DeGray Lake Half Story

(Edit/update: I realized as I rode my bike across this dam on Saturday that it's not the same one we run across. Thankfully.)

This weekend will mark the 7th anniversary of my first Lake Degray half Ironman. I haven't done it every year since, but it will be my sixth time. Wow, I can't believe I've been doing these things so long. The picture is of the dam that we will run across FOUR times during the 13.1 miles. Notice the lack of shade.


This race makes me a little nervous (see above), but makes my mom really nervous, and not because she's participating. She used to come to my early races to make sure I got out of the lake alive. Now that she's sure I can swim, she only really worries about this mid-August race in the middle of Arkansas. Right Mom?


It's all because of what happened that first time, in 2001, when I was attempting my 2nd ever 1/2 Ironman. It was the inaugural Lake Degray 1/2 that year; I'd learn later never to race inaugural anything again (after IMCDA '03). As stupid as it sounded to be doing a 5+ hour race when the temperatures wouldn't be below 85 at 6 a.m., several of us from Memphis decided to give it a try.



It was hot from the start, yes, but all went well until the run. You can only expect a hilly course in that part of the state (or any part west of Crowley's Ridge, I think), and we weren't disappointed. I recall only a few things about the run other than the hills. First, it was hot, and we had little shade. I know I peed behind a truck a couple miles in (this was important to me later). The water stops weren't prepared. There was no ice, nothing but ambient-temperature water and Gatorade. When you're trying to decide between 95 degree water and 95 degree Gatorade, you'll probably pick the water. At one point at about the 8 mile mark, I caught my teammate Jon who was doing the same shuffle I was. He helpfully gave me a push (literally), but I remember almost stumbling because my legs couldn't react that fast. And that's it; that's all I really recall from the run.



When I finished, I'm sure I didn't look so great, not unlike any of the other competitors out there. My friend Tim convinced me that I'd feel much better if I got an IV from the med tent, so off I went for my post-race hydration. I remember showering after that, in the spray from the fire hose set up near transition. I remember eating a chicken salad sandwich, since there was no pizza left by then. The next thing I remember was getting highly annoyed with the race director during the awards. I had received mine, and I was waiting for Tim to get his so he could drive me back to Jenny's house in Little Rock. But the dude decided to stop right before Tim's age group to give away t-shirts. "We don't want t-shirts, we want to get this over with!" I actually yelled at him, loud enough for him to very likely hear. Tim looked at me quizzically and told me to calm down, but by that time, the electrolyte imbalance had taken over my brain, and, apparently, my tongue. I think I made a few more comments to him, feeling unusually agitated (not that I usually am), before we finally got the awards over with and I headed back to the med tent for two more bags of fluid. By the time we finally left the race, I was uncomfortable just sitting in the car. I had an incredible headache, I felt bloated, and I just hurt. I know I called and left Mom and Dad a message on the way home that said, "I'm alive, but barely." I had no idea what was happening to me.


Memories are even hazier from the time I got to Jenny and Tim's. They very smartly tried to force feed me soup and chips, which I generally turned away with disgust. I took a nap. Tim thought I was fine, so he left. I think it was around 10 p.m., 9 hours since I finished the race, when I was still feeling awful, and really worrying my poor sister and brother-in-law. We called the race doctor (she'd given me her number just in case), who was a resident at the local hospital in Little Rock, and she told us to meet her in the ER. For how much it hurt, we may well have driven there completely off-road in Tim's car; I remember the bumping around and the pain it caused me.


In the hospital, I was quickly hooked up to an IV (good thing I have lots of visible veins), and asked lots of questions. The poor nurse would start a sentence, and by the end of it, I had forgotten what she asked. She gave me some anti-nausea meds, and very soon after, I threw up all over her. I apologized to the orderly who had to clean up the mess.


At some point they took my clothes, put me in a gown, hooked me up to an EKG and inserted a catheter. They asked more questions, like "What year is it?" I remember answering quickly so they wouldn't think anything was wrong with me. My answer: 1991. Actual year: 2001. "Who is the President?" Totally a trick question! I got Bush right, but then they asked "father or son?" Come on, they're both fathers and both sons! I should've gotten credit for that one! I knew Jenny and Tim's names, and what I was doing in Arkansas. Then came "how old are you?" "Four, I mean eight," was my response. (Wrong again. I was 24.) My little sister Megan was flattered by this response, because it refers to a story about her. When she was 8, someone asked her, "are you four?" and her response was, "no, I'm eight." Apparently, that's at the top of my subconscious.


At some point I developed tremors and got annoyed with the doctor for asking how long I'd had them. I didn't even notice them until then, plus I couldn't understand what she said when she asked how long I'd been shaking. "Tracing?" "Shaking." "Trekking?" "Shaking." "Oh."


Twelve hours, 2 CT scans, one ultrasound, 9 liters of fluid (18.5 pounds), 11 billion needle sticks, and one trip to LR by my parents later, I got discharged. When my shorts wouldn't button the next morning, my mom said, "Your face is a little puffy too." Little did I know that all this fluid would be excreted small amounts at a time, every 20 minutes, for the next few days. I'm sorry I don't have pictures. My normal outie belly button was a horizontal slit.


At the time I was about to start my second semester in grad school, working on my master's in exercise physiology. This experience obviously interested me for many reasons. I don't remember how I concluded that it was hyponatremia, but before I even got a copy of my labs, I had decided that my symptoms fit perfectly. Bloating, headache, irritability (yay! it wasn't just my personality!), and tremors are all symptoms. Vomiting in this case was due to the brain swelling that was caused by the sodium imbalance. Symptoms that I thankfully did not experience were grand mal seizures, coma, respiratory failure, and death. Unfortunately, at that same race the following year, a 27-year-old man died of hyponatremia. Jon, the one who had pushed me, remembers talking to him as he lay there in the grass and coughed (his lungs were probably filling with fluid, which would later cause respiratory failure). How sad that this is a preventable thing, when an athlete is aware of and careful about their electrolyte intake during long distance races. Unfortunately, race directors seem to be very naive about this condition. Last year at Degray, in fact, the race director stood up at the pre-race meeting telling us it would be hot, so "drink, drink, drink!" This is precisely what gets so many people in trouble. Medical personnel often don't have the knowledge to diagnose and treat exercise-induced hyponatremia properly.


The reasons why the kidneys are not capable of excreting this extra fluid is still not clear; it seems to be because of an inappropriate secretion of anti-diuretic hormone (ADH). Those who are most susceptible include women, smaller people, slower runners (hey! I wasn't running slow. ok, maybe..), and those who exercise over 4 hours at a time. This can include marathoners, as I'm sure you've heard. Normal sodium levels are around 135-145 mmol/L. Serious, life-threatening hyponatremia is usually <=125, but sometimes symptoms (and death) can occur at levels much higher, and sometimes not until levels much lower. Mine was 127 during my first set of labs in the hospital; a few hours later, and many ounces of normal saline later, it had fallen to 125.


I have recently read that people suffering from heat illnesses are sometimes the last to realize that they are having symptoms. So watch out for your friends (and me-- just kidding mom, I've got it covered) at races and make sure if you see any signs of hyponatremia or heat illness appear, you alert the medical staff!


And that's my story.