Disaster Recovery Part 2: Figuring Out the Dehydration

It's been three weeks since I crashed and burned at Ironman Lake Placid. The crash: with six miles to go in the best race of my life, I lost all my cookies (read: fluids) at an aid station, then stumbled one more mile to collapse from severe dehydration at the next aid station. The biggest questions in my mind are still there: Why was there no obvious warning? and why did I seemingly have no chance for recovery?

I've been analyzing what happened over and over in my head since the moment I arrived at the finish line in the ambulance. I asked the medical staff there -- the only answer they gave me for the vomiting and dehydration was that my stomach just "shut down." Why? "It just happens sometimes." Not good enough. I need a reason. This absolutely cannot happen again.

I came up with three causes of stomach shut-down: I ate (or drank) too much, I ate (or drank) too little. I ran too hard. Ok, that's really five causes. And there was a sixth: I didn't get any sleep the night before the race (as I've said many times, no sleep almost always translates to GI issues on race day). Then there were seven: too much water, not enough electrolytes. Eight: not enough water, too much electrolytes. Cause number nine? Anyone?

Basically, there are so many possibilities, it seems impossible to narrow it down. What if it were a combination of things? Now I want to tear my hair out. Am I the only one who has these problems? How could I have trained for it? All my long bike-run sessions went just fine with the nutrition I chose. No vomiting, no dehydration. I even ran a marathon in May to test myself. Will it now be necessary to do a full Ironman in training to test my nutrition and hydration plan?

I guess I have to start somewhere. The search for a nutrition reference has commenced. The first thing I did was Google "stomach shut down ironman" and the first reference that turned up was this: Competitive Ironman Nutrition Planning. There it was, in black and white:

If your stomach “shuts down” during the race you either 1) went out too fast - poor pacing strategy/control, 2) ate too much solid food, 3) did not take in enough water, or 4) are becoming hyponatremic (low blood sodium level).

In all honesty, I don't think I ran too hard. That's the one thing I'm relatively sure of. Well.. maybe 90% sure. So I'm going with it being a nutrition issue. Another reference online suggested, for another athlete's similar situation, that signs point to "dehydration or electrolyte imbalance." I guess I'll start there. In 2008, at age 43, I started experiencing regular vomiting during my long runs while training for the Philadelphia Marathon. I had never had that problem before. Research concluded it was caused by hyponatremia -- increasing my electrolyte intake during long runs took care of the problem. My electrolyte requirements had somehow changed with age, and I could no longer do a 20-miler with only water as I did in my 30s. Perhaps the electrolyte issues continue to increase with age -- I wonder, when I'm 50, will I need to add Marmite to my diet and put soy sauce on everything I eat?

My husband is pushing for me to find a sports nutritionist. I guess that wouldn't hurt either. And maybe I should find a sports psychiatrist while I'm at it.