I just took a DNF at my first IM (B2B), and I am wondering if anyone has any ideas what happened. i am puzzled
Here’s the story:
Really good (for me) swim 1:02 with the massive current. I can’t really swim that fast
Bike 6:15, right on schedule per my pre-race plan
Run:
This is where the wheels fell off. My first 7 miles went pretty much according to plan. I walked most of the first mile, and got my legs back under me, then I started a 2/1 run/walk strategy for the next six miles. At mile 7 the balls of both my feet started to burn a bit and I had to walk more than run. I walked to the waterstop at mile 9 and sat down to look at what was going on with my feet. Both of them had blisters about the size of a silver dollar on the bottom of them, and the on the left foot, the blister was starting to work its way around to the big toe side.
I could not run any more, and started walking. I figured that I would get back to the transition area, check in with the medical folks, get my feet taped up and head back out on the course. Little did I know how things would play out.
I got to the transition finally after a very painful walk and I put on my long-sleeved shirt and headed over to the med tent. I got taken to the triage section by. The folks there got my shoes off and were preparing to look at my feet to see what they could do for them.
The next thing I knew I was being loaded onto a stretcher.
I passed out.
The put me on Oxygen and rau two bags of IV solution through me. I managed to call my wife on a borrowed cell phone and she arrived shortly thereafter. Time passes strangely in situations like that. I thought I had not been laying there for more than 30 min. or so, but it turns out that I was in the med tent for a couple of hours. I was finally able to drink three bottles of water, and eat some gummy bears that my wife brought me, and they sent me on my way.
I drank 5 full aerobottles of water on the bike course, one whole flask (5 servings) of Hammer gel, 3 or 4 big (27oz) bottles of Heed, half a clif bar and a bag of kids Sharkies. On the run I alternated water and Heed at the stops (one every mile) and took a hammer gel at every third mile. I was peeing clear all day, so I thought I was properly hydrated, and I thought my nutrition was pretty close to right. I think that my body just recognized that my feet were messed-up and just shut down.
My blood pressure was a little high in the med tent 133/82 (115/70 is normal for me) and my HR was 80 on the cot (normal rhr is 51-52) I’m not sure what that says, but two bags of saline, and three bottles of water and I was able to hobble away
Yikes sorry to hear what a wacked out happening to you.
How are you doing now?
My guess would be that when they put your feet up your blood rushed to your brain and you passed out.
Ok now the real experts can tell you what actually happened.
What did the people in the medical tent tell you?
I am guessing you used the same socks and shoes on your long training runs.
What do you think caused the blisters in the first place?
Thanks, I’m fine now. They did not put my feet up, I ws just sitting in a folding chair at a little desk. Yep, same socks (Bal-go’s worn 2-3 times before), and Nike Air Structures. The blisters are a real mystery too.
No, They were a little busy.
I believe one of them might have said
“because you did an Ironman…duh”
or words to that effect.
I’m a little fuzzy on what happened in the med tent. If they had broken it down for me with a Powerpoint, I would probably still be asking this question.
I understand much better now. How is your wife doing
She is probably more than a little concerned about you doing another race. My wife doesn’t want me to do another HIM after how I was when I finished my first one.
How long do you think I should wait before I tell her I registered for a full IM? lol
go see a cardiologist - better to make sure everything is OK…
Yes, do that! ^
But there are really 2 things that will generally pass you out. One is low blood pressure and the second is low blood sugar.
You could certainly have had low blood sugar regardless of the fact that you were taking in carbs…there’s just no telling how much you were getting versus burning and what your insulin levels were doing. But one clue there would be that prior to passing out you’d have felt a ravenous apetite. (I’m guessing).
As for the blood pressure one that’s likely. Because you were working for so long when you just stopped and sat down your heartrate may have dropped too quickly for your then-plasma-volume to be properly pumped to the brain. 80bpm sounds very low actually for those circumstances.
But there are really 2 things that will generally pass you out. One is low blood pressure and the second is low blood sugar.
You could certainly have had low blood sugar regardless of the fact that you were taking in carbs…there’s just no telling how much you were getting versus burning and what your insulin levels were doing. But one clue there would be that prior to passing out you’d have felt a ravenous apetite. (I’m guessing).
As for the blood pressure one that’s likely. Because you were working for so long when you just stopped and sat down your heartrate may have dropped too quickly for your then-plasma-volume to be properly pumped to the brain. 80bpm sounds very low actually for those circumstances.
I’ve never heard of that before. I passed-out in my last triathlon (Sep) after finishing. I felt great and finished well - so much so that I thought I had time to clean up my transition area before a buddy of mine would be finishing. I started cleaning up my area and then apparently nose-dived into the bike rack. Marshalls picked me up and said I was shaking. Only out for ~30 seconds, then felt fine 5 minutes later. I was eating an apple at the time (so I doubt it was sugar related). I felt like an ass, and muttered that I wasn’t sure what happened only to get a “you just ran a triathlon…” response. I chalked it up to low blood pressure due to bending over and standing up straight to fast. I didn’t know your heart could slow down too fast after exercising. In fact, I have always used how fast my heart comes back down as a meter for fitness.
There could be a number of reasons for your problem but, My Friend, I am here to tell you as living proof: Go the doctor and have it checked out.
We think we are invulnerable as endurance athletes. To a degree, we are. But we are also human beings. Stuff goes wrong. As athletes we tell ourselves to ignore it. That can be a big mistake.
Your BP and HR increases are normal. BP increases with exercse and will remain elevated for a bit until cardiac output not to mention all of the catecholamines return to normal. Your HR can stay elevated for HOURS post exercise depending on the intensity and duration.
Did they tell you how long you were sitting before you passed out? The change in posture can definitely have an effect on venous return to the heart. ie. your legs weren’t moving anymore helping blood circulate back to the heart. Blood pooled in your legs. heart didn’t have enough to pump to the brain. Brain said FU and you are down for the count. Make sense?
do you remember what happened just before you passed out?
maybe they were dressing your feet - and it was (more) painful?
pain + dehydration + sitting (not laying down) – makes me suspicious that it was a vasovagal, and that it took longer to recover because of the dehydration / exhaustion.
ofcourse very hard to know - this just seems likely to me
Bobby, bending down to clean up your transition area puts your head down between your legs…that’s a recipe for passing out post triathlon (or if you’d been sitting for a long time first).
So, likely culprits are (in no particular order): blood pressure drop (sounds most likely) heart problem low blood sugar (I was not particularly hungry) salt deficiency?
This is helpful. Thanks
I just took a DNF at my first IM (B2B), and I am wondering if anyone has any ideas what happened. i am puzzled
Here’s the story:
Really good (for me) swim 1:02 with the massive current. I can’t really swim that fast
Bike 6:15, right on schedule per my pre-race plan
Run:
This is where the wheels fell off. My first 7 miles went pretty much according to plan. I walked most of the first mile, and got my legs back under me, then I started a 2/1 run/walk strategy for the next six miles. At mile 7 the balls of both my feet started to burn a bit and I had to walk more than run. I walked to the waterstop at mile 9 and sat down to look at what was going on with my feet. Both of them had blisters about the size of a silver dollar on the bottom of them, and the on the left foot, the blister was starting to work its way around to the big toe side.
I could not run any more, and started walking. I figured that I would get back to the transition area, check in with the medical folks, get my feet taped up and head back out on the course. Little did I know how things would play out.
I got to the transition finally after a very painful walk and I put on my long-sleeved shirt and headed over to the med tent. I got taken to the triage section by. The folks there got my shoes off and were preparing to look at my feet to see what they could do for them.
The next thing I knew I was being loaded onto a stretcher.
I passed out.
The put me on Oxygen and rau two bags of IV solution through me. I managed to call my wife on a borrowed cell phone and she arrived shortly thereafter. Time passes strangely in situations like that. I thought I had not been laying there for more than 30 min. or so, but it turns out that I was in the med tent for a couple of hours. I was finally able to drink three bottles of water, and eat some gummy bears that my wife brought me, and they sent me on my way.
I drank 5 full aerobottles of water on the bike course, one whole flask (5 servings) of Hammer gel, 3 or 4 big (27oz) bottles of Heed, half a clif bar and a bag of kids Sharkies. On the run I alternated water and Heed at the stops (one every mile) and took a hammer gel at every third mile. I was peeing clear all day, so I thought I was properly hydrated, and I thought my nutrition was pretty close to right. I think that my body just recognized that my feet were messed-up and just shut down.
My blood pressure was a little high in the med tent 133/82 (115/70 is normal for me) and my HR was 80 on the cot (normal rhr is 51-52) I’m not sure what that says, but two bags of saline, and three bottles of water and I was able to hobble away
Any wisdom?
I’m sorry to hear about this… it was a good effort. To me it sounds like you drank too much water and not enough solid food. It’s hard for me to follow what you ate and drank exactly. 500 calories of hammer and maybe 800 calories of Heed? Calorie wise, with the clif bag and Sharkies, you are probably right on in terms of numbers (~300 per hour), but IMO and this is just me, WAY too little solid food. It sounds like either way, your feet would have destroyed you
Did they tell you how long you were sitting before you passed out? The change in posture can definitely have an effect on venous return to the heart. ie. your legs weren’t moving anymore helping blood circulate back to the heart. Blood pooled in your legs. heart didn’t have enough to pump to the brain. Brain said FU and you are down for the count. Make sense?
It is always on the list of things NOT to do to suddenly sit down and lean over after doing an IM race, even if you don’t quite finish it. At that point your veins/arteries have lost a lot of their elasticity and motion of the legs is the primary thing that is pushing blood back up to your heart and head. Sit down and that return goes away. Bend over and you’ve restricted flow back from your legs…makes it even worse! I’d get it checked out, but I guarantee I won’t be sitting down after any major races, at least not for 10-15 minutes!
In Reply To Did they tell you how long you were sitting before you passed out? The change in posture can definitely have an effect on venous return to the heart. ie. your legs weren’t moving anymore helping blood circulate back to the heart. Blood pooled in your legs. heart didn’t have enough to pump to the brain. Brain said FU and you are down for the count. Make sense?
It is always on the list of things NOT to do to suddenly sit down and lean over after doing an IM race, even if you don’t quite finish it. At that point your veins/arteries have lost a lot of their elasticity and motion of the legs is the primary thing that is pushing blood back up to your heart and head. Sit down and that return goes away. Bend over and you’ve restricted flow back from your legs…makes it even worse! I’d get it checked out, but I guarantee I won’t be sitting down after any major races, at least not for 10-15 minutes!
Yeah, the sitting down was probably a factor, but I’m not sure I could have balanced on one foot while they taped me up either
If you could have, that would have been impressive!
However, it probably still wouldn’t have helped because the blood would still have pooled in your legs and away from your brain. Since you had to stop for a time, elevating your feet/legs may have been your only choice. Try to remember the sensations you had just before you passed out (lightheadedness most likely) so you can see it coming next time.
You also might have been a touch heavy with your hydration. Were your feet swollen at all? Did you have “sloshiness” in your stomach?
