Race Date: October 12, 2009
During my second season of this thing called triathlons, I qualified for the Ironman World Champs in Hawaii with personal goals and ambitions going into this race. Not ever having trouble with any type of open water swimming, what happened to me was the last thing that crossed my mind as a possible setback. Hey, I guess they're right when they say, "things happen when you least expect it." This was for sure, an experience of a lifetime.
Full Ironman races are notorious for their mass swim starts (everyone starts at the same time). The first 500 meters or so are pretty rough as athletes are trying to claim their spot in the water, only resulting in flailing limbs and unrelenting scratching and hitting. Athletes are swimming in the Pacific Ocean; swells inevitably are moving and growing bigger as 1700+ athletes are moving through the water simultaneously. With pure adrenaline at your side, all of that seems minute. I unknowingly paid the price.
Exiting the water in good position and running towards the transition area, I feel a bit off and know that something just isn’t right. As I am making my way through town within the first few miles of the bike leg, I experience unbearable stomach pain, as if I had consumed gallons of water and filled my stomach to the max. I bend forward to use my aerobars to get in a more aerodynamic position on my bike; the pain gets worse. Therefore, I am unable to ride in my aerobars for the majority of the ride. My initial feeling was fear, followed with despair because I knew then that it wasn’t going to be my day.
I continue to ride with agony and just hope that I start to feel better after a little time on the bike. It just got worse and worse and worse. I tried to urinate on the bike, thinking maybe it would take the pain and the full feeling out of my stomach. A little trickle down my leg did absolutely nothing. Then, at about 15 miles or so (I can’t even remember), I see a porta john. With utter excitement, I get off my bike and manage my way onto the seat and experience explosive diarrhea. I figure, okay, whatever was bothering my GI tract is out of my system; I will start to feel better. Boy, was I wrong.
I get back on my bike and my stomach is still feeling full and uncomfortable. As I continue pedaling, I start to get really worried because I am unable to provide my body with proper nutrition. I can barely drink any fluids, and power bars and gels were not even an option at this point. I spew fluids several times throughout the ride, now realizing that I ingested a significant amount of ocean water. I went as far as trying to test my gag reflexes, but it didn’t work. As I continued to cough and spew more fluids along the way, a fellow triathlete rides by and asks if I am okay and to “take it easy”. Man, there’s nothing I can do but hope and just keep going.
After about 30 miles or so, I realize that I am not feeling any better but just enough to start forcing some fluids and nutrition down. Even though it was important for me to try to drink and consume calories, it later proved that it just irritated my GI tract more than it already was. I go through the motions on the bike, feeling very disoriented, weak, and disheartened; the last 30 miles of the 112 mile bike were the longest miles of my life. “This could not get any worse,” I thought to myself—but it did.
I get off my bike and make my way over into the transition area. I put on my hat, sunglasses, and sneakers as the volunteers slather sunblock on my shoulders, arms, and legs. I start to shuffle my way out to the start of the run, not knowing what to expect. I realize from the start of the run that my hands are very swollen, stomach still bloated, and I could just feel the puffiness in my face from the excess seawater still lingering in my system. Not feeling right, I shuffled along thinking, “Maybe I’ll start to feel better after the first few miles.” I also found myself short of breath, not because of the humid air but for other reasons that I’ll explain later on. Taking deep breaths as an attempt to get my breathing under control was difficult.
At about mile three, is when the “fun” really began. I see the first porta john on the run course getting closer as my GI tract churns with irritation—severe diarrhea. This became routine throughout the entire 26.2 miles, hitting every porta john I could find along the course. At one point, I waited at a porta john for about five minutes hoping the guy that went in before me would come out soon. However, I got annoyed and just shuffled up along the course a little bit more and found a desolate woodsy area. Do I have to explain what happened here?
Holding down gels and Gatorade wasn’t even an option, but I still consumed them anyway at each aid station. The fact that I wasn’t feeling right from the start didn’t really make me feel like gold when vomiting became a norm throughout the run leg, as well. It didn’t worry or it didn’t phase me at the time, but the sputum in my vomit had a tint of blood. A chronic cough that wouldn’t leave my side, caused me to throw up countless times, anywhere between 15 and 20. Consistent diarrhea, vomiting, and my body rejecting everything and anything—my body is in complete disarray, and walking became the only option with a couple shuffles here and there. My body bent over with my hands on my knees, gagging and coughing until my vomiting episode ceased—until next time. “Oh my goodness, this is not what I intended for, not what I trained or worked so hard for. But you know what, I am crossing that finish line.” Several athletes have stopped to see if I was okay and if I needed help. I would just nod and say that I was okay and continue on.
Darkness lurks over me as I make my way over towards town. I said to myself, “try to shuffle the last two miles.” That didn’t work. With two miles to go, I tried to shuffle a little bit, but I just had nothing in me and it would just irritate my system more than it already was. At this point, I see a porta john but ignore it even though I really wanted to pay a visit. With one mile to go, I stopped at one point to cough and throw up one more time, regain my composure, and continue towards the finish. Right before the turn to the finishing stretch, I bend down again and gag on whatever I had left in my system. As I stand straight up to start running again, an athlete that had already finished, ran over towards me and yelled out, “Don’t blame yourself! You’re great! C’mon now.” I run through the finishing stretch as the crowd is reaching out with their arms to give me high fives. I thought to myself, “Maybe I shouldn’t have given people high fives,” knowing what I had gone through. Grossssssss?
I cross the finish line and two volunteers come over to me and put a towel over my shoulders. I told them that I had diarrhea and was vomiting throughout the entire race, then I bent over one last time to cough up more “bloody” sputum. They brought me over to the medical tent, where I was analyzed for over an hour because the medics just weren’t certain about my condition. Within that hour, I had to hit the porta john twice, get multiple tests and was simply miserable. Their initial concern was dehydration from diarrhea and vomiting, but when they saw that I had a chronic and raspy cough, their concern doubled. Every time I tried to take a deep breath, it would cause me to cough uncontrollably and put me on the verge of throwing up. When I did throw up at one point in a bag, they saw that there was a tint of blood, so at this point they knew something really wasn’t right. After attempting to use an inhaler several times to see if it would open up my lungs, the medics knew it was a little more complicated. They sent me to the hospital in an ambulance to get a chest x-ray just to rule out any serious medical conditions. Well, it was pretty serious.
Spending two nights in the hospital was not the way I wanted to spend the remaining time I had in Hawaii. I was hooked on oxygen, an IV, had blood drawn several times, had hunger pains, and felt so darn helpless. The doctor in the ER tells me that I do have abnormal amounts of fluid in both of my lungs and will need to get a CAT scan just to rule out blood clots or anything of that nature. So, I waited and waited oh so patiently. At one point the following morning when I was not hooked on oxygen, my oxygen saturation level was at 69 when it should be around 95+, especially for endurance athletes like myself. Measuring oxygen saturation basically tests how well the hemoglobin in your blood utilizes oxygen molecules. Anyway, I finally get my CAT scan the following late morning; I will admit, all that time while I was waiting to get the test done, I kept telling myself that I was just fine and I could just go home and rest it off—whatever it was.
It turns out, as the doctor spills the news, I have aspiration pneumonia. As I was throwing up during the race, the bacterium from my GI tract was entering my lungs. Given that I threw up between 15 and 20 times, the doctor pretty much told me that I should’ve stopped after the first incident. “It’s a pretty severe case,” the doc says. I did not want to hear that. The coughing was due to the fact that I had seawater in my lungs, as well, causing major irritation, swelling, and damage to the blood vessels. Also, the fluid in my lungs restricted my breathing, which explains the blood-tinged sputum and the hard time I had at the start of the run when attempting to take deep breaths.
After spending about 7hrs in the ER bed with absolutely no sleep or food, I finally get moved to a quiet room where another patient is sleeping. I got kind of tired listening to the drunk and obnoxious patient next to me. Slurring his words, talking to himself, making weird noises, and bitching at the nurses—I wonder what his story was. As I begin to make myself comfortable in my new bed, I start to ponder about how in the world I was going to keep myself entertained, or get some shuteye to say the least! I kept getting poked with needles and things shoved up my nose. Still awaiting for my cell phone to arrive at the hospital, I lay with dismay. I realize that I still have not showered. Ewwwwwww, narstyyyyy. Watching the seconds go by on the clock, tic, toc, tic, toc…this isn’t doing it for me. It’s time to get some shuteye but only manage to get in about an hour or two. Eight am arrives and I start to get to know my neighbor after she overheard me speaking with my nurse, explaining what had happened to me. Being an islander herself, she explains the Hawaiian detox:
-----“To help detoxify their body, Hawaiians will actually buy a bottle of seawater specifically meant for cleansing. And what it does is cause you to go to the bathroom; that’s why you were having diarrhea and problems with your GI. Your stomach felt very full, right?”
-----“Oh my God! That totally makes sense. And since I had like five times the normal amount in my system, my body did a great job of getting rid of the seawater! I start to laugh then instantly pouted.
10am arrives and I finally get wheeled over to a room upstairs to get my CAT scan. The doctor giving me the CAT scan explains the process as I helplessly lay stiff in the bed of the machine; after the first round of scans:
-----“Now, I am going to inject you with dye so that we can get a better look at your chest and lungs. When the scan begins, you will feel a warm sensation go through your body and down to your groin. I gave you half the dosage, so you should only feel it as far as your abdomen.
-----In a calming sort of way, the machine speaks to me. “Breathe normally. Take a deep breath and hold. Exhale and breathe normally.”
-----Thinking to myself, “Woah, I feel like I just peed myself.”
The scan is complete and the doc comes back out:
-----“It went all the way down to my groin, Doc.”
-----“Wow, you have a great circulatory system.”
-----“It was weirrrrrrd,” as I laugh out loud.
As I get settled back into my wheelchair, the doc decides that he’s going to bring me back down to my hospital bed (instead of calling a nurse), even though he has a lot on his plate.
-----“Aw, well aren’t you a gentleman.”
-----With a smile on his face, “Don’t tell anyone because then they’ll start taking advantage of it.”
-----“Your secret’s safe with me, Doc <chuckle chuckle>.”
As he’s wheeling me back downstairs, we have a small conversation about triathlons, and then the Phillies, after he came to the realization that I am not an islander.
Some doctor (my primary doc) and patient dialogue Sunday late morning after my CAT scan:
-----With a stubborn tone of voice I say, “I’m scheduled to fly back home Monday early evening. Do you think I’ll be better by then?”
-----With a calm and patient tone of voice the doc says, “As of right now, I wouldn’t be surprised if you were in for a couple more nights.”
-----“So like, the rest of this morning and tomorrow morning?”
-----“We’ll have to see how you progress, but there’s a possibility that you’ll have to stay until the end of the week.”
-----“I can’t do that, I need to get home.”
-----“What I am concerned about is the amount of fluid in your lungs. I don’t want you flying until your lungs are clear. Fluid can rebuild and especially since you’ll be in flight for a long period of time, we just want to make sure that you’re okay before you get on a plane. Earlier this morning your oxygen saturation was really low.”
-----<as I pout>“Oh man, this sucks.”
-----Susan looks at me and says, “Jess, everyone will understand. You need to get healthy.”
-----“I know, ugggggggggggghhhhhhhhhh.”
-----“We are going to give you a diuretic to help your body flush out most, if not all of the excess fluid in your lungs. The diuretic will cause you to urinate at several occasions within a 3-4 hr window. We will measure your output to make sure that you aren’t urinating too much fluid.”
-----“Oh, what fun.”
At this point, all I could do was lay in bed and see how many times I can pee. “Well, I might as well make myself comfortable,” I say to myself. I finally get a shower, a new robe, and even new bed sheets—this is a five star hospital! My lunch arrives and all I can do is stare at it and take a sip of the orange juice. Blah, I can’t eat anything at this point because I just feel weak and nauseated from the combination of sleep deficiency, medication, IV, and the overall aroma and atmosphere of the hospital.
Oh! I’ve got to peeeeeeeee. Fifteen minutes later, I’ve got to pee again! I urinate about eleven times within a two to three hour window, averaging about 700cc, and things are looking good. Making friends with the nurses, cracking some jokes, trying to kill time. I get moved to the neighboring room because my roommate had left; the hospital had to arrange the rooms so that a male and female were not in the same room. As I shuffle into my new room, a patient is moaning and groaning due to a broken ankle. “It’s going to be a long freakin’ night,” I think to myself. But then I am relieved to hear that she will be going up for surgery very shortly. I get my vitals checked for the 10 millionth time and I get a good feeling even though the nurse didn’t say anything about my current status. As I’m updating my status on facebook, texting and calling some of my fellow buds, I wonder if I’m really going to spend another night in the hospital. My primary doc comes in at about 6pm and gives me some good news:
-----With a smile and a look of shock on his face, my primary doctor says, “Well, you are recovering a whole lot quicker than I thought. Your vitals look great. Your oxygen saturation is at 100 and your lungs look pretty clear. I feel comfortable to discharge you tonight; I am going to put you on antibiotics for five days.”
-----With a huge smile on my face, I just say, “That’s awesome!” Free at last!
Ugh, as I gather my things and get ready to walk out of the hospital, the meds and lack of nutrition really hits me. I get nauseas and the only thing I want to do at this point is get to my hotel and go to bed. Twenty minutes later I arrive at my hotel, walking like a drunkard. I scrounge around for my hotel key, drop all of my stuff on the floor, and plop onto my bed. I slept for 12 hours. The way I felt the next day, my trip back home, and my week of jetlag is just another story in and of itself.
The moral of the story—sometimes things just never go the way you plan no matter how much you work for it. Experiences like this only matter in that it’ll make you that much better and stronger physically and in life. People know how good you are at what you do; pride must not get in the way of any journey. The last thing I wanted to do was walk off the course and call it a day. I was going to cross that finish line even if I knew I was making my pneumonia worse, and knowing that I put all of my time and energy towards this race and all hell breaking loose. Heck, if I had a broken arm I would’ve finished the race because I knew in the back of my mind and from the bottom of my heart, that at least one person back home would be proud of me even though it was simply a CRAPPY day. You can’t go to Hawaii for this event and not finish—it’s just not right.