Liza Howard

Liza Howard

Liza Howard is a national champion runner with multiple records in distances ranging from marathons to 100 mile trail races.

November 2011
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Javelina Race Report: Part 2

LizaLiza

If you missed the race recap it’s here: Javelina Race Report: Part 1.

So where were we?

One of the people I got to hug at the end of the race was my friend Aaron who is, among many other things, an ER doc.  I told him about the tea colored urine and how I figured it must be rhabdo.

(“Rhabdomyolysis is the breakdown of muscle fibers resulting in the release of muscle fiber contents (myoglobin) into the bloodstream. Some of these are harmful to the kidney and frequently result in kidney damage….Early and aggressive fluids may prevent kidney damage by rapidly flushing myoglobin out of the kidneys. Fluids may need to be given by IV.  Some patients may need kidney dialysis.”)

I asked him what needed to happen next.

“Well if it was me, I’d go to the ER right now.”

Aaron is hands down the most intelligent person I know.  And he’s certainly the coolest.  If he’d go to the ER right now, I was definitely going to go to the ER right now.  I got up slowly from the chair and hobbled toward the shower house.  Emergency or no, I wasn’t going to spend the next 15 hours lying in an ER bed covered in race grime.  My friend Erin, who had crewed for me, helped get me out of my clothes and get showered.  She helped me the way I help Asa most mornings, and she gave me similar props.  “Nice job with your shirt.”  I think she actually put my socks on my feet and tied my shoes.  It was the first of many instances throughout the night where I felt humbled by the love of my friends.

After that Aaron led Chris and me to one of the nicest hospitals in town.  There was a free coffee bar in the ER waiting room and everything was sparkling clean.  I gave a nice tea colored urine sample and we were hustled to a bed in the back.

“I just ran 100 miles and now my urine is brown… Yes, 100 miles.  Actually 101.4.  Tonight.  Just finished.  Okay, so I have rhabdomyolysis and…”

I had fun telling the story over and over to each new healthcare provider who came in to take my history.  I even pulled out the belt buckle at one point to help explain why I’d been running circles in the desert all day.  I was worried about my kidneys, but otherwise I felt great.  In fact, I felt better than I’d ever felt after an ultra.  And I was pretty happy to be sitting in a soft bed — even though I was wearing a ridiculously large open-backed gown.  I managed to stay in pretty good humor as the nurse missed three IV sticks and then let a good amount of IV fluid infiltrate beneath my skin before calling someone else in to give it a try.  (I’m not a hard stick.)

They infused the IV fluids rapidly to help flush the myoglobin through my kidneys.  And they drew blood to check my creatine phosphokinase (CPK) levels.  (When muscle is damaged, CPK leaks into the bloodstream.  “The diagnosis of rhabdomyolysis is established by a marked elevation in serum creatine kinase.” CPK greater is usually greater than 10,000 IU/L with rhabdomyolysis.)

And then we waited for the blood work results to come back.  Aaron and Chris sat on chairs along the wall and I sat in the bed and we talked and shared a box of Triskets until 3 in the morning.  That’s right, they stayed with me until 3am.

I got a bit teary after they left and my bed was wheeled through the ER towards the elevator.  My CPK was 17000-something and I was being admitted to telemetry overnight.   I was supposed to be cheering other runners across the finish line while shoveling Jelly Bellies into my mouth, not watching the ER ceiling slide by.  I was supposed to be regailing anyone within earshot about my battles getting the compression shorts up and down every time I stopped to use the bathroom during the race.  (I almost fell over during one wrestling match at the 2 mile porta john.)  The tech ignored my tears.  (Jerk.)

I made it to a lovely private room and spent the next ten minutes trying to convince another tech that I should be fed.

“But I ran 100 miles and I’m REALLY hungry.  Actually it was 101.4 miles.  And  I’ve only had a couple of handfuls of Garden Herb Triskets since I finished six hours ago.”

“The kitchen doesn’t open for two more hours.”

I didn’t strangle the tech because my legs weren’t really serviceable anymore and it would have been too difficult with the urinary catheter they’d inserted anyway.

Ultimately the gods relented and I did get two pancake breakfasts around 6am.  The second breakfast was a lovely error/reward for tolerance for adversity and uncertainty and the catheter.

Aaron and his wife, Jess, returned around noon with giant breakfast burritos.  Jess is also a brilliant doctor.  They had my back.  Erin and her husband, Jake, showed up next.  Party.  Jake is a good friend and he’s also the person who got me into trail running.  We ran the Grand Canyon R2R2R together.  It was a slippery slope into the ultra world for me after that, but Jake held out for a while longer.  Javelina was his second 100 and he finished in 22 hours and change.  He told us all about the rain and the ten pounds of mud he carried on his shoes towards the end of the race.  Just brutal.  (I felt guilty about missing the rain until I remembered the urinary catheter.)

I think I’d probably still be in Phoenix if Aaron and Jess hadn’t worked their doctor magic.  They sprang me from the telemetry floor with a CPK around 10,000 and orders to see a doctor in San Antonio.  I had just enough time to pack up my gear and make my flight home.   By the time I shuffled off the plane in San Antonio, my legs and belly were so swollen from all the IV fluids I’d been given, I looked like I’d painted my jeans on.  I could barely stand to keep my shoes tied.  I was a sausage.

It’s taken two days, but I think I might be able to wear some non-maternity clothes tomorrow.  Exciting.

I’ll leave a discussion about why all this might have happened for tomorrow.  Right now I need to start my thank yous before Asa wakes up.

Thank you to Jake and Erin for carting me all over Phoenix before and after the race and letting me stay with you.  And to Erin and Chris for being my pit crew extraordinaire.  I wouldn’t have run the time I did without your help.  And to Chris for running those last 1.4 interminable miles with me.  And for always being my good friend.  And to Aaron for coming to the race and for making sure I was taken care of well at the hospital.  (3am!)  And to Jake and Erin again for dealing with the aftermath of the race with me.

And to Paulette for pacing me so very well.  You deserve a medal for putting up with my whining and demands for small cups of Coke.

To Dave James for his wonderful cheering.  And to Nick and Jamil Coury for inviting me to their stellar race.  And to the volunteers: Thank you with all my heart!

My coach is Howard Nippert.  He brought me back after a stress fracture in my foot relegated me to aqua jogging most of the summer.

And I wouldn’t have done as well in this race  if I didn’t have Meredith Terranova‘s  nutritional guidance.

To Dr. Stephen Offenburger, Sports/Pain Therapy and Rehabilitation Director of Airrosti Rehab Centers, who kept my PF at bay and my foot and hip free of pain leading up to the race.

I couldn’t have afforded to make the trip to Phoenix without the support of New Balance, GU, and Team Traverse.

And my feet were blister free and happy for 15 hours and 47 minutes because I was wearing Drymax socks.

And, finally, thank you to Eliot for supporting my crazy quest for belt buckles and for making my life just perfect.

Comments 26
  • Domingo
    Posted on

    Domingo Domingo

    Reply Author

    Great report!! You are an inspiration.


  • Episternum
    Posted on

    Episternum Episternum

    Reply Author

    Oh jeez, I’m getting teary over here!  Oh wait, that’s my period.  Either way it reminds me why I’m choosing to do ultras instead of Rock ‘N Roll marathons. 


    • Tim Smith
      Posted on

      Tim Smith Tim Smith

      Reply Author

      lol


    • Anonymous
      Posted on

      Anonymous Anonymous

      Reply Author

      I didn’t mention it, but of course that happened during the race too.  Doesn’t rain, but it pours.


  • Caweber2001
    Posted on

    Caweber2001 Caweber2001

    Reply Author

    I always read your blogs. I just don’t comment since you have never met me! But, you are do dang funny and inspiring! I hope to meet you in person…


    • Anonymous
      Posted on

      Anonymous Anonymous

      Reply Author

      You should comment.  I barely know anybody who does.  🙂
      Hope our trails cross sometime too. 


  • Tim Smith
    Posted on

    Tim Smith Tim Smith

    Reply Author

    So what’s it feel like to be pumped up full of IV fluid? Was it truffle-shuffle worthy?

    Did you manage any sleep at all that night at the hospital?


    • Anonymous
      Posted on

      Anonymous Anonymous

      Reply Author

      There was not a lot of sleeping.  I put a baseball cap over my face and did my best in the ER, but mostly that just made it hard to breathe.  
      I felt like a sausage TIm.  I very sore sausage.  Nothing is worth being catheterized.  Not even a cool belt buckle.


  • Gerard Martinez
    Posted on

    Gerard Martinez Gerard Martinez

    Reply Author

    Liza, hope you are feeling better!  Congrats on another amazing run!  You are an inspirations!  🙂 

    You should talk to Lisa Smith-Batchen.   She was diagnosed with Rhabdomyolysis this year at Badwater and had to drop.  She spent a few days in the hospital.


    • Anonymous
      Posted on

      Anonymous Anonymous

      Reply Author

      I will try and do that, Gerard.  Thanks for the recommendation.


  • Pam
    Posted on

    Pam Pam

    Reply Author

    Holy Moly Liza! What a crazy couple of days. Your run was amazing!! Hope you recover as fast as you run!


    • Anonymous
      Posted on

      Anonymous Anonymous

      Reply Author

      Thanks Pam!  I don’t look like a sausage at all this morning and I’m feeling a ton better.  I’m going to have to actually do things around the house now instead of just lying on the couch with my feet propped up above my heart. Sigh. How are you?  


  • Richard
    Posted on

    Richard Richard

    Reply Author

    What a race Liza! Well done on the run and your time and glad that you’re feeling a touch better as well – hope that everything settles back down as soon as possible 🙂 sending you healing vibes.


    • Anonymous
      Posted on

      Anonymous Anonymous

      Reply Author

      Those healing vibes are powerful.  I’m pretty much back to normal this morning and even managed to participate in a pillow fight.


  • coryreese1
    Posted on

    coryreese1 coryreese1

    Reply Author

    This is simply incredible! You are such a good writer. Don’t worry – whatever rain you missed out on, I made up for with my 29 hour finish (www.fastcory.com).

    Way to go on such a speedy time! I’m glad you kept your buckle with you in the ER.


    • Anonymous
      Posted on

      Anonymous Anonymous

      Reply Author

      Congratulations on your first 100!!  Your report was awesome.  I loved that picture of the dead black tree.  And my son always yells “Dig Deep!” at me when he comes to races, so I had that in my head too.
      So what’s next?  🙂


  • PoDog Vogler
    Posted on

    PoDog Vogler PoDog Vogler

    Reply Author

    Nice race Liza!  I enjoy the dry wit of your blog, your race reports and your general down to earth humbleness.  It is one of the things that makes our sport awesome.  I also had dark pee after Arkansas Traveller this year for the first time.  Fortunately, they had a doc and IV fluids at the race finish so I just needed to lay down and take in a couple of bags at the finish and I was as good as new. Congrates again!


    • Anonymous
      Posted on

      Anonymous Anonymous

      Reply Author

      Congratulations for you too for Arkansas!  And thanks so much for the kind words. I’m trying to put something together about rhabdo over the holidays, but bottom line there’s not a lot of “prevention” per se.  One study I saw showed close to 50% of runners after a 90k with rhabdo.  


  • Ted
    Posted on

    Ted Ted

    Reply Author

    Love your writing, and am very impressed by your record time.  However, I am even more convinced of my sentiments towards these sorts of races that I expressed in the Leadville scenario you gave me at WMI back in Sept (something to wit ” folks who do this are nuts “).  I suspect that I am in the minority among those who read this blog.  In any case, I have lots of respect for you.  Where is the picture of you looking like Michelin man?


    • Anonymous
      Posted on

      Anonymous Anonymous

      Reply Author

      I deleted all evidence of my unflattering post-race inflation.  (My cheeks didn’t fit into the frame anyway.)  I do have a great one of me in the ER bed holding my buckle, but I don’t anyone to misinterpret the message.  I’ll have to e-mail it.  
      And I’m going to get you to one of these events eventually, so you can see how relatively sane everyone is.    


  • Keith mason
    Posted on

    Keith mason Keith mason

    Reply Author

    Great race and report. So what’s your takeaway? More hydration in your next 100? 


    • Anonymous
      Posted on

      Anonymous Anonymous

      Reply Author

      Thanks Keith.  And that’s a great question about what next.  I was actually really well hydrated during the race (peeing every 60-90 minutes).  I’m working on a “Why me?/How not to get Rhabdo” article right now and I have fingers and toes crossed I can get it up before the end of the day.  Bottom line though, I didn’t really do much different at Javelina than I’ve done before, so it’s hard to say.  (That does not please my parents.)  More soon.


  • Giridar
    Posted on

    Giridar Giridar

    Reply Author

    Jay wrote about you ysterday to watch for your blog and Nice to read the article in Jay’s blog. Your blog as was such a candid report, I read Jay’s blog, then your write up  in Jays blog and my head was breaking on the suspense of your IV.
    The reason is I  was pacing my friend Mark Hellanthal and you were tearing down on your 6th lap. When we finished our lap they said you had broken the course record(smashed).
    Thanks for sharing the experiences.


    • Anonymous
      Posted on

      Anonymous Anonymous

      Reply Author

      Thanks so much for your kind words.  🙂  One of the neatest aspects of ultra running is all the race reports.  No other sports do that do they?  We’re a crazy reflective bunch.


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