100 mile nutrition DNF - help request (Read 165 times)

I'm looking for a bit of advice on 100 mile nutrition. I dropped at mile 78 of a race this weekend (Mohican 100) after nausea from mile 60 on left me unable to eat or drink (even water). I ran / walked to mile 65 and then walked only (trying to get my stomach to settle) to 78 where I finally dropped. By 73 I was a bit unstable on my feet, felt like I couldn't quite catch my breath, any exertion sent my heart rate through the roof and I just felt like something was seriously wrong. I dropped because I felt like it was that or the hospital, however, I was completely mentally clear the whole time. My fingers had started swelling around mile 35 to 40 and by the end they were very fat (swollen out around my wedding band).

Nutritionally I was drinking tailwind at 270 calories per 21 oz and going through 25 to 35 oz per hour give or take (average pace about 11min per mile). My crew missed me starting at mile 27 for two aid stations and I drank plain water for about 90 minutes and added two s-caps and 1.5 banana at that point. At mile 47 I was back to plain water because I was at an uncrewed aid station. From 54 to 60 on I was nearly all plain water because my stomach had turned and I couldn't stomach the Tailwind but I did get in about 21 oz of water. By 60 I couldn't drink anymore.

The day was cool and heavily raining and I suspect I was sweating fairly little. I wasn't forcing myself to drink or on any schedule but I was treating the fluid as my calories and making sure I got it in.   Up until I switched to only walking at 65 I was amazed with how well I was running, my legs felt good even at 50+ miles and I had the energy to run, I am almost certain I did not run out of fuel.   I never had any sort of cramping.

During the run I was producing lots of clear urine until the mid 40s and which point it pretty much stopped. I dropped around 11pm and back at the hotel (still having eaten or drinking almost nothing) I woke up at 3:00am absolutely drenched in sweat. At that point it was like my kidneys woke up and I again produced a ton of clear urine over the next 2-3 hours and my fingers returned to normal size.   It is like perfusion suddenly returned to my kidneys.

I had not taken any meds (no NSAIDs or otherwise) before or during the race.

In retrospect I don't think I was dehydrated (cool day, lots of fluid, mentally clear, swollen hands).   I wonder if I could have been hyponatremic (pretty much fluid with a fair bit of it plain water, cool day).   I suspect my Tailwind was too strong, I put in more calories than I could handle, that made me nauseated, I switched to water, got even less sodium than I would have if I had tailwind and took in too much fluid.

This was my second 100 (I've done 4 50s) and first DNF. I had a bit of nausea in the first but nothing to this degree.

Sorry for the long description, but I am wondering if anyone might have any insight about what went wrong and also how to deal with a upset stomach during an ultra that just will not resolve. On a related note my hands almost always swell during an ultra but not to this degree, is this normal for the rest of you?

In retrospect I don't think I was dehydrated (cool day, lots of fluid, mentally clear, swollen hands).   I wonder if I could have been hyponatremic (pretty much fluid with a fair bit of it plain water, cool day).   I suspect my Tailwind was too strong, I put in more calories than I could handle, that made me nauseated, I switched to water, got even less sodium than I would have if I had tailwind and took in too much fluid.

Looks like a pretty clear case of overhydration to me. And yes, it sounds like you were probably pretty hyponatremic. You might be lucky to have gotten by with no serious medical consequences. Also it sounds like you were pushing 400 cal / hr at one point, which is really challenging for your digestive system.

Sounds a lot like my first Western States 100, but worse. I overhydrated, and was mildly hyponatremic at the finish (blood test confirmed), but not nearly so bad.

You need to read Waterlogged.

But my single biggest piece of advice would be -- drink to thirst. If that means you have to get your calories via gels or solid food instead of Tailwind, so be it.

MTA:

On a related note my hands almost always swell during an ultra but not to this degree, is this normal for the rest of you?

No. I suspect you tend to overhydrate.

Was this your first time using Tailwind for 100 miles?  The reason I am asking is because I used it last weekend for my 100 miler and was fine up until 70, but I began to feel so swollen that I stopped taking it and switched to just water.  I then proceeded to have to pee every 30 minutes or so for several hours (which was not easy since we were in and around NYC and it was pouring ).  After that I did feel like I was struggling more, but we managed to finish -- the Tailwind certainly fueled me well. I did try to eat a little something at every aid station along the way.

Were you eating real food?  Perhaps you needed more than just the Tailwind to balance things out?

MTA:  I was drinking 20 oz Tailwind (2 scoops) every 10 miles or so or every 3+ hours.  But, I did drink other things at the aid stations.  Maybe I too was overhydrating?

Thanks!  First time this has happened to me, and I guess I just assumed it was the Tailwind.

 

Totally not normal, to pee every 30mins - regardless of activity level!  Go easy on the fluids next time.

Thanks much for all the replies.

Ojo - this was my second 100 on Tailwind, the first went great nutritionally.  I did only tailwind (plus a bit watermelon at a late aid station because it looked good) and came through great.  For both races my hydration plan was to drink when ever I felt the urge to put my bottle to my mouth.  I'm not sure why this time went wrong but I suspect it is a combination less sweating, and having my calories and fluid linked together.

flatfooter - Does continuing to add to a wrecked GI ever let it set down?  I was positive that if I added anything to it I was just going to puke it up.  I've assumed that if I am ready to puke Ive done something wrong and I should leave my GI alone to sort itself out, I probably should have gone the empty it out and start over approach.

Thanks again!

I think you were drinking too much and probably a little more calories than you needed. I know people are trying to say all you need is Tailwind but it doesn't work for everyone.

I consume around 150 calories per hour and I've been using a combination of Sword drink, plain water, a few Huma gels, and small bites of aid station food.  Usually fruit or maybe something salty. I try to have either a gel or a bite of food about every hour. The nutrition has taken a few years to figure out. I tend to alternate between plain water, Sword, and drink extra PowerAid Zero at my drop bags which helps me keep up on hydration. I quit taking S-Caps 3 years ago and no problems. I felt like they might be making me sick. I no longer get the swollen fingers and the water retention during or after my race. My weight is actually down where it should be and am down about 4 lbs, several days after the race. Tailwind probably has enough electrolytes that you don't need to consume any additional unless it is really hot.

I almost always train (including long runs) with just plain water and save the nutrition for race day.  It is my belief if you can learn to run on as few calories as possible, it is for the best since it is difficult to digest food while you are running.  I can run 50K no problem with very little nutrition. The less I can get by with the better but still keep a fairly steady flow of calories from after the first 1.5 hours to near the end.  If I get to the point of nausea and can't drink or eat anything, I try walking for awhile and often the symptoms will eventually go away.

I've finished 43 ultras and finished 8 hundred milers and no DNFs. I finished Mohican last year in 22:32 and finished feeling pretty good although had slowed down by the final loop. It is a tough course and heard it was worse this year.

Andy

I'm looking for a bit of advice on 100 mile nutrition. I dropped at mile 78 of a race this weekend (Mohican 100) after nausea from mile 60 on left me unable to eat or drink (even water). I ran / walked to mile 65 and then walked only (trying to get my stomach to settle) to 78 where I finally dropped. By 73 I was a bit unstable on my feet, felt like I couldn't quite catch my breath, any exertion sent my heart rate through the roof and I just felt like something was seriously wrong. I dropped because I felt like it was that or the hospital, however, I was completely mentally clear the whole time. My fingers had started swelling around mile 35 to 40 and by the end they were very fat (swollen out around my wedding band).

 

Nutritionally I was drinking tailwind at 270 calories per 21 oz and going through 25 to 35 oz per hour give or take (average pace about 11min per mile). My crew missed me starting at mile 27 for two aid stations and I drank plain water for about 90 minutes and added two s-caps and 1.5 banana at that point. At mile 47 I was back to plain water because I was at an uncrewed aid station. From 54 to 60 on I was nearly all plain water because my stomach had turned and I couldn't stomach the Tailwind but I did get in about 21 oz of water. By 60 I couldn't drink anymore.

 

The day was cool and heavily raining and I suspect I was sweating fairly little. I wasn't forcing myself to drink or on any schedule but I was treating the fluid as my calories and making sure I got it in.   Up until I switched to only walking at 65 I was amazed with how well I was running, my legs felt good even at 50+ miles and I had the energy to run, I am almost certain I did not run out of fuel.   I never had any sort of cramping.

 

During the run I was producing lots of clear urine until the mid 40s and which point it pretty much stopped. I dropped around 11pm and back at the hotel (still having eaten or drinking almost nothing) I woke up at 3:00am absolutely drenched in sweat. At that point it was like my kidneys woke up and I again produced a ton of clear urine over the next 2-3 hours and my fingers returned to normal size.   It is like perfusion suddenly returned to my kidneys.

 

I had not taken any meds (no NSAIDs or otherwise) before or during the race.

 

In retrospect I don't think I was dehydrated (cool day, lots of fluid, mentally clear, swollen hands).   I wonder if I could have been hyponatremic (pretty much fluid with a fair bit of it plain water, cool day).   I suspect my Tailwind was too strong, I put in more calories than I could handle, that made me nauseated, I switched to water, got even less sodium than I would have if I had tailwind and took in too much fluid.

 

This was my second 100 (I've done 4 50s) and first DNF. I had a bit of nausea in the first but nothing to this degree.

 

Sorry for the long description, but I am wondering if anyone might have any insight about what went wrong and also how to deal with a upset stomach during an ultra that just will not resolve. On a related note my hands almost always swell during an ultra but not to this degree, is this normal for the rest of you?

 

flatfooter - Does continuing to add to a wrecked GI ever let it set down?  I was positive that if I added anything to it I was just going to puke it up.  I've assumed that if I am ready to puke Ive done something wrong and I should leave my GI alone to sort itself out, I probably should have gone the empty it out and start over approach.

 

That may depend on why it is wrecked.  If it is due to heat and you are trying to keep moving you need to consume a minimum amount of calories per hour.  That amount is very highly individual but I'm pretty sure consuming nothing for several hours is going to end your race.  Chances are there is some other factor driving why your stomach is wrecked and you need to fix that as quickly as possible.  Someone once said (I forgot who and where) that much of successfully running a 100 miler is about successfully troubleshooting your issues on the fly.  Sometimes you just have to try different things until something works and the next time you have that issue it may not work again...