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Vomiting: Please help!, Vomiting at mid to end of long races
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In the past few years I have raced several long course events (i.e. Ironman). I have dnf’d one of these events due to extreme stomach turmoil. Even in the three events I completed I still got sick to a large extent. The progression of events has been essentially the same in every case. I do fine on the swim and through a substantial portion of bike. In some cases I have been able to stave off vomiting until the early- to mid-stage of the run. Regardless of when it occurs, at some point I begin to become extremely fatiguedbonking and my stomach begins to feel very heavy. Continuing beyond this point usually results in vomiting. Once the vomiting starts it often continues for many hours and is somewhat scarey. I have struggled to find a solution to this problem. I typically have no problem in training although I train at slower pace. I do may half's Iron's at a little under 5 hrs with no distress and much like many of my buddies. My full IM's, however, are in the 1230 range unlike the SAME buddies who do them in 1030-11 hrs. I would appreciate any and all comments. My race nutrition water, enduro-lytes, Sustained Energy on the bike, and water, enduro-lytes, and hammer gel during the run. I had the same problem with a Gatorade/Powerbar combo. I've tried both under-hydrating and over-hydrating and various ranges in between. I am happy to provide more background here or offline to anyone who thinks they can help. I am male, age 41. I really help and any educated thoughts will be appreciated!
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Re: Vomiting: Please help!, Vomiting at mid to end of long races [mamdali] [ In reply to ]
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Well, obviously it is the food you're eating....and only you can figure out the solution. My guess would be to try some more solid foods at the mid point on the run. Try some more bananas on the ride and grab cookies on the run. Or even try something real solid at special needs bike?
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Re: Vomiting: Please help!, Vomiting at mid to end of long races [reggiedog] [ In reply to ]
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Reggiedog, thanks. What's your reasoning?
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Re: Vomiting: Please help!, Vomiting at mid to end of long races [mamdali] [ In reply to ]
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"I typically have no problem in training although I train at slower pace."

That could be one of your problems right there. Do some training at the intensity you are going to race at and use your race nutrition plan for a test. (or lower the intensity in races to what you do in training) Most foods are easy to digest at slow paces / lower intensities OR if you sit up more on the bike ... a little rise in intensity can change the dynamics of digestion as well as riding in a compressed position for longer periods than you are used too.

Thats a start and hope it helps ... other issues to look at as well like the make up of "foods" you eat before and during the events.

-------------------------
Dave Latourette
http://www.TTENation.com
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Re: Vomiting: Please help!, Vomiting at mid to end of long races [trifaster] [ In reply to ]
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After cycling competitively for nearly 20 years, I puked for the first time on a bicycle at Disney a few weeks ago, and felt nauseous for hours after. The reason? Brand new bike with a position that's too low in the front. I raised the front end immediately after the race, and raced this weekend with a great result. My stomach was cramped and not emptying.You may want to take a look at your position since you don't have issues on the swim.

I've also had friends who would puke if they went anaerobic really early in the bike. Again, stomach shutting down early on the bike
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Re: Vomiting: Please help!, Vomiting at mid to end of long races [mamdali] [ In reply to ]
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What are you eating and drinking?

What is your water to sugar intake? (sugar in both Gu and Drink)

What is your pre race meal?

Like was said...new bike w/lower position?

We need more info than just sick to get any kinda idea...then I bet we still have no better advice than train on what you race on.

----------------------------------------------------------

What if the Hokey Pokey is what it is all about?
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Re: Vomiting: Please help!, Vomiting at mid to end of long races [mamdali] [ In reply to ]
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Are you getting enough sodium? Sodium can help your stomach absorb water, often it will shut down when it gets too out of balance. Your stomach stops emptying water, but you keep putting it in, eventually you ralph. Other than that, I second the comments about training at race intensity. My limiter on the bike is how fast I can go and still keep my stomach working, not my legs. For a refernce, in an IM bike leg (or similar training ride) I take about 15 sodium tablets, more if it is really hot. You are smart to DNF if your stomach is toast.
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Re: Vomiting: Please help!, Vomiting at mid to end of long races [mamdali] [ In reply to ]
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My reasoning is only from my own experience, I "painted the road" at the 20 mile mark at IMFL. 2 qts. of hammer gel, endurolytes and water; full fire hose...I had never booted before in any sport, ever, and thought it was bizarre that exercize could make one puke. Well, that new experience, coupled with figuring that my Kona slot was history, made me try some stuff that I never did. Chicken broth (another thing that I thought was patentedly weird for an IM!) along with two aid stations of everything solid I could take in. I had the best 6 miles of running of my life thereafter (and copped a Q spot). But that was my 6th IM, and obviosuly I am still experimenting on the food thing. But I will definitely try more solids if I can figure out how...I did IMAZ trying bananas on the bike and cookies on the run, seemed to work fine....but again, still an experiement.
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Re: Vomiting: Please help!, Vomiting at mid to end of long races [mamdali] [ In reply to ]
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do you have

1. asthma

and/or

2. acid reflux disease?

both of these could cause the vomitting...
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Re: Vomiting: Please help!, Vomiting at mid to end of long races [mamdali] [ In reply to ]
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In Reply To:
Once the vomiting starts it often continues for many hours
I would just like to add that this kind of situation is very serious and could be quite dangerous to you. If it was me, I would really make an effort to solve this issue in training and try to get decent, highly qualified sportsmedicine advice before I would continue to race with this kind of reaction.





Where would you want to swim ?
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Re: Vomiting: Please help!, Vomiting at mid to end of long races [mamdali] [ In reply to ]
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Thank you everyone for the feedback. here is some more information. I decided to do this in segments to not pollute the thinking, BTW. So here are more stats:

I'm 41. 5'11". approx 167 lbs at race time. Body fat approx. 7%. Charming, deeply intellectual, and dashing good looks..(:). I go retro and don't shave my legs either.

Last year:

I started the races with a big bowl of raisin oatmeal and right before the swim downed a high power Ensure bottle (approx. 600 calories total).

I was also adding 9 scoops of Sustained Energy to each of two bottles to make an energy paste (total approx. 2000 calories). I was also downing about 3-4 hammer gels (approx 350 calories).

The total calories 'consumed' (and I use that term VERY loosely) by the end of the bike are the sum of these amounts which comes to about 3000 calories. I also will take approx. 4-5 bottles of water with about 5-6 endurolytes.

I feel nausea at around the end of the bike to the first 6 miles of the run and subsequently vomit. Before that contents of stomach are clearly sloshing. My bike work rate seriously diminishes around mile 90 (which is where it becomes painfully apparent that what I've been consuming is has not really been consumed at all). Depending on whether I continue or not or really reduce my speed my vomiting stops or it will persist for hours after the race (and I agree quite scary and perhaps dangerous ergo the DNF). I have onset cramping and always on the verge of full blown cramping but I keep it under control. Cramping has been a big factor my entire athletic life and I usually control it by high salt intake.

Fast forward this year:

After this happened a few times I decided I might be eating and drinking TOO MUCH. Now I have cut my calorie consumption by less than half and reduced the water intake by about %20. I feel a little stronger during training but toward the end I get the shakes and my heartbeat goes up by about 10 beats a minute and I'm clearly de-hydrated. I've also reduced my salt intake by about %20. I'm using this as a base to start increasing my intake slowly to see where I hit the sweet spot. However, I'm not persuaded that my hypothesis is correct ergo the call for help!

There is a direct correlation, BTW, between these symptoms and heat (duh). In a nice 60 degree day I'm in much better shape under same RACE work rates, albeit shorter races.

Yes, there is a problem with my tri -bike where my cockpit was too aggressive, I was hunched over and practically holding myself back from slipping over onto the front wheel and I was also pinching my stomach. I am addressing that and getting a new fit/bike. Meanwhile I'm training on my road bike.

It seems something happens to me around mile 85-90. Regardless, it became clear that the intake I have has not been absorbed and by the time I puke it's too late and I've slowed down significantly. I have NO PROBLEMS for half ironman.

Again thank you in advance for feedback and educated thoughts.
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Re: Vomiting: Please help!, Vomiting at mid to end of long races [mamdali] [ In reply to ]
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I will never consume anything made by Hammer Nutrition again - with the exception of Endurolytes. This is based on my experience with perpetuem - or "pukepetuem".

The only times I have ever hurled or felt like I was going to hurl, either in a long training session or in a race, was when I was taking that crap. Others have had great success with this vomit inducing sludge, but just the though of it is making me ill.

Cytomax and Gu for now.
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Re: Vomiting: Please help!, Vomiting at mid to end of long races [JohnA] [ In reply to ]
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Although I want to take the focus of discussion away from the TYPE of food I eat, I re-iterate I've had the same symptoms with Gatorade and Powerbars. I'm not so sure if Cyto and Gu would make a whole helluva lot of difference for me. I'm still open, however, to this line of thinking if there is scientific reasoning behind it. The main reason I take the HG stuff is the complex sugars. They also come across as quite credible with their commentaries on the subject altho I never forget the possibility of a 'smart' spin.
Last edited by: mamdali: Jun 6, 05 9:57
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Re: Vomiting: Please help!, Vomiting at mid to end of long races [mamdali] [ In reply to ]
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As a chronic long-course vomit guy, let me share my experiences and hopefully give you some things to try. Your mileage may vary. Over the course of sevaral Canadas, a couple Hawaiis, and IMNZ, I've had to play with the hourly caloric rate, the concentration of sugar in my gut, max HR to keep enough blood going to my stomach, and being very careful of the type of sugar in the foods and fluids I was taking.

The reason to try different products, is to find the sugars that work best for you. High fructos corn syrup works good for some folks, I personally need a simpler sugar chain or my stomach will shut down and eventually eject. Bright red fruit punch vomit certainly gets folks attention! The body absorbs at a given rate depending on the sugar % in your stomach. Get the % too high, and shutdown will occur. If your beverage is perfectly formulated for optimal absorbsion, and you add gels, you have just upped the % beyond optimal. That's why they say consume with water. Do some long rides on Gu product. Do some long rides on Powerbar product. Do some long rides on Cyto, Hammer, etc. Try to use only one manfs product because their sugars are usually the same throughout their product line. Put your self into vomit inducing situations (like high temps for me), and give these products a whirl. You'll find the sugar that works with your system, and the max caloric uptake your body can handle.
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Re: Vomiting: Please help!, Vomiting at mid to end of long races [mamdali] [ In reply to ]
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4 - 5 bottles of water assuming 20 oz per bottle leaves you with about 3 liters of water. 3000 calories gtives you 750 grams of carbohydrate.

Your average stomach concentration is then 25% carbohydrate. This is much too much. No way it will go down.

To add to the situaton, absorption is exertion dependent, you will only know if you can absorb the food by training at race intensity and trying to get it down.
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Re: Vomiting: Please help!, Vomiting at mid to end of long races [Kevin in MD] [ In reply to ]
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It's not always about the carbs. Too much protein will slow gastric emptying.
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Re: Vomiting: Please help!, Vomiting at mid to end of long races [mamdali] [ In reply to ]
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I'm also trying to figure out my nutrition and have a similar issue. Did my first race rehearsal this weekend in LP (112/4) and it was the first hot weather riding I've done this year (thank you New England weather). Anyway, my nutrition plan looked like this:

Hour 1: 1.5 Cliff bars, 1 large (22 oz) bottle Gatorade Endurance, ˝ bottle water (11 oz) = 540 cal / 108g carb.

Hour 2: 0.5 Cliff bars, 2 oz. GU, 1 bottle GE, ˝ bottle water = 490 cal / 113g carb.

Hour 3+: 3 oz. GU, 1 bottle GE, ˝ bottle water = 465 cal / 116g carb.

Eat every 20 minutes w/ water, drink every 10 minutes (GE)



All was well until about 80 or so miles into the day when it seems like my stomach was done. Same symptoms as you mention. Used similar scheme on my training rides at roughly the same intensity.

The advice I'm getting is that I'm not drinking enough water to dilute the carbs, etc. and make them easy enough for my stomach to digest.

Not sure if that's the trick, but I'll be trying it in the remaining time before my race.

Adam
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Re: Vomiting: Please help!, Vomiting at mid to end of long races [matrirunner] [ In reply to ]
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and you're eating way too many carbs! Everything I've read (most recently Triathlete mag nutrition issue, a month or 2 ago) tells me that most people can only digest 40-60g carbs per hour.

I'm not sayin', I'm just sayin'
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Re: Vomiting: Please help!, Vomiting at mid to end of long races [JohnA] [ In reply to ]
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Roget that on Hammer Gels. The only time I have ever come close to hurling is after eating Hammer gels. They were like strawberry jam. Gu or powergels -no problemo.

_________________________________
I'll be what I am
A solitary man
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Re: Vomiting: Please help!, Vomiting at mid to end of long races [mamdali] [ In reply to ]
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Change out the Red Bull and Jagermeister in your bottles with water.
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Re: Vomiting: Please help!, Vomiting at mid to end of long races [Chest Rockwell] [ In reply to ]
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No Red Bull...but maybe a little of the J.

But seriously now....any other thoughts on this? I've looked at posts from 2003 that are almost IDENTICAL to mine. I'm surprised there isn't a clear cut process developed to solve this knowing it's a 'known known' or at worse a 'known unknown'. I certainly hope it not an 'unknown unknown' in the tri and nutrition circles. That certainly doesn't bode well.
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