Wednesday, August 20, 2008

Finding Limits at Leadville

Ultrarunning is about pushing your limits. After completing three 100-mile races and several other ultra-distance events in the past year, I was starting to become a bit overconfident in my abilities. However, I found my limit last weekend at the Leadville Trail 100 in Colorado.

The week before the race, I was sitting on the front porch of our home in Indiana with my wife trying to comprehend the fact that the race I was about to attempt would be run 2-miles up in the sky. The same thought occurred when we were flying home from a family vacation last month and they announced that we had reached 10,000-feet and could start using our electronics again. Most of the Leadville race would be higher than we were currently flying in a commercial airplane! I simply could not get my brain wrapped around that while surveying the flat cornfields of Indiana.

Looking Out Towards the Leadville 100-mile Course

As I arrived in Leadville, all eyes were on the weather. The forecast was unusually cold for this time of year with predictions for thunderstorms, hail, sleet, wind, and snow. The scenery was quite majestic, but the constant presence of thunderstorms in the mountains gave me an ominous feeling about what I was about to attempt. I also took note about how quickly the temperature would change as each storm rolled in over the mountains. I proceeded to pack my drop bags knowing that I would need to be prepared for every kind of weather at all times during the race.

I arrived at the start around 3:00am. It was cold and raining, but I was ready. The first 13-miles of the course were on a trail that runs around a mountain lake. The hills are constant, but they are relatively short. This is just like the trails we have in Indiana and I was feeling quite at home. The altitude did not seem to be affecting me and I was running ahead of my anticipated pace.

The first big climb of the course began shortly after leaving the May Queen aid station at 13.5-miles. We moved from an elevation of 9,800-ft up to the Surgarloaf Mountain pass at 11,200-ft. I was thrilled that I was able to make it up and over without much difficulty. As we cleared the pass, I let loose and ran the next 6-miles of downhills until reaching the Fish Hatchery aid station at 23.5-miles. At times it felt like I was simply doing some downhill skiing, albeit with running shoes and rocks instead of skis and snow.

Most people complain about the next portion of the course since it consists of a continuous uphill climb on dirt road into the San Isabel National Forest, but I welcomed the change. Usually it is smart to walk the uphills during an ultra, but I found it more tolerable to alternate timed periods of running with periods of walking until reaching the Halfmoon Aid Station at mile 30.5.

Now well into ultra-distance territory, the course turned onto the Colorado Trail. I began to labor a bit on the uphills and found myself struggling for air as the elevation increased to over 10,600-ft several times. When the trail started a 5-mile downhill path to the the Twin Lakes Aid Station at mile 39.5, I was highly motivated by the fact that each breath had a higher oxygen concentration than the one before it.

At 9,200-ft, the Twin Lakes Aid Station is the lowest part of the course. Over the next 5-miles, I would climb up to Hope Pass, the highest part of the course at 12,600-ft. This is equivalent to climbing all the stairs at the Empire State Building nearly three times. Even though the weather was starting to turn bad, I was looking forward to moving on and hitting the toughest part of the day with full force.

A few miles into the climb up towards Hope Pass, I started to feel more fatigued that I ever have during an ultra. I figured this was just the altitude and continued to move forward, even if it was slower than I had anticipated. Nearing the top, I had to stop several times just to catch my breath. My heart and breathing felt like I was in the middle of a speed workout, even though I was moving forward at the pace of a slow hike.

I sat down for about 15-minutes at the Hopeless Aid Station near the top of Hope Pass. The rain, snow, and hail that were pummeling me on the way up the mountain had stopped and the skies had cleared. As difficult as it was for me to get up the mountain, I wanted to make sure I relished the views before beginning the 5-mile downhill trek to the 50-mile turnaround point in Winfield.

I again hammered the downhills after making it over Hope Pass. My aunt and uncle were planning to meet me in Winfield and I was going to make sure they didn't have to wait any longer than necessary. As I descended the mountain, I was troubled by the fact that the far side of Hope Pass seemed much steeper than what I had just climbed (since the course is "out-and-back", my first job after Winfield would be to climb back up and over the mountain at Hope Pass). Those concerns would have to wait since I was now arriving in Winfield, comfortably down below 10,000-ft elevation, and could celebrate the fact that I just made it halfway through one of the toughest 100-milers in the U.S.

Recovering at the 50-mile Turnaround in Winfield

As I took a break in Winfield, I noticed a bit of nausea coming on. I tried drinking some fluids, but immediately noticed that my stomach wasn't too happy about the idea. After lying down for 15-minutes and not feeling any better, I figured I would try heading out and hoping that some easy walking would calm my stomach. This approach had worked in previous ultras, so I had no reason to believe it wouldn't work this time.

I was overcome by fatigue much quicker as I started the climb back up to Hope Pass. I hiked at a painfully slow pace and still had to stop and catch my breath every few minutes. As I ascended, the time between breaks got shorter and the breaks got longer. My nausea was getting worse and I began vomiting each time I would stop. Even a small sip of water would be immediately rejected by my stomach. Without fluids or food, I could feel that I was starting to dehydrate. Halfway up the mountain with all of my energy stores depleted, it became more and more clear that I would not be able to finish this race.

Resolved that I was past the point of a quick recovery, I was faced with the choice of heading back down the mountain to Winfield or continuing over Hope Pass and down to the Twin Lakes Aid Station at mile 60.5. I determined that I would give it everything I had in order to make it over the mountain to Twin Lakes. As I proceeded above treeline, my pace consisted of about 10 short steps followed by at least a minute of rest. By the time I crested the mountain, it had taken me nearly 3-hours to travel a mere 3-miles. The prospect of reaching Twin Lakes before the mandatory cutoff time was highly unlikely.

My nausea was beyond hope when I began the 5-mile descent to Twin Lakes. Day was turning to night and I was so fatigued that all I could muster was a slow walk. The feeling of being dehydrated and having water but not being able to take a drink created a sense of hopelessness like I have never experienced. As I slowly wandered down the mountain in the dark, I processed all kinds of emotions and found myself dealing with deeply personal issues that I never even knew existed. Although not the most pleasant experience, I now realize that this is the kind of thing that can make an ultra a life-changing event.

6-hours after leaving Winfield, I finally entered the Twin Lakes Aid Station at mile 60.5. I had missed the cutoff time by 30-minutes, so my only option was to let the workers cut off my medical wristband and then find a ride back to my car in Leadville. I used to think that the mandatory cutoff times at each aid station were a bit harsh, but it was a blessing in this case. Even though I would not have made it much farther, I probably would have still considered going on if I wasn't pulled from the race. The cutoff time served the purpose of protecting me from myself.

I took a shower and was able to eat some hard candies 2-hours after leaving Twin Lakes. It took almost 4-hours until I was able to sip on some Sprite and eat some crackers. I fell asleep in my car for the rest of the night and then woke up to see my friend Dan Brenden finish with a time of 27:25:55. This finish puts Dan one race closer to being one of only two people in the world to complete the "Grand Slam of Ultrarunning" five or more times. I now have a much greater appreciation for how difficult of an accomplishment that really is.

In the end, only 2 of every 5 people finished this race and most of those who did were from Colorado. I know I gave it my best effort, but it is still difficult to be one of the runners who didn't make it. I also now realize that what I experienced on the mountain to Hope Pass was actually Acute Mountain Sickness (AMS). I was even starting to exhibit the early symptoms of High Altitude Pulmonary Edema (HAPE). There is no way I could have willed myself through that without putting myself in serious danger.

The next day I did not think that I would want to try this race again. Since then, I have done some research and realized that it would be possible for me to cope with the altitude and finish if I trained specifically for it over the next year. My only decision is whether or not I want to invest the time and energy necessary to make it happen. One thing I do know is that it's not your failures that define you, but how you are able to deal with and rise above the failures when they do happen.

I originally asked my uncle, who lives part-time in Colorado and is an avid outdoor enthusiast, if he would like to run as a pacer for a portion of the race. He declined because he did not want to slow me down. However, as I was leaving town, he left me with these words, "If you come back next year, I'll be ready to join you in Winfield and get you over that mountain". How can I say no to that? Until next year ...

18 comments:

Anonymous said...

I am proud of you~

Anonymous said...

I laughed, I cried, then cried some more...exhilarating read! Love ya~

Anonymous said...

Great race report. I had the same experience up to Hope's Pass. I felt good until getting midway up the mountain, when dizziness and high heart rate set in..I was concerned I would not make it to the top without collapsing. Somehow made it to the Winfield station but could not imagine going back over the pass. I enjoyed your comment about how an ultra runner deals with failure and learns to accept it and go on. Thanks for the nice race report, see you next year!

Christine Harrison #629 (missing from the results....but made it to Winfield 13:42)

Frankie said...

Incredible... just incredible!!!

And to me... inspirational. We all hit so many of those mountain passes in our lives. And many times we often feel like we are trying to get over them alone and in the dark.

What a great story. Congratulations... not only on the race, but on being an inspiration to others.

Get well soon!

FG

The Runner said...

I always viewed Ultra's as way to test yourself. To push yourself to your personal limits, both mental and physical...or to find where your limits exist.

Even though I have never run one, there surely cannot be any failures in a race like the Leadville, even if you don't finish.

You simply found where your limits are and can choose, as you mentioned, to alter training techniques if that is where you want to spend your time.

That race presents additional challenges to someone from Indiana where the terrain is mostly flat, not to mention the difference in altitude.

20-25 years ago in Indianapolis, the ones who always did well in the "Bop-to-the-Top" stair climb race in a downtown skyscraper was a cyclist. Would they do well at Leadville considering the climbs over mountain passes?

One last thought....since you have done so well in the other 100 milers, maybe the race next year will be better for you.

What is considered to be the toughest 100 miler in the US anyway?

Brad Hancock

Anonymous said...

I always am amazed at the accomplishments you make during your races - also very proud of you. I still don't understand "why" but do have lots of faith in you. Love, Mom

Anonymous said...

Great race report! I am sure, Patrick, that lots of folks had similar experiences. I know the runner I paced battled N&V heroically most of the last 40 miles but managed to make it with a long respite at May Queen.
But...he was well acclimated beforehand and ran at least 100 miles on the course over the summer, so it isn't necessarily the altitude. It would be great to figure out what causes intractable nausea to where you can't even takes sips of water and the stomach just seems to stop absorbing any fluids at all, and especially what you can do to overcome it when the usual emedies--antacids, ginger, sprite, saltines, broth--don't work.
Anyone have success at this?

Anonymous said...

Typically nausea in these endurance races is the result of taking in too many calories. Everyone recommends 500 calories per hour between aid stations. Some people can do this with no issues. However, the body is actually only able to assimilate and use about 1/2 that, around 250 calories, so what usually happens is that about mile 50 runners have all this extra food in their system that the body is just not able to process. This causes the nausea. The only real remedy is too reduce the amount of food being consumed for awhile to let the body catch up to what is already in the system. One thing that has worked for me is Swedish Bitters which is an herb that I add to water. It tastes nasty but usually by drinking a liitle my stomach recovers within 10 -20 minutes.

Anonymous said...

For Nausea try Fennel seeds (from the spice rack at grocery store).
Chew 1/4 to 1/2 teaspoon. It sounds weird, but It has worked for me
and others when all else has failed. At some eastern resturants these
are handed out after a meal just like we hand out pepperments.

For gas / bloating: try simethicone-- the active ingrediant in Gas x.
Found cheaper in MyTabs for Gas http://www.drugs.com/search.php?
searchterm=Mytab+Gas

Anonymous said...

Many say there are only two causes of nausea: dehydration and/or low electrolytes. But as everyone here is pointing out, there are many.
- Too much food
- Altitude sickness
- Spoiled food or drink (some items in crew vehicles need refrigeration, but I guess that wasn't an issue last weekend, huh?)
- Nerves - some people react to the nervous stress of big races with diahrea, constipation, vomitting, or a combination.
- And some people just aren't sufficiently trained. They push themselves and keep pushing themselves with the blind phylosophy of never giving up. At some point, even if hydrated, salted, fed, an unprepared body is going to freak out and start going into shock.

In the past, I experienced everything on this list. This year, I didn't experience any of it.
For those of you newbies not wanting to try again, just remember that your first sub-100 DNF will almost certainly be harder than your eventual full 100M.
Hang in there and keep doing what you love.

Anonymous said...

The type of food also matters. This includes protein, carb, fat
content, solid vs. liquid, and other things.

In 2002, I took in about 400 cal/hour without problems. Almost all of
it was liquid - Enduraox R4 as the primary source, also several cups
of soup broth (no noodles or potatoes). That was after starting the
race drinking spoiled (though it tasted fine) Cytomax, and having
nausea only 1 hour into the race, and not being able to take solids
after that.

In 2004, again I had stomach problems, and was only able to manage 10-150 cal/hour. That was not enough. I started falling asleep on my feet around 8:30pm, and had to take a quick nap along the trail (at the bottom of Powerline) before I could go again.

Anonymous said...

Everyone is different and what works for me or you may not work for someone else. The body is an amazing machine and we put it through some serious stress in these long runs. Experimentation is the key to success and finding what works. The rate of 250 calories per hour is from scientific research done on athletes but certainly does not apply to everyone. I tried the liquid fueling this year and it just did not do the job on race day although it had worked in training runs up to 35 miles very well, so I made the mistake of not adjusting well enough on race day. Live and learn.

Anonymous said...

Since my post is the one that started this, I figured I’d provide some more
info and see if anyone has anything else to add.

First, I have completed three previous 100-milers. During a couple of them,
I had minor nausea issues that I was able to easily resolve by changing my
intake and/or slowing down for a period of time. This year at Leadville, I
was taking in between 200-250 cal/hr for the first 12-hours until I began
feeling nauseous on the way up to Hope Pass. Thinking it was a food issue,
I promptly slowed down, changed what I was eating/drinking (several times),
and then cut back on my intake. Once I reached Winfield, I could not take
in ANYTHING without immediately feeling my stomach wanting to reject it. I
threw up several times after leaving Winfield (at a slow walk and with no
additional food or drink being added to my stomach). By the time I was
halfway up to Hope Pass again, I can guarantee that my stomach was
completely empty. I tried drinking a little bit of water and immediately
threw it up. I tried drinking a little bit of Cytomax and immediately threw
it up. For the next hour that it took for me to reach the Hopeless Aid
Station, I did not each or drink ANYTHING. At the aid station, I asked for
some Sprite, but they were out. They gave me some saltine crackers and I
took them with me on the way back down the mountain. I tried nibbling on
them, but even having crumbs in my mouth made me dry heave. I held them in
my hand for 30-minutes and then threw them in the woods without eating so
much as ¼ of a cracker. For the next 2-hours down to Twin Lakes, I did not
eat or drink anything. Even after I left Twin Lakes, it was another 3-4
hours before I was able to drink ½-bottle of Sprite and eat a few crackers.
All in all, my stomach was empty with no input for almost 7-8 hours, half of
which were with me sitting or lying down.

Based on all this information, I have concluded that my issues at Leadville
were more related to the altitude than to the amount/type of food/drink I
was taking in. I have a hard time believing that my stomach would
completely shut down for that period of time just because of what I was
eating and drinking. Plus, I believe the fatigue I was experiencing was
well beyond what would be reasonable based on my exertion level. After I
had dropped out, I also noticed that I had a small amount of fluid in my
lungs.

I think my best hope is not to worry about the food/drink issue, but to be
so much better trained for next year (including as much hill work as I can
stand) so that the effects of the altitude will not be as great. Then I
need to go so slow that I am completely fresh once I start the climb up to
Hope Pass. This year, I started out the race on a 24-25 hour pace. I think
that I might have been able to get over Hope Pass if I would have kept
things to a 27-28 hour pace until getting back to Twin Lakes the second
time. I believe that the altitude was causing me to be so close to my limit
that once I hit the mountain, my threshold was lower than what it would take
to keep moving, thus the complete shutdown.

Any thoughts?

- Patrick

Anonymous said...

Patrick, it sounds exactly like altitude-related issues for you. The kind of total nausea you describe is unusual. It is possible to get that nauseous due to dehydration, but if dehydration were the sole cause, you very likely would not have been able to keep going at the pace you were moving.
Still, altitude-related issues can be mitigated by copious amounts of fluids, electrolytes and carbs. Slowing down until you get a handle on the situation is the accepted remedy. Continuing without fluids is only going to exacerbate the altitude symptoms. Payback's a mother' - i.e. total body shutdown.

Some come up from lower altitudes and simply cannot adjust during the race no matter how slow they go. For them, the only remedy is to drop below 5000 feet. So it's a personal judgment: get it over with as soon as possible without slowing, and hope you don't collapse, or slow down and hope your body adjusts.
I've heard of some amazing athletes whose bodies won't tolerate 5000+ feet for more than 24 hours. For them, slowing down is not an option - they will get worse no matter what.

If you can't keep water or food down, well, your race is over. I don't believe in going on in that situation. Fluids aren't optional, especially at altitude.
If you can keep some morsels down, then you could leave the aid station laden with tons of food and beverage. Recovery is probably best done on your feet, walking very sedately - without adding stress - while nursing your body back. Better to keep the circulation going, stay warmed-up, and still put some walking miles behind you than sit in an aid station.
At Hard Rock last year, one many-time veteran of Hard Rock couldn't keep food down so very early in the race, he was one of the first to DNF. It is wise to have a full race calendar and not destroy yourself on one race. If your body is wrecked, it is prudent to come to a full-stop and do a total reassessment. I've heard of some people wasting 30-60 minutes in an aid station hydrating and fueling, and they do a remarkable recovery. I don't know how they do it, but I've seen collapsed runners with my own eyes come back from the "dead" and finish Hard Rock and Leadville with over an hour to spare. But if you don't pull out of your tail-spin, it's better to save your body for the next race. Take the strategic DNF and hit the trails the very next week without any loss of training. (As you can tell, I'm not a fan of the one-big-race-a-year mentality.)

You did good, Patrick! So what if some did better? - you still are one of the toughest guys in America to do this race and to make it as far as you did, and in some of the trickiest trail conditions ever. Certainly nothing to feel "down" about. We're all learning - mostly the hard way. Good luck next year with better experience. Thanks for sharing your predicament. Everyone learns from it and maybe others will be spared a bit of misery in the future.

JeffO

Anonymous said...

Howdy all,

I've been watching these threads with some interest. I just happen to be
Jim's "runner" that he described many posts ago.

Interestingly enough, my symptoms sound identical to what Patrick
experienced. I was running great and feeling great ... left Twin Lakes at
13:25 inbound feeling like a complete champion. 2 miles later, a little
tickle of nausea began. I ended up running/walking most of the way to
Halfmoon without taking any more food or fluid thinking I was over-salted.
On the way down from Hopeless, I took 4 eCaps, 2 GU packets and a bottle of
double-scooped Heed. Thus my thinking about excess electrolytes.

When Jim picked me up, I had only lost about 20 minutes off of my goal
schedule and still felt like I would recover and get going again. We walked
the entire way to Hatchery in about 1:40 ... along the way we finally
decided I should stop fighting the nausea and empty the stomach. What came
up was a little bit of perpeteum that I'd taken HOURS before. My stomach
was totally shut down.

I still felt like we could get back on track and was mentally ready to
hammer Sugarloaf like I have the last two years. We could not get anything
to stay in me, though. By the time we summited, I could barely stay away
and had poor control of my feet. It took me around 3:45 to go from Hatchery
to Mayqueen, a journey I expect to be 2 - 2:30. I ended up resting in
Mayqueen for 0:47, laying down for 30 minutes and then working to get broth,
diet-coke and potatoes in me. They stayed in place 'cause we kept the pace
pretty slow leaving MQ for about an hour. Then, when we picked it back up
in an attempt to stay under 25, I could not run very far without retching.
Just about anything going in would cause more stomach distress and attempts
to throw up.

Finally, with 1.5 miles and 15 minutes to the 25 hour limit, I knew I simply
could not get it done and we backed way off, taking 30 minutes to cover that
last bit. Still went MQ to finish in 3:15. Not bad given that I'd probably
only had a couple of cups of liquid and maybe 300-400 calories over the last
40 miles.

It's hard to believe that it could be altitude illness for me. I live in
Longmont and train in Leadville all summer. I put in 162 miles on the
course including a double-crossing and stayed in Leadville from the Sunday
before the race.

One thing for the curious is that I had a mild cold on Thursday ... slightly
runny nose, tender throat, lethary and frequent sneezing. It didn't get any
worse so I sort of forgot about it.

My current theory, started by my dad, is hyponotremia. I was not being very
aggressive with the eCaps. Probably only took 7 total over the 14 hours
before the trouble started. I drank nothing but 2 x Heed or 2 x Perpeteum,
but from what I've been reading, sports drinks alone do not cut it for
electrolyte balance. Given the cold conditions and probable lack of
sweating (except for climbing Hope on the back side), perhaps I should have
been more aggressive with the eCaps to counteract the buildup of water.

I do remember peeing large volumes of reasonably clear liquid on Sugarloaf,
at Mayqueen, on the Boulevard and after the finish. Somewhat surprising
since not much liquid was going in.

Thoughts?

Chris

Anonymous said...

Chris, I would tend to agree with your suspicion of hyponatremia. I had an almost
complete shutdown (muscle spasms) at San Juan this year from not taking in
enough electrolytes, so I took about 70 S-caps during Leadville this year
and didn't have any issues. I can't imagine myself taking only 7 e-caps
(less sodium that S-caps) in 14 hrs and not having issues, but then I seem
to have a very high requirement for electrolytes.

Tami said...

Wow Pat, what a story! I enjoyed reading about your experience. Thanks for taking the time to write about it.

Daniel said...

Man! That was some story! I got sick for about 24 hours while hiking in Colorado. I think it was dehydration and altitude. But, not nearly as bad as your experience! Thanks for sharing!