Thursday, September 26, 2013

3/4 of the UTMB....

I've been meaning to write something about my UTMB race, but haven't really been feeling up to it. In summary, I developed what felt like a urinary tract infection, and the pain caused me to make a couple of medical stops around the mid-way point and hang out in the med tent at Arnuva (km 94) for an hour or so. Once I was freed to go, I continued on to Champex-Lac (122 K), where I eventually dropped. It was vomiting inside the aid station at Champex-Lac that caused a third medical tent visit there, but it was a combo of the UTI-like issue and vomiting that caused me to drop. I dug myself into a hydartion/nutrition hole, and while I could have just hung out for several hours and gotten myself into a place to move forward, at the time, the issues seemed such that I didn't believe pushing on for another 8+ hours was in my best interest. I guess I'm not one to push through the types of issues that many do in a hundred mile race. I'd like to continue doing this for a long time. So, when basic body functions become painful and stop working altogether, I may be somewhat quick to throw in the towel.
A street scene in Chamonix. A fun town, but I enjoyed hanging out in a quiet valley the days leading up to the race. All pics are mine.
In hindsight, there were any number of solutions to the problems I faced during UTMB and ways I could have turned things around in order to finish UTMB, but at the time, the solutions were not apparent and my failure to figure them out forced me further into a hole. I would love to go back and restart the race with the knowledge of what would go wrong, and thus preemptively fix the issues as they came up, as I made a number of stupid mistakes that led to some health issues that it felt wise not to push through. I'm disappointed that I did not finish, but given the circumstances, I don't necessarily regret pulling the plug. I just regret getting myself into a place where I felt like I needed to pull the plug.
The trail heading down into Arnuva.
The night start at UTMB means that you start out and run hard through the night, and thus, need to be taking in calories and fluids, even though the temps drop and fluids might seem less critical. At least this is my guess for why I didn't hydrate/eat like I should have. And this led to what appears to have been a urinary tract infection or what one would feel like, feeling like I had to pee constantly, without being able to, except when I could, which was really painful, and just painful, in general. I've never had a UTI before, and the obvious solution to try to clear something like this up would be to down lots and lots of fluids, but when it feels like you need to pee, but can't, and then when you do pee it is excruciating, then drinking lots of fluids to lead to peeing (and thus, pain) sounds intuitive, but in the moment didn't happen because at some subconscious level, I avoided drinking to avoid peeing (again, it hurt). I started having issues with this about 50K in, and then stopped at Courmayeur (80K) to consult medical, who advised me to drink lots of fluids, and then stopped again in Arnuva (95K) to consult again, and the medical tent there kept me for an hour to get me to drink fluids and do a couple of urine tests in addition to getting my blood pressure back up. It was 90/60, which is in the low range and low for me; I'm not sure what that even means or if that's normal mid-race to be low--it doesn't seem like it should be after running down a long descent to the aid station. 
Meghan and I at the start of the race. Stupidly, I didn't drink much in the hour or so leading up to the start, because last year I'd almost peed my pants waiting for the start. 
After an hour at Arnuva, they told me to go on my merry way, and I did go, and was fairly merry. My mindset had changed from racing to just finishing it.  I made the climb up to Gran Col Ferret feeling stronger than I'd been climbing all day, and quickly passed back the two women that had gotten ahead of me during my hour on the cot, along with another couple of dozen of runners before I reached La Fouly. I felt like I had a new lease on life. Had I been smart here, I should have worked to get back into a good place from both a hydration and calorie standpoint. I also should have spent the hour in Arnuva focusing on getting food and water in, but I was in short sleeves laying on a cot alone in the medical tent, wrapped in an emergency blanket, and was too cold to think intelligently about getting up and spending that time in Arnuva working on eating and drinking. I was more concerned with staying warm wrapped in that piece of foil. Of course I had 2 more layers in my bag, which I also failed to put on. So, I consumed the 2 cups of tea with a sugar cube that the med team brought me, but nothing else, and while I felt great leaving Arnuva, those 2 sugar cubes wore off eventually--shocking, I know.  Again, in hindsight, there were so many simple ways to get myself back into a better place, but I got myself further into a hydration defecit, and an empty stomach.  
The trail heading up the Gran Col Ferret.
After Arnuva, I felt relatively great for most of the entire stretch to La Fouly, and continued to pick off runners, and came into La Fouly re-energized, but again, didn't grab as much as I should have in La Fouly. A banana and some protein drink, along with a glass of coke, which had been going down well all night.  I had survived most of the race on coke up until this point, with some protein drink thrown in and a couple of gels early, but I'd stopped eating gels a few hours into the race, and opted to go on liquid calories. I think this plan would have been fine, but I wasn't actually taking in enough liquid calories, as my hydration bladder was filled with water, and the liquid calories I was only grabbing in glasses of coke at aid stations, and my protein drink, which tasted good and went down well, but which I could only grab in small quantities when at the infrequent crew points. 

On a positive note, my legs felt pretty good and it wasn't the climbs and descents that caused me issues. While training locally is definitely beneficial, I felt like I knew what I needed to do going in to get ready, and my quads were relatively prepared for what they would face. It wasn't my legs that were the issue. It was a failure to have a good hydration/fueling plan and being fairly nonchalant about fueling/hydration and the issues that caused me.
The trail heading down into Arnuva, where I hung out in the med tent for an hour. Not a bad place to be, as I had enjoyed a few days in Arnuva before the race. 
In the end, we all need to make our own decisions. I did that at UTMB and made what seemed to be the smartest decision at the time. After suffering with UTI pain and infrequent and painful attempts to go the bathroom for 45 miles, followed by a nausea bout that had me, again, in a prone position in a medical tent, pushing on in the heat of the day over another 3 tough mountain passes just didn't seem the wisest choice. I'm guessing it was hydration-related, but for whatever reason from my neck down, things had just been "off" for most of the race. Could I have done it? Yes. Did I fear that my internal systems weren't processing things well, and that another 8 hours of intense exercise could potentially damage them? Yes, but I guess that's always a fear in long-distance events. I guess the difference being that it's always a risk, but you either continue to fight through or throw in the towel once you can tell that there are problems. Some people are of the opinion that you should never throw in the towel. I'm definitely not of that mindset, and feel that not throwing in the towel when your body tells you to, can be a bit short-sighted. Dropping is a personal decision, and in the end, each of us has to make the decision that is in our own best interest.

I felt pretty down after the race, and still do to some degree. While at some level I realize I'm not a complete loser, I definitely don't feel good about my UTMB race. It was one of my goal races for the year, and dropping out of a "destination" race always leaves a bad taste on what was, otherwise, a great trip. I was having a bit of a pity party for several weeks, but am starting to feel excited to jump into some races again, and reminding myself that I don't completely suck. Sometimes it's good to have a melt-down race to rattle the confidence and force some reflection on what's been a solid several years of racing.
Flowers on the UTMB course near Arnuva. 
It's a strange sport in some regards. In some ways, it's a seemingly cohesive community out there who support other runners and build people up, but there seem to be also a growing number of people within the community ready to criticize--look at how much shit Anton got for dropping. Sometimes there's a damned if you do or damned if you don't feeling. I've heard athletes criticized for dropping, especially the "elites", but have also heard folks criticize other athletes for putting themselves into the hospital. I'd guess that many people that drop can probably get to the finish line, but at some point you've got to decide at what cost. There's sometimes no way to win, both figuratively and literally, so when having one of those days when normal bodily functions become painful, and the body is clearly unhappy, I made a decision to pull the plug. There's a difference between certain types of "unhappy" and while sore quads is one thing, kidneys that are unable to properly process waste, or the body struggling to excrete said waste is a different type of unhappy, and a type of unhappy I'm less willing to run through. I'd like to continue processing waste well into my 80s.

I continued to have some issues for a couple of days following the race, but everything did clear up and I felt fine within a few days and like I probably wasn't anywhere near to the point of causing damage, but at the time it sure felt like it. So, of course I doubt my decision, and kick myself for dropping now, although I didn't immediately following. Pain, in hindsight, always seems less severe.  I guess that's why we keep signing up for these things.
A day relaxing in Annecy after the race. Annecy is a place I could spend some time.
I do want to go back to UTMB, and I'm anxious to race another 100 miler, and may try to jump into one soon, but maybe not. Sadly next year UTMB falls on the same date as the IAU World 100K, and assuming I'm on the team (Meghan and I have qualifying times from the Japan Shibamata 100K, so assuming no more than 4 people run faster 100Ks at MadCity or another road 100K I'll be on the team), I'll likely be in Latvia next year instead of Chamonix. It's a tough call, because while I'm more drawn to mountain running than road, I would have a hard time passing up the opportunity to represent the USA at the World 100K championships. If my Shibamata time does not get me on the team, then I will try to get into UTMB again.
While the race didn't go as planned, it's really hard to complain. I lead a fortunate existence and get to travel the world and visit places like Chamonix, with window displays such as these. I enjoyed more than my fair share of treats on this trip.
In the meantime, I'm super grateful to my sponsors Montrail and Mountain Hardwear and the amazing opportunity to travel to Japan in a couple of weeks for the Hasetsune Cup, a 71K race in the mountains near Tokyo with an estimated 15,000 feet of uphill (and the same in descent) over many short and steep ups and downs. I'm not sure I've done anything previously that I can compare it to, and I'm hoping to stay upright on what is said to be a very technical and tough run, and one of the oldest and most popular trail races in Japan. Starting at 1 p.m. on a Sunday afternoon with a field of 2000 runners with only one aid station half-way that gives each runner just 1.5 L of water, and run at least half in the dark, it should be an interesting and unique experience. 

8 comments:

Olga King said...

Amy, I've had similar UTI developed in a few races, first time at old Pueblo 50. That pain and urges suck! And thanks for bringing to my attention the idea that when the race starts in the evening, we (you, and I, too) tend not to drink much as it's cold, but we HAVE to! I'll have to make sure to remember that next week...Also, I hear you on the sport - not only that the personal decision gets dissected by so many, when you're in "public eyes", it gets practically scrutinized. Then those who made the decision have to just take a deep breath and say: Scree you, my life. Sometimes it's hard. Others times a little easier:) Have fun in Japan!

Anonymous said...

As much as it's hard to quell the self-doubt about these kinds of decisions, you made the right choice for you. And, as a result, you will run a lot longer...no matter what anyone else says, it is always best to listen to your body and be able to run healthy another day. Just because you might technically be able to finish something, it doesn't mean it's best that you do. Congratulations on making a good decision for yourself and a fantastic season overall!

Jill Homer said...

I find the "finish at all costs" attitude to be the most off-putting aspect of the ultrarunning community, as it does seem to be fairly prevalent and ultimately makes no sense. People do their stuff for their own reasons. Many times those reasons don't include placing so much importance on an arbitrary goal to risk a trip to the hospital or long-term bodily (or emotional) damage. Maybe a finish isn't even worth a blister to some people. Why would anyone else care?

Small rant aside, your post-UTMB emotional recovery seems to be significantly farther along than mine. After I timed out of PTL, I adamantly vowed to quit ultra-distance foot races. ("They're just mean, unlike cycling which is a friendly kind of suffering.") One month later I still sort of feel that way, admittedly. I'm starting to come back around though. I'm thinking more about throwing my name in the UTMB lottery for 2014. Damn it, I want to make that full loop around Mont Blanc once and for all, too.

Emir said...

Great post Amy. I think "finish at all costs" attitude comes from regular people that spend a lot of money to get to races. So in some sense they feel like they need to finish. At the same time there is an envy towards the "elites" who get their way paid to said races. One always thinks about, would that person dropped if they actually paid for it themselves.

I hope to see you at the UTMB again kicking some butt. Good luck on your upcoming races.

amy said...

Emir, that's an interesting comment on the "elites" dropping out because they didn't pay their way. First, many "elites" don't get their way paid, at least not all the time, and it varies greatly from runner to runner and among sponsors. And secondly, when a sponsor is paying my way, I would feel more obligated to finish, or worse that I don't finish, than if I were paying my own way. In that case, I feel some sense of responsibility to my sponsors.

Anonymous said...

Amy, bummer about dropping, but it sounds like you made the right call. I agree there were a number of yahoos taking potshots at AK, but I try to never confuse anonymous internet wankers with actual real people. Performance artists!

Good luck at Hasetsune!

Jenn

Scarecrow said...

I don't have much sympathy for elites who drop only because they are not in contention to win. However, dropping for medical reasons is wise and sane. You made the right choice. And you learned some valuable things in the process. Good luck next year!

Melissa Schweisguth said...

It seems like a victory to have run as far as you did with UTI symptoms along w/ other physical issues. Don't be so hard on yourself. Your running performance, honestly and humility command a ton of respect.