Tuesday, June 05, 2007

Longest post ever

At long last, here is my race report. Unfortunately it will be a bit abbreviated because of some bad news I received over the weekend. I won't hold you in suspense; I've been diagnosed with iron-deficiency anemia. As I understand it, this means my iron stores are gone and my hemoglobin is low. I'll go on about that in length, but first let me get the race report out of the way.

This was a really good day and I wish it wasn't now somewhat overshadowed. But I simply cannot say enough good things about this race. Packet pick-up was a breeze, even though it was already extremely crowded when we got there. It was held in a high school gym which was completely full of people, but the three of us (me, Mark, and Mike, Mark's dad) were in and out in a matter of minutes. We were even in different lines (they did the 10K). The t-shirt is plain but that's okay with me. It's a Brooks tech shirt so I'm very pleased with it.

Next morning I was up at four to eat and drink. I nibbled on a Clif bar, sipped water, listened to music and dozed for another hour or so, then I got dressed and prepped for the race. I was debating on wearing a long-sleeve shirt, and decided against it. It was a little chilly, but I did not regret this decision at all. I made my way over to the start (only a few hundred yards away from the hotel; score!) and found the people I was going to run with. They were a group who ran with Team in Training. There were a few of them but the ones I ran with mostly were Al and Ryan.

After a few moments of standing around and trying to stay loose, we finally lined up and and were off.

The Warm-up

1. 10:10
2. 9:17

We concentrated on taking it very easy for the first mile and then used the second mile to gradually speed up. It felt perfect. By the beginning of mile 3 were in the the groove and felt great.

The Honeymoon

3. 9:01
4. 9:02
5. 8:58
6. 8:53
7. 9:04
8. 8:53
9. 9:01
10. 9:07
11. 9:06

We started to slow up just a tad here, but as we neared the halfway point (it's an out-and-back race) the energy from the runners coming back our way gave us quite a lift.

12. 9:00
13. 9:10 (a bit of uphill here)

Going through the halfway point (split was 1:59) was a big rush. There were a lot of people around to cheer, and I was excited about being right on pace and feeling great. We were also feeling the benefits of having negotiated some barely noticeable but nevertheless present climbs on the way up. Now it was all downhill.

14. 8:52
15. 8:44
16. 8:47
17. 8:59

Here is where I started to feel it. It was starting to be a little more work to actually keep up with Al and the rest, and the balls of my feet were starting to feel the pounding. I told them to go on ahead.

18. 9:12

Okay, still on pace, kind of. But I knew it wouldn't last.

The Death March

19. 9:43

Losing it, crap. It was going to a long last 6-7 miles...

20. 10:14
21. 10:55
22. 11:41
23. 10:52 (one last push to pick it up a tiny bit)
24. 11:17

The difference was like night and day. I felt drained, but had known worse and was determined not to walk. There were people passing me, but I also caught a few who were run-walking, so I felt a little better.

The Death Crawl

25. 12:08
26. 12:15

But there came a point when it took every bit of determination I had not to stop. I felt annoyed with myself that after all that preparation, I still hit the wall, but I knew I could still probably PR as long as I kept running, so I just plugged along.

The Sprint

26.2. 1:47

The 26-mile marker was at the entrance to a high school track. People kept saying "200 meters to go!" but we got on the track at the 100-meter mark. I was trying to figure out how many meters 0.2 miles was, but that math definitely was not happening in my head at that point. Or at any point, for that matter. I sped up a bit but the track seemed endless. By the time I made it to the 200-meter mark I realized that now I had 200 meters to go; the finish was on the actual track finish line. Went on around the curve, and then as I rounded the final turn, my old track instincts kicked in and I kicked it hard to the end. I even caught a few people. Kick of the Week, eh?

Final time by my watch was 4:14:21. Official time was one second faster at 4:14:20. Excellent. Although I was a little disappointed at not being closer to four hours, it felt great to back down in the fours again, and better than my former PR to boot. I made for the ice cream, and was lucky enough to find both Ryan and Al to find out how they did. Ryan, in his first marathon, ran about a 4:10 and Al a 4:06 if I remember correctly (need to go read that race report!)

This race is HIGHLY recommended. Absolutely gorgeous course, great organization, a nice balance of cheering crowds and peaceful, quiet expanses, and we were lucky this year to have perfect weather. And another good thing for me: for the first time I have gotten some race photos that are actually pretty good! They can be found here.

Other notes: Mark had a disappointing race after having to make a pit stop during the race, but Mike really enjoyed his first 10K and seems keen to do more.

Now, at this point I had planned on analyzing my sudden encounter with the wall and trying to come up with ways to avoid this in future, but I think I may have found at least part of my answer in this anemia. Overanalyzing carbo-loading methods and other race prep details will have to go by the wayside as I deal with this problem, which was surely a contributor in some way.

So here's the anemia story from this past weekend:

It was a long and nutritionally deficient weekend, but on Saturday evening I felt pretty much normal other than a slight upset stomach. I'd eaten a huge lunch and some small snacks throughout the afternoon (no more than a few bites). After seeing Clinton's speech (which was wonderful and inspiring, by the way--go here for pictures, video, etc.) we ate and headed over to Coach Pio's house, where we sat around for several hours and reminisced along with several other alums. I had a couple of beers and actually got pretty tipsy (no tolerance left, at all). We left much later and headed to Chris' house to play Guitar Hero. Everyone had eaten a lot of finger food at Pio's (me least of all), so we didn't get dinner. We went on a quick liquor run and then had a few more drinks as the boys played Gears of War, and then we watched parts of Pirates of the Caribbean. In total, I had about four and a half drinks spread out over about six hours. So, not much at all, and certainly not nearly enough to account for what was to happen.

So we arrived at Cherry Street, the default Knox hangout. Not many people had arrived at the bar yet (it was probably 11:30 or so). I was standing at a booth talking to a few people when I suddenly felt dizzy. I remember getting that whited-out sight that happens sometimes when you stand up too fast or something. I had just enough to time to think that maybe I should sit down or go outside or something, and then I just remember waking up on the floor. There were people's feet all around me and other people behind me trying to get me to sit up. It was incredibly surreal, and I actually felt embarrassed, as if I had lay down on the floor to take a nap and people thought I hadn't meant to. But of course, I had blacked out and collapsed on the floor. I am told this lasted only a few seconds. After they got me up, I managed to say, "That was so weird!" And then I blacked out again. This time I was out for almost a minute. I was unresponsive, so my friend Jenn called an ambulance. I am told that people around were saying stuff like, "Oh, it's just a drunk Knox girl," etc. but of course this was not the case. I don't think I said anything else; it was like my brain couldn't process what was going on. I do remember being carried outside. I think someone said there was an ambulance coming. This time there were people holding on to me, so I didn't fall again, but I think I went under again. I think the fresh air helped revive me, and I woke up for good. There were police officers and various people from inside the bar. This was scary because I realized that some time had passed. At this point I felt nearly normal; they asked me if I wanted the ambulance to take me to the hospital. I didn't, especially, but knew I should be sensible, so I said yes. I could tell everyone thought I would keel over again the way they were holding on to me, but I felt pretty stable.

In the ambulance, I heard them okay Mark to ride in the front seat to the hospital. Meanwhile, the paramedic asked me how I felt and I said that I felt pretty good, just tired. I felt mortified and embarrassed, not to mention guilty for using up resources and causing people to worry, so I tried to be as helpful and nice as possible. I don't think she really heard me because she put in an IV and said I would start to feel a lot better. Since I wasn't dehydrated to begin with, there was no change that I could discern. She took my pulse and blood pressure. I started to cry a little, thinking about my friends back at the bar who didn't know what was going on and were probably worried. I also figured this would pretty much ruin the night for at least a few of my friends.

We got to the hospital and they wheeled me inside. They kept warning me about the bumps, but I told them it was like riding a cloud and they were doing just fine (they really were!). Michelle and Margaret were there already and I waved and gave them a thumbs-up to let them know I was fine. I must have looked like a wreck--I had an IV and one of those oxygen tube thingies up my nose. Those are really uncomfortable, by the way. Margaret said "You look great!" so I had to laugh even though I was still crying. Inside, they had me change into a hospital gown and then they took my blood pressure and pulse and everything again. After a while, they let Mark come back to sit with me, so that helped. They drew some blood and took my blood pressure about four more times. Eventually a doctor came in and asked some questions. I signed a bunch of things--can't even remember what, isn't that nice?

They gave me another IV bag and I was actually starting to feel worse than when I had gotten into the ambulance. I also really had to go. I felt a little better after this, but I still felt nauseous. Then I started to get really cold, so Mark went to find a blanket. He actually found one that had been heated, so it felt like heaven. At last the doctor came back and told me that I am anemic and that my hemoglobin is low. Almost as an afterthought, he mentioned that finding that was a coincidence and that it hadn't caused me to black out. They couldn't find anything else wrong with me. If I hadn't been half asleep and unable to form coherent thoughts, I would have gotten more details. He certainly didn't volunteer any. He gave me a prescription for iron.

They found a pair of scrub pants for me to wear out of there (I had soiled the pants I was wearing), and I finally left. I think it was about 3 a.m. I felt worse than ever, but I didn't say anything because I wanted the hell out of that hospital. Margaret took us to Chris' and then I threw up and felt quite a bit better. I still felt nauseous, but couldn't throw up anymore. I finally got to sleep around 5.

I didn't look at the papers I got until the next day. My official diagnosis was some unpronounceable V-word that is caused by the sight of blood, needle sticks, or stressful circumstances. Riiiiight. And no details whatsoever about the anemia. I suppose I can conclude that it's iron-deficiency anemia. But I would sure like to know my hemoglobin level and other details. I'm getting more and more mad at that doctor. I'm pretty sure that he took one look at me and assumed I'm some half-anorexic lush party girl. I didn't have a chance to tell him that I'm a marathoner, which was pretty important information for him to know. The whole thing seemed like of sketchy to me. The paramedics and nurse were all very nice (the doctor was kind of a dick) but I got the feeling they all thought I had partied too hard and was paying the price I deserved to pay. Being stereotyped really pisses me the hell off. But at least my blood alcohol level was probably so low they had to rule that out.

I don't know much about anemia, but it seems like something that could cause a person to black out. I mean, I know one symptom is dizziness or lightheadedness. And iron/hemoglobin is responsible for getting oxygen to the muscles and organs, including the brain. It makes much more sense than any other explanation I heard.

So now I'm kind of at a loss for what to do. I am thinking of finding a doctor here and getting more blood work done to confirm the anemia and find out what my levels are. If not, I'll find one after I've been on the iron for a while to see if my iron levels are getting back up to normal. I haven't tried running since it happened, and I'm not sure if I should or not. I feel pretty normal. I'll probably try it and just listen to my body. If I need to take time off, so be it. I'm wondering how long I might have been anemic and how much it's affected me over the past several months. Could it have slowed me down? I don't remember feeling overtired or anything, except a little at the peak of my marathon training, and that's normal. I just don't know. We'll see what happens.


DawnB said...

Miranda thank you for race report nice job and agian congratulations!!!
Wow I'm really sorry to hear about what happen. I would confirm with a doctor. go ahead and get the second opion

Al Durham said...

Great story! I did not realize those miles in the middle of the event were that fast. I hope that did not affect you to much. I actually fell into the "death - please God let me make it to the finish line - march" around mile 23. So I understand what you were going through. I did cheat and walk a little though. I am very sorry to hear about your iron issues. I know that you can make it through. I was actually diagnosed with a calcium defficeney a number of years back. Thus the reason I have to take tons of supplements. Plus my doctor has warned me in the past that my blood tests show that I am slightly anemic and that it may be caused by all of the stress I put my body through. Running - biking etc... Thus the reason he says I need to consume so many calories a day, and also during my training sessions. I took 9 power gels during the marathon! I guess the good news is that he says he has seen the similar situatuon in other runners and bikers that he treats. He just wants to keep an eye on it in case it gets worse. Good luck and if you are ever bac in Michigan running a race let me know.

Nitmos said...

First of all, congratulations again on the PR. It looks like you are right where you want to be for the first 18 miles or so and just may need a bit more distance work to extend that, however, there seems to be a plausible reason for that....

...which brings me to the second point: get in to see a personal physician who can formalize the impromptu emergency room diagnosis. You can't move along to managing whatever it is until your doctor has run all the tests. Plus, you want to know how it impacts your running.

Good Luck!

jen said...

Wow! That was an epic post, thank you for sharing all that!

First, congratulations!!! You did so great at the marathon. You ran beautifully controlled pace for most of the race, a sign you trained very well and are a super runner. I can't believe your perseverence through the last miles, that's incredible. Given how you were feeling, that pace is actually very strong and very respectable! Your finishing kick is so impressive too. Congrats on the PR! And great pictures too, you look so cute! The course looks pretty too. :)

I don't have any information to offer on the anemia and your awful experience that night, but I'm so glad you are ok! You handled the situation very well. I love how you were so worried about everyone else, you are so selfless! I hope you are better soon and that you get all the information you need on your condition. ((hugs))

Nuke Runner said...

Wow, those blackouts sounded scary just reading them. I know nothing about anemia, but it certainly does sound like something you need to pursue with a good competent doctor (unlike the ER doc).

Congratulations on the PR!

Russ said...

congrats again on pr. great report. the good news is now you have some physical answers (if diagnosed correctly) that give you confidence that with proper treatment will allow you to go even faster.