Amateur Endurance Athlete looking for help and advice.

Hello everyone
I haven't posted here in some time however I'm always reading your wonderfully informative write-ups. Unfortunately, I haven't come across any information with regards to training for a race with UC. In 2 months I will be attempting to run my 1st ultra marathon. The race is 113k over 2 days. Up until the last couple of weeks things have been good. Great even! But since my mileage has gone up I've been experiencing dizziness and the feeling of low blood pressure right before having a BM. I've had this before and usually once I go it goes away but lately this is not the case. It lingers for some time. I'm also getting abdominal pain with cramps that now only goes away with oxycodone. Tylenol dies nothing and Advil is a no-no. I know racing shuts down the GI tract but what's funny is my stomach always feels good when I'm running AND when my stomach is empty. All other times it feels like crap. I do take Salofalk which works some of the time.
I just wondered if there was anyone else in the same boat. I would really like to hear tips and ideas from others who run races with UC. Not doing the race is not an option because I'm a believer in where there's a will there's a way. Look forward to hearing from you!

Believe it or not I already take a Vit D supplement along with Zinc, Calcium, and Mg. I've just recently introduced Coenzyme Q10 also. Never thought about getting the blood profile though. I was taking fish oil for inflammation but I was getting way too much reflux and gas. So I stopped. My no-nos are exactly the same as yours and I've tried SCD and paleo diets with only short term success. As for working out, it's the only thing that makes me feel good both physically and mentally (I have bipolar disorder and now only take 1 med for that due to exercise) so when I weigh the pros and cons I'd rather exercise. Plus I've come across stories of elite athletes who have UC and/or Crohn's so I know it's possible.

foxyroxy7226 said...
Believe it or not I already take a Vit D supplement along with Zinc, Calcium, and Mg. I've just recently introduced Coenzyme Q10 also. Never thought about getting the blood profile though. I was taking fish oil for inflammation but I was getting way too much reflux and gas. So I stopped. My no-nos are exactly the same as yours and I've tried SCD and paleo diets with only short term success. As for working out, it's the only thing that makes me feel good both physically and mentally (I have bipolar disorder and now only take 1 med for that due to exercise) so when I weigh the pros and cons I'd rather exercise. Plus I've come across stories of elite athletes who have UC and/or Crohn's so I know it's possible.

It's possible, but it's rare for a reason. Some people are in remission for years, occasionally even decades.

But trying to run an ultra-marathon with active UC sounds like suicide to me. The fact you are taking Oxycodone for abdominal pain worries me; if you happen to have severe pancolitis, it will increase your chances of getting toxic megacolon.

I think you should at least have a colonoscopy before attempting this and see where your disease is at.

TADA!.......it's just your nervous system.

I have your answer.....What you are having is a vaso-vagal response, brought on by stimulation in your stomach. Vasovagal problems occurs in response to a trigger (in this case your stomach irritation and proceeding to evacuate), with a corresponding malfunction in the parts of the nervous system that regulate heart rate and blood pressure.

The heart rate slows, blood pressure drops, and the resulting lack of blood to the brain causes light headedness, fast heartbeat, nausea, paleness, break out in a sweat, fuzzy thoughts...that's a standard vaso-vagal reaction, chiefly brought on by a lowering of your blood pressure.

This is also what causes us to pass out when you bear down on the toilet...like Elvis did....except he never came back from it because he was on so many drugs his body couldn't recover itself from the spiral.

I'm not really sure if you can prevent it at all, but that's what it is. Most of us have that reaction and don't realize that's what it is right before or even during our bowel movement or even vomiting.

Being on pain killers will make it harder to rebound back from it since they lower your blood pressure as a side effect. If you can get off the painkillers, which are usually not used for UC, you may find this problem less of one.

Also, if you are an endurance runner, your BP is probably always on the lower side, meaning you have less wiggle room to spare before you get fuzzy.....so it all makes sense.

Getting off pain killers will get your BP back up and less a problem while pooping, and getting the UC under control will give you less of an irritating and strenuous vaso-vagal response when going to the bathroom...hope this helps.

I'm sorry to be a downer, but I think your body is trying to tell you something. You're obviously very worried about pleasing it with the food and supplements you take in, but you don't care to listen to it when it needs to talk to you? You may ignore it at your risk, I just hope the price you pay isn't too high. Good luck with your race if you choose to continue.

As an athlete, I admire what you're planning to do. I did a Tough Mudder at the beginning of my current flare (fall 2012) and was both proud of myself and really regretted doing it because I was sick for months afterward with respiratory problems I picked up doing the race (who knows what was in all that mud!?) due to my weakened immune system. Last year, I was training for a triathlon in 2013 and had to withdraw due to my health issues, which was pretty devastating but necessary.

You know your body better than anyone. I think everyone here is expressing concern that you listen to your body and know if you need to stop. I hope that you have an ongoing relationship with your GI and have been talking about your training and the upcoming race.

Remember that in ultras, finishing is not the most important goal; it's getting to the starting line.

Also, as an addendum, others have added some good points.

Dehydration can complicate the issue as well. This also puts a strain by further stressing your bowel, and if you are already constipated, it's going to make the vaso-vagal reaction worse. Low hydration = lower blood volume = lower blood pressure = even worse vaso-vagal response.

Although I commend you for what you are doing, this may also be hurting you in the long run. It may be a little easier for you to be NOT constipated and try Metamucil (or whatever would work without aggravating your UC) to avoid your very sensitive vaso-vagal reactions.

Whatever it is, it will certainly take some fine tuning. Regardless, you cannot drink too much water is my guess....your trigger is your bowel, and the constipation. Don't aggravate it.

Nice to hear from you Marathon 5!
This will actually be only my 2nd ultra race. My 1st was 50k a cpl years ago but like you I do a variety of 5s, 10s, halfs, and fulls. So nice to finally hear fom someone whose actually doing what I do. You're right about hydration. My trainer checked m body water level a month ago and it was borderline. I thought I was doing a pretty good job with the water then. However, this month's reading says I'm down so I've started doing what the bodybuilders at my gym do and carry the 4L jug of water. Would you believe I am still a little thirsty after that?! I don't drink juice, pop, or coffee. Just herbal tea here and there. So I'm probably not getting enough.
I'm trying my 4th kind of gel tomorrow. The others have gone through me so far but I never thought about taking Imodium. Gotta get some. So back to the drawing board :) I also use Honey stinger chews. And for the ultra, I will be using sunflower butter and honey on gluten free bread. I've tried this and it works. I will need it after about 35-40k (22-25 miles).
I'm in Canada so were just starting to warm up. It's funny you mention weather because in the deep cold of winter I don't have these issues. Only since getting warm do I feel things.
I've made my choice though and I'm sticking with it. If i had a choice I'd rather die while living than live while dying.
Cheers!

Scott Z said...
Also, as an addendum, others have added some good points.

Dehydration can complicate the issue as well. This also puts a strain by further stressing your bowel, and if you are already constipated, it's going to make the vaso-vagal reaction worse. Low hydration = lower blood volume = lower blood pressure = even worse vaso-vagal response.

Although I commend you for what you are doing, this may also be hurting you in the long run. It may be a little easier for you to be NOT constipated and try Metamucil (or whatever would work without aggravating your UC) to avoid your very sensitive vaso-vagal reactions.

Whatever it is, it will certainly take some fine tuning. Regardless, you cannot drink too much water is my guess....your trigger is your bowel, and the constipation. Don't aggravate it.

I have restarted my fiber tablets and increasing the water won't be an issue. I love water. It's my favorite drink! :)

Pluot said...

foxyroxy7226 said...
Not doing the race is not an option because I'm a believer in where there's a will there's a way.

Former competitive athlete checking in to say that the most important thing I learned from being sick is that this is an insidious lie. Motivational speakers, friends and family, and society at large does an incredibly cruel and massive disservice to the chronically ill by insisting that we can overcome medical issues through sheer force of will. I do believe that where there's a will you can perform at a level that is 100% of what your body is capable of. But your body is not arbitrarily capable of doing something just because you want it to be.

So if I understood you correctly given that you are a former competitive athlete. Your saying that when you were competing you were only able to do so when you were 100%? You never competed with an injury? Competing with an illness or injury requires more will because the physical is not there. For example, people who are missing limbs perform competively all the time and they do not have the 100% physical you say. Yet they have overcome their challenges and made due, ExCEPTIONAL due with what they have. Which is more than I can say for those of us who have everything. I may not be 100% but I'm not down and out either. I will always see the glass as half full because life is more joyous this way. I'd rather die living than live dying..

foxyroxy7226 said...

Pluot said...

foxyroxy7226 said...
Not doing the race is not an option because I'm a believer in where there's a will there's a way.

Former competitive athlete checking in to say that the most important thing I learned from being sick is that this is an insidious lie. Motivational speakers, friends and family, and society at large does an incredibly cruel and massive disservice to the chronically ill by insisting that we can overcome medical issues through sheer force of will. I do believe that where there's a will you can perform at a level that is 100% of what your body is capable of. But your body is not arbitrarily capable of doing something just because you want it to be.

So if I understood you correctly given that you are a former competitive athlete. Your saying that when you were competing you were only able to do so when you were 100%? You never competed with an injury? Competing with an illness or injury requires more will because the physical is not there. For example, people who are missing limbs perform competively all the time and they do not have the 100% physical you say. Yet they have overcome their challenges and made due, ExCEPTIONAL due with what they have. Which is more than I can say for those of us who have everything. I may not be 100% but I'm not down and out either. I will always see the glass as half full because life is more joyous this way. I'd rather die living than live dying..

No, you misunderstood me. I was saying that when you give it your all, you can achieve 100% of what your body is capable of. 100% of what my body is capable of is VERY different from 100% of what an olympic athlete is capable of. Try as I might, my 100% will never be that person's 100%. Having IBD places a REAL limit on what you can do that cannot be changed just by wanting it more or less.

You say: I have UC but I am going to run an ultramarathon anyway because where there's a will there's a way.

How is that different from telling someone: you have UC but you are going to have a perfectly solid once a day BM with no blood, pain, or mucus because where there's a will there's a way? Or, if you really wanted to be healthy you wouldn't be sick? Or, you are sick because you have a poor attitude?