From Blister to Sepsis

Last fall when I ran the Chicago Marathon, I got a blister on my little toe. The poor guy was pretty mangled and bloody by the time I finished the race, and I got it cleaned up in the medical tent and went on my way. While it hadn’t bothered me during the race, it was enormously painful after. I kept a blister block bandage on it to cushion it a bit, but by the Thursday following the race, it was so painful that it kept me awake at night. Since I had to work that Friday, I figured I’d go to the doctor Saturday morning and get it checked out. I thought it was a simple infection and some antibiotics would clear it right up.

As I was sitting in the doctor’s office that Saturday morning waiting for them to write my prescription, I got very nauseous and cold. I figured I just needed to get home and lie down, so I took my prescription and went on my way. The 5 mile drive home was excruciating. Every time I pressed the clutch with my left foot (where the infected toe was), I cried out in pain. I’m usually pretty tolerant to pain, but this was intolerable. I was also shaking all over–not trembling, but a more jarring shaking–and shivering with cold. I also had shooting pain running through my whole body. Similar to serious muscle soreness–that lactic acid buildup kind of soreness–the pain was everywhere. I somehow made it home and stumbled inside to the couch where I immediately covered myself with a blanket and continued to shake and shiver. I remember that I was freezing and in so much pain that I was moaning aloud (and not for dramatic effect for, well, no one, since I was alone). I called my mom and told her something was wrong. I’m not even sure what I said, but without asking any questions, she told me to hang up and dial 911. She later told me that I was barely coherent.

The firetruck arrived first, where a whole lot of firemen took my vitals until the ambulance arrived. My temperature was 96–almost 3 full degrees lower than usual–and my blood pressure was very low. The ride to the hospital felt endless, and even though the EMT was nice and trying to keep me talking, I couldn’t even keep my eyes open. At one point, I remember hearing the driver talking to the ER and saying we’d be there in 7 minutes. It sounded like a very long time to wait.

In the ER, I was immediately tested for sepsis, and the tests were positive. My lactic acid levels were more than 3 times the normal rate, my body temperature remained low, and I was in excruciating pain. I was given morphine, but after an hour, the pain returned and they gave me a stronger med to help take the edge off. While the pain throughout my body was horrible, my toe was the worst. It felt like it was going to ignite, and at that point, I would have happily had them cut it off just to take away the pain. It was intense and scary.

Several hours later, as they were getting ready to discharge me and send me home, I finally got up to go to the bathroom. It was only 10 feet away, but I was dizzy and incredibly nauseous just from the short walk. When I told the doctor, he threw away my discharge papers and told me I would be admitted–probably just for a night or two–to be monitored. My blood pressure was too low for them to take me to a room right away, so they kept giving me IV fluids until it came up enough to be considered stable.

I wound up staying in the oncology unit (because there’s no infectious diseases unit . . . ) for the next 5 nights. I was given a high volume of IV fluids to keep my blood pressure up and wound up getting fluid in my lungs from all the excess which resulted in pneumonia. I also had a lot of antibiotics and dilaudid (a narcotic) for my pain. It made me extremely itchy and between that and the infection in my blood, I developed an uncomfortable rash all over my abdomen and back. I was also in a really awesome <sarcasm> bed to prevent bedsores that moved on its own every 55 seconds. Every 55 seconds for 5 whole days. Not conducive to resting at all.

That’s the reader’s digest version so if it’s TL;DR for you, no worries. I’m sure the 4 of you who are interested enough in reading this blog will deal 😉 But I needed to recount this to remind myself that I was really sick. The mortality rate for septic shock is 40-60%. There was a serious chance I was going to lose my toe. I had to have a cannula because I couldn’t get enough oxygen on my own, and when I went to a cardiologist for my follow up appointment, he was shocked that I hadn’t been in intensive care. I tend to diminish things, but looking back on this objectively, I can see that it was very serious, and I need to recognize that training hard for another marathon just 3 months later might not have been in my best interest.

Can I run a marathon now? I’m sure I can. Will it be a PR and a representation of me at my strongest and best? Maybe not. Once you’ve had sepsis, your chances for death, even in the years that follow your recovery, are higher because of the toll it takes on your immune system. So for me to think that I’d be back at 100% within 3 months was probably a bit ambitious. But now I know, and I’ll try to go a little easier on myself. I’m still going to continue training (which went fine last week) and try my hardest, but I’m also going to be realistic and honest with myself about what my body can do. It’s just a race, and being healthy is more important than any race ever will be.

Vancouver Marathon Training: Week 7

I want to want this race. I want to be excited about it. But I’m just not. I don’t know if it’s the fact that this has been the longest winter ever or that I felt like I was overtraining or what. It’s been a frustrating training cycle, to say the least.

I think the thing that stands out to me the most is that I feel tired and weak more often than not. Don’t get me wrong, I definitely have good runs here and there when I feel really strong and push myself. But those have be the exception rather than the rule. I’m not especially motivated, even for my easy runs, and the workouts I enjoy most are cross training. Not the best.

Apple fritters in the car after a long run console me.

Apple fritters in the car after a long run console me.

I’m afraid I might have a bit of a mental block as well. I read plenty of running blogs and threads, and I know that really successful (read: FAST) marathoners run a lot more miles than I do. Their weekly mileage tops out anywhere from 55-70+ miles, and mine is nowhere near that. So while I began this training cycle with big goals for myself, the realization that my body isn’t cut out for that kind of training has me doubting myself, big time. And really, I know I should be happy with a sub 3:30 marathon and that everything beyond this should be gravy, but it’s not. I want to be better. I want to run faster. I think I can run faster, too. Can I do it with a much lower weekly mileage than most? Guess we’ll find out May 3.

Week 7

Monday
What I was supposed to do: 5 miles, easy @8:35-9:00
What actually happened: 5 miles @8:26
Legs felt heavy for the first part of this, but after I warmed up, I felt ok.

Tuesday
What I was supposed to do:
XT or rest
What actually happened: 4 miles @8:32; physical therapy appointment
This will come as a shock to no one, but I decided to run this day because I either had time to work out or walk the dog, and I am a slave to her. It was breezy and mild, and I think we both enjoyed getting out for a few miles.

I will own you and you will like it.

I will own you and you will like it.

Wednesday
What I was supposed to do: 
7 miles total with 1/2 mile repeats–6 x 1/2 mile @ 6:40 – 6:43 per mile pace. 2-3 min jog in between
What actually happened: 7 miles total–1 mile warm up–7 x 800 m repeats with 400 m rest for each; 1 mile cool down
6:35–6:31–6:27–6:27–6:27–6:27–6:18
Yep, threw in an extra one for good measure. This was my good, strong workout for the week. I loved it so much that I ran faster than I needed to AND added an extra interval. If only they could all be this good! 

Thursday
What I was supposed to do: 
4 miles EASY
What actually happened: 48 minutes HIIT training
I’ve been missing my strength workouts, and since I didn’t need fresh legs for Friday, this seemed like a good time to squeeze in some muscle work. Just what the doctor ordered.

Friday
What I was supposed to do: 
rest or XT
What actually happened: REST
4 hours in the car and a long day of meetings. Rest, indeed.

Saturday
What I was supposed to do: 
20 miles @8:25-8:45
What actually happened: 20 miles @8:31 average pace
The worst. Yet again. It was 17* with the windchill on Saturday morning, and even though I was bundled up, my hands were swollen, numb, and painful by the time I stopped at my car for Gu after 9.5 miles. I spent 10 very painful minutes waiting for the feeling to return to my hands. Damn Raynaud’s! Since I like having 10 fingers, I drove home, changed and went to the gym to finish on the treadmill. It was the worst. If I never run on a treadmill again, it will be too soon. My body felt fine, but I would’ve been much happier if I were able to do the whole run outside.

I refuse to get up! You cant make me!

I won’t get up! You can’t make me!

Sunday
What I was supposed to do: 
rest or XT
What actually happened: 45ish minutes of HIIT training
The world is a cruel, cruel place, so I woke up at 6 am on Sunday even though I had absolutely nowhere to be. Since Roo wasn’t about to get out of bed, and Trader Joe’s doesn’t open until 8, I killed time with a workout. My legs felt surprisingly fine after 20 miles the day before, and I finished with a fair amount of core work that I sort of loved.

Total for the week: 36 miles
vancouver marathon week 7

Vancouver Marathon Training: Week 6

Redemption! Kinda. This week was better than last week, for sure. I tell you what, though–having an off week really messes with your head. I know I’ve overtrained in the past, so I knew the signs, but it’s hard to get back to a place of confidence and strength in your running after you get to that place where you’re just completely burnt out. BUT, my speed workout and my long run went well, so I think I’m back on track.

My coach also adjusted my training plan, so I’m running 4 days/week instead of 5, which I think works better for me. I’ll still cross train one day, and then probably take 2 rest days. That’s what’s worked well for me in the past. I envy runners who can run 50+ mile weeks and take fewer days off, but I’m not one of them. Which is fine.

The other thing I know I need to work on is all the maintenance work–things like stretching, foam rolling, core work, and hip/glute exercises. I am HORRIBLE at keeping up with them. Sometimes I’ll be sitting on the couch watching TV, and I think about doing them. But Roo is so snuggly, and foam rolling is painful so I stay on the couch. So much lazy.

Don't blame me, lady!

Don’t blame me, lady!

Week 6

Monday
What I was supposed to do: 4 miles easy
What actually happened: REST
I wasn’t ready to run yet. Still felt completely exhausted, so I listened to the ol’ body and rested.

Tuesday
What I was supposed to do: 
rest or XT
What actually happened: 4 miles easy @8:52 pace
Eased back in with some very relaxed miles. This felt ok, but I definitely didn’t want to run any faster.

Wednesday
What I was supposed to do: 
8 mile progression run–start easy and work up to last 5K @7:02-7:08 pace
What actually happened:
 8 mile progression run– 8:31, 8:17, 8:04, 7:50, 7:41, 7:24, 7:08, 7:08
This felt really good. The rest served me well, and my legs were ready to go for this run. The last 5K was definitely challenging, and I had to really push myself both mentally and physically, but I was able to get those last 2 miles at pace so I felt good about that. I really needed a boost, and this run did it.

Thursday
What I was supposed to do: 
4 miles easy
What actually happened: 4 miles @9:15 pace
My right foot was bugging me a bit on this run, and there was no way I could’ve gone any quicker than this. Luckily, the foot pain didn’t linger, but I have been babying it a bit, just in case!

Friday
What I was supposed to do: 
rest or XT
What actually happened: REST
Had some quality time on the foam roller and lacrosse ball. Let me tell you, a lacrosse ball in a tight, knotted TFL is no joke. I’d rather be dry needled any day, but I had a conference for work, and I had to miss PT. Can’t wait to get needled next time!

Saturday
What I was supposed to do: 17 miles–first 13 easy, last 4 @7:21-7:25
What actually happened: 17 miles–first 12 easy, 1 ramping up to fast finish (@7:49), last 4: 7:16, 7:18, 7:19, 7:23. My knees were a little sore during this run. I took a freezing 20 minute bath with 24 lbs. of ice while watching the Unbreakable Kimmy Schmidt on Netflix, and that seemed to help.
The fast miles on this run were challenging, and I had to do a fair amount of zig-zagging and people dodging since I was in downtown DC. Even early on Saturday morning, people need to see the monuments! I also tried to avoid stopping by turning whichever way the crosswalks were green, so I was a little bit all over the place. The last mile I was pretty dead, but after 17 miles, I’m ok with that.

Sunday
What I was supposed to do: 
rest or XT
What actually happened: REST