in 82 degree heat with no shade.
EMT: Fair point.

After about 10 minutes, I decided it was time to take the bathroom test. With 3 people ready to catch me if I tumbled out the back of an ambulance (would have been funny to see), I gently stepped down. The results were in the right direction and had a nice coherent chat with Parrot along the way. Mostly it was about how stupid I was and that this was preventable.

Parrot: Better to have this happen here then in Leadville.

Agreed.

I am very fortunate that a few days before the race Parrot offered to drive to the race. Otherwise, I would have stayed there a lot longer to drink Heed. I’m not sure what the food situation was there, but we drove back to Denver and stopped at a Subway. I had no problem eating a footlong turkey sub, bag of chips, banana, and a Coke. Life was starting to breathe back into me.

The EMT said he could write a note to my wife saying I should just keep off my feet and not do anything for 3 weeks. I told him I appreciated the offer but don’t think she’d believe it. Really, amazing staff at this race!

16 races and this is the first one I did not finish. Not easy to say that I had to stop something. Sometimes though, you have to stop in order to really move forward.

A huge thank you to the thoughts and concerns I’ve received over the past 2 days from people on Facebook, Twitter, email, and phone. It has helped get me moving and looking ahead.

Time for 5 questions people won’t ask me but I continuously ask myself …

1. You had 4.5 hours to finish the last 12 miles … couldn’t you have finished the race?
Yes there is that possibility. It would have included me sitting at the aid station for an hour to fix myself. As the temperature was rising, I was sitting at the aid station determining on the damage that had already been done. Stopping to seek medical advice from someone in a more stable mind state seemed to be the best long term option.

2. Shouldn’t you have known better?
Absolutely. It’s a standard rule: when you sweat, you need electrolytes. However, it wasn’t blatantly obvious that I was sweating. The sun and temperature were sucking it out of me while the wind whisked it away.

3. How hard was it saying you were stopping?
Pretty hard. I was doing the pros and cons in my head. Unfortunately, it was a very biased discussion with my brain/body heavily favoring stopping over continuing.

4. So call it a learning day?
Absolutely. Every race and run from now to August 18th is training for the Leadville 100 Mile Trail Run. That means running with gear that I’ll use during that race and dialing in nutrition to work like clockwork.

5. Will you do it again?
Oh yeah … push me down and I’m ready to get up faster and stronger.