Hydrating for a desert ultra

Monday, November 19, 2018

The biggest worry people seemed to have about my desert ultra was how I was going to stay hydrated.  In actual fact, more people tend to suffer from hyponatremia during these sorts of events than dehydration.  Hyponatremia happens when you drink too much water and the salts in your body reach a low concentration.  I remember hearing stories of people dying from chugging water for a radio contest or when pledging a fraternity (because they were under age).  Careful planning went into the food and supplements I brought with me to Jordan.  I chose salty foods, like Lucky Me instant noodles and pretzels.  I also brought Tailwind and nuun tablets, both of which provide electrolytes by dissolving the product in your water.  Finally, I invested in salt tablets from Decathlon as an additional preventative measure.

The week before the race, I started taking the salt tablets as directed on the bottle to make sure I could stomach them and also to start off with a higher-than-normal salt concentration.  I avoided drinking loads in the week leading up to the race and on the plane.  Starting off my adventure with a hangover would not be wise.  My plan was to space out the salt suppliments I had evenly throughout the day and hope it did the trick.

It is hard to know exactly how much salt is gained or lost during an ultra.  I couldn't really see what color my urine was nor did I have a lot of salt sweat on my skin.  I was drinking 1-2 liters of water every 10k with either a serving of Tailwind or nuun.  The food was pre-planned out but could be swapped if I felt thirsty or a bit off.  Luckily, I did something right as I was able to maintain my body weight, muscle mass and percent body fat over the 5 days.  Some people lost as much as 10kg while most lost 2-3kg.  One person even gained weight (I have no idea how!).  This is reflection of what they ate and drank over the entire week, not just during the running bits.  One person needed an IV after day 4 and another started to exhibit signs of hyponatremia.  She quit for the day after a short trip to the ambulance.

We finished the race on a Friday and spent half of Saturday on a bus and half walking around Petra in the midday sun.  We also partied hard on Friday and Saturday, celebrating our crazy feat.  When I got home on Sunday night, I was exhausted from the ultra, the Jordan heat, the late night parties and the early morning flight.  Luckily, I had a visit from the IV Doc booked in as my last defense against my body rebelling against a tough week.

What is the IV Doc?
It is a visiting nurse service that comes to your home, work, gym, etc to administer saline in addition to detoxifying and energizing additives, such as vitamins and amino acids.  When I made the appointment in August, I had to complete a short medical history questionnaire and have a screening call with the doctor.  The at-home visit was eight hours after I landed from Jordan but I still sent them my flight details just in case I was delayed.  The IV Doc confirmed my appointment for an antioxidant IV hydration therapy 24 hours in advance by email too so I wouldn't forget in my jet lag haze.

My experience
My nurse, Judy, arrived at my home with a suitcase full of goodies.  She had saline, liquid vitamins, syringes, and everything else needed for my treatment.  She reviewed my medical history, allergies and asked how I was feeling.  With my info, she said she wouldn't be able to give me one specific solution due to my allergy to sulfa drugs but she could give me extra vitamin B with an intramuscular injection.  We then called the doctor to confirm my prescription.   I actually talked to him too about my allergy and current medications.

Once we got the all clear from the doctor, we set me up on the couch with Bridezillas on the television and a needle in my arm.  My husband got Judy and I tea and we chatted for a while about my race, her upcoming wedding, and working for the NHS.  After 30 minutes, Judy increased the drip speed as I hadn't had any ill effects.  It took just over an hour for the bag to drain entirely. The time passed quickly though as she was very easy to talk to.  Before the appointment, I was wondering what the nurse does during the treatment.  Judy said it depends on the person and where they are having the treatment.  She said people at work tend to be more tense and formal, while home visits are relaxed.

I had read that some people get the chills during the at-home IV treatments, but I was comfortable the entire time.  The needle didn't bother me and I didn't have to go to the bathroom during the drip.  When the bag was nearly empty, Judy unhooked me, tidied everything up and took all of the waste with her.  My husband and I didn't have to worry about needles in the rubbish, which was a relief.  In total, the appointment took about two and a half hours.  It was wonderful to have the treatment in my home, rather than having to travel to an office after a grueling week of travel.

Who is this service for?
Judy told me that athletes use The IV Doc before and or after big competitions.  Entertainers who have a long gig (such as at a festival) or two performance a day (matinee and evening) have also booked in with her.  Obviously, after traveling is a popular choice, as well as after a big night out that results in a hangover.  It is something that would have been a game changer during the Wadi Rum Ultra for participants who were struggling a bit (I am going to suggest it to the organizers).  My treatment was designed to help me get back to a balanced state by providing immediate hydration.  The solution also boosted my immune system and helped increase my oxygen delivery to improve my energy levels and fight fatigue.

The following day, I was back to work and feeling fine.  I was still a little stiff but my feet were less swollen and I slept well.  It was back to normal life after an incredible experience I will never forget.

Thanks to the The IV Doc for the complementary service.  All opinions are honest and my own.

To run or not to run? That is the question.

Thursday, November 15, 2018

I wrote this post in the week leading up to NYC Marathon. It gives a good insight into the worries runners have when training no longer takes up most of their time. 

Maranoia- paranoia about your health, including but not limited to niggles, aches, pains and cold-like symptoms, in the weeks leading up to a marathon

Since coming back from the Wadi Rum Ultra, my right ankle hasn’t felt right.  The range of motion (ROM) was decreased and something inside the joint felt locked and stiff.  Many other parts of my body hurt too so I didn’t pay too much attention for the first few days I was back in the UK.  Over time, the other aches went away and the blisters on my feet healed (no toe nails have dropped off yet).  But my ankle was still off.

I knew only having three weeks between these two big races was a risk.  Running across all of the unstable sand made my ankles work harder than usual.  My biggest fear is that if I run the NYC Marathon on 4 November, I will do long-term or permanent damage to my ankle.  This winter, the plan was to cut back on the miles a bit and spend more time strength training.  However, I also wanted to get back to Track Tuesdays with Advent Running.  I haven’t been in two months and I miss seeing everyone and working hard.  Hopefully my performance will not have suffered by the time I make it back.

Luckily for me, osteopath consultations are covered under my Simplyhealth active plan.  The team at Function360 have a few osteopaths on site, so I booked in for an hour long appointment with Victor.  He had seen me prior to Wadi RUm Ultra for a pain I had in my neck (another case of maranoia).  As we already had a rapport and he knew a bit about my 4x4 Challenge, I felt safe in his hands.  I also know that the Function360 team supports their clients’ goals.  If I said I definitely wanted to run NYC Marathon, Victor would make it happen.

We began with a chat about what the pain was, where it was, and how it felt.  He then observed me moving a few different ways (on my toes, on my heels, bending knees, etc) to see how my ROM and flexibility was on my right vs left side.  He then had me sit on the table and palpated my feet, ankles and calves.  By observing what points were painful for me and how ankles and feet felt under his touch, his detective work continued.  He determined I had a strain and possibly sprain on the inside of my right ankle.  As treatment, he spent some time massaging around my medial mallelous, and also on my calves (sometimes tight calves can cause pain in the feet) to help relieve the pain.  Victor moved my right leg and foot around to encourage lymph drainage and inserted about five acupuncture needles in my ankle to help address the pain.  The last step of my treatment was taping the inside of my right leg from my ankle to mid-calf with a single piece of kinesiology tape. I had always thought taping was a placebo affect, but Victor told me that this study showed that kinesology tape helped promote lymphatic drainage.  The tape stayed in place for three days.

Victor recommended active recovery that was low impact, such as swimming or cycling.  He also wanted me to do some ankle strengthening exercises to help loosen the joint and promote strength.  I only went swimming once, combining walking the water with a doggie paddle as I didn’t want to get my hair wet (but it did anyways).  I also did a yoga class, some slow dog walks, taught indoor cycling once, and lead a beginner’s 5K before work one day at a 10 min/mile pace.

A week after my initial visit, my ankle ROM had improved but it still wasn’t feeling 100%.  I booked a 30 minute appointment to follow up with Victor.  We chatted briefly about what I had been doing to recovery since we last met and how the ankle was feeling.  He again observed me walking and stretching in various ways before manipulating my foot and ankle to find the source of the pain.  Using massage wax, he used manual therapy on the tenderest areas.  He also performed some traction on my ankles.

At this point I was really torn.  Victor confirmed there was still a strain (ligaments) and/or sprain (tendon) in my right ankle.  The process takes 21 days to heal so I technically would have enough time to be ready for the NYC Marathon.  On the other hand, working too hard during the race (like for a PB) so soon after injury could make the complete recovery process take longer.  Victor said the decision was up to me as there was a chance I would be better.  Again, he recommended low impact activities and that I invest in an ankle brace if I was going to run the marathon for additional support.  My ankle feel fine running unless it moves left and right, which might happen during the race as I avoid water bottles and other runners on the road.  Luckily, I know I have medical care available if I do decide to run as my active plan runs for a full year and covers physiotherapy, osteopathy, acupuncture, and more.

There is a chance my travel insurance will reimburse my trip after receiving a letter from Victor, who is a member of the General Osteopathic Council, explaining I am not fit to travel.  I have been doing some soul searching to decide what I should do.  This trip is a package deal with a tour company, so I won’t get a refund from them, not would I be eligible to defer my place to next year.  I am working hard to complete all of the World Marathon Majors but my Chicago race last year was a horrible time due to injuries.  I wanted NYC to be a PB.

Update #1:  I was able to run the entire NYC Marathon.  A full review of the race is forthcoming here on the blog.  Luckily, my ankle didn't bother me at all.  Instead, I ended up stopping to use the loo five times.  It wasn't a PB race but not my worst either.  I am back to light running this week and look forward to getting that PB in 2019.

Update #2:  After teaching spin class Monday night, going to track Tuesday, and then leading a run club Wednesday morning, my ankle was a bit tender to the touch.  I was able to book an appointment last night with Victor who said I need a longer break from running.  He also taped my ankle and gave me isometric exercises to do.  Someone please hold me accountable on these as I am eager to run again!

Have you ever been in a similar situation?  What did you do?  Leave a comment below and let me know.

Thanks to Simplyhealth for sponsoring my 4x4 Challenge.  NYC Marathon is the last race in the set. 

Join my beginner's run club

Monday, November 12, 2018

I was never a fast runner.  Even now, I am fast for me but nowhere near as speedy as some of my friends.  There have been many times where I have showed up for a group run (either formally or informally organized) and found myself at the back, wondering how much longer it would be until I got lost (have a read of my blog post on how to be a good run club leader).  Turning up to track or even parkrun can be scary because nobody wants to finish last.

You know what?  It is ok to run slower than other people.  Perhaps you have a goal though to improve your running speed. It is up to you if you want to build up your run/walk intervals or want to finish a 5K without walking. There are several ways to get faster.  One is to develop your running muscles (primarily glutes and hamstrings) by lifting weights.  Another way is to add speed work and hill sessions to your training regime.  If you are a beginner though, you might just need to run more frequently.

Rather than wait for the calendar to change to 2019, why not join me on Wednesday mornings through 19 December for a beginners' run club?  We meet at 6:45am for 7am departure near Kings Cross/St Pancras stations.  There is a free bag drop available and our route is predominantly along the towpath.  We have up to 60 minutes to run and or walk 5K before returning to the start point to collect our bags.

Early morning runs can be tough, especially when it is cold and dark outside.  Running with a group is the perfect way to add accountability.  Plus you will be ready to set brand new goals in 2019.

Sign up for MyCrew app today and then register for the runs you can make.  I would love to see you there.  Feel free to invite your friends and colleagues.  I always say, "the more the merrier".

My 4x4 Challenge is complete!

Friday, November 9, 2018

I am experiencing a wave of relief as I type this.  I knew that the 4x4 challenge would be tough on me physically, mentally and emotionally.  There was so much packing, logistics, planning and physical effort involved to get it done.  My house is a mess with bags half unpacked and new kit without a place to go. My usual habit is over-committing, so I am really looking forward to having no races booked in until February 2019.  My first first priority now that I am done is sorting out my house (which will also keep my husband happy) and then focus on strength training.  That Boston Qualifier isn't going to come without some more hard work.

Here is a very brief recap of the races:

Marathon du Medoc, near Bordeaux France
Unofficial time:  6:21:31 (Link to my strava stats here)
Read my race review here

Ragnar Relay, along British coast
4 legs totaling 26.5 miles in less than 40 hours
Race review forthcoming

Photo by Ben Tufnell

Wadi Rum Ultra
, Jordan
257 km over 5 days.  Hardest thing I have ever done
Race review forthcoming

NYC Marathon, USA
Official time: 4:49:15 due to 5 bathroom stops and sore legs from mile 20. Also my 4th World Marathon Major.
Race review forthcoming

Hogwarts Running Club Platform 9 3/4 run, benefiting Rods Racing 
Bonus virtual race because I have a t-shirt that says "Run like You Know Who is chasing you".

Coming soon are a million blog posts about the races, the kit, and preparation.  If there is anything in particular you want to know about, leave a comment below and I will do my best to answer it.

Big thanks to Simplyhealth for supporting my 4x4 Challenge.  Learn more about their new Active Plan by clicking here.

And don't forget that through the month of December, I have an inspirational advent post every day through Christmas.  Be sure to bookmark www.ptmollie.com so you see each and every one.

Healing power of nature

Thursday, October 25, 2018

Urban forest
This weekend I had the pleasure of attending Wild and Well Festival in Bristol.  It offered four different themes: Move, Explore, Connect and Eat, with workshops, panel discussion, fitness classes, and demonstrations across five venues.  For me, the theme of nature and being outdoors kept cropping up as I thought about my happiest moments, what calms me, and why I take on crazy fitness challenges.  I also learned about the Blue Mind movement, which has sparked my interest as marine biologist, personal trainer and health coach.  After the NYC Marathon, I will be reading up on these in my down time and sharing the highlights with you here on the blog and on social media (click on pink circle to the right to follow me).

It absolutely makes sense to me that being outside and connecting with nature can have healing powers.  This really became clear to me after visiting Cape Town in February 2017.  Two weeks in the sunshine and one week along the sea changed my outlook on life.  I now know I need to be outside as much as possible, with a good dose of Vitamin Sea to be content, as well as ample sunshine.  I found a sense of calm and enjoyed being alone in my thoughts while visiting South Africa.  Part of this was due to a semi-digital detox without a SIM card to stay connected when away from my hotel.  Think about how much time you spend each day being bombarded with emails, phone calls, text messages, meetings, and personal space invasions while on public transport.  Removing technology can make a big difference in how you experience your free time.

Taking the path less traveled
As I spent Sunday outside in the chilly sun of along Bristol's harbor side, I realized how hard it can be for people living in cities to find ways to be in nature and/or unplugged.  Available green spaces in cities might be small, with audio stimulation from traffic and visual stimulation from people walking by. Areas with water, such as rivers, streams, canals or reservoirs, are even harder to come by when landlocked.  When was the last time you sat alone in the woods or a field and took in your surroundings?

Walking wild
If you make an effort though to visit nature, maybe not daily, but at least once a week, (and leave the phone at home), it will help calm your body and mind.  City life is overstimulating.  Being alone in nature can help combat the effects.   Here are some tips on how to find and enjoy the experience of nature healing:
  • When you get to an open green (or blue) space, turn off any music you might be listening to and silence your phone.  Listen to wind, trees and birds around you.  Breathe deeply and listen to your breath.
  • If you live in London, walk along the towpath in the early morning when it is least busy.  Look at your surroundings rather than down in front of your feet.
  • Flotation therapy, such as that offered by Floatworks in London, is where you float in super salty water in a pod which allows for sensory deprivation in a meditative state.  You will experience physical and mental relief of life's stressors that occur outside the tank.  This is a great option to try if you cannot find green space or water near where you live.
  • Consider a train or bus journey to the woods or coast for a day trip off the grid.
  • Book an active holiday where you bike, hike, swim, run, or camp.
Capri length can be a good options in the spring and autumn
  • Dress appropriately so you enjoy the moment rather than worry about rain or temperatures.  I know I can be miserable if I am too hot or too cold!  The Jack Wolfskin tank show in the photos is great for warm days and for layering in the autumn.  The cut is very flattering for someone who has wider hips, like me.  Capri length trousers (such as the ones in the photos by Jack Wolfskin) are helpful too when the seasons are changing and you aren't sure if the temps will be the same in the afternoon as they were in the morning.  You never know what will happen so have some layering options in your bag if you can, including hat, gloves and rain jacket.
  • Look at the plants and wildlife as you explore.  See what you recognize and what you need to learn more about.  You might want to pick up a flora or fauna guide to help you identify what you saw during your time in nature.
I love having my dog with me on my walks
Do you ever feel the urge to be explore in green space?  How do you feel when your phone is off and you are alone in your thoughts?  What is your favorite part of being out in nature?  Leave a comment below and let me know.

Thanks to Simply Hike for providing me with the Jack Wolfskin kit to review.  All opinion are honest and my own.

Preparing my feet for desert running

Friday, October 19, 2018

Preparing for a desert ultra like Wadi Rum Ultra takes a lot of planning and organization.  Slowly you need to build up miles, gather the specific kit you will need, try out said kit, research camping food, try said camping food, and prepare your feet.  Then, in the last three weeks before the race, you need to add in sauna or Bikram yoga sessions, make sure your luggage doesn't go over the weight limit, and finally go see a chiropodist/podiatrist for a “medical pedicure” one week out.  This bit of advice can from my friend, Becs, who has done countless ultras, including Marathon Des Sables.  I don't usually get cosmetic pedicures unless I am going on a beach holiday.  Turns out “medical pedicures" are very different.

Using my Simplyhealth Active Plan, I found a place in London that meets the criteria for reimbursement under the chiropody/podiatry benefit of the Active Plan.  I went to Margaret Dabbs for a “medical pedicure” at cost of £85 for a 45 minute appointment.  I traveled from work to Marylebone on a sunny afternoon at the start of October and wasn't sure what to expect. “Medical pedicures” are performed on dry feet by a podiatrist or chiropodist.  The purpose is to thoroughly exam the feet, addressing any issues (such as nail fungus, ingrown toenail nails, dry skin, bunions, calluses, etc), shape/file the nails, and remove dead skin.

Using the drill to buff off skin around my toe nails
When I arrived at the clinic, there were several women having manicures with nail polish on the ground floor of the clinic.  My podiatrist, Laura, brought me to the basement into a small private room. She began by disinfecting my feet while explaining what she was going to do as it was my first time.  She examined my feet very carefully, looking in between and under each toe. I am lucky as my foot condition was 'mild' according to Laura.  She said my feet don't have a lot of fat on them (they are quite narrow) and I didn't have too much dry skin built up.  She proceeded to cut, then file, my toe nails.  She also buffed the nails before she put oil on my cuticles and explained that cuticles should never be pushed back as they compromises the protection around your nail bed.  Cosmetic manicures and pedicures have got it all wrong. Who knew?

Laura took a 'drill' (which it kind of is) to file down the rough skin around the bed of each nail. She used a scalpel to carefully scrape off all the dead skin on my feet and heels.  Next, she used a big rough file to further smooth the skin on my feet.  The treatment ended with the application of lotion to leave my feet feeling super soft and smelling fresh.

Laura taking a close look at my tootsies
Although Laura was not a runner, she had seen many runners for the same reason I was there.  She told me that it was good that I came in at least a week before my race.  To keep my feet in prime condition, I was to continue to moisturize in the lead up to the race but not to file (if I wasn’t racing, I was supposed to file every day).  We discussed black toenails (touch wood I have never experienced this) and she said that if I get one, I am to leave it alone unless it becomes painful.  She assured me if a black toenail falls off, it will grow back, although perhaps a little differently.

Scraping dead skin off with scalpel
Because me feet were in good condition, Laura said I could come back quarterly for a “medical pedicure” or sooner if I had any problems.  She was easy to talk to and I am very happy with how soft and smooth my feet were.  It did seem like a bit of an indulgence so I am glad my Simplyhealth Active Plan will reimburse me for the cost.  I think if my feet had a lot of issues, it would be something I would want to do regularly.  Although it didn't prevent me from loosing any toenails, I think I would definitely do it again if I signed up for another desert race.

The clinic emailed me the receipt the same day, which I will submit to Simplyhealth.  I did contact the clinic prior to booking to ensure their staff were registered with HCPC in order to meet the Simplyhealth criteria.  Hopefully I will have time this weekend to make my claim online.

Final result
Have you ever had a "medical pedicure"?  If so, why?  Let me know in the comments below.

Thanks to Simplyhealth for sponsoring my 4x4 Challenge and allowing me use of their Active Plan. All opinions are honest and my own.

Medical sign off for my first ultra

Tuesday, October 16, 2018

When you start running bigger and more challenging races, the organizers want to ensure you are in tip top shape to compete.  Some countries, such as France, will ask for a doctor to sign a release form stating you are fit for each and every race you run.  I had to do it for the Paris Half Marathon, which meant an appointment with my GP, taking time off work, and a £30 fee for a signature on a form.

Pre-race weigh in
Wadi Rum Ultra, race 3 in my 4x4 challenge upped the ante a bit and asked for an electrocaridogram (ECG), in addition to a doctor's note saying I was fit and healthy.  The race didn't provide an official form for the doctor to complete so I looked at what the Marathon des Sables form covered.  Included was a medical history, blood pressure, resting heart rate, allergies, and current medications.  I forwarded the link over to the Walk-In Clinic when they invited me in for my medical sign off.

I thought it would just be an ECG because that was included in my original wellwomen appointment in 2017 as that is all the race asked for.  Instead, I was pleasantly surprised for a full physical, ECG, and urine analysis which in total lasted just under an hour.  The Walk-In Clinic have their own sports physical form which made it a bit easier to send the required info over to the race organizers.

Low blood pressure
The doctor is the one I have met in my past visits (including travel vaccination) so we have already built up a bit of a rapport.  She asked relevant questions about the race (how far, how long, what is the environment, how have you been preparing).  We had plenty of time to discuss these answers and much more.  I asked her about hydration strategies as I was still trying to figure that one out.  She talked to.me about my anxiety medication and how I might experience hallucinations under these extreme conditions.

Hooked up for my ECG
The ECG was painless although a bit of a faff to connect to all of the wires.  I think I moved or took a deep breath during the first measurement because my graphs showed a bit dip.  We repeated the process and my resulting ECG was normal. Hurrah!

ECG results
The clinic receptionist offered to scan across my letter and ECG for me even though also they give me the original.  The team is always helpful and efficient.  I love visiting their clinic as the appointments run to time, are long enough that you don't have to rush any conversations with the GP you see, and the customer service is superb.  If you ever need something for a race (ECG, physical, travel vaccination, etc), I recommend booking in. This private practice offers more flexibility than a GP office with a central London location, next to the Gherkin.

Thanks the City Walk-In Clinic for the complementary service.  All opinions are honest and my own.