Home Races & Places 🏁⛺

Naftali Presser's abbreviated IM boulder Race Report....advice needed!!

Race report:

 

OK here it is… the race report of my first attempt at an ironman.. its quite abbreviated as the race was quite abbreviated… ending in the back of an ambulance.  Anyway here goes…

Arrived Friday late morning.  Went from the airport to check in, dropped of stuff/athlete briefing etc….things went smoothly and relatively straightforward.

Tried to rest up Saturday with variable degree of success fought with headaches and restless sleep which I am blaming on the altitude change.

Race morning- woke at 3:10. Ate 2 rolls with strawberry jam, 1 honey stinger waffle, coffee and started sipping GatoradeE.  Got an uber to race start and hopped on first bus out to the reservoir at 0400.  Put my nutrition in my run/bike bags respectively and triple checked to make sure stuff was in order in the transition bags and then waited.  Nerves were actually quite minimal as I kinda had convinced myself that this wasn’t happening and that I was going to DNF the swim again (I’d DNFd 2X 70.3 swims).  This might have been OK as I usually get super anxious/hyped up and waste a ton of energy.

I lined up with the 1:51-2:00 group  (actual time 2:07).  Once walking down the ramp the nerves came back.  First 2 buoys I had to grab boards like 3 times, convinced myself this was the stupidest thing every to be attempting, that I was going to drown (Ok maybe not actually drown)…etc…

Eventually, sanity started to sink in and the panic subsided.  The distance between breaks got longer and longer and things started going better.  I was still all over the place and this probably swam a good deal more than I needed to (Must work on sighting!!!).  

Of note: after the orange buoy marking midpoint and much worse after the second turn, I started to get really bad nausea. even to the point of stuff coming up once. Not sure if this is related to motion sickness (I get really bad motion sickness) as kinda felt like when I go kayaking and forget to take Dramamine/meclizine.

Made it out of the water and was really wobbly.  To my surprise no one stopped me to take my chip!!  I had survived

 

The good: 1. made it through! 2. Only cramped once at ~500meters from the end which for me is practically unheard of.

The Bad: 1. Sighting 2. The Nausea- which I thing was likely the beginning of the end for my day (see later)

 

T1. 12:12- slow as took some time to get stability,  (took 2 bites of a roll a placed in bike bag (thought the solid food might settle my stomach?) and realized first planning goof of the day….forgot my socks (I’ve never biked without socks…. I guess there is a first time for everything.

 

Bike: OK here is where things started to unravel.  Started Good and slow to try to get my heart rate down.  I knew I was behind on hydration and nutrition having finished the swim and having swam for a long time.  So I started to try to take in GE.  Problem was I was still super nauseated from the swim and every time I took the GE it made it worse.  After a while of failing to get down anything more than a trivial amount I decided I needed to improvise.  I started taking water along with increased numbers of gels for nutrition and salt separately.  Not what I had planned but the GE wasn’t being tolerated and the nausea was getting worse and I started to feel weaker and weaker. I tried switching back to the GE as I sensed things were going south but to no avail.  This continued for sometime. By mile 50 when I realized I had yet to pee and really no urge to I knew I was in real trouble.  My technical execution of the bike was also compromised as I found it near impossible to ride aero given the nausea.  I managed to make it through the first lap but by the end was really feeling it.  On the second out and back on 119 had to pull over.  Took some salt and sat down for 3 minutes.  At that point I got up and started to ride but really slowly.  I was completely sick.  Got off to walk and that’s when A medic found me apparently looking like S@#$ and not quite coherent, started vomiting at the side of the road.  On eval was tachycardic, hypotensive and my EKG showed signs of electrolyte badness (nice example of peaked T waves)- at that point it really couldn't stand anymore and it was into the back of an ambulance and my day was done.

 

 

Thoughts:

Clearly some things contributed: heat, altitude probably didn’t help but lets face it, many of the races we do will be hot and its something I’m going to have to learn to manage better

I am interested to here any and all of your thoughts.  I was honestly really quite surprised by the results. I figured that I wouldn’t get through the swim but if I did I thought I had a least a good shot at finishing and at the very least to be in the second half of the run before things turned south based on how my training had been going.

In particular, any thoughts on the nausea issues wound be great as I think at its root this is what ultimately lead to the results and something I'm going to need to address before attempting again.

thanks in advance

Naftali Presser

Tagged:

Comments

  • I'm curious, did you go to the hospital with the tachycardia / hypotension / peaked T waves?  Did your labs show some electrolyte abnormality - hyperkalemia?  Any sodium problems in the labs?  Did anything in particular make the symptoms go away?  
    Was there any headache associated with the nausea?   Overly tight goggles?
    During your swim did you ingest a bunch of water?
    Have you ever had any heart problems or inner ear problems?
    Sorry you had such a tough day!
  • @Jeff Horn so no hospital.  Abnormalities improved with 2.5L of NS boluses. Had 2 great EKGs which I was able to show the medical student shadowing the ER doc showing normalization of the abnormalities with hydration.  Interestingly, the Sodium was 143. borderline high K but thinking that was dehydration/a bit of acidosis.  things improved after said boluses and cooling. Just a couple of hours in the med tent back at the main.
    As to swim.  there was indeed a headache.  almost no water ingestion (think tiny bit once).  no inner ear problems (save for bad history of motion sickness) or heart problems (though heavy family history of cardiac issues).

  • @Naftali Presser ok good feedback.  I'm curious with your history of motion sickness if this is just another manifestation?  Does it happen during long training swims where you are constantly craning and turning your head to breath?  Do you breath bilateral or just to one side predominantly?  Have you ever done meclizine or dramamine prior to long training swims?  
  • @Jeff Horn possible I suppose? never happened during long training swims but I am exclusively a pool swimmer.  basically 1 sided breather never done meclizine/dramamine prior to swims but do take them routinely before helicopter rides/flights (do a fair amount of these for work)
  • Sounds like the primary issue is dehydration brought on by a combination of normal response to acute exposure to altitude, heat and low humidity on race day, plus the "normal" fluid losses from swim/bike racing, with insufficient fluid intake to account for these factors.

    FYI, the worst time for nausea and headache symptoms is just about 48 hours after arrival at altitude. Going to Boulder, I think one would ideally want at least 5-6 days before racing. There may not have been enough time to adequately redistribute the fluid you did take in after arrival. Also, the "thinner" air and low humidity mean sweat is not apparent even though fluid losses are occurring at the skin - truly insensible.
  • @Naftali Presser just like Al said, it seems you had no time for altitude adjustments.

    Do you train with GE? If you are not used to it, it can kick your stomach badly. GE has a different formulation than the regular Gatorade you get in stores.

    Seems you just need to be more confident in the water and I’m sure next time you will cross that finish line. If you can, you should practice some open water swims to avoid being so nervous on race day
  • @Naftali Presser- hoped you booked a post race call with Coach Patrick to review this?
Sign In or Register to comment.