Tuesday, August 20, 2019

An asymptomatic stomach ulcer: the internal grief of the people

My summer races have been catastrophically dissappointing. I've DNF'd Bighorn, Never Summer, and Bigfoot, for one consistent, justified reason: uncontrollable vomiting 5-7 hours into the race.

I have vomited in races before, and it's always due to an electrolyte/fluid volume mismatch or too much food and too much effort. The fix is easy - rehydrate and keep eating. Preventing it is also easy - just take in adequate electrolytes and don't eat too much too fast!

Let's rewind to Bighorn. I assumed the weird vomiting episode I had at the Quad Rock 50 was a one-time thing. By Cathedral Rock at mile 33 at Bighorn, I was getting the same symptoms: a bitter, acrid taste in my mouth and an extreme revulsion to food and water. An hour later, the vomiting began. It continued until I reached Footbridge again, at mile 66, at which point I called it. I had vomited 20+ times, sometimes wretching nothing more than a teaspoon from my stomach. You cannot really move through the mountains, let alone run, absorbing no calories or fluids. I sat near the fire at Footbridge, trying to eat, but constantly wretching and vomiting for the next 5 hours. Sleeping it off seemed to help, but for the next two days I had no hunger.

So I thought, maybe it was my switch to VFuel gels this year. I ate VFuel at both races, and it does taste kind of weird, so I decided to go back to an old stand-by: Cliff Shot gels. At Never Summer, the same thing happened: the same pre-vomiting bitter taste, the same non-stop vomiting.

Other runners and volunteers are obviously always trying to be helpful, but when you vomit for hours on end, no matter what you put in, sometimes vomiting nothing but bile - being told you just need some ginger, or electrolytes, gets patronizing very quickly. I've won a 100 miler, I think I know how to eat and drink!

So at Bigfoot I decided I'd try one last thing - getting even more electrolytes into my body. I focused on a steadier stream of salt by using some Tailwind and S-Caps cracked open in a bottle of water, rather than the occasional S-Cap or broth. Both of these drinks have served me well in the past. Same result. No matter what I do, even eating or drinking nothing, I vomit.

I did the only thing I could do: I set up an appointment with a gastroenterologist. And you know what? I'm not an idiot. Well, I am an idiot for taking this long to go to the doctor, when I knew I couldn't be doing anything bone-headed with my hydration. But the vomiting has been completely out of my control.

I have all of the symptoms of severe gastric reflux driven by an ulcer that would otherwise be asymptomatic. Apparently, you can have a non-bleeding stomach ulcer and not really notice it - unless, of course, you subject your stomach to the intense stress of eating and running in the mountains in hot weather. Being unable to eat for a day or two afterward? That's the ulcer calming down.

The supposed solution? Prilosec for a couple of weeks, and some anti-vomiting pills just in case. Will I go to Tahoe? Oh absolutely. I'm the kind of idiot that shows up to a race no matter what, but I think I've wrangled this thing. If I can run Tahoe, even badly, without uncontrollable vomiting, it will be the greatest physical victory I will have ever had in my life. I can't let that slip away.

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