Croom Zoom 100k: DNF….Did Nothing Fatal

Thanks to all of you who offered your consolation to me on not being able to finish my first 100k this past Saturday.  I have heard the old adage said many times that you learn more from your failures than your success and now know this to be very true.  I wanted to share what I learned from my experience this past weekend for the sharing of our successes AND our failures as a community, I feel, will not just help us to be better performers on the day but may just keep us from doing harm.  My lesson is one definitely of the latter.   This is a long one but promise it is of value so please try to see it through.  It is also posted as a blog at my website, if you do not like reading it in this format ,at www.runnaturalcoach.com. 

I now realize after reviewing my symptoms, doing my own research and talking with several experienced ultrarunners that, and contrary to what I believed on the day, I had hyponatremia on Saturday and not dehydration.  Easy read on specifics of condition here, http://www.mayoclinic.org/diseases-conditions/hyponatremia/basics/definition/con-20031445,  if interested.  I had all the symptoms of both and that was the first lesson…the symptoms are very similar.  A few that pointed to hyponatremia though, once I began thinking on what happened, were an early sloshing stomach and swollen fingers.  As far as the stomach, I had had that in the past and if stopped consuming fluids for a while it would go away, which is what I did on Saturday and why I THOUGHT I may have got dehydrated.  By the time I had 2^nd symptom of swollen fingers though, I was becoming a bit disoriented and was not really sure whether my fingers were really swollen or I just thought they were.  The indention of my otherwise regularly loose ring still being on my pointer finger 3 days later is an indication that they were truly swollen, but again I was in no state of mind to evaluate this at the time.  Another sign was throwing up tons of fluids…if your body is dehydrated you would not have all these fluids in you…and I continued to do this until 11 pm that night even after not consuming ANY fluid from last loop completed at 5:30 pm.  Had I been dehydrated I would have had extreme thirst and wanted to drink.   Your body is smart and when all were telling me to drink it was the one thing I did not want to do.  Funny enough even till late in the night when contemplating going to the hospital for IV fluids because was so sick is what I thought I still needed to do, again due to not being in right state of mind at all, as this condition leads to confusion and disorientation due to low sodium levels. 

So why did I become like this..ah the next lesson.  Well I was taking in electrolytes as my form of nutrition I use UCAN has sodium and potassium in it.  And actually quite a high amount of both compared to most.  I also was supplementing with Nuun hydration, which also includes electrolytes.  I know most will say you should have taken Scaps or Salt tabs also but I had never done this before and is also a matter of debate (see “Waterlogged” by Tim Noakes for more on this).   I have ran hot weather races and not had this problem before, like Tick Tock.   Where it was 115 degrees heat index and I did not feel great but I finished and was mostly happy with results.  I certainly did not feel like this and really had not had enough to drink that day as had not carried a handheld.  I have come to learn that the problem I had on Saturday was due to the high carb concentration of my form of nutrition combined with the high heat and humidity leading to it not being absorbed into my body and so essentially instead of putting in 20 oz of nutrition/fluid per hour was only getting in the water and ended up over hydrated and with hyponatremia. 

Now there were those who told me when I was contemplating whether to continue on my last lap that I needed to take in salt but at that point nothing food or fluid wise would stay down.  And I did finally take an Scap to see if it would help me to stop feeling so horrible and it promptly came up a half hour later.  So herein you can see the danger to my continuing to race…no electrolytes…no fuel…thought I was dehydrated and should drink more…could not keep anything in….and most of all could not think straight and felt like I was going to pass out due to low blood pressure.  And here is the final and most important lesson of all.

When all were encouraging me to continue out of good intention (because that is what we do for each other is encourage each other through the pain and suffering because quite honestly for whatever reason what we have decided to do and love is filled with a lot of it J )  I would look out to the trail and think “should I do this?”  And a voice deep inside me kept saying “do not do this”  And believe me I wanted to as I had a feeling that I was going to be first masters even if I could manage to walk the last 10 miles which most likely would have taken me a long 3 hours.  Once the results came out the next day to my horror this was confirmed J  The lesson here then is always listen to that voice.  It is wise and will keep you safe.  And I can tell you I almost did not listen to mine.  But thank god I had a good friend there who had been to races with me in past, Carla Cellini, who looked at me when I told her “I am not sure I should go on…I just do not feel right” (which by the way is also one of the main symptoms of hyponatremia that differentiates it from dehydration and is often what sufferers of condition will say) and said “Dawn, this is not like you.  You do not quit things.  And I have never seen you get sick like this before.  If you do not feel right and are having a feeling not to continue then that is what you should listen to.  And what you would tell any of your athletes.”  And then it just clicked and none of it mattered anymore because I knew it was the right thing to do.  But I will tell you I still had to call my husband and have him say “what are you thinking….of course you should not go on”J  We are all tough or we would not even think of doing the distances we do so when you are faced with this kind of decision don’t question your toughness…listen to the voice. 

As a post script I am finally feeling a bit more normal 3 days after but still not totally right.  I was still quite sick Monday.  I am still planning to run the Keys 100.  But after conferring with two well respected, experienced, multiple hundred mile finishers, will now approach my nutrition with the mindset that the same nutrition does not work in every scenario ie cold vs hot races or for every distance and that I should have backups.  I also will be careful as to time of month I race (came next day), as sorry guys, but ladies this does matter and does affect hydration/fluid levels too.  Women are more likely to get hyponatremia as are those who are premenopausal and those with adrenal or thyroid issues.   Lots of info on this out there if you want to read more.  I also as an RD will have a scale at my race as is a simple way to tell if runners are either dehydrated or have hyponatremia.  And for the record to add to confusion you can be both at the same time.  And finally I am planning to get back on the 100k horse very soon…sooner than you may think J  as long as my recovery continues well.   Muscular wise I probably could have ran the next day, after completing 52 miles on a somewhat difficult trail course, so was pleased with where I am there.   I have some exciting posts to come in next few days for 2015 but this is so long already I am just hoping you made it to the end and possibly gained something out of it.  I know I did and will continue to.  As one well known ultra runner aptly reflected “personally I always get more out of the journey than the finish line” J  Happy Running…because in the end that IS what it is all about.