ER Visit--Heat Stress and Dehydration
Ugh. What do the coaches beat into our heads about a successful Ironman?? Something about Execution. Yeah, I think that is one of a few words I hear repeated over and over.
Well, my 4 hr bike ride yesterday did not go so well. First off, it was a gorgeous day in the Pacific Northwest. Sunny and about 76 degrees. We haven't had a day like that yet. It was nice to not have to don the cold weather gear and rain booties for a change.
I chose a hilly 34 mile loop and headed out. There were lots of hills, which is a part I need a lot of work on. But instead of "going backwards" or "sitting on my RPE" i decided to crush the hills, just to gain the fitness. I completed the first loop in just over 2 hrs, so I restocked my drink bottles and decided to do it again.
One hour into the second loop and I was starting to have problems. My quads were killing me. Very tight and painful. Probably because I was standing on the pedal when going up the hills, pounding them out. I stopped at a gas station and got a banana, an orange and some G2. I rested for about 20 minutes.
After I took off, I knew it was going to be difficult the rest of the way. I hit the wall several times, my legs were screaming, my body was ready to quit.
I finished the entire 70 mile ride in 4hr 40. By far the longest ride I have ever done. But then I started to really hurt afterwards. My temperature rose to 100.5 deg F, I became nauseated and threw up. I went to the ER and they gave me a bag of fluids and I started feeling better. I was released about 1:30 in the morning, but today I have had a dull fever (about 99.5), my mouth is parched and now have severe heartburn. I haven't had heartburn in over 2 years. I am weak, get dizzy every once in awhile and basically just feel like crud.
I took today off from training, I am thinking about taking tomorrow off, too. You folks out there have any suggestions on modification to training plan when something like this happens? Also, I obviously blew my nutrition plan for the ride, but what is a good way for me to rehydrate.
Thanks.
Comments
On this ride I had a Gel-Bot container with Water and Hammer Gel and a bottle filled with a mix of protein, electrolyte and boost. During the first loop (2 hrs 10 mins) I drank almost all of the water, almost all of the gel and about half of the mix. I refilled the water bottle (water only) and then poured water into the half-full mixture bottle (so I didn't add any protein or electrolytes, but just diluted them with more water).
At 3hrs 15 mins I stopped at a minimart. I had drank almost all of the water and about 2 swigs of the mixture. I bought a 32oz G2 and poured it into my Gel-Bot, then drank the rest. I ate a banana and orange and a Clif Mojo Bar. I was feeling a bit better, but my quad muscles were really sore.
After I left the minimart, it wasn't long before I hit my first wall and was hurting. I tried to suck down the G2 and mixture as best I could but then my stomach started getting a bit upset and I had to slowdown on the intake.
It has been over 24 hrs since I finished the ride and I still don't feel quite right. Very fatigued, a little dizzy sometimes, kind of like pre-flu symptoms. Luckily I don't have a fever anymore.
So looking back, I need to increase the intake of water and electrolytes, especially in that first hour. I need to EXECUTE my training better when it comes to hills. If I am going to do hill-work then do it on a day when the ride is much shorter. And lastly, when the temps are over 70, I need to increase liquid consumption significantly.
Maybe that will be a start. We shall see when I ride the IMCDA bike course this weekend (one loop only).
Get well!
P
Defintely need to lock down your nutrition plan. I find a simple plan works best for me. Not sure what I think about your protein, electrolyte and Boost mixture. I've taken Ensure pre-race (2+ hours). I don't think it's a good idea to use something like that during training as it is very high in fat and could impair the absorption of calories. I'm not a doctor but that's my underdstanding. Calling Penny.
You should be aiming for 200-250 calories per hour as a baseline with water as needed. I also think that a 2-3 hour ride is significant. I can burn 1500 calories in a 2.5 hour ride myself. That's a lot.
Take care and rest up. Hope you feel better.
Please, please, please rest and get your body back on track before heading out again. And start smaller until you're sure you're handling the nutrition. Also, could you could have something else going on in your body? A bit of an illness, other stress, allergies...you may just need rest not hammering to get through it. It sounds like overall, even though you ended up in the ER, your visit ended fairly positively. I would hate to see you end up in worse shape in the future.
Your body went through a helluva trauma. In the ER and you want to take ONE day off to recover? Um, not advised. This is exactly the kind of situation where, if you don't repair and get strong now, mark my words, in 8 weeks you'll be wondering why you feel so bad and are having a fall off in training. Don't make this a stoopid streak (I say that with love cuz we've all been there to one degree or another
). Be smart now, let your body heal. Otherwise, I'm telling you, in won't be good down the road.
How long (or more specifically how many liters of IV fluids) until you urinated? Was your urine very dark? If so, you probably also had some rhabdomyolysis too. That's muscle breakdown with muscle protein being eliminated through your urine. It can really damage your kidneys.
Dehydration, heat exhaustion/heat stroke, hyponatremia (low blood sodium levels) are serious problems (not just to athlete performance, but to overall health) that occurs much too often for the endurance athlete. Just visit the medical tent at any Ironman, especially around 4pm until after midnight.
For the immediate future, be very mindful to hydrate. Drink fluids (non-caffeinated!) until your urine is clear or very, very light yellow. Avoid NSAID's (like Ibuprofen, Aleve, Celebrex) as those drugs are metabolized by the kidneys. Your kidneys have been through alot in the last few days so give them a break.
Once you have restored your intravascular and extravascular fluid that you lost---you'll know this when you're peeing clear, not dizzy when you get up, not feeling dry mouthed, your HR is back to normal---then slowly resumed your training.