Here's how it stands today, a week after my DNS on stage 6, including 5 days of hospital ER and travel:
- Broken Radius: stable fracture, nothing they can do for me
- Infection in my arm/elbow: after 5 days of IV antibiotics, turns out to be non-MR Staph
- Hyponatremia: electrolyte imbalance in my blood, which ended up causing massive Edema
- Heat Stroke
- Normocytic Anemia: Probably from blood loss through urine
- General shitty feeling and a non-cooperative stomach
I had a great conversation with Ian Corless yesterday morning. Here is a link to the @TalkUltra podcast. We talked a lot about digging deep in races, and specifically how I managed myself at The Coastal Challenge. At the end of the interview he asked me something along the lines of 'Would I do it this way again? Do I regret pushing myself this hard?’
My quick answer was that I would absolutely do it again…but I didn’t give a reason why. I’ve had some time to think about it a bit deeper now, and here are my reasons:
It’s easy to go through life giving 80,90,95%... It’s safe, it’s predictable, and it’s easy to maintain the self image that we want. At those outputs (in racing and in life), it’s possible to control both how we see ourselves and how we project ourselves to others (we sort of hide the bad spots).
But things change when you absolutely lay it all out there, especially in a race. When you fully commit, and give everything that you have, then you strip yourself right down to the truth.
It’s sometimes unpleasant or brutal, but it’s also cleansing and addictive. I always want to get back to that spot to see if I am any better/stronger than the last time. It’s tough to get there though; you can’t always find 100%…but when you make it there, it’s always worth it.
Before I get into the gritty details of how and when I broke down, I definitely want to point out that I do have some great, positive memories from TCC. Costa Rica is a beautiful country, and the South Coast is just incredible. Most importantly though, I met a lot of amazing people; both runners and TCC staff. Joe, Iain, Samantha, Anna, Karl & Cheryl, Nikki, Luke, Veronica, Fidel, Ashur....We went through something special together, and I really hope that I am able to stay in contact with many of those people.
How and When
When I give an honest look back at how my race went, it's obvious that I set myself up for the Heat Stroke and the Hyponatremia by day 2. I wasn't taking enough care to replace fluids AND electrolytes, and I wasn't cooling myself down enough right after racing. Add in the fact that I wasn't sleeping, and the writing was on the wall. Plus, I was pretty sure I had blood in my urine after day 2.
Day 3 is where I did the 'arm' damage. I fell multiple times in the river...on hard rocks...and my right arm took a beating. I know for sure that's when I opened it up to infection, but I'm also suspicious that's when i cracked the head of the Radius.
Day 4 is where I really turned down the road to Heat Stroke and Hyponatremia. With a bad stomach for the first half of the stage, I was drinking only water...NO ELECTROLYTES. After the stage, my stomach was horrible and I struggled to take in any type of fluids or food for the rest of the day/night.
The constant theme of sleep deprivation was also a big player in what was happening. Without sleep, no healing takes place, and the damage begins to just compound.
Day 5 was the nail in my coffin. I hammered myself so hard that day, that all my previous problems got magnified. My CNS was shutting me down, probably trying to protect my brain. I couldn't keep my eyes open, and I was stumbling all over the last half of the route. My hands had gone numb and swelled up like sausages from the Hyponatremia, and my sweat response had stopped mid-stage. By the time I finished, my arm was killing me, but the Heat Stroke and Hyponatremia had almost dropped me.
No matter what I did during the day and night following Stage 5, I wasn't really getting any better. I just couldn't shake the Heat Stroke, my stomach was a total mess, the Edema in my legs was getting really bad, and well...my arm was starting to really worry me. There is no doubt that the right move was to DNS stage 6, and to get to a hospital ASAP.
When I got off the plane is San Jose, Pablo (a friend of Luke) was there to meet me. He took me straight to the ER at CIMA hospital. The care there was great, and they definitely focussed on the infection....it was the top priority for sure. IV Antibiotics every 8 hrs for the next 2 days, and things seemed to be under control. The only regret I have about the care at CIMA, is that I should have pushed harder about the swelling in my legs and hips (Edema). Hyponatremia was the cause, and all the IV's were actually making it worse.
When it came time for me to fly home, I was was just so happy about seeing my family, that I didn't consider the Edema and flying. I felt like total crap, but I just hopped on the plane...knowing that 18hrs later I would be home. Something really strange started to happen to me though on my second flight, the one from Toronto to Vancouver. My (previously loose) pants had become tight, and my legs felt like the skin was going to rip apart. Three hours into the 5.5 hour flight, things were going in a bad direction. I went to the bathroom to check out the swelling....it scared the crap out of me! I looked like a different person, probably 15-20 lbs heavier than normal. I almost grabbed a flight attendant to say I was having a medical emergency. Instead though, I gave myself a window of an hour. I decided to stand instead of sit; if things stabilized I'd ride it out...if they got worse, get the flight diverted to Calgary.
Thankfully, the edema didn't appear to get any worse. I got off the plane in Vancouver and immediately found my wife Jodi. She pretty much started crying as soon as she saw me. We grabbed my luggage and went straight to the ER at Vancouver General. Even though that ER is crazy busy, the staff could see how bad I was. I was into a bed in minutes...where I stayed for the next 60 hours.
As soon as they pumped me full of concentrated electrolytes, I started to pee...a lot. The hyponatremia/edema was essentially solved, and my kidneys were kicked into overdrive to dump all the extra fluids from my body. X-rays on my arm came back, and the Ortho docs said it was a stable fracture (just a crack really), and they couldn't do much for it: no cast, just Tylenol as needed. The infectious disease team, despite their best efforts, couldn't find anything exotic in my infected arm. When I left two days later, we stopped the IV's for the really bad stuff, and opted for a 2-3 week course of strong oral antibiotics...definitely manageable. As for the anemia, that's something I have been struggling with for years. This whole episode seemed to erase all the hard work/progress I had made in the last year. I'll be seeing (more) specialists for my iron issues over the next month.
I feel like I turned a real corner once I got back home (and stopped the harsh IV's). My stomach has now come back around, I'm eating a lot, and trying to gain back a few pounds. My energy is definitely low, so I'll be cautious for the next few weeks, but I did go for a couple easy jogs already... really just to make myself feel human again. I'm not going to commit to any races for the next couple months; I'll just make decisions as they come. I'd really like to be able to run Diez Vista in 2 months, but the big picture (general health) is more important.
So there you go....it doesn't seem so bad as I type this out today, but I was pretty worried at times. I'm just so happy to be back home with my family.